LDL particle size test

[nubill]

I have been prescribed statins and have been taking them for over 10 years because of a high LDL number. I have read recently that statins my be over prescribed and their utility in preventing heart disease is questionable. I would like to know if anyone has had an LDL particle size test and if they were able to convince their doctor to eliminate statins.
My last legacy (1980’s) lipid panel test had a high LDL number (198) while taking 20mg of a generic statin. All other numbers are good (i.e. HDL = 47, Triglycerides = 125). I made some dietary changes a month before the test severely restricting processed carbs and sugar by being on a paleo type diet.

 

[braumeister]

About three years ago, I got that test on my own through a local (Labcorp) office. Not very expensive, under $100 as I recall.
https://requestatest.com
About a yer later, my doc got the same test for me unasked.

Interesting results, and probably worth doing.
I quit statins five years ago due to side effects. Although my doc would rather have me on them, he's OK with it. High LDL but very high HDL and very low trigs.

 

[latexman]

The opposite happened to me. My HDL was just under the limit, but particle size analysis showed I was at high risk. They were the wrong size, dang it! Luckily it was well controlled and I had no side effects from daily 20 mg atorvastatin.

 

[nubill]

Thanks Braumeister and Latexman. I will call tomorrow and ask if they will do the new test at my next visit in 3 months. I also have side effects although not as bad when I was taking the 40 mg (now 20 mg) of atorvastatin dosage.

 

[Beldar]

Never heard of this test, thanks for mentioning it, I'll do some research.

I did notice, and shared with my doctor, that one of the side effects of statin use (muscular aches) disappeared for me when he reduced the dosage down to 10 mg. Of course, this is individual-specific.

_B

 

[big-papa]

Some years ago I had a Heart CT scan (generally not paid by insurance). Lots of research later, I changed diet, exercised more, yada yada. 3 years later had another scan and calcium score increased, though under the "average" increase expected of somebody showing a calcium score >100. Then went to cardiologist who put me on 10mg Atorvastatin after a full panel that included LDL particle size. Kept the diet and exercise changes. 3 years later, another scan and while the score had increased, it was only a small percentage.

One more thing about LDL tests - next time you have one ask for a direct measurement. Most standard cholesterol tests derive the LDL number from other measurements instead of measuring it directly.

 

[Options]

I had the Heart CT scan last year. Doctor, who is a cardiologist, told me because of my diet/exercise/etc. I had nothing to worry about (also because I had substantially reduced my bad/increased my good cholesterol through a diet change). Hadn't thought of having a repeat of the test, especially since it isn't covered by insurance, but may consider it again in about ten years. The three main sources of biological aging are cardiovascular, immune system impairment, and stress, so I've been paying particular attention to these areas.

 

[Helen]

My doctor kept on me to go on statins. I upped my exercise, cleaned up my diet and lost weight, but she still didn't like my numbers. I finally asked her what my particle size was and she sheepishly admitted she had not tested me. She ordered the test and I have the healthier large particles.

She has not brought up statins since.

However, since switching to a mostly whole food, plant based diet my numbers are good.

 

[Chuckanut]

For you folks who don't mind long, technical discussions about things this Podcast with Dr. Peter Attia and his guest is a quite good discussion (IMHO) of what we know and don't know regarding heart disease causes, cholesterol, and drugs like statins.

Pick the podcast with Dr. Krause - The Deep Dive

https://itunes.apple.com/us/podcast/the-peter-attia-drive/id1400828889?mt=2

My take on this (and I did not understand a lot of the medical techy stuff) is

• There is a lot of work left to figure out the mechanism(s) behind heart disease.
• Statins are not all good or all bad.
• Cholesterol issues - including what is OK and what is harmful - are very complicated.

If your main interest is statins, listen to the last 50 minutes of the podcast.

 

[VanWinkle]

I have had the particle test about 5 years ago and results were less than stellar. I have low LDL and Low HDL(30) My doctor allowed me to work on it with diet and exercise. I have improved the HDL, but not as much as I had hoped. I will like go on some type of statin later this year. I am on no prescriptions at this time, so starting is a little scary for me.

 

[athena53]

About three years ago, I got that test on my own through a local (Labcorp) office. Not very expensive, under $100 as I recall.
https://requestatest.com

Ooh, I'm saving that link! My last checkup, my first with Medicare, a lot of perfectly normal tests got kicked back by Medicare as "not medically necessary" and they refused $800 worth of tests. I ended up not owing anything; apparently the lab was supposed to have me sign some consent form and didn't so they had to eat the costs, but I still felt it wasn't right. It sucks that I have to pay out of pocket but for me it's worth it to save the hassle. Twice out of the last 3 visits the lab my doc uses couldn't find her orders for the blood tests so I had to wait almost an hour (while fasting, of course) till her office opened. The third time I had a hard copy with me!

Between requestatest.com and the routine checks at the blood bank when they let me back in 12 months after my last trip to India (BP, RBC and platelets) I should be good. Just have to do the in-person tests such as mammograms and colonoscopies as recommended.

 

[RAE]

I have been prescribed statins and have been taking them for over 10 years because of a high LDL number. I have read recently that statins my be over prescribed and their utility in preventing heart disease is questionable. I would like to know if anyone has had an LDL particle size test and if they were able to convince their doctor to eliminate statins.
My last legacy (1980’s) lipid panel test had a high LDL number (198) while taking 20mg of a generic statin. All other numbers are good (i.e. HDL = 47, Triglycerides = 125). I made some dietary changes a month before the test severely restricting processed carbs and sugar by being on a paleo type diet.

