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Aug 31

Lab Tests – Measuring your Metabolic Health

Note from Craig–

In addition to helping Dave wrangle data behind the scenes, I will occasionally be dropping in as a guest writer to contribute some additional content. This blog was an invaluable resource when I first found out I was a hyper-responder, and I’m looking forward to helping others understand their own cholesterol situations. Hope you enjoy!

Background

I started on Keto five months ago as an experiment in endurance running. Tall and slim, I’d get funny looks whenever someone heard I was on a diet. But, if they didn’t have to eat it, nobody cared much about what was on my plate.  Then, the cholesterol bugaboo appeared.

Total Cholesterol 358
Triglycerides 66
HDL-C 114
LDL-C 231

(Frequent readers may find this pattern familiar.)

Suddenly, everyone was “concerned about my cholesterol” – my doctor, my mom, distant relatives. I wasn’t worried during the test, since I heard it was possible to manipulate, but the seed of doubt had been planted. I now needed a lot more evidence to prove to myself, and others, that I wasn’t doing myself harm with this experiment.

I redoubled my efforts reading and watching everything I can find on the links between diet, health, disease. I was especially worried about heart disease (what they say might kill me), and metabolic syndrome (what I think is most likely to kill them). Fortunately, a certain N=1 pioneer had already made a lot of progress on this path, and he was generous with his advice.

This article is one software engineer’s opinion on what blood tests are worth your while when you get your annual poke in the arm. These tests will provide the necessary feedback for those interested in “debugging” and “optimizing” the complex system that is their body.

If you can’t measure it, you can’t improve it. 

– Peter Drucker.

Asking for Tests

Ideally, you want your doctor to order the tests you’re seeking so that your insurance pays for it. But different doctors can have different reactions to these requests. Some will happily rubber-stamp your request without question, others will ask why you are interested in these tests and how you found out about them in the first place. If you find your doctor won’t order the tests you’re asking for, you can usually order them privately through a service like http://RequestATest.com.

If find yourself needing to explain ‘why’, here are some arguments that your doctor might find persuasive.

You will use this data to make informed decisions about your lifestyle.

“I am actively tracking my food, sleep, stress, and exercise and I want to know how my body is doing. Even though I feel much better on my diet, I’d consider changing if there was good evidence something was going wrong.”

You want to establish a broad baseline of health and disease risk.

“I’m concerned that conventional diets contribute to obesity and disease. I choose my diet to help with that, and I want to see if I’m making progress across the board. Then, I can tell if future changes help or hurt.”

Your body uses a higher percentage of energy from fat compared to typical diets.

“There’s a good reason that my numbers might be unusual. I want to see if my body is working well, but differently, or if something is going wrong. I also want to be careful when considering treatments, since they are rarely tested on people with my diet.”

Treating complications later is much more costly than testing now.

“A diabetes diagnosis more than doubles your average lifetime medical expenses, while a heart bypass surgery is over $100,000. I want to accurately assess my risk now, so I can take action to improve my chances of avoiding these outcomes.”


The Tests

Every time:

  • Insulin
  • Hemoglobin A1c
  • C-Reactive Protein (High Sensitivity, Cardiac)
  • Comprehensive Metabolic Panel (14)

Tracking your lipids:

  • NMR Lipoprofile (Nuclear Magnetic Resonance)
  • and/or Apolipoprotein A1, B

Tracking your risk of metabolic syndrome:

  • GGT
  • Ferritin, Serum
  • Uric Acid, Serum
  • Homocyst(E)Ine, Plasma

Tracking your general health:

  • Vitamin D, 25-Hydroxy
  • Cortisol
  • Cbc With Differential
  • Iron And Tibc-Iron Binding Capacity (TIBC)

Only once if normal:

  • Apolipoprotein Lp (a)
  • Thyroid Panel

Apolipoprotein A-1, B

Apo A-1 is the distinctive protein of HDL. Apo B is the distinctive protein of VLDL, IDL, LDL and Chylomicrons.

Measures the composition of your lipoproteins (the mass of the apolipoprotein), unlike cholesterol tests, which only measure their contents.  The lipoprotein particle tests are much better correlated with outcomes than cholesterol, but those two metrics are often discordant on a low-carb diet. I’d certainly want to have both results before making any decisions about “my cholesterol”.

$49 at RequestATest

Apolipoprotein Lp (a)

Apo (a) is the distinctive protein of lipoprotein(a), a subclass of LDL.

