I want to introduce you to something called Remnant Cholesterol. And if you’re on a #LCHF/#Keto diet, this will be especially relevant.
It is very simply calculated: you just subtract HDL Cholesterol (HDLc) and LDL Cholesterol (LDLc) from your Total Cholesterol. For example, if your Total Cholesterol were 300, your LDLc 200, and HDLc 80, then you’d have a Remnant Cholesterol (RC) of 20. That’s 300 – 200 – 80 = 20.
You can be forgiven if you thought Total Cholesterol was simply LDLc + HDLc. I thought so too before I was into keto since I was always told, “cholesterol is divided into two types, LDL and HDL…” — wrong! That little gap of cholesterol left over is very, very meaningful. When fasted, it is the cholesterol found in Very Low Density Lipoproteins (VLDL) and Intermediate Density Lipoproteins (IDL). When not fasted, it includes those two and Chylomicron Remnants.
Why This is a Problem
The lipoproteins mentioned above aren’t supposed to be hanging around in the blood for very long. VLDLs pop out of the liver ready to drop off fat-based energy in the form of Triglycerides (TG) from the getgo. They bounce around your vascular system binding to tissues that need the energy and get smaller and smaller from less cargo in the process. From there they are remodeled to IDLs, which are then cleared by the liver or remodeled again to an LDL. This succession of stages to the final LDL takes under 90 minutes. So how long do LDLs hang out? 2-4 days!
This is worth reemphasizing because it’s key to understanding Cholesterol Remnants. Again:
- VLDL half-life is 30-60 minutes
- IDL half-life is less than 30 minutes
- LDL half-life is 2-4 days
So given this, we’d fully expect that the vast majority of lipoproteins that originated from the liver would be in that final LDL stage, even if they started out as VLDLs, right? Yes, of course!
A Simple Traffic Analogy
So imagine it this way… you have two jobs. When you leave the house in your car, you have a lot of food which you then drop off to people around the neighborhood who are hungry. This is supposed to take 1-2% of your time.
The other 98-99% of your time is spent doing the other job — patrolling the same area to help out in other ways. You might be doing citizen arrests of robbers (binding to pathogens) or helping out repairing houses that need it (non-hepatic endocytosis).
But what if there’s a problem with the roadways such as a traffic jam or you’re having a tough time finding people to take any of the food you’re offering (exceeded personal fat threshold). So now you’re spending much more time in that first job because there’s a widespread problem throughout the neighborhood that’s holding you up (and your fellow delivery drivers as well).
How They See It vs How I see It
I’ve been obsessively reading these Remnant Cholesterol papers for a while now. And this is a common opinion among them:
Remnant cholesterol, also known as remnant lipoprotein, is a very atherogenic lipoprotein composed primarily of very low-density lipoprotein (VLDL) and intermediate-density lipoprotein (IDL).
So VLDLs and IDLs themselves are “very atherogenic”?
Let me offer an entirely different viewpoint.
As many long-time readers know, I certainly see the lipids and their containing lipoproteins in our bloodstream as primarily an energy distribution system. That first tiny little stage of delivering energy as VLDLs or Chylomicrons is arguably the bulk of their “work.” Sure, it is done so quickly that it might seem like it is a small part of it. But when you see their largest payload is fatty acids (in the form of triglycerides) and their most reliable “activity” is hydrolyzing it off to the tissues that need it, you realize these guys just aren’t procrastinators, they get the biggest job done early and quickly…
… except when they don’t.
I offer two major reasons VLDLs and IDLs would be slowed down from remodeling to LDLs:
- VLDLs aren’t effectively distributing fat-based energy (triglycerides) and thus they have longer residence time before they can move on (remodel) to their next stages.
- The lipid system is being employed to a higher degree in fighting or repairing a disease state. I won’t be covering this point here, but I’ll return to it in another post.
The first point is well illustrated in many who have hypertriglyceridemia, a commonly associated CVD risk. Often they have a much higher proportion of VLDLs. Why? Not surprisingly, these are likewise associated with hyperinsulinemia and metabolic syndrome.
Perhaps Broken Systems are Atherogenic, Not Lipoproteins?
To put it simply, a problem arrises when the fat-based energy has few places for the VLDL to park it. Those places it does park often can’t stay there long if one is well past their personal fat threshold. The fatty acids keep spilling back out into the bloodstream, binding to albumin, and finally making their way back to the liver to… wait for it… get repackaged into a VLDL again. You see the cycle?
A hypothesis: VLDLs, IDLs, and LDLs are not independently atherogenic, but a body that is undergoing oxidative stress, chronic inflammation, or hyperinsulinemia can be. Yes, lipoproteins participate in this process as that is one of the many “hats” they wear in trying to fight it off and/or repair it. But trying to identify a single lipoprotein to label as the bad guy misses the point of the larger perspective on what’s happening inside the body to begin with.
Remnant vs LDL Cholesterol
Here’s a couple of example RC studies:
From this study: “CONCLUSIONS: Both lipoproteins [RC and LDL] were associated equally with risk of IHD and MI; however, only nonfasting remnant cholesterol concentrations were associated stepwise with increased all-cause mortality risk.” (See graphic at right from the study)
From this study: “CONCLUSIONS: Increased concentrations of both calculated and measured remnant cholesterol were associated with increased all-cause mortality in patients with ischemic heart disease, which was not the case for increased concentrations of measured LDL cholesterol. This suggests that increased concentrations of remnant cholesterol explain part of the residual risk of all-cause mortality in patients with ischemic heart disease.”
I’m hesitant to name any single lipid marker as the “best” one to measure. But if I had to choose right now, I’d be pointing to Remnant Cholesterol (RC). As of this writing, I haven’t found a single study that includes RCs in matchups with other lipids where it isn’t the clear winner in predicting all-cause mortality.
At a minimum, one should be looking at Remnant Cholesterol over LDL Cholesterol. That’s why I added a new tool for people to check their Remnant Cholesterol here on the site. Feel free to do yours and share the results in the comments section.
What This Means for Low Carbers
While I have read through a lot of these studies, I still consider this early in my research on it. I’m naturally thinking through the mechanics and how it applies to those who are LCHF and thus powered by fat.
