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  #1   ^
Old Fri, Jul-11-08, 22:48
dlynnRN's Avatar
dlynnRN dlynnRN is offline
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Default Low triglycerides and high LDL's

I hope this is in the right forum... but I just recently had some labs done and my results are this...

Total cholesterol - 208
Triglycerides - 93 (good)
HDL's - 46
VLDL's - 19
LDL's - 143!!!!

I am concerned but have been reading that low triglycerides and moderately elevated LDL's are not necessarily a bad thing according to recent research. This scenario is suppose to produce larger, fluffy LDL's which is good. High LDL's paired with high triglycerides produce smaller LDL particles... this is bad.

What are your thoughts and what have you heard. Should I be too concerned. Should I alter my diet? I love Atkins and am feeling great and losing weight.

Anyone else read this or any similar articles. I have read a few and they say the same thing.

http://livinlavidalocarb.blogspot.c...er-markers.html

Here is something similar I found on a forum.

"LDL cholesterol can be broken down into two kinds, pattern A and pattern B. LDL pattern A is large fluffy particles that are less dense than pattern B and not easily oxidized. LDL pattern A is essentially benign with respect to heart disease. LDL pattern B on the other hand is small dense particles that are easily oxidized and more closely associated with heart disease. It has been theorized that the harm to the arteries is associated with oxidized cholesterol. Ok, enough about that. To summarize, LDL pattern B (think small dense BBs) is bad, LDL pattern A (light and fluffy) is not a problem.

Now you would think that the lab actually measured your LDL, but they likely didn't. Most labs just calculate LDL from the following equation: LDL = Total Cholesterol - HDL - triglycerides/5. So from this, you don't know if you are predominately LDL pattern A (no big deal) or predominately LDL pattern B (much more risk). Some labs do have the capability to measure the LDL gradient and can determine your predominate LDL pattern type. However, there is another way. Studies have shown that there is a strong correlation between a low triglyceride/high HDL level and LDL pattern A (the non risky kind), and conversely, a high triglyceride/low HDL level is strongly associated with LDL pattern B (the harmful kind). This is one reason that high triglycerides alone are an independent risk factor for heart diease.

Ok, where am I going with this with respect to your situation. Other studies have shown that a high triglyceride/HDL ratio is the best indicator for heart disease risk (approximately 8x better at predicting heart disease risk than high total cholesterol alone). A triglyeride/HDL ratio of 5.0 is moderate risk and the higher the number, the higher the risk, while a ratio of < 2.0 is very low risk.

From what I have just described, you can see that with your very low triglyceride level (<100) and moderately high HDL level (>50) you are at very low risk of heart disease. Also, your very low triglyceride level indicates that your LDL is predominately pattern A, the harmless kind. If you are still concerned, you can have your LDL gradient measured to determine your LDL pattern type.

I wouldn't even remotely consider cholesterol lowering medications without knowing your LDL pattern type to see if there is any risk associated with your lipid levels because there are potential significant side effects (muscle damage, neurological damage, liver damage, even death - i.e. the Baycol recall) associated with many cholesterol lowering medications (statins in particular)."

So whats your take??
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  #2   ^
Old Fri, Jul-11-08, 23:11
NoWhammies's Avatar
NoWhammies NoWhammies is offline
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Plan: keto ancestral/IF
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LDL is actually a calculation based on triglycerides, HDL and total cholesterol. They don't measure the actual LDL. PPLP has a great section in it that explains all of this and is worth a read.
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  #3   ^
Old Sat, Jul-12-08, 07:02
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Wifezilla Wifezilla is offline
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Quote:
Should I be too concerned. Should I alter my diet? I love Atkins and am feeling great and losing weight.


I wouldn't be too concerned, I wouldn't alter my diet, and Atkins rocks.

Here is a great article about cholesterol.... http://www.loveforlife.com.au/node/2103
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  #4   ^
Old Sat, Jul-12-08, 08:18
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ReginaW ReginaW is offline
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Plan: Atkins/Controlled Carb
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Default

Quote:
Total cholesterol - 208
Triglycerides - 93 (good)
HDL's - 46
VLDL's - 19
LDL's - 143!!!!

I am concerned but have been reading that low triglycerides and moderately elevated LDL's are not necessarily a bad thing according to recent research. This scenario is suppose to produce larger, fluffy LDL's which is good. High LDL's paired with high triglycerides produce smaller LDL particles... this is bad.