Lp(a) appears to be an independent risk factor for CVD beyond other blood lipid markers. It is largely determined by genetics, so testing it at least once will inform the importance of other more readily available LDL numbers. This result could raise the stakes of any lifestyle tradeoff you make.

$49 at RequestATest

Cbc With Differential

Measures the composition of your red and white blood cells.

Red blood cells deliver oxygen for burning. White blood cells are part of the immune system that protects your body from infection. This test helps give a broad picture of your health.

$29 at RequestATest

Comprehensive Metabolic Panel (14)

Measures various minerals and nutrients (including electrolytes) involved in your body’s processes.

This is a common test used to screen for a variety of conditions and nutrient deficiencies. This panel comes in (8) and (14), so be sure you specify the number.  This test helps give a broad picture of your health.  You can also use it to tweak your nutrition, for example, adding more salt if sodium is low.

$29 at RequestATest

Cortisol

Cortisol is a steroid hormone that your body releases in response to stress.

Chronic stress is extremely taxing on the body and can contribute to pain, hunger signaling, and heart disease.  Measuring your stress allows you to judge the effectiveness of your stress-reducing efforts, like exercise and sleep.

$45 at RequestATest

C-Reactive Protein (High Sensitivity, Cardiac)

CRP is a protein produced by your liver as part of the inflammatory response.

Inflammation is a process your body uses to fight foreign invaders. Appropriate when you scrape your knee, but problematic when prolonged. High CRP can be a warning sign that your body is reacting to something in your diet (gluten or vegetable oils) or body (damaged arteries).

$59 at RequestATest

Ferritin, Serum

Ferritin is a protein that stores Iron.

Elevated ferritin can be an indicator of high iron or metabolic syndrome. Recent research suggests that it may even play a causal role in CVD.  You can also mitigate high ferritin with regular blood donations. This test helps give a score in your struggle against metabolic syndrome.

$29 at RequestATest

GGT

γ-Glutamyl Transferase is an enzyme found in many parts of the body.

Elevated GGT is a diagnostic marker for diseases of the liver and pancreas. This test helps give a score in your struggle against metabolic syndrome.

$29 at RequestATest

Hemoglobin A1c

Hemoglobin A1c measures the glycation of your red blood cells and is a used to diagnosis diabetes.

Glycation is when blood sugars stick to a protein or lipid in your body, causing trouble. HA1c is an approximation of your average blood glucose of the past 3-months. This test helps give a score in your struggle against metabolic syndrome. Amy Berger’s low-carb testing series covers HA1c in detail.

$29 at RequestATest

Homocyst(E)Ine, Plasma

Homocysteine is a non-protein α-amino acid.

Homocysteine in the blood can make you more vulnerable to endothelial damage, so it’s a risk factor for CVD. These results could raise the stakes of any lifestyle tradeoff you make.

$69 at RequestATest

Insulin

Insulin is a control hormone that regulates the metabolism and storage of nutrients.

Elevated Insulin is part of the vicious cycle of metabolic syndrome. Although not as informative as a full Kraft Test (multiple insulin measurements tracking the response to glucose intake), fasting insulin provides a much better snapshot than glucose or HbA1c.  With the prevalence of diabetes in society today, it’s a wonder this test is not standard. Amy Berger’s a low-carb testing series covers Insulin in detail.

$49 at RequestATest

Iron And Tibc-Iron Binding Capacity (TIBC)

Iron is an essential nutrient used to produce red blood cells.

This test measures your levels of iron and proteins that transport iron. This test helps give a broad picture of your health.

$29 at RequestATest

NMR Lipoprofile (Nuclear Magnetic Resonance)

The NMR lipoprofile measures the number and size of your lipoproteins.

Not all lipoproteins are created equal, and those on a low carb diet often have much more favorable size distributions.  This gives the most detailed snapshot of your lipid system is working.

$99 at RequestATest

Thyroid Panel

The thyroid gland regulates energy use in your body in a multi-step process. This panel measures the levels associated with each step of that process.

How well your body metabolizes nutrients affects energy levels, heart rate, weight regulation, and temperature.  This test helps give a broad picture of your health. Amy Berger’s a low-carb testing series covers Thyroid in detail.

$49 at RequestATest

Uric Acid, Serum

Uric acid is an end product of purine breakdown and is found in urine.

