Got a couple blood panels, and here are the results. Doctor wants me to followup with a VAP because she's concerned with my cholesterol results (go figure). I actually wanted them to do the VAP right away, but they wanted me to take the metabolic panel first. The practice is low-carb friendly, but I get the impression that they're not too well versed with paleo despite this.
Any thoughts from the paleo crowd? Age 31 male, ~160lb, 6'2".
Testosterone, Free-tot, LC-MS-MS
Testosterone, Total, LCMSMS 598 Testosterone, Free 87.9
TSH* W/Free T4 RFX
CBC (includes DIFF-PLT)
White Blood Cell Count 6.4 Red Blood Cell Count 5.18 Hemoglobin 15.6 Hematocrit 46.6 MCV 90 MCH 30.0 MCHC 33.3 Platelet Count 170 RDW 13.6 MPV 10.3 Absolute Neutrophils 3834 Absolute Lymphocytes 2150 Absolute Monocytes 314 Absolute Eosinophils 83 Absolute Basophils 19 Neutrophils 59.9 Lymphocytes 33.6 Reactive Lymphocytes 0.0 Monocytes 4.9 Eosinophils 1.3 Basophils 0.3
Hemoglobin A1C 5.3
C-Reactive Protein <1
Vitamin D, 25-hydroxy, LC-MS-MS
Vitamin D, 25-OH Total 55 Vitamin D 25-OH, D3 55 Vitamin D, 25-OH D2 <4
Comp Metabolic Panel W-eGFR
Sodium 140 Potassium 5.1 Chloride 103 Carbon Dioxide 26 Glucose 88 Urea Nitrogen 16 Creatinine 1.19 Calcium 10.2 Protein, Total 7.3 Albumin 5.1 Globulin, Calculated 2.2 A/G Ratio 2.3 Bilirubin, Total 1.0 AST 17 ALT 21 Alkaline Phosphatase 38 Non-African American eGFR 81 African Amerucab eGFR 94
Cholesterol 320 Triglycerides 69 HDL Cholesterol 87 LDL Cholesterol, Calculated 219 Cholesterol/HDL Ratio 3.7
VAP Cholesterol Test
Total LDL 207 Total HDL 78 Total VLDL 17 Sum Total 301 Triglycerides 55 Total Non-HDL 223 LP(a) 8.0 LDL 14 Sum Total LDL-C 207 Real-LDL Size Pattern A Remnant Lipoproteins 24 No constellation of lipid risk. HDL-2 27 HDL-3 51 VLDL-3 10 Total APOB100 Calc 135
High LDL in the presence of high HDL and low triglycerides simply isn't indicative of a risk for heart disease, at least with regards to the lipoproteins and their propensity to be oxidized. Elevated LDL can be caused by a bunch of things. It could be inflammation and insulin, but you look good for that. It could be genetic, or it could be that you are deficient in cholesterol in your cells. If your cells become damaged you need cholesterol to help fix them, that's a huge part of what LDL does. Eating a diet that uses a lot of cholesterol due to damage and not supplying the body with all of the substrate it needs to produce cholesterol leads to a chronic deficiency and poor health, and when people start eating a lot of good fat their LDL tends to go up. But as they get healthy and need less cholesterol, their levels eventually go down. The solution isn't to eat "cholesterol-lowering diet but to eat a cholesterol raising diet to provide the cholesterol you need AND reduce damage to the body. Paul Jaminet points out that a deficiency in copper can cause damage to the arteries and increase the need for cholesterol. http://perfecthealthdiet.com/?p=2547 So make sure to get enough copper and all nutrients for that matter. Just keep doing what you're doing and striving to be as healthy as you can and don't worry about cholesterol, if you do everything fairly well it will go down, and if all of your other markers are excellent and you have enough of all nutrients then you are commanded to forget about it. There is no evidence that high pattern A LDL predicts CHD disease risk or that high LDL causes any disease, quite the opposite actually.
The labs on absolute numbers are fine. But to point out some finer points.....Your Testosterone for a 31 yr old male is not optimal. Your free T is also not optimal. Neither is your Vitamin D. My bet is you have a very mild case of Pregnenlone steal likely from higher levels of cortisol.....I would suggest you get salivary cortisol checked to see what that is doing. Clinically tracking your sleep will tell you if the cortisol is a problem. If I am correct then fixing that will autocorrect the T and D issues. The reason is cortisol T and D are made from the same precursor and evolution dictates that we make cortisol first before T and D because its more important to be able to run away from a Tiger than have sex or protect you bone or immune system.
Your kidney function is low and that is likely secondary to volume depletion and dehydration. So I suggest you drink more water too. If you are supplementing creatine I would back off a bit
I think you should be happy, very happy. Everything looks good and your VAP more than likely will show you are mostly Pattern A, large bouyant particles.
Your HDL/LDL 87/219 = .39 is excellent. Anything above .3 is great and preferable over .4
More paleo eating will keep you and your lipid panel happy. If your VAP show a distribution of 50/50, just keep on trucking with paleo as you have practiced.
Vit D3 level is fine. The Quilt wants his clients to be 70-100ng/ml. You could be a little higher here by a little more sun during the day or a bit more supplementation.
How long have you been paleo?
I'd agree the SCr (kidney) test is mildly high which could be temporarily high from dehydration or if you have more muscle mass compared to the average person. You seem skinny from your stats but are you a hard gainer or is your BF (body fat) < 10%? High muscle mass translates to higher SCr which is innocuous.
Not enough sleep!!! Sleep makes people bionic -- and grows GH and T (growth hormone and T) and lowers cortisol as others have mentioned above.
Don't worry about the LDL --- as Dexter mentioned likely the $99 VAP will just verify how great the labs otherwise are. FH (famililar hypercholesterolemia) is common among northern Chinese and northern European descendants. It indicates apo E status, that is all. Your body may absorb more cholesterol from the GI than normal (and toxic chemicals and toxic metals). Avoid heavy metals, contaminated tuna/seafood, scented products, petroleum products etc (which increase estrogenic effects anyway). These are all neolethal and best to avoid but specifically in those apoE4/E4 (aluminum is associated with Alzheimers in these folks studies show).
I think the liver tests are mildly high -- > 15 for guys (> 12 for women) is sometimes suggestive of mild NASH/fatty liver. How much fructose and carbs do you consume? consider < 100 grams daily if you are eating a ton. I think there is some mild insulin resistance and possibly estrogen dominance from the T, lack of sleep and ALT/AST status.
Have you ever read Ori Hofmekler? Read him. He's the author of the warrior diet -- he has good info on how to up the T and lower the estrogens...
Would love to hear about the improvements later!
For a 31 year old guy, your creatinine seems a bit high and, as a result, your GFR is low. Have you have kidney-related problems? Your calcium is also high normal. Based on just your GFR only, you could be taken for someone at Stage 2 of Chronic Kidney Disease, CKD (unless you're African American) ... not to worry, very mild. I would get your Parathyroid Hormone (PTH) tested with calcium and redo the GFR, as they all could have been faulty.
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