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Help me understand my numbers
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shannon9585 posted:
Total cholesterol = 241
HDL = 108
LDL = 111
Triglycerides = 109

Total is high, but my HDL is very high (which is good, right?) and Triglycerides in the normal range. LDL is elevated, but not too much.

Why is my total considered 'high' if each individual component is good, or near-normal?

Could this indicate a genetic predisposition to high cholesterol? (My parents both have or had high cholesterol, but I assumed theirs was mostly due to insufficient exercise.) I run 3 miles 2-3 times per week (~30 minutes each session) and do yoga once a week for an hour and half. I also do a lot of walking. However, my job involves mostly sitting all day.

I'm seeing my Dr. on Thursday to discuss my results. Should I request additional testing?
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billh99 responded:
From my readings it is not the amount of cholesterol that is a problem, but rather the number of particles containing cholesterol.

You might want to ask for an NMR test which measures the number of particles. It is only don't by one lab (I think), but is available through the national Quest and Labcorp system.

There is also a ApoB100 test that I think is a little more available. For the LDL cholesterol particles there is one ApoB100 per particle.

But other than cholesterol other risk factors or high blood pressure, diabetes (or any family history), weight (abdominal body fat) , and family history of early heart disease.

Also you might ask your doctor about getting an CACS (Cardio Scan).

http://www.heartfirst.md/doctor-to-doctor/cac-score-and-coronary-cta/

It shows if you are getting any calcified plaque.

Note - it is not covered by insurance. It can cost $300, but a number of hospital offer it for $50-100.
 
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bobby75703 replied to billh99's response:
Bill is right about the cardio scan. I myself am curious what those areas look like, but didn't want to subject myself to the radiation without probable cause.

Since my ultrasound showed no calcification at all. Zero. The probability I have calcification in others areas is slim.

I don't really care what my cholesterol is, but keeping an eye on my vascular health is very important to me. Gonna use ultrasound to keep an eye on it.
 
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bobby75703 responded:
Shannon, your cholesterol levels look normal healthy to me, although its not often you see someone with HDL of 108. I don't think you have anything to worry about.

Your total cholesterol is right on with a population group that had the lowest rate of vascular disease in the world.
 
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shannon9585 replied to bobby75703's response:
Thanks for your reply bobby and Bill. I'll definitely read up more on the ApoB100 test, the NMR test, and the cardio scan. I don't know if this is relevant but I'm only 27 years old, and not overweight. Are cardio scans typically reserved for someone older?
 
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bobby75703 replied to shannon9585's response:
Because heart scans subject the patient to higher doses of radiation, some people recommend not doing them unless there is sufficient reason to suspect cardiovascular disease.

Because you are only 27 years old, the odds of having vascular problems are much smaller at that age. Not impossible, but highly unlikely.

Again the ultrasound bears no exposure to radiation and can look at your neck arteries, your heart valves, and leg arteries. The only disadvantage is the ultrasound can't look at chest arteries. But the pictures are incredible! They can look at a cross section of the artery, or turn the artery longways and look at it that way. Color pictures show blood flow. Red in one direction, blue in the other. If there is any soft plaque build-up it will show. Calcium deposits, if any, show up as white reflections.

It would answer a lot of questions with no risk, and at a reasonably low cost.

Not only is it fun and educational watching the images, it beats the heck out of treating yourself for a disease you may not have based on a lipid panel.
 
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billh99 replied to shannon9585's response:
I am not real sure of this, but I don't think that in most case there won't be any signs of enough plaque buildup to show in either an CIMT or CACS until the 40's or 50's.

But autopsies show that the beginning of fatty deposits in the artery walls start in the late teens or early 20's.

At 27 the best information is probably the family history and that include grandparents and aunts/uncles.

This is a bit technical, but I think that it has some good information.

http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=14&ved=0CH0QFjAN&url=http%3A%2F%2Fwww.lipidcenter.com%2Fpdf%2FUnderstanding_the_Entire_Lipid_Profile.pdf&ei=wpJbUcyCIcv-2QWl84HoBw&usg=AFQjCNHD-n-SGT_jX4eTsWQJDBpX6figoQ&sig2=vSglgTD5KSc50r5qTyBgpQ&bvm=bv.44697112,d.b2I&cad=rja

Specially looking at the summary on the last page.

Looking at your non-HDL (133) yours is near ideal (100-130).

And more information on NMR http://www.lipoprofile.com/
 
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billh99 replied to shannon9585's response:
Here is an explanation of ApoB and LDL- particles.

It is the simplest and easiest articles that I have seen on this.

http://www.docsopinion.com/health-and-nutrition/lipids/apolipoprotein-b-apob/

http://www.docsopinion.com/health-and-nutrition/lipids/ldl-p/
 
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shannon9585 replied to billh99's response:
Hi All,

I saw my doctor to review my results, and I figured I'd share in case anyone is curious. I'll backstep a little: before I had my bloodwork done, my Dr. said she would call me if the results were fine and have me come in if there was a problem. After bloodwork, I got a call from the Dr.'s office saying she wanted me to come in to review my results... so looking at my numbers, I figured the cholesterol was the problem (only thing not in the normal range). Turns out, my Dr. was NOT concerned about my numbers and the office just wanted me to come in person. She said, yes, my total Cholesterol is high, but my HDL is very high and that's a good thing. Her words were "keep doing whatever you're doing" !


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