Excess uric acid levels can cause gout and kidney stones. Your levels are affected by diet and kidney function, but also may be an independent risk factor for diabetes. This test helps give a score in your struggle against metabolic syndrome.

$29 at RequestATest

Vitamin B12 And Folate

Vitamin B12 is an essential vitamin used for making red blood cells and DNA.

Excellent B12 levels should be a expected on a diet rich in animal products. This test helps give a broad picture of your health.

$69 at Requestatest

Vitamin D, 25-Hydroxy

Vitamin D is a fat soluble vitamin needed for mineral absorption (calcium, magnesium, phosphate, zinc) and metabolic function.

Your body converts cholesterol to Vitamin D in the skin when exposed to sunlight. However, since we get much less sun exposure today, it often requires active supplementation to achieve adequate levels.

$59 at RequestATest

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BobM
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BobM

They say Lp(a) is genetic, but mine has decreased by about 28% in 3 years, and this also seems to go up for long fasts.

Bonnie
Guest
Bonnie

Thank you for this list! I had very similar lipid results last spring and my GP was adamant I should take Statins. Of course I would not take such a controversial drug without a lot of research on my part. I am a fit, active 64 year old female. When I asked my GP for access to CAC and further bloodwork, she looked at me and said she was not familiar with the tests, would not be comfortable ordering them and referred me to a cardiologist. That was 3 months ago. I went ahead and paid for a CAC (750 dollars later, score 80) and now, armed with suggestions from your list, I’m heading to Seattle to get bloodwork done there and pay privately.
Since May I have faithfully followed a ketogenic diet with carbs less than 20 and mod. Protein. About 75-80% of my diet are fats (following Dietdoctor and other sites, like this one on what would be healthy fats).
Now I am curious to see what the bloodwork shows. Some tests I can easily get through GP so these are the ones I am ordering from online lab –
C Reactive Protein
NMR Lipoprofile
Apoliproprotein A-1,B
Apoliprotein Lp (a)
Hemoglobin A1C

I’ve had annual bloodwork done for years as I have been diagnosed hypertensive since early nineties. (CBC, electrolytes, thyroid, common blood work always normal). My BP is well controlled (thinking I might be able to get off meds for that as BP is lowering and I’m tracking daily results. GP does not see the need for HgB A1C as my fasting blood glucose has never been high. Do you think I should bother with the HgB A1C?

I’m quite distressed about the CAC score – doesn’t seem fair given I have always been active and other indicators always suggested I am healthy. To know that 75% of women my age have lower CAC scores is distressing. I do seem to have a pretty strong family history of heart disease but they all smoked or were subject to 2nd hand smoke. I wish I had known about CAC tests before now as I would have certainly had one done years ago.

The more I learn about conventional dietary guidelines, big Pharma, big Food industry, AHA and our Canadian Heart Association being sponsored by questionable donors, the more angry I get. And frustrated, impatient with physicians who know sooooo little about nutrition and current research on CVD but still have no qualms perscribinh heavey duty drugs. My GP never once asked about lifestyle, my diet, excercise – just wrote out the script! Ok, I’ll stop ranting but my way of the future is to take control of my own health and learn as much as I can, and continue my own N=1 experimente Thanks again! Great site. I will support this site with monthly contribution and encourage others to do so as well. Great service so freely given.
Bonnie

C
Guest
C

Hi Bonnie,
Methinks you were ripped off with the CAC test….. in my neck of the woods it is $99 self-pay!

BTW, here is an interesting site that estimates your arterial age based upon your CAC score: https://www.mesa-nhlbi.org/Calcium/ArterialAge.aspx

Unfortunate, I am mostly in the same boat as you with the ignorance of doctors. My doctor never heard of most of these tests either… but I was lucky enough that he had heard of a CAC scan and was willing to write me a prescription for one. For most of the blood tests, I use RequestATest.

In my layperson opinion, you should definitely get a Hb A1C test and also a fasting insulin test periodically. You can get A1C self-test kits on Amazon for about $40 for two of them. Since A1C changes very slowly (~3 months due to average life span of red blood cells), it is not necessary to take it all the time. But it is a general marker of your metabolic health.

I also do a fasting insulin periodically, because metabolic problems will show up there before they show up in the A1C. RequestATest also offers that one. Another good insulin test is the Kraft insulin assay, but I haven’t done this test since my fasting insulin is very low. It measures the insulin response to a glucose stimulus over several hours. You can get it here: http://meridianvalleylab.com/Kraft-Prediabetes-Profile

Bonnie
Guest
Bonnie

Thank you for the feedback. That will save me a few dollars. One more question, if I get an A1C done, should I also get a fasting insulin? Or is that redundant?

