High ldl-p and apob

Newcomer introductions, personal anecdotes, caregiver issues, lab results, and n=1 experimentation.
EB4129
New User
New User
Posts: 2
Joined: Sat Feb 26, 2022 3:26 pm

High ldl-p and apob

Post by EB4129 »

Hi there. First time poster, intermittent lurker.
Just hoping for some advice regarding ldl-p and apob. I am a 38 y/o female APOe 3/4 who struggles with elevated ldl p and apob. I am insulin sensitive and not overweight. My current particle number is 2045 but I have gotten it as low as 1200 in the past eating a very low saturated fat diet. The thing is a super low saturated fat diet is not sustainable for me. I tend to need a lot of food and animal protein makes me feel better. My apob is also always elevated :80’s-120. My Lpa is low (24), my hdl is high 80-90’s, trigs are 60-100. My main area of modification seems to be ldl p and apob. Other than a very low sat fat diet (which is not sustainable for me) I am thinking the only thing to bring down my numbers is a statin. I am thinking of taking a statin 3 days per week. I’d appreciate anyone’s advice or thoughts. I don’t have a family history of heart disease but I do have a grandmother with early onset Alzheimer’s. Also I have read the primer before.
Thanks!!
User avatar
NataliaReyn
Contributor
Contributor
Posts: 98
Joined: Fri Jan 20, 2023 11:29 am
Location: Colorado
Contact:

Re: High ldl-p and apob

Post by NataliaReyn »

EB4129 wrote: Wed Mar 15, 2023 3:20 pm Hi there. First time poster, intermittent lurker.
Just hoping for some advice regarding ldl-p and apob. I am a 38 y/o female APOe 3/4 who struggles with elevated ldl p and apob. I am insulin sensitive and not overweight. My current particle number is 2045 but I have gotten it as low as 1200 in the past eating a very low saturated fat diet. The thing is a super low saturated fat diet is not sustainable for me. I tend to need a lot of food and animal protein makes me feel better. My apob is also always elevated :80’s-120. My Lpa is low (24), my hdl is high 80-90’s, trigs are 60-100. My main area of modification seems to be ldl p and apob. Other than a very low sat fat diet (which is not sustainable for me) I am thinking the only thing to bring down my numbers is a statin. I am thinking of taking a statin 3 days per week. I’d appreciate anyone’s advice or thoughts. I don’t have a family history of heart disease but I do have a grandmother with early onset Alzheimer’s. Also I have read the primer before.
Thanks!!
Hello, EB4129!

As a Support Team Intern, I would like to make sure you feel welcomed!
Thank you for sharing this information on our forum. I am sure other members will be able to provide some feedback as well.
Sounds like you're doing great job tracking your numbers and taking interest in addressing the markers you're worried about. I wonder if you have already explored Cholesterol, Lipids, and Treatments, including statins article on Wiki. Lots of information there, including some other strategies besides limiting saturated fat.
Also, we have a list of providers just in case you want to explore that as well Searching for a Healthcare Practitioner and ApoE4-Aware Healthcare Practitioners.

To learn more about navigating this site consider How-To Guide.

Two more tips to improve your experience here:
  • If you want to Search for posts on a specific topic, you can use the text box labeled "Search" right under your user name and enter those specific terms.
  • To be sure a forum member is notified of your post, just click use the large quotation mark icon in the upper right corner of they post.
We are here to support you!

Warmly,

Natalia
Functional Medicine Certified Health Coach
Bredesen Protocol Health Coach
User avatar
floramaria
Support Team
Support Team
Posts: 1434
Joined: Tue Jul 04, 2017 11:22 am
Location: Northern New Mexico

Re: High ldl-p and apob

Post by floramaria »

EB4129 wrote: Wed Mar 15, 2023 3:20 pm Hi there. First time poster, intermittent lurker.
Just hoping for some advice regarding ldl-p and apob. I am a 38 y/o female APOe 3/4 who struggles with elevated ldl p and apob. I am insulin sensitive and not overweight. My current particle number is 2045 but I have gotten it as low as 1200 in the past eating a very low saturated fat diet. The thing is a super low saturated fat diet is not sustainable for me. I tend to need a lot of food and animal protein makes me feel better. My apob is also always elevated :80’s-120. My Lpa is low (24), my hdl is high 80-90’s, trigs are 60-100. My main area of modification seems to be ldl p and apob. Other than a very low sat fat diet (which is not sustainable for me) I am thinking the only thing to bring down my numbers is a statin. I am thinking of taking a statin 3 days per week. I’d appreciate anyone’s advice or thoughts. I don’t have a family history of heart disease but I do have a grandmother with early onset Alzheimer’s. Also I have read the primer before.
Thanks!!
Hi EB4129, I share your difficulty with sustaining a super low saturated fat diet. Have you considered getting a coronary calcium scan? When my PCP was recommending a statin for me based on high LDL and LDL particle # she agreed to order that first. Based on my result coming back as zero she did not think a statin would be necessary. That's just my one little experience out of what probably amounts to thousands of posts in these Forums discussing cholesterol, LDL particle numbers, apob, statins, and heart health. For a deeper dive, you could use the search function, located under you user name in upper right hand area of the page. Heart health is discussed a lot. You could type in apob, LDLp , statins, coronary calcium scans (CAC).....any of those will take you on a journey.
Functional Medicine Certified Health Coach
IFM/ Bredesen Training in Reversing Cognitive Decline (March 2017)
ReCODE 2.0 Health Coach with Apollo Health
Plumster
Senior Contributor
Senior Contributor
Posts: 636
Joined: Mon Oct 30, 2017 6:19 pm

