You Need This Test If You Have High Cholesterol
It’s likely that you’ve had your cholesterol levels checked by your doctor and continue to do so on a regular basis. If you haven’t, I highly recommend that you do so, but with at least one addition to the standard lipid panel!
A standard lipid panel consists of the following (recommended levels according to the American Heart Association) included:
- Total cholesterol: below 200 mg/dL
- High-density lipoprotein cholesterol (HDL or HDL-C): above 60 mg/dL
- Low-density lipoprotein cholesterol (LDL or LDL-C): below 100 mg/dL (for those with diabetes: below 70 mg/dL)
- Triglycerides: below 150 mg/dL.
Many people rely on these numbers to assess their risk for heart disease, so much so that many can rattle off their numbers without a second thought. HDL has become colloquially known as the “good” cholesterol, while LDL has been coined the “bad” cholesterol.
While this is generally true, there is more to the story! There is an additional marker that you should be aware of that has been shown to be a much better predictor of your risk of heart disease, yet most doctors don’t order it unless you ask.
That Marker Is Called LDL-P!
LDL-P (which stands for LDL particle number) measures the actual number of LDL particles circulating in your bloodstream. This differs from LDL-C (often simply referred to as LDL on your bloodwork), which estimates the total amount of cholesterol within the LDL molecules.
As a reminder, LDL molecules are the lipoproteins that carry and transport cholesterol. You can have varying amounts of cholesterol within a single LDL molecule.
In other words, LDL-C tells you the estimated amount of cholesterol, but it does not tell you how many LDL particles it is taking to carry that cholesterol, which turns out to be what matters more in terms of predicting heart disease risk.
Why Knowing Your LDL-P Number Is So Important…
While LDL-P is not the only predictor of heart disease, according to research, we do know that it is more strongly associated with risk of cardiovascular disease and atherosclerosis than LDL cholesterol. Additional research also showed that “LDL-P was related more strongly to future [cardiovascular disease] in both sexes than LDL-C or non-HDL-C.”
According to Dr. Chris Kresser and the Journal of Clinical Lipidology, “patients with high LDL cholesterol (LDL-C) and low LDL particle number (LDL-P) are not at high risk of heart disease.” In other words, knowing your LDL number may not be enough to assess your risk! Knowing your LDL-P number in addition to your LDL can help you glean more insight as to your true risk for cardiovascular disease.
According to Labcorp, LDL-P should be under 1000 nmol/L, and is considered very high if above 2000nmol/L. These numbers are based on the Multi-Ethnic Study of Atherosclerosis (MESA).
What Contributes to High LDL-P?
According to Dr. Chris Kresser (read his 4 part series for lots more info!), the following are some of the top contributors to undesirably high LDL-P levels:
- insulin resistance
- poor thyroid function
- bacterial or viral infections
- increased intestinal permeability (“leaky gut”)
If you are struggling with any of these contributing factors, check out my 12 Weeks to Well program where I can help you rebalance these underlying issues.
What to Do Next…
If you have never seen a marker for LDL-P on your bloodwork, you should consider asking your doctor to test for it. Another option is to order an NMR LipoProfile® Blood Test yourself through a website such as Life Extension.
Knowing your LDL-P can help you and your doctor decide if a statin is right for you. While statins are generally considered safe, taking a statin to lower cholesterol in someone who doesn’t actually have a high risk for heart disease can potentially do much more harm than good.
Knowing your LDL-P number can help you and your doctor make a more informed decision in regard to treatment and lifestyle changes.
Let’s Have a Conversation:
Have you ever heard of LDL-P? Have you ever had your LDL-P tested? Do you have high cholesterol? Do you take a statin to manage your cholesterol? What lifestyle changes have you made and did they improve your cholesterol numbers?
Tags Medical Conditions
Thank you for this information. I will be asking that this be included in my next complete bloodwork with my physician. I will have the calcium test performed. I too will not take statins. I am not comfortable with medications affecting the cholesterol my body feels it needs to make for my bodily systems. I have no interest in tampering with unnatural medications in my body. Our bodies need cholesterol to function and are designed to make the appropriate amount needed.
Someone here mentioned the Lp(a) test and I must encourage everyone—perhaps especially those of you with low total cholesterol and great cholesterol numbers on the typical panels—to get that test! Despite eating butter and meat etc, ice cream if I feel like it, and with normal weight (BMI 21.5), at 66 I have low total cholesterol (145) and great numbers all throughout the usual lipid panels. And low BP and low blood sugar etc. But everyone, and I mean everyone, in my family has died of major heart disease. All of them normal weight, good health, low BP, and all with low and good “traditional” cholesterol measures.
Lp(a), Lipoprotein A, is what they call “the evil twin” of LDL, is genetic, a very highly plaque-forming molecule that cannot be stopped with statins, or with diet, or with exercise. And it triples the risk of heart-attack and stroke deaths. So it is very dangerous.
There are clniical trials right now in their third phase (the last phase before market) with drugs to reduce Lp(a). (You can maybe still get into one—I am in the Eli Lilly trials but there are others, just google it.)
I hope this helps someone.
I had high cholesterol a few months ago. Not anymore it is normal now. I changed my diet.
Another important cholesterol test to have done is the Lp(a) test. Many doctors aren’t even aware of this test! It typically only needs to be done once in a lifetime. Research it to on reputable websites to see it’s significance with regard to heart disease.
Yes! I have it! Very important to check.
Except statins aren’t generally safe. They are given more often than not and not needfully.