Bonnie

Amy Paulshock
Guest

Hey,

How do I jump on this bandwagon? I’ve also responded poorly, cholesterol-marker-wise, to low-carb/keto diets, and need help figuring out what to do about it. My latest particle count is 2152. My HDL is 132, which I now understand is NOT good. I am insulin resistant and was overweight until I went on this diet about 10 years ago. (no longer :o) Even now my A1c hovers around 5.6- 5.7.

So the icing on the cake is, I have parkinson’s disease and want very badly to be able to stay in ketosis–studies suggest it might be neuroprotective. (And, interestingly, my neurologist said: “Hmm. Your symptoms seem to be worsening very slowly. Huh. Excellent.) (Of course, I am a study of one, so I get it–it means nothing.)

And of course it doesn’t help if I drop dead of heart attack. Anyone have any ideas?

Thanks in advance!

Amy Paulshock
Guest

Thanks for your quick reply!

My understanding is that (sadly) the latest info on HDL is that anything over 100 might be, paradoxically, a bad thing. (Who’da thunk it!)

I know, I know, read those books, and Peter Attia and Thomas Dayspring et al. and I’m not convinced I’m gonna die tomorrow, but I’m not convinced I’m not, either. I guess I’d feel better if I could get my LDL P down to 1600 or so…hedge my bets. I also have some inflammation markers, high Lp-PLA2, Lp(a)-P. And yes I want to get a CAC score! Excellent idea!

I am keto-ing on, but being a bit frantic about it: cut out the MCT and most of the cream and butter. Keto is VERY VERY hard with only olive and avocado oil. And no MCT to cancel out the occasional raspberry! :o(

– amy

Colleen
Guest
Colleen

Amy: I believe from other reading that the MCT is a different structure saturated fat than the dairy, such that you may be able to keep MCT even if you are cutting out diary.

Colleen
Guest
Colleen

Craig or others:

Any thoughts on Quest vs Labcorp? I had a sky high ferritin test with one and shortly thereafter, the other normal (basically an impossible result if both were accurate). I am thinking about rerunning a ferritin at both on the same day. Any thoughts on the cholesterol and other test kits online from Amazon?

Richard Maurer
Guest

Colleen,
Ferritin does bounce around – inflammatory reactions, especially infectious etiology, result in elevated serum ferritin. This helps drive the acute inflammatory response to eradicate the infection. Whenever I see an elevated ferritin, I run a repeat # a couple months later.

Labcorp and Quest in the US are very comparable -Practically, I would consider the results apples to apples. – note that even the same blood sample at the same lab can be up or down up to 5% (I have seen up to 10% on several tests) on repeat tests the same day.

Amy Paulshock
Guest

Colleen–
I wondered about the MCT! I cut out straight coconut oil, but continued w/MCT until recently. Maybe I’ll go back to it. It does help.

Craig–
I try to avoid omega 6 PUFA’s (I mean, OK, we do eat Duke’s mayo once in a while, yes) but I take a teaspoon of ultimate omega 3 every day and eat a fair amt of fish. And yes my meats and dairy are grass fed blah blah I know the drill! :o)

You know, I wish I had my own lab! I’d love to tweak my diet–test my blood….tweak again–test again. Because the whole: try butter, go off butter…try MUFA…try plantain… etc…it’s hard to know what’s working best when you can really only test once a year or so.That’s a long time.

But Craig you brought up the best idea. I am going to get a CAC. I think that will put my mind at ease. Or not.

Jordan
Guest
Jordan

I’ve been fairly strict keto for 1.5 years. Like Dave I’m fairly lean (7-8% BF) and muscular. Had a few cholesterol/blood draws in that time and my cholesterol is high but not as high as some folks here, but I’m not absolutely worried about it at the moment. One thing I am worried about is my inflammation markers. Of the 4 measured (CRP, Fibrinogen, Lp-PLA2 and Myeloperoxidase), all were within optimal range expect Lp-PLA2, which everytime I’ve measured has been greater than detection limit (>600 ng/mL). I’ve never done the cholesterol drop test to see if this changes with dietary fat. Is anyone familiar with this test and know where I can learn more about it? Anyone else have similar experience? I’m happy to include more numbers if that helps.

