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Thread: Where can I get a cholesterol test with LDL breakdown?

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    Default Where can I get a cholesterol test with LDL breakdown?

    I got some bloods done a few months back after having been on a low-carb/keto diet (typically ~60% of my calories from fat) and surprise, surprise, all my cholesterol numbers were high. Total, LDL and HDL were all at or slightly above the upper limit of the desired range while tris were perfect.

    total, HDL and Tris are not a worry to me, but i do have my concerns about the high LDL number. The numbers I've got are based on traditional cholesterol testing, ie they measure total, tri and HDL and then determine the LDL via equation hence it's not a direct measurement. I've also read studies suggesting that keto + exercise does interesting things to your tris which messes up the calculation method of LDLs. Lastly, i know there's a difference between different types of LDLs - a further breakdown of good and bad depending on particle size and this information is not available without direct measurement.

    So, yesterday i went to the DR seeking a 3 month follow-up to get my numbers re-tested to see if they had settled (my diet has been much more consistent, my weight has been stable and my stress levels are lower) and expressly asked for a VAP or similar test that directly measured LDL and could give me the LDL profiles I'm after. 2 Drs in the centre gave me blank looks - 1 had never heard of such witchcraft, the other was adament that it was expensive, unjustified and most importantly not available from their preferred pathology lab. Instead, i got a conventional test which isn't really going to help me any :\

    so bottom line, does anyone know of anywhere in sydney where i can get a full LDL measurement and profile? they seem so common in the states (the home of the statin), but not so much around here...





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    not too sure where you could get one, but if you're concerned about your LDL levels, just power through 1-3g of krill oil for 90days. studys show a decrese in LDL of around 40% is the norm, and an increase of HDL by almost 60% goes with it.

    and as far as i was aware it was the overall ratio of HDL:LDL that was most important,

    was it just a standard Fasting Lipid Study you did before?


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    Quote Originally Posted by March83 View Post
    I got some bloods done a few months back after having been on a low-carb/keto diet (typically ~60% of my calories from fat) and surprise, surprise, all my cholesterol numbers were high. Total, LDL and HDL were all at or slightly above the upper limit of the desired range while tris were perfect.

    total, HDL and Tris are not a worry to me, but i do have my concerns about the high LDL number. The numbers I've got are based on traditional cholesterol testing, ie they measure total, tri and HDL and then determine the LDL via equation hence it's not a direct measurement. I've also read studies suggesting that keto + exercise does interesting things to your tris which messes up the calculation method of LDLs. Lastly, i know there's a difference between different types of LDLs - a further breakdown of good and bad depending on particle size and this information is not available without direct measurement.

    So, yesterday i went to the DR seeking a 3 month follow-up to get my numbers re-tested to see if they had settled (my diet has been much more consistent, my weight has been stable and my stress levels are lower) and expressly asked for a VAP or similar test that directly measured LDL and could give me the LDL profiles I'm after. 2 Drs in the centre gave me blank looks - 1 had never heard of such witchcraft, the other was adament that it was expensive, unjustified and most importantly not available from their preferred pathology lab. Instead, i got a conventional test which isn't really going to help me any :\

    so bottom line, does anyone know of anywhere in sydney where i can get a full LDL measurement and profile? they seem so common in the states (the home of the statin), but not so much around here...
    LOL I had the same issue.

    OK I'm assuming that since you have asked about your LDL breakdown you already have a working knowledge (or better) about the different types of LDL with regard to particle size and the implications for health?

    The technology used to measure lipid particle size that has been used in all the studies (e.g. by the leading proponent Prof Krauss et al and others) was really only developed in recent years. It's really expensive so not generally used commerically - mostly just for studies.
    So you won't be able to get these tests done via normal channels, I'm wagering.

    However, a few interesting things to note:

    1. Studies have CONSISTENTLY shown that if you have high HDL and low triglycerides, this is very strongly correlated with LDL being predominantly of the "large, fluffy" particle type. This is the type which has been shown to be benign with regards to cardiovascular and other chronic diseases. The dense, small ldl particles are strongly correlated with low HDL and higher triglycerides.

    2. Generally LDL isn't even directly measured in standard lipid testing (at least here in Oz). It's usually calculated/estimated based on the measurement of HDL and total lipids via a standard model formula.

    3. I had the same problem as you and it freaked me out a bit until a nurse friend of mine told me my lipid ratios were perfect and under clinical conditions, no one would be concerned (as per point 1. above). My doctor used the now outdated argument that my ldl was slightly high and my total chol at 7.4 ... did I know that they medicate with statins at 7.5? So I did the following:

    a) I gave him a list of references to update himself on current knowledge regarding blood lipids in human beings and

    b) I asked him what we would do if my total chol measured 7.49? medicate? don't medicate? run around chasing our tails? LOL

    But hey, I am due to have my blood work done again in January and like you, I would dearly love to have point 1 above vindicated in my own case...to make me feel more secure.