Here’s a summary of my notes thus far:
- Given the data I have so far from the followers of this site, those going LCHF/Keto will more likely to see an improvement in their RCs, even if they are a hyper-responder.
- Ironically, the reference range for RCs as they apply to those on a fat-based diet may actually be inflated. In other words, I’d expect RCs to actually be higher for appropriate mechanistic reasons given the higher proportion of distribution by VLDLs when LCHF/Keto.
- Like triglycerides, RCs seem to be a great “cheat detector” within my own group of family and friends. Anecdotally, when they fall off the wagon and have too many carbs while still being very high fat, their RCs tend to go up.
Final Note on Fasting vs Non-Fasting Remnants
Lastly, I should warn that much of the newer research on Remnant Cholesterol compares populations who have had non-fasted lipid numbers. I suspect this will not work for those on LCHF/Keto. I’ve already found in my own data and those of others that when on a fat-centric diet, you can often have higher triglycerides relative to a carb-centric diet when taking lipids while not fasted. Hello! You are literally observing triglycerides from the food you just consumed as part of the total amount found in the blood.
TC 254
LDL 163
HDL 83
TG 38
RC 8 mg/dl
RC/HDL 0.1
AIP -0.699 didn’t forget the negative this time
TC/HDL 3.06
TG/HDL 0.46
Heh — the negative matters!
Hello! If remnant cholesterol is a negative value, what does that mean?
TC 511
HDL 67
Trig 101
LDL 467
It could have been due to how the LDL was measured or calculated, or a lab error. If you put your numbers into the report down near the bottom it gives you what your LDL is according to the friedewald equation – an alternative you can use if you get an error. If you use that, you get remnant cholesterol of 20 mg/dL which is just on the cusp of what I would personally prefer to have (<20 mg/dL). Certainly not the worst result to get, and makes quite a bit more sense than a negative number.
Thank yoy so much for taking the time to answer! Doctors here in Greece prescribe statins for those numbers and it’s absurd! With a keto lifestyle, I believe they are going to improve.
Thx dave for another great blogpost. For the last months I also Did a lot op bloodtesting. And was plating with your calculator and I discovered my “best” cholesterol was one month ago. 12/12/2017.Tot chol225- Ldl 137 – HDL:77 – TG 56.
Remnt cholesterol: 0.28mmol/L remnt chol to Hdl 0.14. This was 3 days After a 30Km trailrun -500hm. On keto But After the run I indulged on carbs! Just half a Day. Rest of diet Before and After race was Keto No cal deficit
“Worst cholesterol” 2 days ago: Tot chol: 308 Ldl:232 Hdl:53 TG:114. Remnt chol 0,59 mmol/L remnant chol to hdl 0.43
Diet now is zc high in prot lower in fat. Losing weight So think caloriedeficit. Ran Evening Before 7km easy run.
So endurance and keto healthier than zc?
Maaaaaybe. Again, I think the reference ranges for RCs are probably a little inflated if you are powered by fat. You MUST have a higher proportional load to provide for cells, the catch is that too is influenced by how much sub-q body fat you have as well. Lots of potential confounders.
So no, as I stress in this article, I don’t hang my hat on any marker (or set of markers). Just that if I HAD to point to one, it would be RC. (for now)
Did it again using the Iranian formula instead of Freidwald, and got identical results.
I am a 56 year old female on LCHF:
–==== CholesterolCode.com Report v0.7 ====–
Total Cholesterol: 306 mg/dL 7.91 mmol/L
LDL Cholesterol: 197 mg/dL 5.09 mmol/L
HDL Cholesterol: 100 mg/dL 2.59 mmol/L
Triglycerides: 46 mg/dL 0.52 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 9 mg/dL 0.23 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.09 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.697 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL RATIOS–
Total/HDL Ratio: 3.05
Triglyceride/HDL Ratio: 0.46
Will your formula for RC work when LDL is calculated? I’d think for those with either very high or low TG your formula could be misleading, on the optimistic side for LCHF people with low TG.
Much of the research is with calculated LDL, so I’m working within the parameters we’re stuck with.
But my preference would certainly be that all lipid panels had direct LDL cholesterol measurements!
First, thanks for all the great work you do. I know that this is an old thread, but I am just now seeing it and have a comment/question. I understand your point Re calculated LDL, but if I understand correctly, if LDL is calculated with the fiedewald equation Remnant Cholesterol will just be TG/5. And Remnant Cholesterol will correlate perfectly with TG and will add no additional value to TG as an indicator of risk. Inclusion of calculated LDL results would seem to me to “water down” the true (using measured LDL) Remnant Cholesterol data and obscure the possible value of true Remnant Cholesterol data. I would think it would be appropriate to exclude any data that uses a proxy in the derivation of Remnant Cholesterol. And maybe even compare the TG/5 to the “true” RC to see how good that proxy is among the LCHF community. And then maybe we start looking at the measurement noise that may be the cause of people that have “true data” that calculates RC as a negative number, for instance where HDL + LDL > Total C (all assumed to be measurements). Is my thinking wrong about some part of this? Once again, thanks for your work…
No, you’re on the right track. RC being effectively TG/5 is indeed relevant with LDL is calculated. You may have noticed I don’t put as much effort into discussing RC these days as it’s hard to explain it in detail. So I put more toward talking about triglycerides directly, which tightly track with RC/RLp (as you’d expect).