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[…] were much less common. These included particle counts (HDL-p, LDL-p), glucose, HbA1C. See my previous post for recommendations on the best tests to […]

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[…] 
A good number of the lab tests that I order are very well explained by Dave Feldman on his website The Cholesterol Code, which is amazing. Dave is a senior software engineer and entrepreneur, and he’s created a protocol for people whose cholesterol doesn’t respond the way it normally does on a keto diet. So, you can check out the definition or reason behind certain labs here. […]

Justin J Lomery
Guest
Justin J Lomery

Hey Craig,

I was following a keto diet since March of 2017 fairly strict until mid Sept of 2017.

My bloodwork was taken a week after starting Keto and it was as follows

TC 224
Tri 81
HDL 44
VLDL 16
LDL 164

All other tests were normal

My next bloodwork was taken on 10/30/2017

Mind you the month prior I wasn’t as strict keto and was also,coming off antibiotics and also not sure if Sam-E could have had any effect on the bloodwork but was also taking that for 2 weeks that month.

I also demanded an LP(a) test and CRP test

Results

TC 231
TRI 99
HDL 54
VLDL 20
LDL 157

LPA – 266 NMOL

CRP 0.6 MG

I am quite aware of the whopping L.p.(a) … I am happy my LDL went down a little and my HDL went up a little..I think the CRP is good. Not happy my VLDL went up a little.

The LP(a) though has me very concerned on staying on a keto path. I am considering going full vegan/low oil diet to decrease my LDL as they carry the LP(A) … I’m not sure what to do

Do you think having an L.p. a that high should draw my attention to controlling my cholesterol even though the whole cholesterol concept has been debunked? Or does that go out the window for people with a genetic predisposition like this ? Obviously this has me extremely concerned about which lifestyle/diet to adhere to…Keto or the completely other side of the spectrum…being something like Dr.Furhman or Caldwell type vegan/low fat/no sugar diets.

I am a 37 year old male , weighing 176 and 5 ‘9. Btw.

Appreciate your time in advance.,

Justin
Guest
Justin

Hey Dave,

I was following a keto diet since March of 2017 fairly strict until mid Sept of 2017.

My bloodwork was taken a week after starting Keto and it was as follows

TC 224
Tri 81
HDL 44
VLDL 16
LDL 164

All other tests were normal

My next bloodwork was taken on 10/30/2017

Mind you the month prior I wasn’t as strict keto and was also,coming off antibiotics and also not sure if Sam-E could have had any effect on the bloodwork but was also taking that for 2 weeks that month.

I also demanded an LP(a) test and CRP test

Results

TC 231
TRI 99
HDL 54
VLDL 20
LDL 157

LPA – 266 NMOL°°°°° good is <75NMOL

CRP 0.6 MG

I am quite aware of the whopping L.p.(a) … I am happy my LDL went down a little and my HDL went up a little…I think the CRP is good. Not happy my VLDL went up a little.

The LP(a) though has me very concerned on staying on a keto path. I am considering going full vegan/low oil diet to decrease my LDL as they carry the LP(A) … I’m not sure what to do

Do you think having an L.p. a that high should draw my attention to controlling my cholesterol even though the whole cholesterol concept has been debunked? Or does that go out the window for people with a genetic predisposition like this ? Obviously this has me extremely concerned about which lifestyle/diet to adhere to…Keto or the completely other side of the spectrum…being something like Dr.Furhman or Caldwell type vegan/low fat/no sugar diets.
5
I also take 1000mg of high quality fish oil and 400mg of Coq10 and European Milk Thistle
Just started taking 500mg of pure Niacin too for the LDL and LP(a)
Take a multivitamin /magnesium/L-Arginine and Carnitine/inisotol

I am a 37 year old male , weighing 176 and 5 '9. Btw.

Appreciate your time in advance

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[…] test (NMR) for particle counts, and the standard lipid panel (for redundancy).  I followed my own advice on testing and also got hsCRP, Insulin, Metabolic panel, and […]

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Victoria
Guest

This is an immensely helpful post, thank you so much! I’m a LMHR, but already have CAD. What about calcium for women? I was advised years ago to take large doses of calcium (for osteopenia), which I did, and only recently was advised to reduce it. At the time I asked if it was not atherogenic and was told “No, different mechanism.” No one told me to take K2, I now see I’ve had high calcium the whole time I was developing disease, and eating it like candy, please comment? Also, what about LP-PLA2?

