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The VAP Cholesterol Test
Old 07-17-2008, 09:57 AM   #1
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The VAP Cholesterol Test

I just had my annual physical. My doctor has started doing The VAP Cholesterol Test, which adds several new measurements to standard cholesterol tests.

By the standard measures my cholesterol is good -- all the numbers in the "desirable" range. But by this new test several of the new values are out of the desirable range.

We're starting with four months of lifestyle changes -- lose weight, reduce fat and carbs in diet, and add a little alcohol. If that doesn't work, he'll probably put me on niacin. I suspect in four months he'll recommend niacin, and I'm not sure how I feel about that idea.

I'm curious if any forum members are familiar with this test and if you have any opinions about it. I think of my Doc as a pretty level-headed guy, but he seems a little gaga over this test.

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Old 07-17-2008, 11:54 AM   #2
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The only tested indication for direct LDL measurement is the convenience of not having to fast. You might wish to dig up a recent thread here on lipoprotein measurement for more information on that.

While better LDL testing methods are welcome, it is a long, long leap to go from there to achieving better outcomes based on this test versus the well-tested traditional calculated LDL (unless you have ongoing fasting hypertriglycerides).

This technology seems like a convenient enhancement (no fasting required) but ironically, triglycerides need to be done fasting anyhow.
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Old 07-17-2008, 12:02 PM   #3
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We're starting with four months of lifestyle changes -- lose weight, reduce fat and carbs in diet, and add a little alcohol.
Coach
So, in effect, you are being asked to replace some fat and carbohydrate calories with calories from alcohol?

Does your Doc happen to own a rehab center?

Ha
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Old 07-17-2008, 12:40 PM   #4
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So, in effect, you are being asked to replace some fat and carbohydrate calories with calories from alcohol?
HEY!!! Haven't you heard? Alcohol is good for you. Now pipe down before my wife hears you and starts asking questions.

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Old 07-17-2008, 02:53 PM   #5
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Originally Posted by Rich_in_Tampa View Post
The only tested indication for direct LDL measurement is the convenience of not having to fast. You might wish to dig up a recent thread here on lipoprotein measurement for more information on that.

While better LDL testing methods are welcome, it is a long, long leap to go from there to achieving better outcomes based on this test versus the well-tested traditional calculated LDL (unless you have ongoing fasting hypertriglycerides).

This technology seems like a convenient enhancement (no fasting required) but ironically, triglycerides need to be done fasting anyhow.
Thanks for the info, Rich. I'll do some searching.

It was kind of funny, when I was scheduling the blood draw for my next test in 4 months, the scheduler told me fasting wasn't necessary, but it was better if you did.


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So, in effect, you are being asked to replace some fat and carbohydrate calories with calories from alcohol?

Does your Doc happen to own a rehab center?

Ha
Ha, I found that kind of amusing too. My doc was pretty circumspect about the alcohol recommendation, "you might think about maybe having a drink a couple of times a week." With all the good news I've been hearing about alcohol and HDL I'd been thinking about it anyway.

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Old 07-17-2008, 10:24 PM   #6
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My doc was pretty circumspect about the alcohol recommendation, "you might think about maybe having a drink a couple of times a week." With all the good news ...
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Why would cutting back to a couple times a week be good news? :confused:

Seriously, unless you have an alcohol problem, it seems the common recc is for a drink or two a day. Just to avoid the calorie intake, I generally limit myself to one 12 oz (occasionally a 16 oz if it is packaged that way) a day (but I *think* about having one several times a day ) , two on weekends, maybe more over a long dinner/evening with friends. Our Thursday turned into a Friday this week, so 2 Sierra Nevada's with dinner tonight. Gotta remember to have just one tomorrow, since Friday is Thursday this week.

A 'couple times a week' - you are missing out on some health there, and some good beer.

-ERD50
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Old 07-18-2008, 07:33 AM   #7
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If you go on niacin, remember to get the no flush kind. The rash and tingling in your face is not fun. May want to talk to your doc about how much to take as well. I was taking niacin for another ailment (tinnitus), along with B12 CoQ10 and an herbal supplement for the ears about a year ago and got the numb tingley feeling in my face after a long flight...scared me pretty bad, and the niacin was the no flush kind.

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Old 07-18-2008, 09:19 AM   #8
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Thanks for the tips, Rambler. IIRC he's talking slow release niacin, ramping up to 1 g per day. But that won't start for at least four months, and I'll see him again before starting niacin.

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Old 07-18-2008, 09:23 AM   #9
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If your cholesterol numbers are not what you'd like, talk to your doctor about the therapeutic use of niacin.

Do a little reading at Fight Cholesterol with Niacin before you talk to your doctor.

I had been taking Lipitor to control my cholesterol. Since I switched to niacin, all my numbers have improved. Especially my bank account balance numbers.
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Niacin
Old 07-18-2008, 09:24 AM   #10
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Niacin

If your cholesterol numbers are not what you'd like, talk to your doctor about the therapeutic use of niacin.

Do a little reading at Fight Cholesterol with Niacin before you talk to your doctor.

I had been taking Lipitor to control my cholesterol. Since I switched to niacin, all my numbers have improved. Especially my bank account balance numbers.
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Old 07-19-2008, 07:22 AM   #11
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If you go on niacin, remember to get the no flush kind.