–==== CholesterolCode.com Report v0.7 ====–
Total Cholesterol: 386 mg/dL 9.98 mmol/L
LDL Cholesterol: 233 mg/dL 6.03 mmol/L
HDL Cholesterol: 138 mg/dL 3.57 mmol/L
Triglycerides: 52 mg/dL 0.59 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 15 mg/dL 0.39 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.11 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.782 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL RATIOS–
Total/HDL Ratio: 2.8
Triglyceride/HDL Ratio: 0.38
–==== CholesterolCode.com Report v0.7 ====–
Total Cholesterol: 288 mg/dL 7.45 mmol/L
LDL Cholesterol: 164 mg/dL 4.23 mmol/L
HDL Cholesterol: 117 mg/dL 3.03 mmol/L
Triglycerides: 37 mg/dL 0.42 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 7 mg/dL 0.18 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.06 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.858 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL RATIOS–
Total/HDL Ratio: 2.46
Triglyceride/HDL Ratio: 0.32
PRE LCHF
–==== CholesterolCode.com Report v0.7 ====–
Total Cholesterol: 217 mg/dL 5.6 mmol/L
LDL Cholesterol: 128 mg/dL 3.3 mmol/L
HDL Cholesterol: 40 mg/dL 1.04 mmol/L
Triglycerides: 239 mg/dL 2.7 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 49 mg/dL 1.27 mmol/L >>> High Risk Quintile
Remnant Chol to HDL: 1.23 >>> High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.414 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL RATIOS–
Total/HDL Ratio: 5.38
Triglyceride/HDL Ratio: 5.98
1yr of LCHF
–==== CholesterolCode.com Report v0.7 ====–
Total Cholesterol: 166 mg/dL 4.3 mmol/L
LDL Cholesterol: 93 mg/dL 2.4 mmol/L
HDL Cholesterol: 62 mg/dL 1.6 mmol/L
Triglycerides: 73 mg/dL 0.82 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 11 mg/dL 0.28 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.18 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.29 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL RATIOS–
Total/HDL Ratio: 2.69
Triglyceride/HDL Ratio: 1.18
Wow! Great changes — especially in HDL and TG!
Yes, just goes to show how crucial the impact of LCHF is to human health . In my own case the simple dietary switch took Hba1c from 92 to 35 in a year and changed everything else as above. Its a story repeated dozens of times over and truly criminal that the message is not at the top of every lawmakers desk.
Congratulations, seriously. Yes, I wish the message would get out.
I’ve been talking to people about this for 19 years.
Keep in mind that results may change a lot depending on whether you have direct LDL measurements or only calculated LDL. In my experience with low-carb/keto your measured LDL is likely to be higher then calculated (therefore your calculated remnants will be lower). In my case:
TC 223
LDL (measured) 123
LDL (calc) 111
TG 49
RC 0 (based on LDL measured)
Cool — good to know.
@john, was that Friedenwald or Iranian method of calculation?
I understand Friedenwald tends to overestimate LDL in LCHF.
Says the doc: https://www.docsopinion.com/2017/01/02/ldl-cholesterol-overestimated-low-carb-high-fat-lchf-diet/
–==== CholesterolCode.com Report v0.7 ====–
Total Cholesterol: 226 mg/dL 5.84 mmol/L
LDL Cholesterol: 151 mg/dL 3.9 mmol/L
HDL Cholesterol: 45 mg/dL 1.16 mmol/L
Triglycerides: 151 mg/dL 1.7 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 30 mg/dL 0.78 mmol/L >>> Medium-High Risk Quintile
Remnant Chol to HDL: 0.67 >>> Medium-High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.166 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL RATIOS–
Total/HDL Ratio: 5.03
Triglyceride/HDL Ratio: 3.36
Are you already on LCHF? – it took me a year of LCHF 60% fat ( no veg oils) 22% protein% 5% whisky 13% carbs ( 1350 calories) to convert between the two numbers I’ve posted.
Lol at least I’m not the only one with that 5%
Units of measurement:
687
Total Cholesterol (TC)
567
LDL Cholesterol (LDL-C)
91
HDL Cholesterol (HDL-C)
145
Triglycerides (TG)
(Copy and paste everything below for reuse)
–==== CholesterolCode.com Report v0.7 ====–
Total Cholesterol: 687 mg/dL 17.77 mmol/L
LDL Cholesterol: 567 mg/dL 14.66 mmol/L
HDL Cholesterol: 91 mg/dL 2.35 mmol/L
Triglycerides: 145 mg/dL 1.64 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 29 mg/dL 0.75 mmol/L >>> Medium-High Risk Quintile
Remnant Chol to HDL: 0.32 >>> Medium Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.156 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL RATIOS–
Total/HDL Ratio: 7.56
Triglyceride/HDL Ratio: 1.59
Thanks Dave, very interesting.
–==== CholesterolCode.com Report v0.7 ====–
Total Cholesterol: 218 mg/dL 5.64 mmol/L
LDL Cholesterol: 117 mg/dL 3.03 mmol/L
HDL Cholesterol: 90 mg/dL 2.33 mmol/L
Triglycerides: 53 mg/dL 0.6 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 11 mg/dL 0.28 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.12 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.589 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL RATIOS–
Total/HDL Ratio: 2.42
Triglyceride/HDL Ratio: 0.59
Hi I am a healthy (I have to asume?) 70 years old lady, still no medication, yes I can loose a few kilos
My LDL bellow it is calculated, have been doing LCHF for 2 years
–==== CholesterolCode.com Report v0.7 ====–
Total Cholesterol: 329 mg/dL 8.5 mmol/L
LDL Cholesterol: 213 mg/dL 5.5 mmol/L
HDL Cholesterol: 104 mg/dL 2.68 mmol/L
Triglycerides: 53 mg/dL 0.6 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 12 mg/dL 0.31 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.12 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.65 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL RATIOS–
Total/HDL Ratio: 3.17
Triglyceride/HDL Ratio: 0.51
============
BEFORE LCHF
============
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 185 mg/dL 4.78 mmol/L
LDL Cholesterol: 120 mg/dL 3.09 mmol/L
HDL Cholesterol: 46 mg/dL 1.19 mmol/L
Triglycerides: 98 mg/dL 1.11 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 19 mg/dL 0.49 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.41 >>> Medium Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.03 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 119 | Iranian LDL-C: 127
Total/HDL Ratio: 4.02
TG/HDL Ratio in mg/dL: 2.13 | in mmol/L: 0.93
============
AFTER LCHF
============
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 206 mg/dL 5.33 mmol/L
LDL Cholesterol: 97 mg/dL 2.51 mmol/L
HDL Cholesterol: 53 mg/dL 1.37 mmol/L
Triglycerides: 279 mg/dL 3.15 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 56 mg/dL 1.45 mmol/L >>> High Risk Quintile
Remnant Chol to HDL: 1.06 >>> High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.362 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 97 | Iranian LDL-C: 234
Total/HDL Ratio: 3.89
TG/HDL Ratio in mg/dL: 5.26 | in mmol/L: 2.3
🙁
Hi Vladimir–
I’m curious as to why your triglycerides jumped up so much. In my experience with friends/family, if TG jumps up but HDL doesn’t bottom out, it is often a sign of “leaks” with carbs in the diets. Sometimes different things they weren’t accounting for added much more, like certain sauces, seasoning, beverages, dips, etc.
