apoB/apoA1 ratio test

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anne from california
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apoB/apoA1 ratio test

Post by anne from california »

Hi Everybody,

I've been looking further into my lipid counts--familial postmenopausal high cholesterol has kicked in, and my GP is grumbling about my LDL and using words like "statin." (Nope--not after watching my mom's cognition decline rapidly once she started a statin.) My GP won't refer me to a cardiologist or anyone else who would actually order more detailed lipid testing, so I've had Quest's CardioIQ done and also a Precision Health Report on my own. I'll include some of my related numbers below. Mostly, I'm curious about how to get a number for my ApoB/ApoA1 ratio, as I understand that's more telling than ApoB on its own. My insulin resistance seems to be fine, but LDL is showing some signs of trouble.

Do any of you know where I could get that ApoB/ApoA1 ratio done on my own, without going through a physician?

I'd also be eager to hear any thoughts or opinions about my lipid values and whether some dietary changes might be in order. Do I need to start seriously scaling back on saturated fat to try and bring those numbers more into line? My weight is low (BMI 18ish), BP is low (105/70ish), moderately active (brisk walk 45+ minutes daily, Pilates), diet low carb most of the time but not always (50–80 gm or below), high fat, moderate protein, tons of veggies, low grains, no beans, no alcohol, follow KetoFlex 14/3. Family history of dementia (mom, age 75+, diabetic, hyperlipidemia, overweight, high alcohol consumption, statin use). I'm 58, ApoE 3/3, no meds, no supplements exc Vit D, MK7, magnesium and fish oil.

Fasting glucose: 83
A1C: 5.1
HS CRP: <0.3
Homocysteine: 8
Insulin: 2.6
Triglyc: 47
Total C: 232
LDL: 134
HDL: 90
NonHDL: 142
ApoB: 96
LDL Particle: 1603
LPa: <10
Large VLDL-P: <0.8
Small LDL-P: <90
Large HDL-P: 14.3
VLDL Size: 36.3
LDL Size: 21.5
HDL Size: 10.4
LDL Pattern: A
60 years old, ApoE 3/3, mother and grandmother have/had late-onset dementia, eager to save brain and optimize health.
Thank you all for sharing your knowledge!
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TheresaB
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Re: apoB/apoA1 ratio test

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anne from california wrote:Do any of you know where I could get that ApoB/ApoA1 ratio done on my own, without going through a physician?
Our wiki includes this subject Direct to Consumer Lab Testing Options which offers a number of options. I called up just one of the options, DirectLabs, and they offer an Apolipoprotein Assessment test for $88.
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Re: apoB/apoA1 ratio test

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anne from california wrote: Do any of you know where I could get that ApoB/ApoA1 ratio done on my own, without going through a physician?
Life Extension offers this test at $55.
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Tincup
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Re: apoB/apoA1 ratio test

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My ApoE 4/4 wife & I have a doc who isn't really concerned about our LDL He's more concerned with small LDL and oxidized LDL. As your small LDL particles are low, the small LDL-C is likely low as well. As a non-MD, your lipids look great, though a statinizer wouldn't be happy. There is a correlation of A1 to HDL and with yours at 90, I'm guessing your A1 will be as well. Hence your B/A1 ratio will likely be stellar.
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anne from california
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Re: apoB/apoA1 ratio test

Post by anne from california »

Tincup wrote:My ApoE 4/4 wife & I have a doc who isn't really concerned about our LDL He's more concerned with small LDL and oxidized LDL. As your small LDL particles are low, the small LDL-C is likely low as well. As a non-MD, your lipids look great, though a statinizer wouldn't be happy. There is a correlation of A1 to HDL and with yours at 90, I'm guessing your A1 will be as well. Hence your B/A1 ratio will likely be stellar.
Thanks, Tincup. This has been my hope. It's interesting, though, because on the Precision test, my small LDL was <90, but a Cardio IQ test from about 8 months ago said they were 188 and marked them as high--I rather doubt they've lowered that much in that timeframe, especially since I've made very few lasting changes since the Cardio IQ was run. I'll get the B/A1 ratio run, just to see what it says. Either way, I've recently recommitted to getting off the processed sugar and carbs and extensively high saturated fat (been a bit of a sh*tshow dietwise lately!)--I was actually kind of shocked that the Precision test, which I just did recently, didn't show any dismal metabolic markers.
60 years old, ApoE 3/3, mother and grandmother have/had late-onset dementia, eager to save brain and optimize health.
Thank you all for sharing your knowledge!
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Re: apoB/apoA1 ratio test