"No flush" niacin is ineffective.

Varying Cost and Free Nicotinic Acid Content in Over-the-Counter Niacin Preparations for Dyslipidemia -- Meyers et al. 139 (12): 996 -- Annals of Internal Medicine
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Old 07-19-2008, 07:41 AM   #12
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If you go on niacin, remember to get the no flush kind.

"No flush" niacin is ineffective.
Over the counter no-flush niacin is neither reliable nor regulated. Sustained release niacin is available, has reduced tendency to cause flushing and is regulated, reliable and effective.
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Old 07-19-2008, 02:49 PM   #13
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Ha, I found that kind of amusing too. My doc was pretty circumspect about the alcohol recommendation, "you might think about maybe having a drink a couple of times a week." With all the good news I've been hearing about alcohol and HDL I'd been thinking about it anyway.
Coach
When I was visiting a cousin of mine in England I asked how his stomach ulcer was doing and he told me the Doc told him that beer was an irritant and that he needed to cut back to no more a pint or 2 after eating a meal. I asked how he was doing and he scowled back and said "how would you feel on 10 meals a day?"
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Old 07-19-2008, 03:33 PM   #14
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Back in college (40 years ago, gaack), someone was told to cut back on beer because it was irritating her stomach, so she switched to CocaCola; I don't see how that would be less likely to cause digestive problems.
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Old 07-19-2008, 07:30 PM   #15
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Back in college (40 years ago, gaack), someone was told to cut back on beer because it was irritating her stomach, so she switched to CocaCola; I don't see how that would be less likely to cause digestive problems.
In my cousin's case he typically drinks at least 10 pints of beer several nights a week (20oz pints). He is also a high stress, type A personality, so the beer was probably only one of the many reasons he had an ulcer.

But I agree with you that oz for oz, I would think CocaCola would be equally bad for your stomach.
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Old 07-19-2008, 10:50 PM   #16
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In my cousin's case he typically drinks at least 10 pints of beer several nights a week (20oz pints). He is also a high stress, type A personality, so the beer was probably only one of the many reasons he had an ulcer.

But I agree with you that oz for oz, I would think CocaCola would be equally bad for your stomach.
Alan, is this man still normal weight? That is an amazing amount of beer!

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Old 07-20-2008, 10:08 AM   #17
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Alan, is this man still normal weight? That is an amazing amount of beer!

Ha
Overweight but not obese. These quantities of beer drinking are not uncommon in my home town, (Coal mining community) and most men have big beer bellies as a result. I was over there last September when a friend of the family arrived back from vacation in Australia. We were in the local pub with him and he ordered 3 (20oz) pints, downed them in 3 straight swallows as the barman put them down, and then said, no, that still hasn't done it and ordered a 4th. That "quenched his thirst" so he could take his time over the rest of evening.

Some of the women are almost as bad with their beer drinking. In fact there is one pub where the only way you can tell the difference between the men and the women is that the women will take the cigarette out of their mouth before they spit
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Old 07-20-2008, 11:15 AM   #18
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Overweight but not obese. These quantities of beer drinking are not uncommon in my home town, (Coal mining community) and most men have big beer bellies as a result. I was over there last September when a friend of the family arrived back from vacation in Australia. We were in the local pub with him and he ordered 3 (20oz) pints, downed them in 3 straight swallows as the barman put them down, and then said, no, that still hasn't done it and ordered a 4th. That "quenched his thirst" so he could take his time over the rest of evening.

Some of the women are almost as bad with their beer drinking. In fact there is one pub where the only way you can tell the difference between the men and the women is that the women will take the cigarette out of their mouth before they spit
Hilarious. If I drank as much beer as this guy above I would be instantly and profoundly drunk.

Ha
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Old 07-20-2008, 11:27 AM   #19
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Hilarious. If I drank as much beer as this guy above I would be instantly and profoundly drunk.

Ha
Me too. Before I left home at age 18.5 I would easily down 6-8 pints myself just because that was what guys did. My brother never left home until forced to find work in his late 20's then ended up in a coal mining town in Australia where the drink culture is the same He is 3 years younger than me and is enormous and has lots of health problems caused by obesity (age 50). So it certainly does catch up with you. My Dad was never a regular big beer drinker and he is normal weight at age 83

These days when I'm visiting I have 2 pints then switch to whisky - in England the measures are much smaller than what they are here. (1/6 of a gill which is less than an oz)
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Old 07-21-2008, 08:59 AM   #20
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Over the counter no-flush niacin is neither reliable nor regulated. Sustained release niacin is available, has reduced tendency to cause flushing and is regulated, reliable and effective.
This article out of the Annals of Internal Medicine has a good analysis of OTC preparations of Niacin:

Varying Cost and Free Nicotinic Acid Content in Over-the-Counter Niacin Preparations for Dyslipidemia -- Meyers et al. 139 (12): 996 -- Annals of Internal Medicine


"No flush" (inositol hexaniacinate) niacin is ineffective in humans.

The OTC niacin by Rugby has been tested in a clinical trial and was safe and effective. It is dirt cheap. You can order it online.

The article noted that all the OTC preparations of 500mg niacin tested had 520 +/- 12.6 mg of free nicotinic acid (niacin).
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