If you aren’t already, I’d highly recommend tracking your diet very closely to ensure you aren’t getting *both* high fat and carbs (or even moderate carbs).
My (general) doctor also had doubts on it. The are 2 main things that can affect the measures:
1° some carbs (as you said). But if was, was too little.
2° a few days before, a very close friend died.
In a 2 o 3 weeks a will repeat the test. I’ll posted here.
As you, I won’t leave LCHF cuz I feel really great. That’s why if I can do something in order to help you research, let me know it.
Thanks!
I’m so sorry to hear about your loss, Vladimir! 🙁
Yes, certainly a painful stressor can impact lipid numbers. I’d retest again, myself.
hi Dave. just wanted to tell you that i did the test again a few days ago. this is what i got now:
–==== CholesterolCode.com/Report v0.9.2 ====–
…8 months on LCHF (20g to 120g carbs) ::: 13 hours water fasted…
Total Cholesterol: 198 mg/dL 5.12 mmol/L
LDL Cholesterol: 124 mg/dL 3.21 mmol/L
HDL Cholesterol: 50 mg/dL 1.29 mmol/L
Triglycerides: 122 mg/dL 1.38 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 24 mg/dL 0.62 mmol/L >>> Medium Risk Quintile
Remnant Chol to HDL: 0.48 >>> Medium Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.029 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 124 | Iranian LDL-C: 147
Total/HDL Ratio: 3.96
TG/HDL Ratio in mg/dL: 2.44 | in mmol/L: 1.07
i think it gets better, doesn’t it?
Wow! Much, much better triglycerides! Can you share what you did differently?
1º relax! even when there were much stress at work, i try to stay “calm” few days before
2º didn’t track it but i think i stay over 50% fat at least 2 days before.
3º last meal was exactly 13 hours before test.
(BTW site didn’t notify me about your replay. got to enter manually to check it)
Awesome! I’m genuinely wondering if it was more stress relief than anything else. And if so, that would be a strong encouragement for others to keep it down.
Units of measurement:
212
Total Cholesterol (TC)
125
LDL Cholesterol (LDL-C)
74
HDL Cholesterol (HDL-C)
63
Triglycerides (TG)
(Copy and paste everything below for reuse)
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 212 mg/dL 5.48 mmol/L
LDL Cholesterol: 125 mg/dL 3.23 mmol/L
HDL Cholesterol: 74 mg/dL 1.91 mmol/L
Triglycerides: 63 mg/dL 0.71 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 13 mg/dL 0.34 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.18 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.43 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 125 | Iranian LDL-C: 106
Total/HDL Ratio: 2.86
TG/HDL Ratio in mg/dL: 0.85 | in mmol/L: 0.37
66 yr old male, national level marathoner, 3 years LCHF
Total Cholesterol (TC) 8.05
LDL Cholesterol (LDL-C) 4.78
HDL Cholesterol (HDL-C) 2.94
Triglycerides (TG) 0.71
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol:
311 mg/dL
8.05 mmol/L
LDL Cholesterol:
185 mg/dL
4.78 mmol/L
HDL Cholesterol:
114 mg/dL
2.94 mmol/L
Triglycerides:
63 mg/dL
0.71 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol:
12 mg/dL
0.31 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL:
0.11 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.617 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 184 | Iranian LDL-C: 153
Total/HDL Ratio: 2.73
TG/HDL Ratio in mg/dL: 0.55 | in mmol/L: 0.24
Dave, you say “At a minimum, one should be looking at Remnant Cholesterol over LDL Cholesterol” but isn’t this the same mistake many other researchers have made – eager or desperate to find simple cause for CVD they jumped from measurement correlation to causation without acknowledging the rest of the picture? I think you are absolutely right that lipos are simply transport vehicles with additional immune system functions (like neutralizing toxins, malignant cells, viri, etc.), and it was ridiculous that experts chose one size as the bad one when there is *continuous* variability of size for all the lipos, so I fully support your view that “Broken Systems are Atherogenic, Not Lipoproteins”, but want to caution again that just looking at the numbers we can easily measure still doesn’t tell the whole story.
I’m not sure if we disagree…
I *do not* want to identify one marker as definitive. As I caveat at several points:
–“But trying to identify a single lipoprotein to label as the bad guy misses the point of the larger perspective on what’s happening inside the body to begin with.”
–“While I have read through a lot of these studies, I still consider this early in my research on it.”
And just before the quote you cited, I say:
–“I’m hesitant to name any single lipid marker as the “best” one to measure. But if I had to choose right now, I’d be pointing to Remnant Cholesterol (RC).”
I certainly stand by that. One score can be shown as *better* than another without being declared it the “causal” one, hence my long explanation on systems over simple markers. Yes, to reemphasize, RCs appear much stronger than LDLs, particularly with regard to all cause mortality. But that’s not my saying RCs are causal or even that you should look at them in singularity.
But is it not true that, in turn, is it not actually the size that matters but differences in the surface that stop it being re-used by the liver? The way it works, these particles are also smaller and more dense, so we use the size to differentiate, it is a bit of a blunt tool, but it is the only tool we have at the moment.
Hi Dave,
Thanks for the very interesting article and the tool.
My numbers after 1 year of LCHF / Keto are:
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 298 mg/dL 7.7 mmol/L
LDL Cholesterol: 236 mg/dL 6.1 mmol/L
HDL Cholesterol: 48 mg/dL 1.25 mmol/L
Triglycerides: 71 mg/dL 0.8 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 14 mg/dL 0.36 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.29 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.194 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 236 | Iranian LDL-C: 206
Total/HDL Ratio: 6.21
TG/HDL Ratio in mg/dL: 1.48 | in mmol/L: 0.64
My numbers PRE-LCHF (May 4, 2016):
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 217 mg/dL 5.6 mmol/L
LDL Cholesterol: 151 mg/dL 3.9 mmol/L
HDL Cholesterol: 41 mg/dL 1.07 mmol/L
Triglycerides: 124 mg/dL 1.4 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 25 mg/dL 0.65 mmol/L >>> Medium Risk Quintile
Remnant Chol to HDL: 0.61 >>> Medium-High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.117 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 151 | Iranian LDL-C: 172
Total/HDL Ratio: 5.29
TG/HDL Ratio in mg/dL: 3.02 | in mmol/L: 1.31
Coronary Arterial Calcium Score Jan 19, 2018: NIL !!!!
