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Hi there,

I recently had a lipid profile done and just got my results, which I'm including attached as a PDF.

It's going to be a month or so before I can talk about them with my doctor, and I'd like to know, based on the totality of the results, what my cardiovascular assessment is overall: low risk, medium risk, or high risk.

I find the results difficult to interpret. In several areas (total cholesterol, triglycerides, LDL Particle NU, Apolipo B, Lipoprotein (A), HS-CRP, and LP-PLA2), I'm in the optimal/low risk category! However, my HDL has always been low, and other areas (LDL Small, LDL Medium, HDL Large, LDL Pattern, LDL Peak Size), I'm in the high risk category! So I'm not sure what to think about it all.

Traditional risk factors are being overweight/obese and prehypertension. However, I exercise regularly, am working with a nutritionist to eat healthier/eliminate processed food, eat lots of fruits and veggies, concentrate on healthy fats (olive oil, avocados, nuts, etc.), take supplements to help (Kyolic aged garlic, whole foods multi, fish oil, and others), and don't smoke. I do drink, but moderately most of the time, and I'm trying to lose weight.

Aside from the cholesterol results, I'm aware Lyme came back positive, and I'm having a followup test regarding that. Please feel free to bring up anything else you notice that might be worth noting.

Thanks much for your help/interpretation. I'm hopeful the aggregate results of this bloodwork isn't bad, but I need to know either way.

Category: Adult Cardiologist

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Dr. Deepu Sebin Sebastian is online now

Expert:  Dr. Deepu Sebin Sebastian replied 4 Days.

Thank you for your query at DoctorSpring.com
I understand your concern.
I have reviewed all your reports and I can assure you, when it comes to cholesterol, the values are really good, and it seems like your efforts in losing weight is reaping you good results.
To predict the risk of terminal life events like Stroke/MI, we need to consider the values of Total Cholesterol, LDL ( bad cholesterol ), TG, and HDL. The only issue with your report is that the HDL is low, and this should be over 40 ideally. This is the protective factor. However, with consistent exercise and loss of weight, the HDL levels will also improve.
I will advise you to continue the same diet and exercise regime as of now, as they have kept your values in a very good range.
Regarding Lyme disease, yes you need to follow-up. What are your current symptoms?
Feel free to discuss further,

Patient replied :

Hi and thanks for your feedback!
I'm happy you feel my numbers are good! Would you say, even with HDL where it is, I'm still relatively low risk overall?
For some reason, HDL has always been low for me (though my hope is antioxidants and things like the aged garlic can help make up for any lower HDL numbers for the time being and keep my cardiovascular system clear). Is there anything, aside from not smoking, eating well, drinking moderately, and exercising regularly, I can do to boost HDL? Could the reason mine tends to be low be genetic?
And from the sounds of things, you aren't too concerned about the various particle sizes being in the risky ranges since total cholesterol and LDL are good?
As far as Lyme, I've already had the followup bloodwork and am waiting for the results. The initial test was prompted because I've had random bodywide twitching since late 2013 that has yet to be explained (but also improved greatly from when it first started). That was my only symptom, and Lyme was a shot in the dark at a possible explanation - my doctor was quite surprised that initial test came back positive.
Thanks again for your help!

Expert:  Dr. Deepu Sebin Sebastian replied 3 Days.

It's combination of low LDL and high HDL is important to reduce cardiovascular risk. Though your HDL level is a bit on lower side I can assure you that it will come up with lifestyle modifications only.Yes, you have rightly said that small size and medium size are little higher in levels which slightly increases the risk it should come down with low carbohydrate and low low-fat diet and healthy lifestyle which you are already following. If not you might need to see a cardiologist to who might prescribe you lipid-lowering drugs.

Patient replied :

Thank you for the clarification.
I do hope my HDL will raise and my particle sizes will be modified, but I recall even from years ago (though I am living much more healthily now) HDL has always been low (I think this is the first time they've looked at particle size). I've also been exercising and eating more healthily for a while now, so these numbers should reflect some of that, but I will continue to try to improve.
Assume for the moment these levels (including current LDL, HDL, Triglycerides, pattern B, and particle sizes) stay where they're at. Would you say, overall, my risk is low, medium, or high when we take everything in aggregate?
I have mixed feelings about going on something like statins, but I can talk to my doctor. I'd prefer to keep my risk low as naturally as possible.

Expert:  Dr. Deepu Sebin Sebastian replied 2 Days.

You are overall at low risk considering all your values.
There is no question of statins now.
Please maintain your lifestyle and avoid fatty foods as you have been doing.

Dr. Deepu Sebin Sebastian
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MD, Internal Medicine - Stanley Medical School
Medical School - MBBS - Govt. Medical College, Kottyaam

Diagnostic Prediction - Stanford School of Medicine
Received Specialty training in Critical Care, Cardiology, Neurology, Gastroenterology, Nephrology from Stanley Medical College and in Endocrinology, Rheumatology.

Hematology and Geriatrics from Madras Medical College.
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