Dave
Admin

Not as familiar with taking calcium as a supplement specifically. But as it happens, I do take K2 (MK7). To what degree it matters I’m semi-skeptical.

The Lp-PLA2 test I feel is a bit “young” right now and its real value isn’t fully field tested. I believe I’ve gotten it around three times (usually lands in the low 200s).

Victoria
Guest
Victoria

Thank you! This is a big deal for women in particular, and I think potentially dangerous, as all the internists and Ob/gyns put women on calcium. I’m working on a new blog to address some of the more obscure things I’ve learned about CAD and this is going to be an area of research for me. The K-2 interaction with bone deposits for mostly small white women I’m thinking is critical when they dose us up on all that extra calcium for so many years because my understanding of one of it’s functions is that it directs calcium toward bone and away from vessels. The fact that this isn’t addressed between the specialized caregivers is more than concerning.

Jamie
Guest
Jamie

Any thoughts why the NMR LipoProfile test from Request A Test does not have HDL Size and Large HDL-P. It appears that this is an option based on LapCorp’s site (https://www.labcorp.com/sites/testmenu/files/123638.pdf) and was part of the report back in the LipoScience days (https://ww5.allinahealth.org/ahs/allinalabs.nsf/page/ColorreportGraph.pdf/$FILE/ColorreportGraph.pdf). Is this info too costly to obtain? Is it not useful?

Reading Peter Attia’s article on HDL (https://peterattiamd.com/the-straight-dope-on-cholesterol-part-vii/), I’m curious about HDL size and other info. Are there other tests that include this? Looks like the CardioIQ Lipoprotein Subfraction may cover: http://requestatest.com/cardio-iq-lipoprotein-subfractionation-testing.

Victoria
Guest
Victoria

I’d appreciate some help with selecting tests. I have CAD, and exercise-induced angina, I’m a LMHR, eating keto, starting some 8/16 fasting. My goal is to reverse my disease and beat the longevity odds while remaining very active and living well. Therefore I want every bit of information about my health I can get from labs.

Craig suggests NMR “and/or” Apolipoprotein A-1, B I’ve got a list of tests from a keto cardiologist which includes fractionation (CardioIQ lipoprotein fractionation ion mobility) and (subfractionation) Cardio IQ Lipoprotein Subfractionation, Ion Mobility) but does not include NMR. What does the NMR test add to or duplicate about these? The doctor did not request Apolipoprotein A-1, B, did not request Apolipoprotein Lp(a) but did add, at my request, LpPLA-2. Can you please illuminate distinctions and overlap if any?

Assistance greatly appreciated!

Sunil Koduri
Guest
Sunil Koduri

I did an NMR test recently my first one but do have lipid test results (HDL, TG, LDL-C, etc.) from past years. See below for the results. If someone can answer why my HDL is getting lower & TG is increasing slightly, that would be great.

LCHF since 3/2017. All tests done with 12-14 hours fasting. Do HIIT 5 days/week

TC – 225 (5/2017). 259 (4/2018). 250 (7/2018)
LDL-C – 117 (5/2017). 168 (4/2018). 165 (7/2018)
LDL-P – 1423 (7/2018)
smallLDL-P – 371 (7/2018)
LDL Size – 21.4 – Pattern A (7/2018)
HDL-C – 95 (5/2017). 80 (4/2018). 72 (7/2018)
HDL-P – 40.2 (7/2018)
TG – 58 (5/2017). 53 (4/2018). 63 (7/2018)
VLDL – 13 (5/2017). 11 (4/2018). 13 (7/2018)

I come out in lowest risk category in Dave’s reporting tool but can’t answer the question as to why HDL is dropping and TG is rising? I even reduced my coffee intake for 3 weeks before my last test (7/2018). Not looking for a medical opinion but a plausible cause(s).

Dave
Admin

Not sure on why your HDL has gone lower, but as per my research, much of this could be variations of your diet in the days just before your blood draw. Needless to say, an HDL-C of 72 is considered extremely good, and a TG of 63 is likewise highly associated with positive health. (See study graphics here: http://cholesterolcode.com/cholesterol-endgame/ )

Sunil
Guest
Sunil

Thanks Dave. Appreciate your input. I would like to get CIMT and CAC tests done. Any suggestions on which lab facilities to get these tests done? I’m being quoted $140 for CIMT in the Seattle area but don’t know if that’s a good price or not? I can also get an ultrasound test done via https://www.lifelinescreening.com/screening-services/abdominal-carotid-artery-disease-screening which is for $149. Debating which one make sense? Appreciate it.