Nice trade up, David.
“I’ve already found in my own data and those of others that when on a fat-centric diet, you can often have higher triglycerides relative to a carb-centric diet when taking lipids while not fasted. Hello! You are literally observing triglycerides from the food you just consumed as part of the total amount found in the blood–==== ”
WOW, thanks Dave:). This was the first time I had my lipids taken when non-fasting and the numbers freaked me up little bit. Never had tryglicerides higher then 0.5 mmol/L. But it makes sense!
CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 278 mg/dL 7.19 mmol/L
LDL Cholesterol: 120 mg/dL 3.1 mmol/L
HDL Cholesterol: 133 mg/dL 3.44 mmol/L
Triglycerides: 128 mg/dL 1.44 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 25 mg/dL 0.65 mmol/L >>> Medium Risk Quintile
Remnant Chol to HDL: 0.19 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.378 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 119 | Iranian LDL-C: 142
Total/HDL Ratio: 2.09
TG/HDL Ratio in mg/dL: 0.96 | in mmol/L: 0.42
Yep. I just wish everyone else could be aware of this as well.
So many people are panicking because this is anti-intuitive. You’d presume cholesterol would go down or even remain the same from fasting instead of spiking.
Have been Keto since Sept ’16, no cheating, ever! I’m suspecting I’m a hyper responder as my Total & LDL has increase significantly.
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 286 mg/dL 7.4 mmol/L
LDL Cholesterol: 151 mg/dL 3.9 mmol/L
HDL Cholesterol: 128 mg/dL 3.3 mmol/L
Triglycerides: 35 mg/dL 0.4 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 7 mg/dL 0.18 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.05 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.916 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 151 | Iranian LDL-C: 104
Total/HDL Ratio: 2.23
TG/HDL Ratio in mg/dL: 0.27 | in mmol/L: 0.12
Wow! That’s a crazy high HDL and low TG!
Your LDL isn’t actually that high at all. In fact, I’m surprised it’s that low given your HDL and TG as you are well past those two cutpoints with a Lean Mass Hyper-responder.
I want those results! Are you a marathoner? I see those HDL numbers with triathletes or hyper exercisers.
Hi, I started LCHF on 1 MAY 2017. Below are my reports from about one month in (first report) and about 5 months in (second one). I turned 50 in the middle of the two times the blood was drawn. I take methotrexate for psoriatic arthritis, so I have autoimmune issues (that is only one of my diseases). So I am not alarmed by the amount of total cholesterol. Thankfully neither is my doc so I have not had a statin pushed on me.
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol:
284 mg/dL
7.34 mmol/L
LDL Cholesterol:
215 mg/dL
5.56 mmol/L
HDL Cholesterol:
52 mg/dL
1.34 mmol/L
Triglycerides:
84 mg/dL
0.95 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol:
17 mg/dL
0.44 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL:
0.33 >>> Medium Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.149 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 215 | Iranian LDL-C: 198
Total/HDL Ratio: 5.46
TG/HDL Ratio in mg/dL: 1.62 | in mmol/L: 0.71
SECOND REPORT
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol:
337 mg/dL
8.71 mmol/L
LDL Cholesterol:
264 mg/dL
6.83 mmol/L
HDL Cholesterol:
55 mg/dL
1.42 mmol/L
Triglycerides:
92 mg/dL
1.04 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol:
18 mg/dL
0.47 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL:
0.33 >>> Medium Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.135 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 264 | Iranian LDL-C: 244
Total/HDL Ratio: 6.13
TG/HDL Ratio in mg/dL: 1.67 | in mmol/L: 0.73
Hi Michelle–
Your lipids are generally in line with a typical hyper-responder. I’m used to seeing very unusual lipid panels for those who are on a number of medications, so overall I think this looks pretty straightforward.
I figured I was a hyper-responder. I only take the Synthroid, Methotrexate, and am on Norethindrone for Endometriosis. Symbicort for Asthma. I also take some medical cannabis at night for sleep aid (works great!). I try to limit my pharmaceuticals as much as possible and see an ND.
I was also wondering if you have looked at the ACAT2 and hyper responders. I found that snp in one of the DNA reports I have.
Not specifically, no. I’ll eventually try to get a lot of 23andMe reports from a lot of HRs and see what commonalities we see in the SNPs.
Let me know if you want to see my report I ran through Genetic Genie. I ran it to check for methylation and saw a note about the ACAT and SHMT snps on it. I do not have any of the APOE variants though which I thought was interesting.
I want to modify my last comment. I dug into the APOE a bit more and I am an E2. ” E2 tend to have higher serum lipids since cellular delivery is impaired. It is associated with Type III Hyperlipidemia (Familial Dysbetalipoproteinemia), which can promote xanthomas (fatty deposits in the skin), higher serum triglycerides, and atherosclerosis at a younger age. The e2/e2 genotype confers a 2% risk of developing Type III Hyperlipidemia.” Not the best news.
I did my DNA on 23andme. Is there an easy way to look up ones APOE?
I actually use Promethease to digest my 23andMe data. It makes the data very searchable. https://promethease.com/
New report from May 2018: –==== CholesterolCode.com/Report v0.9.2 ====–
…12 months on LCHF (20g to 120g carbs) ::: 14 hours water fasted…
Total Cholesterol: 313 mg/dL 8.09 mmol/L
LDL Cholesterol: 235 mg/dL 6.08 mmol/L
HDL Cholesterol: 64 mg/dL 1.66 mmol/L
Triglycerides: 69 mg/dL 0.78 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 14 mg/dL 0.36 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.22 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.328 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 235 | Iranian LDL-C: 203
Total/HDL Ratio: 4.89
TG/HDL Ratio in mg/dL: 1.08 | in mmol/L: 0.47
Hi Dave,
Thanks again for your investigations into this bewildering field!