    I have read that in most studies where diet was changed to a keto/low carb ... it spiked initially but over time settled down again. Might be worth having another test in 6 months if you are worried?

    and maybe reduce the proportion of saturated fats vs monounsaturated and fish oil fats in your keto diet. can't hurt.

    hope that helps
    Last edited by chocchillimango; 13-11-2012 at 12:39 PM.
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    yeah, just a standard fasting lipid study.

    my understanding of HDL:LDL ratio was that it was just a good general indicator but in reality it tells you nothing more than HDL and LDL numbers in isolation (keen to hear otherwise if that is so). A full LDL profile would be far more useful, but from what i can tell it's only really widely available in the states due to the massive market for statins - the more tests you can do to demonstrate high cholesterol, the more drugs you can push to try to reduce them...

    I don't think i want to game a cholesterol test for the sake of seeing good numbers, i'm more interested in adopting habits that are lasting and liveable so getting the right data is what matters. if i simply cannot get the data i need then maybe i'll have to consider precautionary measures like a reduction in sats VS monos and polys or supps like krill to keep my LDL in check :\


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    lol, thanks ccm great to see someone else in the same boat...

    this is my background reading on the topic: The straight dope on cholesterol ? Part I The Eating Academy | Peter Attia, M.D. The Eating Academy | Peter Attia, M.D. and the remaining parts of his series.

    yes, your #1 is exactly what i want to know - am i worrying about LDL numbers that are largely made up of the benign, larger LDL or do i legitimately have something that i need to fix?

    my previous tests were taken at the end of a 3 month period of weight loss (~10kg) including a major change in diet, a reduction in training load and high work stress so it's a particularly poor "baseline" to work from - i really regret not getting full bloods done prior to commencing my change of lifestyle. yeah, i have read similar re "settling time" during the first 3-6 months of keto and paleo diets and after significant weight loss. I will definitely be continuing to monitor until i can get 2 tests in a row to look OK

    for the record, I'm 29, M, 185cm, 90kg and my numbers from august '12 were...
    * cholesterol: 7.2mmol/L [target range = 3.9 - 5.5]
    triglycerides: 0.6mmol/L [target range = 0.5 - 1.7]
    * HDL: 2.4mmol/L [target range = 0.8 - 1.5]
    * LDL: 4.5mmol/L [target range = 1.7 - 3.5]

    sats VS monos: that's pretty much what my GP said - "why not just look at that and regulate it regardless?" short answer because i don't want to if i don't have to, but it seems that the information i need to make that call is not available to me...

    my deepest darkest fear is that i'm a hyper-responder to dietary cholesterol and that i'll have to give up eggs. that is my nightmare...


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    thanks interesting read.

    two years back last test I had done showed to low cholesterol 2.2 mmol/L and got told to eat more fat . Pretty much everything else was dead center except for slightly high triglycerides.

    I hate going in for a check up as most dr's seem fixated on bmi and instantly try to put me on weight loss drugs. Due one though.Plus was on monthly tests for 8 years after bike accident due to being on antiinflamatories.


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    Quote Originally Posted by March83 View Post
    lol, thanks ccm great to see someone else in the same boat...

    my previous tests were taken at the end of a 3 month period of weight loss (~10kg) including a major change in diet, a reduction in training load and high work stress so it's a particularly poor "baseline" to work from

    ok, the bit in bold? I also had my blood work done during a prolonged period of stress ... so we're both in the chronic stress situation.

    Chronic stress increases levels of cortisol in the blood which increases LDL as well.

    So I'm guessing that maybe that's a contributing factor too.

    My LDL is in the 3's and my HDL is higher but our tris are close and perfect.

    The reading you've done is all consistent with the current literature. But again, getting those specific tests done is nigh on impossible, unless you have a way through to someone who does them.
    Not sure when they'll make it commercially viable for pathology labs to do it. I suspect there's someone doing it in the US already but at $$$

    Worth maybe doing your own controlled study. Keep track of stress levels and a change in diet and give it some time and then test again. See if it makes a difference.
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    Quote Originally Posted by lex View Post
    thanks interesting read.

    two years back last test I had done showed to low cholesterol 2.2 mmol/L and got told to eat more fat . Pretty much everything else was dead center except for slightly high triglycerides.

    I hate going in for a check up as most dr's seem fixated on bmi and instantly try to put me on weight loss drugs. Due one though.Plus was on monthly tests for 8 years after bike accident due to being on antiinflamatories.
    if you cut out refined carbs, your tris will drop
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    Quote Originally Posted by chocchillimango View Post
    if you cut out refined carbs, your tris will drop
    got told by Dr to cut out hard cheeses to drop tris


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    Quote Originally Posted by lex View Post
    got told by Dr to cut out hard cheeses to drop tris
    really? lol it's a freaking minefield out there with the blood lipids

    well, tris tend to go up and down in relation to carb types as well as fat intake but hey ... who really knows?

    what we still don't know about blood lipids is a vast ocean of undiscovered knowledge.

    I actually think there is quite a bit of individual variance involved too. What affects one person may leave another indifferent.
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