Sunday, May 23, 2010 Virginia asks

Q: How to get particle numbers within range, i.e. LDL-P, small LDL-P, LDL Size, VLDL, etc

I am female, 57 years old, postmenopausal, taking no medication, except for "alternative" vitamin packet which includes a fish oil concentrate capsule. A year ago my lipid profile seemed out of "whack' for me. I run 35 miles a week, excersize every day before work. Last year I weighed 131, which was a bit high for me.NMR Lipoprofile last year: LDL-P 2329, SMall LDL-P 1735, total cholesterol 226. LDL-C 113, HDL-C 49, Triglycerides 319!! Large HDL-P 6.1, Large VLDL-P 5.5

For one year (to present) I have not eaten any animal products. No meat, cheese, etc. l also reduced red wine intake. Still running, weigh 118, but lipid profile is still "abnormal". My diet is very healthy, plenty of whole grains, rough oatmeal, vegetables, etc. Recent NMR profile: Total chol 248!, LDL-C 161, HDL-C 64, triglyceride 116. PArticle numbers remain high: LDL-P 2246, SMall LDL-P1341, LDL size 20.5, LArge VLDL-P 3.4, Small LDL-P1341,LArge HDL-P 4.5(low) VLDL size 48.6(high) LDL size 20.5(low) HDL size8.6(low) LP-IR score 68 (high)

Doctor will most likely want me to take Trilipix but I do not want to. Will plant stanols work? Should I stop taking fish oil concentrate? I read that it can skew LDL profile. ( my c reactive protein =.80)

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Answers (2)

Lisa Nelson, RD, LN, Health Pro

5/24/10 12:24pm

Hi Virginia,

It is very surprising with your level of activity, optimal body weight, and healthy diet that you are struggling with your cholesterol levels. Well done lowering your triglycerides, raising HDL, and weight loss. However, your LDL particle levels and elevated CRP still puts you in a category that typically receives agressive treatment.

Yes, it may be wise to do a trial of discontinuing your fish oil (and maybe even the alternative vitamin packet) for a period of time and retesting to see if the supplements have negatively impacted your levels. However, I do encourage you to work closely with your physician and begin pharmaceutical treatment if necessary. If your physician is willing to do a little trial and error with you, you may be able to do a few steps and have your levels checked every 6-8 weeks. For example, discontinue all supplements and test, then add in plant sterols and test, etc. Add 1 new step or supplement and test the results so you can identify what is having a positive impact and what is not. Maybe adding a high quality fish oil supplement will have a different impact. Also, I can't stress the importance of a diet high in fruits and vegetables enough.

Here are two posts for a quick review of what impacts LDL and what impacts triglycerides/HDL.

Cholesterol - 4 Steps to Lower LDL Cholesterol
Triglycerides: Why They Matter and How to Lower Them

All the best,

Lisa Nelson RD

How to Lower Cholesterol in 8 Simple Steps

Virginia

5/25/10 8:51am

Dear Lisa,

Not sure you received my reply, but here it is again!

Thank you for your advice and timely reply. Just to clarify, my CRP is not elevated. It is 0.80 which is in the low risk category.

If it's ok, I'd like to keep you posted on methods which may work to get the cholesterol particle numbers within range.

Ginna Walsh, DMD

Lisa Nelson, RD, LN, Health Pro

5/25/10 12:12pm

Hi Ginna,

Yes, please keep me posted on your progress.

I want to quickly clarify on the c-reactive protein so we are on the same page. I was going by SpectraCell lab reference values, which recommends CRP be below 0.4 mg/dl. It's possible SpectraCell and your lab use a different reference range or different unit of measurement. Labs generally use guidelines provided by one of the major medical boards. These boards can interpret research differently and therefore have slightly different reference value recommendations. Although, they should be pretty similar. I'm thinking maybe your unit of measure was different than mg/dl since it fell into the low risk range.

All the best,

Lisa Nelson RD

How to Lower Cholesterol in 8 Simple Steps

chuck

7/30/10 1:42pm

You can't be so consumed about the numbers. I've been working out my entire life and eating healthy and my nubers are all out of whack according to what they tell us. The problem is what they tell us is not necessarily true. There are thousands and thousands of people who have high cholesterol numbers in the U.S. and never develop CHD. Same holds true on the other side. There have actually been many tests in other countries that show low cholesterol is not good either. In Switzerland they have the highest average cholesterol per person in the world and the lowest rate of CHD. How can that be? We have been brain washed to believe something that isn't true. Since the advent of cholesterol lowering drugs CHD rates the U.S. have not dropped, not even 1%. If the goal of these drugs is to lower cholesterol numbers, and they do, then why haven't CHD numbers fallen. The European Aborigines have the lowest average total cholesterol numbers in the world and have the highest rate of Coronary Heart Disease. There is no right formula as far as I can see. I have a neighbor that just had open heart surgery(he was a personal trainer for 20 years) and his total cholesterol was never above 180 and his HDL was always over 50(low tri's). Someone needs to bring these facts into light.

Hope this helps,

chuck

Q: How to get particle numbers within range, i.e. LDL-P, small LDL-P, LDL Size, VLDL, etc

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