Predictably, I’m not sure how to interpret my remnant cholesterol results. Most of my indicators are “medium-low risk quintile” – except for the atherogenic index of plasma, which is in the “lowest risk third”.
Also, the LDL cholesterol number is calculated, rather than a direct measurement. Are there any tests that measure it directly?
Also, is age a factor in calculating these risk levels?
Units of measurement: mmol
09.49 Total Cholesterol (TC)
6.71 LDL Cholesterol (LDL-C)
2.26 HDL Cholesterol (HDL-C)
1.14 Triglycerides (TG)
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 367 mg/dL 9.49 mmol/L
LDL Cholesterol: 259 mg/dL 6.71 mmol/L
HDL Cholesterol: 87 mg/dL 2.26 mmol/L
Triglycerides: 101 mg/dL 1.14 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 21 mg/dL 0.54 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.24 >>> Medium-Low Risk Quintile
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.297 >>> Lowest Risk Third
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 260 | Iranian LDL-C: 244
Total/HDL Ratio: 4.22
TG/HDL Ratio in mg/dL: 1.16 | in mmol/L: 0.5
Hi Helena-
Overall, I think this panel looks pretty standard for a hyper-responder. You have a very exceptional HDL, in particular.
I mention it briefly in the article, but worth repeating — I actually think the risk ranges are going to be even higher for those on LCHF since we have a mechanistic reason for trafficking a higher *proportion* of VLDLs relative to someone on a carb-centric diet. So even with RCs improving in general for low carbers, it might actually be even better than it looks if my theory is correct.
Hi Dave,
I finally went to my usual doctor, who wanted me to have a lipid panel done asap. She asked me to go have the samples drawn immediately, and not to bother with the 12 hour fasting – I’m guessing she was seriously worried by the high LDL in my November results. How much – and what – effects does not having fasted have?
I just got the numbers, and they’re significantly different from November’s:
Total Cholesterol: 283 mg/dL 7.33 mmol/L
LDL Cholesterol: 178 mg/dL 4.61 mmol/L
HDL Cholesterol: 88 mg/dL 2.28 mmol/L
Triglycerides: 86 mg/dL 0.97 mmol/L
How much of this change is likely due to the short time between eating & having the blood drawn? I don’t remember exactly how long, but it was likely two or three hours.
Thanks,
Helena
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 17 mg/dL 0.44 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.19 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.371 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 178 | Iranian LDL-C: 165
Total/HDL Ratio: 3.22
TG/HDL Ratio in mg/dL: 0.98 | in mmol/L: 0.43
Ugh! I literally just made a video on this! https://www.youtube.com/watch?v=ZQHztlN1Yls
The short answer is: I don’t fully know.
What I *do* feel pretty sure about is that triglycerides will be higher (as discussed in the video). But I don’t have much research of my own into what the quad numbers (TC/LDL/HDL/TG) do postprandial for a LCHFer (which will likely be different than someone on SAD).
Now, all that said, I think your Remnant Cholesterol turned out well regardless. Of course, that’s something we care about in the community and your doctor likely doesn’t. As always, I recommend asking them to provide any studies that show Remnant Cholesterol is *not* a much better indicator than LDL for both CVD and all-cause mortality. As of this point, I’m not aware of a single one.
Hi Dave,
I wasn’t aware that the 12-hour fast was no longer required. Sounds like a really bad idea hatched by someone who is under the impression that lipid numbers are static!
That being said, in this latest test, all my numbers moved in the “right” directions, even my triglycerides, which went from 1.14 to .97!
For comparison, my November numbers were:
Total Cholesterol: 367 mg/dL 9.49 mmol/L
LDL Cholesterol: 259 mg/dL 6.71 mmol/L
HDL Cholesterol: 87 mg/dL 2.26 mmol/L
Triglycerides: 101 mg/dL 1.14 mmol/L
On the whole, I’m encouraged by these changes, but I’m still uneasy about the tunnel vision most physicians seem to have on the subject, and not at all confident that the medical world knows much about what does what to what, and how, in the lipid universe.
The biggest plus of this latest set of tests: my primary care physician is delighted that I’ve lost so much weight (20 kilo), brought my blood pressure down to 110/80 from the 140/90+ range, and improved my cholesterol numbers. In contrast to the lecture she read me about “everything in moderation” when I asked her about LCHF diets a year ago, she was actually asking me about details of the LCHF diet. Maybe she’ll eventually get on the bandwagon!
Thanks again for working so hard to shed light on this – it’s vitally important, but seems to have suffered from too little research and too many fixed opinions!
Sure thing! And grats on your many improving markers!
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 237 mg/dL 6.13 mmol/L
LDL Cholesterol: 163 mg/dL 4.22 mmol/L
HDL Cholesterol: 62 mg/dL 1.6 mmol/L
Triglycerides: 59 mg/dL 0.67 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 12 mg/dL 0.31 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.19 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.378 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 163 | Iranian LDL-C: 136
Total/HDL Ratio: 3.82
TG/HDL Ratio in mg/dL: 0.95 | in mmol/L: 0.42
I’m 36, my blood pressure is around 110/70, my resting HR ~60bpm. Upon seeing these results, the last doctor I saw wanted to put me on statins. I also work out regularly (5-6x week) and would guess I’m easily on the upper 10% of the population in physical fitness for my age (though that last part was never talked about).
Is there any way to find MDs who actually understand cholesterol and look beyond just one number? I understand we all have our biases but when I asked my (now former) doctor about looking at the LDL/HDL ratio as a better indicator than just the LDL or total cholesterol (I didn’t even know of remnant cholesterol at the time) she looked at me as if I was wearing a tin foil hat.
So, again, it would be great to have a network of trusted MDs who look beyond what is fed to them (essentially funded by drug companies). Does that exist?
I’ve had some use https://ketogenic.com/tools/keto-clinicians-finder/ With some success.
If that doesn’t hit your location, let me know where you’re at and I’ll see if I know someone in that area.