Re: High ldl-p and apob

Post by Plumster »

Hi EB4129,

I agree with Floramaria that a coronary calcium scan would be a good baseline. You can take a tablespoon of whole psyllium husk mixed in water with your meal high in saturated fat. (You can find psyllium husk at health stores, Whole Foods, etc.) It helps you absorb less of the fat. In general, fiber is really helpful in combatting the effects of saturated fats, especially viscous fiber (brown rice, oatmeal, legumes, etc) that forms a gel in your gut. The cardiologist Belardo recommends at least 60g of fiber a day--vegetables, fruits, legumes, etc.--to help lower cholesterol.
Last edited by Plumster on Thu Aug 10, 2023 12:44 pm, edited 1 time in total.
e3/4 MTHFR C677T/A1298C COMT V158M++ COMT H62H++ MTRR A66G ++ HLA DR
User avatar
JML
Support Team
Support Team
Posts: 490
Joined: Wed May 31, 2017 3:40 pm
Location: Chicago area
Contact:

Re: High ldl-p and apob

Post by JML »

EB4129 wrote: Wed Mar 15, 2023 3:20 pm I am thinking the only thing to bring down my numbers is a statin. I am thinking of taking a statin 3 days per week.
One thing to consider if you do decide to take a statin is to ask your doctor about using a hydrophilic statin rather than a lipophilic statin. This is a recommendation of Dr. Bredesen (p. 126 of The End of Alzheimer's Program).
Julie
Daughter of 4/4
Functional Medicine Certified Health Coach
National Board-Certified Health & Wellness Coach
ReCODE 2.0 Certified Health Coach
User avatar
MarcR
Mod
Mod
Posts: 2028
Joined: Wed Mar 05, 2014 8:28 pm
Location: Sammamish, Washington, US

Re: High ldl-p and apob

Post by MarcR »

Before tinkering with your body's cholesterol homeostasis, I think you should consider the possibility that nothing at all is amiss. Do you believe Peter Attia and Thomas Dayspring, or do you believe Vladimir Subbotin and your daily experience of health and wellbeing? More here.

The hypothesis that LDL particles directly cause cardiovascular disease in dose-dependent fashion rests on observational data and the fallacious assumption that correlation implies causation. Even worse, that data is tainted and supercharged with the inclusion of results from people with familial hypercholesterolemia, a genetic disorder that causes a variety of malfunctions in LDL receptors. This is like lumping Type 1 and Type 2 diabetes or familial Alzheimer's disease (FAD) and late onset Alzheimer's disease (LOAD) together.

But in this case, I think we are lumping a disease state together with a physiologically normal, health state. What's happening functionally in these two people with LDL=300 mg/dL?
  1. High body fat percentage, sedentary, high blood sugar, heavy alcohol consumption, smoking, poor immune function, feels poorly
  2. Lean and fit, regular exercise, seldom sick, high overall well-being
Group 2 member Dave Feldman has spent years exploring that rabbit hole, and he offers an alternative hypothesis, the Lipid Energy Model, which suggests that high HDL, high LDL, and low triglycerides is a normal, functional phenotype in which lipids are used to distribute energy in the form of fatty acids to cells throughout the body. A recent paper is here, and much more information and a community of healthy people with "high" cholesterol can be found at his website.
EB4129 wrote: Wed Mar 15, 2023 3:20 pm
Quantifier
Contributor
Contributor
Posts: 127
Joined: Sat Feb 20, 2021 3:48 pm

Re: High ldl-p and apob

Post by Quantifier »

The connection between LDL-C (but more strongly ApoB) and heart disease relies on more than correlation. Mendelian Randomization studies show that people with a genetic tendency towards high LDL-C (not just from monogenic familial hypercholesterolemia, but polygenic risk) have a higher cardiac risk. Since in these people LDL-C is elevated by genetic causes compared to others from the same population (ie environmental causes are roughly the same between those with the genetic tendency towards elevated LDL-C and those without) the elevation in LDL-C happens before the increase in risk. Also, the longer LDL-C levels are reduced the lower the risk.