What are your thoughts and what have you heard. Should I be too concerned. Should I alter my diet? I love Atkins and am feeling great and losing weight.


As NoWhammies said, LDL is calculated.

TC - [HDL + TG/5]

Let's just pretend a test previously was TC 200, HDL 40 and TG 150

200 - [40 + 150/5]
200 - [40 + 30]
200 - [70]
Calculated LDL = 130

Now you have a TC of 208 and HDL of 46 and TG of 93....how would that change LDL?

208 - [46 + 93/5]
208 - [46 +19] <---- SEE the critical difference in the equation? The 19 because the TG's a lower and the lower number is divided by 5?

208 - [65]
Calculated LDL = 143

So....did your LDL really go up, or is the calculated LDL a phamton number that is less worrisome when it's really your HDL increased and your TG's declined and the calculation makes it appear to be a problem now?

A better way to show it is to pretend your TG's did not change - only your HDL rose....

208 - [46 + 150/5]
208 - [46 + 30]
208 - [76]
Calculated LDL with no change to TG = 132

Now a doc would see that and think LDL is better....despite TG not declining, which we know lower TG is better! It's the calculation that is the problem IMO......if you want an accurate look at your LDL, get a VAP test done!
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  #5   ^
Old Sat, Jul-12-08, 16:10
LC FP LC FP is offline
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Plan: Atkins
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Default

The last two heart attack patients I saw in the hospital had LDLs of 72 and 68. And they weren't taking any cholesterol meds.

Most other heart attack patients I see are already on statins. Why don't people complain about the apparent lack of protection from the statins? I'm sure if they were eating LCDs it would be all over the newspaper.
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  #6   ^
Old Sat, Jul-12-08, 17:04
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zedgirl zedgirl is offline
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Plan: Carb'n negative + IF
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Default

Quote:
Originally Posted by ReginaW
As NoWhammies said, LDL is calculated.

TC - [HDL + TG/5]

Let's just pretend a test previously was TC 200, HDL 40 and TG 150

200 - [40 + 150/5]
200 - [40 + 30]
200 - [70]
Calculated LDL = 130

Now you have a TC of 208 and HDL of 46 and TG of 93....how would that change LDL?

208 - [46 + 93/5]
208 - [46 +19] <---- SEE the critical difference in the equation? The 19 because the TG's a lower and the lower number is divided by 5?

208 - [65]
Calculated LDL = 143

So....did your LDL really go up, or is the calculated LDL a phamton number that is less worrisome when it's really your HDL increased and your TG's declined and the calculation makes it appear to be a problem now?

A better way to show it is to pretend your TG's did not change - only your HDL rose....

208 - [46 + 150/5]
208 - [46 + 30]
208 - [76]
Calculated LDL with no change to TG = 132

Now a doc would see that and think LDL is better....despite TG not declining, which we know lower TG is better! It's the calculation that is the problem IMO......if you want an accurate look at your LDL, get a VAP test done!


Wow Regina this is the first I’ve seen or heard of this equation or explanation. I never knew LDL was calculated that way. Now it all makes perfect sense!

I had a similar outcome with my last cholesterol test :

TC 302
HDL 117
TG 53
LDL 175

My doctor was very negative regarding the LDL and wasn’t interested in the fact that I had great HDL and TG numbers. I left her office feeling very upset and confused (I got over it) and decided that I wouldn't bother with cholesterol tests in the future. I’ve since read several posts from other low-carbers experiencing the exact same scenario. I’ve just copied your post for my records if that’s okay.
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  #7   ^
Old Sat, Jul-12-08, 18:11
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Daryl Daryl is offline
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Quote:
Originally Posted by Wifezilla
I wouldn't be too concerned, I wouldn't alter my diet, and Atkins rocks.

Here is a great article about cholesterol.... http://www.loveforlife.com.au/node/2103


Thanks for linking to that
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  #8   ^
Old Sat, Jul-12-08, 19:18
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aj_cohn aj_cohn is offline
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Plan: Protein Power
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I know of just one study correlating the TG/HDL ratio with heart attacks: Circulation (Vol 96, pp 2520-2525 [1997]). Does anyone know of subsequent studies?

And for those, like myself, who'd never heard of a VAP test, WiseGeek has an explanation.

Last edited by aj_cohn : Sat, Jul-12-08 at 19:24.
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  #9   ^
Old Sat, Jul-12-08, 20:07
dlynnRN's Avatar
dlynnRN dlynnRN is offline
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Plan: Primal
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Wow. Thank so much! That does make sense... It looks like the calculation is what makes it appear higher. That last calculation with the triglycerides higher and when the calculation was done it made the LDL's appear lower is really crazy!