Thanks! I’ll definitely use that resource trying to find a new general doctor (though I doubt they would be inside my insurance coverage…). Just as a note, I’m not on keto, and don’t really stress too much about low carb, but probably eat LC for the most part (allowing myself some occasional treats). As far as I understand, though, those numbers (combined with my lifestyle and age, etc) would not support me going into statins treatment.
Thanks again for all the good work digging through the research!
========
PREKETO
========
Total Cholesterol: 219 mg/dL 5.66 mmol/L
LDL Cholesterol: 142 mg/dL 3.67 mmol/L
HDL Cholesterol: 58 mg/dL 1.5 mmol/L
Triglycerides: 94 mg/dL 1.06 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 19 mg/dL 0.49 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.33 >>> Medium Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.151 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 142 | Iranian LDL-C: 143
Total/HDL Ratio: 3.78
TG/HDL Ratio in mg/dL: 1.62 | in mmol/L: 0.71
=========
19 mos keto
=========
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 334 mg/dL 8.64 mmol/L
LDL Cholesterol: 236 mg/dL 6.1 mmol/L
HDL Cholesterol: 82 mg/dL 2.12 mmol/L
Triglycerides: 82 mg/dL 0.93 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 16 mg/dL 0.41 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.2 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.358 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 236 | Iranian LDL-C: 211
Total/HDL Ratio: 4.07
TG/HDL Ratio in mg/dL: 1 | in mmol/L: 0.44
Nice change up!
Here are my results – i seem to have zero RC – that is good right? I have also got these results which I am told are very bad ApoA 169 ApoB 161- not sure if these relate or not. LCHF for about 5 years – maybe eat too much fruit – mainly berries.
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 328 mg/dL 8.48 mmol/L
LDL Cholesterol: 269 mg/dL 6.96 mmol/L
HDL Cholesterol: 59 mg/dL 1.53 mmol/L
Triglycerides: 97 mg/dL 1.1 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 0 mg/dL 0 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.143 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 250 | Iranian LDL-C: 235
Total/HDL Ratio: 5.56
TG/HDL Ratio in mg/dL: 1.64 | in mmol/L: 0.72
You may want to double check your numbers, I’m skeptical you have zero RC.
ApoA1 exceeding ApoB is likely excellent. Check out the many studies that compare the two (Ivor has some great charts on this).
Same as with my first numbers: LDL + HDL > TotC. Something weird in labs.
Well, if we can speculate RC to be low, I’d consider that generally good news. But again, I’m still early into my RC research.
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 296 mg/dL 7.65 mmol/L
LDL Cholesterol: 198 mg/dL 5.12 mmol/L
HDL Cholesterol: 87 mg/dL 2.25 mmol/L
Triglycerides: 57 mg/dL 0.64 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 11 mg/dL 0.28 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.13 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.546 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 198 | Iranian LDL-C: 162
Total/HDL Ratio: 3.4
TG/HDL Ratio in mg/dL: 0.66 | in mmol/L: 0.28
This test (taken a year ago) was 1 year LC and previous 6 mos Keto. Will get another lipid test soon; have been keto since that last test.
Nice work team!
-==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 210 mg/dL 5.43 mmol/L
LDL Cholesterol: 131 mg/dL 3.39 mmol/L
HDL Cholesterol: 66 mg/dL 1.71 mmol/L
Triglycerides: 98 mg/dL 1.11 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 13 mg/dL 0.34 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.2 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.188 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 124 | Iranian LDL-C: 130
Total/HDL Ratio: 3.18
TG/HDL Ratio in mg/dL: 1.48 | in mmol/L: 0.65
LCHF since May 2017. VLDL 26. APOE 3/4…….such a confusing topic, thank you for dumbing it down so well that it almost makes sense.
HS-CRP .59 mg/L and HbA1C is 5. I’m wondering if it makes sense to have my Lp(a), LDL-P and ApoB tested. I would very much appreciate your opinion on those tests or just be happy I’m in the lowest risk quintile?
Many thanks for your work and blog!
Kim
-==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 314 mg/dL 8.11 mmol/L
LDL Cholesterol: 159 mg/dL 4.1 mmol/L
HDL Cholesterol: 143 mg/dL 3.69 mmol/L
Triglycerides: 62 mg/dL 0.7 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 12 mg/dL 0.31 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.08 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.722 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 159 | Iranian LDL-C: 128
Total/HDL Ratio: 2.2
TG/HDL Ratio in mg/dL: 0.43 | in mmol/L: 0.19
Wow — you look like you’re a lower LDL Lean Mass Hyper-responder. I’d guess by your lipids you’re lean and/or athletic.
Hi Dave,
I’ve read your articles and watched your videos with interest but find it a lot to absorb.
I’m a 56 year old Male. Currently 283lbs, 6’5″.
The following is my blood work from the begging of last month (Prior to going on the Keto diet:
Score from Dec 9, 2017
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 208 mg/dL 5.38 mmol/L
LDL Cholesterol: 150 mg/dL 3.88 mmol/L
HDL Cholesterol: 41 mg/dL 1.06 mmol/L
Triglycerides: 85 mg/dL 0.96 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 17 mg/dL 0.44 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.41 >>> Medium Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.043 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 150 | Iranian LDL-C: 144
Total/HDL Ratio: 5.07
TG/HDL Ratio in mg/dL: 2.07 | in mmol/L: 0.91
Needless to say my doctor has wanted to put me on statins for some time. I was actually on them for a while and took myself off. A couple of weeks later I went on a 5 day water fast, got into ketosis and now IF and fat adapted. I also had a Calcium Heart test done about a year ago with a score of 0. I have been told that the calcium score is a better indicator of heart health than Cholesterol screening yet my doctor continues to have me concerned. Just this last weekend I had taken another Cholesterol test done with the score below (on my own). I’m quite concerned that the HDL has dropped and with the Remnant score it has me more concerned. Do you believe that another test in 3 months with the continued LCHF diet that I’m doing that the HDL will respond favorably? Any other insight?
Thanks!