The current view is that the longer one is exposed to high levels of ApoB particles the greater one's risk. EB4129, you are a young person, so you are going to be living in your body for a long time (I hope!) so this is the time to be more cautious rather than less. Increasing fiber as Plumster suggests sounds like a good idea to me.
User avatar
MarcR
Mod
Mod
Posts: 2028
Joined: Wed Mar 05, 2014 8:28 pm
Location: Sammamish, Washington, US

Re: High ldl-p and apob

Post by MarcR »

As a purely statistical analysis, Mendelian randomization is blind to functional factors. In a world beset by metabolic dysfunction and the resulting chronic disease, MR plausibly shows LDL as a causative factor within Group 1 ...
MarcR wrote: Fri Mar 17, 2023 12:05 pm But in this case, I think we are lumping a disease state together with a physiologically normal, health state. What's happening functionally in these two people with LDL=300 mg/dL?
  1. High body fat percentage, sedentary, high blood sugar, heavy alcohol consumption, smoking, poor immune function, feels poorly
  2. Lean and fit, regular exercise, seldom sick, high overall well-being
... while offering little regarding root cause(s). Meanwhile, Subbotin offers a compelling root cause explanation that relegates high LDL to an exacerbating role when the root cause is active. If the Lipid Energy Model is correct, those of us who do not suffer from metabolic dysfunction are doing ourselves harm by consuming statins and thereby reducing the efficiency of fatty acid beta-oxidation as a source of ATP. The source of that harm is well-documented as statins are known to increase insulin resistance and blood sugar.
EB4129
New User
New User
Posts: 2
Joined: Sat Feb 26, 2022 3:26 pm

Re: High ldl-p and apob

Post by EB4129 »

Thank you everyone who has replied. I am planning on seeing a functional medicine physician for additional testing but my appt is not until July. One thing I failed to mention with my most recent numbers was that I took red yeast rice x 3 months prior to testing. I was just interested to see if it affected my numbers but obviously it did not help.

I think I will go ahead and increase fiber in my diet. I bought some psyllium. I also use an infrared sauna 3-4 times per week and am hoping this also helps with cardiovascular health.

I think it would be easier to control my cholesterol numbers if I wasn’t so hungry all the time. But eating and moving are the two things I really like. In case anyone is interested I will post what I ate today (I am personally always interested in what people eat).

Breakfast: 2 scrambled eggs in olive oil, salsa, 1 corn tortilla, oatmeal with maple syrup, decaf coffee with goat milk
Lunch: ground chicken taco meat, beans, salsa, white rice, lettuce, onions, kombucha
Dinner: chicken salad sandwich, sweet potato soup

I find I do best with a mix of foods. I like variety and will usually have beef, chicken, pork, fish or shrimp every week. I almost always have eggs for breakfast. I like dark chocolate a lot but have been trying to reduce this.

Thanks again for the replies.
Quantifier
Contributor
Contributor
Posts: 127
Joined: Sat Feb 20, 2021 3:48 pm

Re: High ldl-p and apob

Post by Quantifier »

MarcR wrote: Fri Mar 17, 2023 2:33 pm As a purely statistical analysis, Mendelian randomization is blind to functional factors. In a world beset by metabolic dysfunction and the resulting chronic disease, MR plausibly shows LDL as a causative factor within Group 1 ...
MarcR wrote: Fri Mar 17, 2023 12:05 pm But in this case, I think we are lumping a disease state together with a physiologically normal, health state. What's happening functionally in these two people with LDL=300 mg/dL?
  1. High body fat percentage, sedentary, high blood sugar, heavy alcohol consumption, smoking, poor immune function, feels poorly
  2. Lean and fit, regular exercise, seldom sick, high overall well-being
... while offering little regarding root cause(s). Meanwhile, Subbotin offers a compelling root cause explanation that relegates high LDL to an exacerbating role when the root cause is active. If the Lipid Energy Model is correct, those of us who do not suffer from metabolic dysfunction are doing ourselves harm by consuming statins and thereby reducing the efficiency of fatty acid beta-oxidation as a source of ATP. The source of that harm is well-documented as statins are known to increase insulin resistance and blood sugar.
If you want data from lean, active individuals, how about the hunter-gatherers in Hunter-gatherers as models in public health?
The Hadza of Tanzania are very active, have low lipids (some too low to measure with the field equipment used, so the values assigned were likely higher than actual ones). You won't find your lean, healthy people with high LDL-C there. But you can try this (I wish Deirdre Tobias published the results, but it seems she just did it as an exercise) - she compared women whose data was in UK Biobank, and initial LDL-C levels were a good predictor of death, even among women who were metabolically healthy and had high HDL and low triglycerides.
Post Reply