So my values really are not that bad! I bookmarked this for future reference!!
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  #10   ^
Old Sat, Jul-12-08, 20:08
dlynnRN's Avatar
dlynnRN dlynnRN is offline
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Posts: 571
 
Plan: Primal
Stats: 238/165/140 Female 5'4"
BF:
Progress: 74%
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Default

Quote:
Originally Posted by Wifezilla
I wouldn't be too concerned, I wouldn't alter my diet, and Atkins rocks.

Here is a great article about cholesterol.... http://www.loveforlife.com.au/node/2103


Thank you!

Atkins does rock.

I have been feeling like I need to alter my fat intake and decrease my intake of eggs. I am going to keep eating the same though!
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  #11   ^
Old Sat, Jul-12-08, 20:09
dlynnRN's Avatar
dlynnRN dlynnRN is offline
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Posts: 571
 
Plan: Primal
Stats: 238/165/140 Female 5'4"
BF:
Progress: 74%
Location: Maryland
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Quote:
Originally Posted by NoWhammies
LDL is actually a calculation based on triglycerides, HDL and total cholesterol. They don't measure the actual LDL. PPLP has a great section in it that explains all of this and is worth a read.


I will look that up too.

Thanks to EVERYONE for the awesome info!!! Its exactly what I needed!!!
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  #12   ^
Old Sat, Jul-12-08, 23:55
Nancy LC's Avatar
Nancy LC Nancy LC is offline
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I would definitely get a VAP or NMR and a heart scan and try a lot of other options before going on a statin.

But... I have a question about the TC calculation.

TC is the total cholesterol. You're implying it is something other than triglycerides, HDL and LDL. Is this the dark matter they've been searching for?

Seriously, the calculation assumes anything not a triglyceride or HDL is LDL. But if it isn't, what is it?
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  #13   ^
Old Sun, Jul-13-08, 10:39
dlynnRN's Avatar
dlynnRN dlynnRN is offline
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Plan: Primal
Stats: 238/165/140 Female 5'4"
BF:
Progress: 74%
Location: Maryland
Default

Quote:
Originally Posted by Nancy LC
I would definitely get a VAP or NMR and a heart scan and try a lot of other options before going on a statin.

But... I have a question about the TC calculation.

TC is the total cholesterol. You're implying it is something other than triglycerides, HDL and LDL. Is this the dark matter they've been searching for?

Seriously, the calculation assumes anything not a triglyceride or HDL is LDL. But if it isn't, what is it?


I am definitely NOT going on a statin

I am just going to keep doing what I am doing. I will have it rechecked in 3 months.

Do you guys think the extra tests are necessary at this point (since I have only been on it for 3.5 months? I have been on strict induction the whole time.) BUT I read in ANDR that you can stay on induction for 6 months safely. I am so happy with the way I look and feel. I want to lose about 25 to 30 more pounds.
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  #14   ^
Old Sun, Jul-13-08, 11:11
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LessLiz LessLiz is offline
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What is it you will get from more tests? How will you interpret the results? If you get results that make you uncomfortable what will you do about it?

I have a deal with my doctor -- he can do all the cholesterol tests he wants but I'm not changing anything based on the numbers. He does cholesterol tests largely because if I have a health problem down the line the first thing a specialist is going to want to know are historical results. You know, if you break your ankle they want to blame it on your cholesterol levels.

Maybe I am jaded or just have a bad attitude, but it seems to me that "preventive medicine" beyond eating well is pretty much a joke. I'm not seeing how it is improving anyone's life -- quite the opposite. And in the medical community a "healthy diet" is anything but eating well.
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  #15   ^
Old Sun, Jul-13-08, 11:20
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NoWhammies NoWhammies is offline
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Plan: keto ancestral/IF
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Well said, Liz. I agree. My cholesterol results at my last doctor's visit last month were interesting. Triglycerides, HDL - fantastic. LDL and TC were frightening from a typical health standpoint. My doctor wanted me to go on statins, I refused. I did agree that I would take niacin, which can't hurt, I don't think. It was a compromise - because this doc has actually been wonderfully supportive of everything I've done - the cholesterol is the first place we've disagreed, but I gave her the names of some books to read about it. She's usually pretty open to doing that, so I'll be interested to talk with her in a few months.
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