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Cholesterol calculation
Hi B and team. Always hearing and reading to not be afraid of cholesterol and that there is specific tests and ratio and other numbers to take into consideration when assessing cholesterol. Can you please share with us what are the prepped cholesterol tests and what numbers and ratio to look for? And calculation if there is any?
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3 Replies
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Hey ,
Good question! Cholesterol is a fascinating, but complex topic to discuss. Understanding the different lab markers on a traditional panel will help.
I wrote a tip about cholesterol (you can find it here). It explains the difference between Cholesterol, HDL and LDL and will discuss ranges as well.
To summarize shortly, Cholesterol is a molecule that is transported by LDL and HDL. Although LDL (and HDL) particles come in different sizes, the backbone of LDL is a molecule called ApoB.
Here the discussion becomes a bit more nuanced.
Small LDL particles can get easier stuck in damaged arteries, which can cause plaque to build up. Bigger particles fit less well in small holes and are in general less damaging.
LDL or LDL-C
When the lab value LDL (or LDL-C, with C for Cholesterol) is on your lab report, this gives back the cholesterol mass transported by the LDL taxies. It doesn’t say anything about the average size of these LDL transport molecules.LDL-P
A better marker to asses risk would be to count the LDL particles. This is done, but it isn’t the standard. You would like to see the lab value LDL-P (P stands for particles).ApoB
Measuring the amount of ApoB (since it is the backbone of LDL) will be an even better way to count the LDL particles. Depending on someone’s genetics ApoB can be more or less plaque-forming. This has to do with the next lab value:Lp(a)
Lp(a), pronounced like LP little a, is a special form of LDL that has attached a molecule called “apolipoprotein a” to Apo-B. These particles are more plaque-forming than LDL. It is estimated that 20 per cent of the population of the world has this genetic variance. Therefore measuring Lp(a) is important as well.Pattern A and Pattern B
People with smaller LDL particle sizes have a pattern B LDL profile. Having on average bigger LDL particles is, therefore, an advantage. People having this type of LDL profile are having a pattern A profile.Triglycerides
You can find these on a traditional lipid panel as well. Elevated levels
are often indicative of metabolic dysfunction, fatty liver, elevated blood sugar, hypothyroid function and/or high stress hormones. Low levels may be from low intake of dietary fats, hepatic-biliary congestion, hyperthyroidism, or an autoimmune disease dynamic.Triglycerides/HDL Ratio
The most predictive of CVD risk in the traditional lipid panel is an elevated ratio of triglycerides to HDL cholesterol (it somehow estimates LDL particle size). The Triglycerides/HDL ratio would be desired <2.0.Now to answer your question:
For all these reasons, I personally like the cardio IQ report from Quest Diagnostics. You can order it here. It will also help you interpret the reference ranges.
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thank you for this thorough answer. You always have very informative answers I’d love to know if there are tests that are done by the dr that can give us greater picture. I’ve seen this info on Dr Ben Lynch stories but didn’t save it and cannot find these info. It was stage regular tests and which markers to calculate to know if we are at risk.
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Hey ,
I don’t know what Dr. Ben Lynch posted, unfortunately. However, on a traditional panel, triglycerides and HDL are always mentioned.
The Triglyceride/HDL ratio can be calculated from this – which isn’t often on the report (sometimes it is though). On a traditional panel, you will find the cholesterol ratio (which is total cholesterol devided by HDL). This ratio isn’t a ratio I personally pay a lot of attention to.
It is the triglyceride/HDL ratio that can help you assess your risk. You would like to have it below 2.
Other markers
The other markers in my previous response, which aren’t on a traditional panel, are ‘stronger’. Especially the pattern A/B information, the ApoB and the Lp(a) markers. I’m just mentioning it if you are considering more advanced labs.One last note on Lp(a). Lp(a) doesn’t vary much in a lifetime. It is more genetically influenced. If you measure it only once in a lifetime, it would help you understand if you belong to the group of 20 per cent that is more vulnerable to plaque forming.
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