I’m about to shock everyone, that is unless you’ve read my books in past years.
Recently I wrote a column about LDL and that we should not necessarily strive to lower LDLs.
That’s because it’s about semantics, and the question you must ask is what type of LDL do you have. Is it Lp(a)? That is definitely one you should try to reduce.
You need to know the type and number of LDL particles that you have because total LDL and total cholesterol don’t mean a lot. For example, Lipoprotein A or “Lp(a)” and another called apolipoprotein B or “Apo B” are two subtypes of LDL particles. These particular scores directly affect your cardiovascular risk. Do you have those numbers on your lab test? I bet you don’t.
In my first book, The 24-Hour Pharmacist and many syndicated columns I’ve explained that statins are not very effective in reducing LDL particle number or Apo B and usually do not increase the size of your LDL particles, that’s why I don’t encourage the category of drugs for that specific purpose.
It’s confusing for consumers (and physicians who accept propaganda) because studies conclude statins reduce total LDL. And yes, they do reduce “total” LDL. As a side benefit, they are excellent anti-inflammatories so they have merit.
But I’m more concerned about you reducing Lp(a) and Apo B because those are the dangerous sub-types of LDL that are known to raise risk for heart attack and stroke. So on your lab test, it’s a bit of a dilemma.
I’ll never submit myself for a routine “Lipid Profile” because it would waste my money. Half the people who have heart attacks have normal total cholesterol. If your results shows a low LDL (considered the bad particle), then you may assume you’re okay but you see, a low total LDL score doesn’t say much. Your triglycerides might be through the roof! You may have a huge concentration of dangerous Lp(a) and Apo B, subtypes of LDL that are never measured in that basic lipid profile.
Likewise, you may be happy with your high HDL cholesterol score, (HDL is considered a good cholesterol), but what if you have the wrong kind of HDL particles? Yeah, some HDL is bad, you didn’t know that?! You’re still at very high risk. These basic “Lipid Profiles” and “Total Cholesterol” don’t provide the crucial details. It’s like a car mechanic who you hire to fix your engine, but you only let him look at the hood of your car, he can’t actually open the hood to see what’s going on inside!
The better tests, sometimes covered by insurance measure particle size, type and sometimes the actual number of LDL and HDL particles. I urge you to test yourself with a more comprehensive test. You can self-order tests nowadays. Do you know that? If not, READ THIS article I wrote entitled, You Can Order Your Own Blood Work and Lab Tests.
Today, there are labs that do this all day long. It wasn’t like that when I first wrote about this 8 or 9 years ago. There’s one by Quest called the Cardio IQ test. Labcorp offers a test called the “NMR Lipoprofile with Lipids.”