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anne from california wrote:
Tincup wrote:My ApoE 4/4 wife & I have a doc who isn't really concerned about our LDL He's more concerned with small LDL and oxidized LDL. As your small LDL particles are low, the small LDL-C is likely low as well. As a non-MD, your lipids look great, though a statinizer wouldn't be happy. There is a correlation of A1 to HDL and with yours at 90, I'm guessing your A1 will be as well. Hence your B/A1 ratio will likely be stellar.
I'll get the B/A1 ratio run, just to see what it says. Either way, I've recently recommitted to getting off the processed sugar and carbs and extensively high saturated fat (been a bit of a sh*tshow dietwise lately!)
Hi Anne! I’m getting my APO A/B tests run next week - I’ll report back what my readings are. From my understanding, APO B is just another way to get LDL particle counts (similar to NMR LDL-P), and that elevated numbers are bad news regardless of LDL size. The test literally say that in the notes.

Anecdotally, my LDL-P shot up to > 1500 when I was in my “saturated fat is fine” phase. I’m looking at you, Bulletproof coffee. I cut that crap out and went back to a Mediterranean Diet and LDL-P came down to ~700. That’s where I intend on keeping it.
Last edited by grommet on Tue Oct 26, 2021 1:21 pm, edited 1 time in total.
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anne from california
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Re: apoB/apoA1 ratio test

Post by anne from california »

grommet wrote:
Hi Anne! I’m getting my APO A/B tests run next week - I’ll report back what my readings are. From my understanding, APO B is just another way to get LDL particle counts (similar to NMR LDL-P), and that elevated numbers are bad news regardless of LDL side. The test literally say that in the notes.

Anecdotally, my LDL-P shot up to > 1500 when I was in my “saturated fat is fine” phase. I’m looking at you, Bulletproof coffee. I cut that crap out and went back to a Mediterranean Diet and LDL-P came down to ~700. That’s where I intend on keeping it.
Yes! Keep me posted! I've got the test form but haven't done it yet. I do use a splash of coconut milk in my coffee, but not MCT (too hard on my gut). I need something to cut the coffee, and I need the coffee . . . VERY interesting about your readings during your "saturated fat is fine" phase.
60 years old, ApoE 3/3, mother and grandmother have/had late-onset dementia, eager to save brain and optimize health.
Thank you all for sharing your knowledge!
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Re: apoB/apoA1 ratio test

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anne from california wrote:
grommet wrote:
Hi Anne! I’m getting my APO A/B tests run next week - I’ll report back what my readings are. From my understanding, APO B is just another way to get LDL particle counts (similar to NMR LDL-P), and that elevated numbers are bad news regardless of LDL side. The test literally say that in the notes.

Anecdotally, my LDL-P shot up to > 1500 when I was in my “saturated fat is fine” phase. I’m looking at you, Bulletproof coffee. I cut that crap out and went back to a Mediterranean Diet and LDL-P came down to ~700. That’s where I intend on keeping it.
Yes! Keep me posted! I've got the test form but haven't done it yet. I do use a splash of coconut milk in my coffee, but not MCT (too hard on my gut). I need something to cut the coffee, and I need the coffee . . . VERY interesting about your readings during your "saturated fat is fine" phase.
Hi Anne :-) I got my test results…Apo B was 74 nmol/L which is a great result and not unexpected since I’ve been limiting saturated fat through a mostly vegan/Mediterranean diet. < 100 nmol/L is considered “normal” and < 80 is preferred for people with high CVD risk which arguably includes people with the the ApoE 4 allele. Conversely, high Apo B is objectively bad.

I also tested Lp(a) for the first time and mine was unfortunately a smidge high @ 87.7 nmol/L. After a little hand-wringing, self research, and consultation with my doctor it seems it’s not much of concern until it starts creeping up past 125 nmol/L. Lp(a) is an independent risk factor for CVD and supposedly is wired in our genes and therefore can’t be changed through lifestyle and/or diet. I’m going to test that theory anyway with supplementation and a retest in 6 months.

Hope that helps! And good luck on your health journey. :-)
Dan
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sandyt
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Re: apoB/apoA1 ratio test

Post by sandyt »

So is apoa1 the same as lp(a)?
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apoB/apoA1 ratio test

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sandyt wrote:So is apoa1 the same as lp(a)?
It’s not. The apoa1 test is a surrogate for HDL particle count (the higher the better), and lp(a), if measured in nmol, counts the number of lp(a) particles (the lower the better). lp(a) is basically an LDL particle with an extra protein marker (apo a) that makes it particularly nasty.

Most doctors don’t order these tests unless there’s a history of CVD that can’t be easily explained via the more traditional lipid panel.


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