How To Get Particle Numbers Within Range, I.e. Ldl-p, Small Ldl-p, Ldl Size, Vldl, Etc


Asked by Virginia

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)


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

Answered by Lisa Nelson, RD, LN