High Choleserol/low triglycerides

[Mdweather]

I recently had my annual physical and came back with a total chol of 219 and direct LDL of 159, HDL of 48 and triglycerides of 60.   I am an active 55 year old male that plays indoor soccer once a week in addition to regular excercise. My weight is 170 and I am 5' 10" tall.  For the life of me I can not get my LDL down to normal levels despite watching what I eat (not a lot of fat, except for almonds which I love!) Someone told me the LDL has two forms, one which is bad and one which is not so bad.  I was also told that a low HDL/Triglyceride level was good and probably meant that I had LDL that was not the bad kind.  I am somewhat concerned since I can't do much more to lower my LDL.    Should I be on statins or is there another way to test my LDL?  Thanks, Bruce

[Lee Kirksey, MD]

Hello
It sounds like your question is "Im doing everything that they have told me, but I still have high LDL" It is important for you to have a detailed cardiovascular risk assessment including family history. Additional labs should include CRP (creactive protein). Also, high cholesterol with Inc LDL can be associated with very low testosterone, low thyroid hormone or insulin resistance. These values will give insight into possible reasons for your refractory LDL and also provide an overall Vascular disease risk assesment.

Your correct that statins are the best pharmacologic agent. Discuss this with your physician. Starting it is largelydependent on your risk profile as described above. My book, Your Guide to Optimal Health (www.personalwellnesswheel.com) also describes adjunctive therapies like fish oil, coenzyme Q10 including the appropriate doses.

Your diet should obviously be low saturated fat (12 gm day).

Lastly, on my website, www.optimalhealthtoday.com, I describe a lab profile that we use that fractionates your cholesterol measurements to assess the good and bad types of HDL, LDL and triglyecerides as well as genotype testing for CAD riskk profile

You need aggressive management of this process with all of these tools

You should have CRP studied. Statin have been the best shown. Coenzyme Q10. Fish oil. Very low testosterone, diabetes or insulin resistance

[rbrwn310]

A related discussion, IS CHOLESTEROL THE REAL ENEMY? was started.

[Mdweather]

Just got back results from VAP Cholesterol test
HDL  45
VLDL 21
Trig  94
Non HDL Chol  155
apoB10Q-cal   102
Lp(a) Chol  13
Remnant Lipo 26
IDL Chol 13
Probable Metabolic Syndrome -- no
HDL-2  12
HDL-3  33
LDL1 Pattern A 16.5
LDL2 Pattern A 47.9
LDL3 Pattern B 50.9
LDL4 Pattern B  0
LDL Density Pattern   A
LDL Chol   135
Cholestrol total  201
LDL-R (Real)- C   115
VLDL-3   13

I did not get a true assessment of this test, other than my doctor saying overall vap profile wasn't too bad.   What the heck does that mean?   Is is good, bad, or indifferent?   Thanks for your help.  Bruce