Dave
Admin

My CIMTs I get for $75 each, but I think my doc gives me a discount. So $140 doesn’t sound outlandish. Can’t speak to as many of the other ultrasounds tests outside of CIMT, but you might want to ping Bret Scher on that.

Pati
Guest
Pati

Hello Dave,
I have been following a carnivore based diet–keyword “based” for a little over 90 days. I haven’t been strict about it, but for the most part I primarily try to stick to fatty grass fed meats, pasture raised eggs, some bacon, some pastured chicken, some pork, raw HWC, raw cheddar cheese, coffee, water, electrolytes, celtic sea salt, etc. Anyhow, I’d like to test myself and see how I’m doing. This will be my first test while following this WOE. Prior to this, WOE I was following paleo, whole 30, some keto, primarily eliminating grains, sugars, refined carbs–did have some cheat meals/days here an there. This message is primarily to ask if I need to prepare in any way, besides just the typical water fast prior to my fasting insulin test? I plan on ordering the 4 tests your have above, under “every time”. Do you recommend I do other tests, considering it’s my first time? Also, I don’t have a doctor, so I’ll be ordering via Request A Test and while I search for a doc I’ll be posting my results here or on FB forums under carnivore or other keto forums. Please provide guidance. I’m very interested and would like your advise and support.–Pati

Linda
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Linda

Which insulin test is correct for someone who appears healthy metabolically but wants to ensure fasting insulin is within the normal range? When I go to order the test, there are several available under insulin including: insulin, insulin diabetes antibodies, insulin like growth factor 1&2, insulin like growth factor binding proteins. thanks!

Siobhan Huggins
Admin

Just plain old “insulin” — and make sure you’re water fasted for 12-14 hours before the blood draw.

Linda
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Linda

I just saw the link above goes to the general insulin test. please ignore my previous question.

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FERNDA HQ
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I think this is for diabetics?

Siobhan Huggins
Admin

These tests are for anyone who wants to put their fingers to the pulse of things and check on how they’re doing 🙂

Rob
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Rob

For somebody interested in conducting a variety of diet and lifestyle studies, is there anything in the post’s list of tests that should be added or taken away since it was posted or you all have had more experience?

Also, have you guys run into any self-studies where doing it longer than 7 days produced an appreciable difference (I’m trying to plan how long to try some of these ideas before retesting)?

Siobhan Huggins
Admin

Hi! Funnily enough, I’m working on a 2.0 version of this list right this very second 🙂
Mostly things have been added after we’ve looked into them more.
Generally for lipid related self study I do a 5 days minimum, for things like removing coffee it seems to be two weeks. I think it’d largely depend on what you were looking at.

Rob Wichtman
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Rob Wichtman

I’ll be interested in reading about v2.0 – due to holidays, I probably won’t be try-harding until the new year.

I have a family of APOE4/4’s – both parents, and sister. So, very interested in the whole omega-3, omega-6, MUFA, SFA effects on heart and brain.

I hear you on the “depends” part – still working on the matrix of lifestyle changes to test vs time and $$$ – I dunno fully yet. For sure, effects of caffeine, alcohol, heavy dose omega-3, heavy dose omega-6, MUFA vs SFA, dairy, intermittent fasting, full fasting, …

Is there anything from labcorp or quest that tests for the various sterols – Dayspring and Attia mention it off and on? I didn’t see anything from their sites. I’d be curious to try keto vegan vs keto carnivore. Even if the standard markers may change quite a bit, does it really matter…?
Thanks for the info! Wish we could clone you self-experimentation peeps x1000!

Siobhan Huggins
Admin

I’ll certainly have the 2.0 out by the holidays 🙂
Hopefully the way I’m writing it will make it pretty quick and easy to choose which labs to get, depending on what you’re trying to look for plus budget.
I think the testing they mention is through Boston Heart Labs. I haven’t quite determined how to go about getting it, as it appears to be through a different lab system than LabCorp or Quest, but I haven’t looked into it a lot yet.

Lab Testing Guide 2.0 » Cholesterol Code
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[…] little over a year ago, Craig wrote a post on what lab tests to get to measure your metabolic health. Although the original post still has […]