The LDL particle size test is a good one to have done, and as Braumeister said, it's not expensive. If you are still on a paleo-type diet, my guess is that your triglyceride number will keep coming down further. Your triglyceride/HDL ratio is about 2.6, and from what I've read, you want it to be under 2.0. If you can get it to 1.0 or lower, that's better yet. Triglycerides are greatly affected by carb consumption, so if you are not eating that many carbs anymore (especially carbs from refined grains), and you get some exercise daily, your triglyceride/HDL ratio should continue to improve over time. So if you have the LDL particle size test done, make sure they run another lipid panel also, so you can monitor that ratio. The triglyceride/HDL is one of the best predictors of heart attack risk, so it's important to monitor it.

 

[bjorn2bwild]

For you folks who don't mind long, technical discussions about things this Podcast with Dr. Peter Attia and his guest is a quite good discussion (IMHO) of what we know and don't know regarding heart disease causes, cholesterol, and drugs like statins.

Pick the podcast with Dr. Krause - The Deep Dive

https://itunes.apple.com/us/podcast/the-peter-attia-drive/id1400828889?mt=2

My take on this (and I did not understand a lot of the medical techy stuff) is

• There is a lot of work left to figure out the mechanism(s) behind heart disease.
• Statins are not all good or all bad.
• Cholesterol issues - including what is OK and what is harmful - are very complicated.

If your main interest is statins, listen to the last 50 minutes of the podcast.

Thanks, looks interesting.
I plan to listen to the entire 1:56 podcast when I get a chance. I found this page of key takeaways for a quick summary.


The Peter Attia Drive: Ron Krauss, M.D. – A Deep Dive Into Heart Disease – Podcast Notes

 

[Chuckanut]

Thanks, looks interesting.
I plan to listen to the entire 1:56 podcast when I get a chance. I found this page of key takeaways for a quick summary.


The Peter Attia Drive: Ron Krauss, M.D. – A Deep Dive Into Heart Disease – Podcast Notes

Thanks for the above link.

I guess if this cholesterol thing was easy, we would all be MD's.

 

[eytonxav]

I have had the particle test about 5 years ago and results were less than stellar. I have low LDL and Low HDL(30) My doctor allowed me to work on it with diet and exercise. I have improved the HDL, but not as much as I had hoped. I will like go on some type of statin later this year. I am on no prescriptions at this time, so starting is a little scary for me.

One other problem with statins, while they will reduce your LDL, they will also lower your HDL as well.

 

[Bamaman]

I certainly hope every one of you gets a yearly physical, including a chest XRay and a complete chemical blood test.

We have had seven family friends die recently in their early 70's. One was a smoker, and was Stage IV lung cancer before he even knew he even had cancer. One was surgeon that had done a thousand cancer surgeries, but we don't think he had been getting colonoscopies.

This is life and death. A proactive health approach is important so I can live long enough to spend my kid's inheritance.

 

[athena53]

I certainly hope every one of you gets a yearly physical, including a chest XRay and a complete chemical blood test.

This is life and death. A proactive health approach is important so I can live long enough to spend my kid's inheritance.

I can't remember when I had a chest X-Ray; no history of smoking (and yes, DH knew one super-healthy young woman who died of oat-cell carcinoma).

You're preachin' to the choir on mammograms, colonoscopies and Pap smears. I am seriously considering doing the test below every other year when I don't need a Pap smear.

https://requestatest.com/ultimate-heart-health-panel-testing

I have all my previous stats and they always flag values that are out of bounds on reports. I won't have to deal with the clueless lab my Doc uses that never can find the bloodwork orders and makes me wait, tired, starving and grumpy, till her office opens. Given the costs, which I consider manageable, I don't have to mess with trying to convince Medicare what's medically necessary, either.

 

[nubill]

Late update. Sorry, but at the time of the original post (July 2016), I moved from SC to FL. I had to get a new doctor and wait for a new set of tests. My last lipid panel test (July 2017) had LDL at 216, HDL at 47 and Triglycerides at 80 while taking 20 mg of statins daily. I can’t remember if it was following the new doctor’s advice or reading online but I asked the doctor about a CT Cardiac Scan. I had one done for $87 at an office in The Villages. The results were a score of 13.7. Based on the calcium score, I was taken off of statins.

Since I am now Medicare eligible this month and kept my insurance for my wife, I can no longer be a patient of this doctor’s practice. I have my first appointment with the new doctor next week. No Lipid panels scheduled yet but i’ll let you know.

 

[Oz investor]

am on 40mg of Rosuvastatin , i have very low lipids level ..., except for a one inch piece of my Left Anterior Descending artery .. where the lipids are deeply embedded in the artery wall .
i have been on that dose for nearly two years now ... and there is not talk of cutting the dosage down ...

 

[homestead]

I just got full blood work done this week. They didn't do a test for particle size just the std tests for blood. Everything was within normal limits but I don't really understand what it all means. I did a search on the internet and found this free calculator https://bloodcalculator.com that runs a report based on all your numbers and gives you what age they think your blood suggests. I was surprised by the results that said my blood age was 52yrs as I am 65yrs old. The age result is free, if you want the full report they charge $50. It didn't work with Safari browser but did with Chrome and Firefox.

 

[nubill]

Just had my follow up with my new PCP with my most recent Lipid panel. Total cholesterol = 248, HDL = 52, Triglycerides = 77, LDL = 178. Based on my last CT Cardiac Scan with a score of 13.7 and my active lifestyle, PCP thinks my high cholesterol may be hereditary. PCP told me to continue on my current exercise and diet. Will see you next year.