Ask for an advanced lipid panel. Most labs offer that.

MRB10 said:

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Annual physical today. Late 30s.

CHOLESTEROL, TOTAL: 247 H (mg/dL)
HDL CHOLESTEROL: 65 (mg/dL)
TRIGLYCERIDES: 40 (mg/dL)
LDL-CHOLESTEROL: 170 H (mg/dL (calc))
CHOL/HDLC RATIO: 3.8 (calc)
NON HDL CHOLESTEROL: 182 H (mg/dL (calc))
LDL PARTICLE NUMBER: 1907 H (nmol/L)
LDL SMALL: 265 H (nmol/L)
LDL MEDIUM: 449 H (nmol/L)
HDL LARGE: 6084 L (nmol/L)
LDL PATTERN: A (Pattern)
LDL PEAK SIZE: 223.1 (Angstrom)
APOLIPOPROTEIN B: 112 H (mg/dL)
LIPOPROTEIN (a): <10 (nmol/L)
HS CRP: 0.2 (mg/L)
LP PLA2 ACTIVITY: 166 H (nmol/min/mL)

CAC score was 0.
Rest of the labs were great.

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Were you prescribed any treatment or modifications?

Absolutely. I told mine I wanted the advanced lipid panel and it was no problem.

No. A few of my responses on the last page shed some light on the conversations my doc and I had.

Sorry didnt see that part.

I did an annual checkup for the first time in a couple of years and my numbers were slightly elevated. Doctor wasn't worried, just gave me the standard better diet, etc. suggestions. But the only reason I'm kind of concerned is my diet has been solid. Since August I'm down about 27 lbs (208 to 181). I've been tracking everything I eat and cutting out sweets and most processed foods since mid-August as well.

CHOLESTEROL, TOTAL: 202 (mg/dL) (stated a preferred range of <200)
TRIGLYCERIDES: 58 (mg/dL)
HDL CHOLESTEROL: 69 (mg/dL)
LDL-CHOLESTEROL: 122 (mg/dL) (stated a preferred range of <100)
NON HDL CHOLESTEROL: 133 (mg/dL)
CHOLESTORAL/HDL RATIO: 2.93

Any reason to be concerned or actions to take?

ETA: I'm 38, male

Is this before or after the weight loss. If before, I'm sure you panel is better by now. If not, try getting an ApoB and LP(a). That'll help figure out risk a little better.

bigtruckguy3500 said:

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Is this before or after the weight loss. If before, I'm sure you panel is better by now. If not, try getting an ApoB and LP(a). That'll help figure out risk a little better.

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During, but after a significant amount of weight loss. Started losing the weight in August. Bloodwork was in late October, I was at 188 then.

Tailgate88 said:

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MRB10 said:

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Annual physical today. Late 30s.

CHOLESTEROL, TOTAL: 247 H (mg/dL)
HDL CHOLESTEROL: 65 (mg/dL)
TRIGLYCERIDES: 40 (mg/dL)
LDL-CHOLESTEROL: 170 H (mg/dL (calc))
CHOL/HDLC RATIO: 3.8 (calc)
NON HDL CHOLESTEROL: 182 H (mg/dL (calc))
LDL PARTICLE NUMBER: 1907 H (nmol/L)
LDL SMALL: 265 H (nmol/L)
LDL MEDIUM: 449 H (nmol/L)
HDL LARGE: 6084 L (nmol/L)
LDL PATTERN: A (Pattern)
LDL PEAK SIZE: 223.1 (Angstrom)
APOLIPOPROTEIN B: 112 H (mg/dL)
LIPOPROTEIN (a): <10 (nmol/L)
HS CRP: 0.2 (mg/L)
LP PLA2 ACTIVITY: 166 H (nmol/min/mL)

CAC score was 0.
Rest of the labs were great.

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Can I ask my doc to order the blood test with the different sizes? Mint just says HDL, LDL and Lipids.

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you should,

the standard lipid panel (chol, HDL, LDLc, trig) is an incomplete picture

ApoB, LPa, LDL-particle (LDLp), LDL-small, OxLDL are all very important markers regarding the bodys cholesterol status

We're almost the same weight and age. If that was me, I wouldn't rush to a statin if you didn't want to. I would wait till you have another set of labs at your new weight, and that included ApoB and Lp(a). If all looks good, then of course stay the course.

That being said, my labs do look a good bit better than yours, and I still decided to take a 5mg crestor once or twice weekly. It's a pretty baby dose of statin, and probably makes minimal difference. But based off my research into the topic I do feel as though it will minimize my risk of heart or brain issues long term.

https://www.foxnews.com/health/daily-pill-slashes-bad-cholesterol-levels-60-year-long-trial

Quote:

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A new daily pill could reduce bad cholesterol levels by 60%, according to a new study.

Enlicitide, which was developed by Merck, lowered "bad" LDL cholesterol by more than half in a global study published this week in JAMA, the journal of the American Medical Association.

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So I'm seeing people virtually currently.

If you are interested in speaking with a dietitian (I am one) let me know.

Your health insurance should cover it

Any recs on a cardiologist in dfw? I went to one who was only interested in basic lipid panels, wanting someone to discuss a full panel, apo a/b, lpa, etc.

Thanks!

My two cents: last year my LDL was 157. Doc said try Zetia (I did not want a statin due to link to increased blood sugar). 6 months later LDL was 103. Doc still wanted me to go on statins because "under 100" was his magic number. Nope. 54 point drop seems ok to me.