Tim
Score from last Saturday-
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 222 mg/dL 5.74 mmol/L
LDL Cholesterol: 167 mg/dL 4.32 mmol/L
HDL Cholesterol: 34 mg/dL 0.88 mmol/L
Triglycerides: 107 mg/dL 1.21 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 21 mg/dL 0.54 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.62 >>> Medium-High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.138 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 167 | Iranian LDL-C: 174
Total/HDL Ratio: 6.53
TG/HDL Ratio in mg/dL: 3.15 | in mmol/L: 1.38
Hi Tim—
Of course I’d be more inclined to wait a longer period of time before checking in on your lipids. I see all kinds of wonky labs right after people start on LCHF/Keto for the first time and it makes sense given you’re literally switching primary metabolic pathways.
Dave,
Thanks for your reply. I suspected that I might have jumped the gun and won’t worry about it until the end of the year. Your tests regarding the short term manipulation of the numbers with your diet is fascinating and could prove that whole cholesterol concern a moot point. Thanks again! Tim
Following the process and keeping total cholesterol constant (no hyper responder), this happens when carb is changed to fat:
Hi-carber has high number of VLDLs. Body takes the fat, IDL forms and finally LDL is left with cholesterol in it.
In LCHF, number of VLDLs is low, and if amount of cholesterol is same, it means more cholesterol is packed into VLDL-particle. So the size of the forming LDL must therefore be bigger (more cholesterol in it) and the number is low.
Hi-carber has smaller size of LDL-particles and the number of those is big. So this may have unpleasant consequences to hi-carber, because of more atherogenic pattern of LDL. Even when the lab results gives low values, as we all know, that about 70% of people hospitalized due to CHD, have “good” LDL values (and low HDL values).
In practice, LCHF rises total cholesterol, but usually only because of better HDL. Hyper responder rises both HDL and LDL, but not by atherogenic way as we can see. When HDL is good, it indicates that metabolic system is in tact, and low remnant cholesterol follows.
Seems logic, but what do you think?
Interesting theory, Johan… but I don’t think there’s more cholesterol packed into each particle for those on LCHF. The amount of VLDL cargo can change, but of what I’ve seen, the cholesterol amount on a per-particle basis is fairly consistent. This is why so many of the labs I see for faithful keto-ers tend to have a fairly consistent LDL-C to LDL-P ratio (about 10x).
Dave
I graphed out my last several years of tests including the remnant calculation and it looks like for me that remnants directly follow my triglyceride levels. The graphs are virtually identical. Is this what you are seeing?
Thanks
Yes — overall this is what led me to RCs in the first place. They are extremely correlative with TGs.
Hi, Dave.
Interesting.
It makes sense that VLDL and IDL can be involved in heart disease, as well as LDL.
My previous model for heart disease was small/dense LDL, remnant cholesterol adds another layer.
In my reading sdLDL seems to come about through excess carb input and insulin resistance.
That is excess carbs (above about 50g/d) gets routed by the liver into glycogen and triglycerides via VLDL formation. These VLDL tend to be of the larger type which is more atherogenic. Insulin resistance adds another stream of FFA to the liver which also results in VLDL build. So together you get excess VLDL. VLDL gets delipidated to IDL and LDL by way of interactions in plasma.
Excess VLDL means excess triglycerides in plasma. In VLC you get pulses of plasma trigs but they dissipate quickly so fasting triglycerides are much lower. With higher trigs you get more apo-B proteins because the supply of lipid is continuous (with lower trigs the supply becomes interrupted and in that case, the nascent VLDL/IDL assembly in the liver cannot complete and get disassembled so fewer particles get released to plasma).
Higher trigs are mostly deleterious because they foster higher levels of CETP (cholesterol ester transfer protein). These particles promote esterase activity in that they transfer cholesterol from LDL and HDL into VLDL (typically there is very low esterase activity in normal plasma). The particle does this by constructing a lipophylic channel between itself and the LDL/HDL particle. Cholesterol is transferred out and the LDL and the HDL particles become smaller due to the loss of cholesterol. Subsequently, lipases attack these smaller particles to delipidate them and remove lipids, so they become even smaller. The fate of these particles typically is to become modified. Small LDL becomes subject to oxidation and glycation because it has fewer antioxidant defences and remains longer in circulation (typically 5 days as opposed to 2 for normal LDL). Small HDL becomes more deranged because the damage is typically more severe (CETP burrows deeply into the particle, whereas for LDL the penetration is shallower). HDL becomes so small that it cannot hold onto the apo-a1 protein and it gets shed and the protein quickly gets cleared from circulation. Thus you get the combination of small/dense LDL low HDL and higher trigs that is typically seen in cardiac admits.
Goldstein and Brown discovered the LDL receptor and subsequently tried to show that atherosclerosis was caused by the uptake of cholesterol in the artery wall. They failed, partly I think because the uptake is performed by macrophages using coated pits of these receptors and invagination to internalize the particles within the wall where the cholesterol can be processed by lysosomes to free the cholesterol (and other constituents). This system works but the amount of cholesterol processed this way is too small to account for atherosclerosis (ie the macrophage LDL receptors are few in number). Steinberg showed the entry of damaged cholesterol (ie oxidized or glycated or methylated etc) was much larger as macrophages have a much larger array of receptors for these damaged LDL particles. Sikaris has shown that the liver does not take up damaged LDL so it appears that the artery wall takes over the recycling of damaged LDL from the liver (Seneff also supports this view). This can be overwhelmed by the supply of damaged LDL increasing as trigs rise further and the slower acceptance of recycled cholesterol via HDL and other cholesterol acceptors. So this seems to tie in with the facts, atherosclerosis is primarily associated with damaged LDL and lower HDL caused by rising trigs.
Additional factors may also play a large part, particularly hemodynamic pressures, virus, bacteria, calcium deposition, low levels of ascorbate thus lower collagen production for maintenance of the artery wall structure and other vectors causing or being caused by endothelial damage so attracting LP(a) as a damage repair mechanism and possibly other lipoproteins for the same purpose. So the buildup of cholesterol is multifactorial but I think native undamaged LDL plays only a very small part.
Enter into this model remnant cholesterol. Logic would say that these particles are remnant because they are not being taken up by the liver. Ergo they are damaged and the same mechanism may be at play as is the case for damaged LDL. I’m not sure but I suspect these may be recycled by the artery wall in the same way as damaged LDL, ie by specific receptors. So it makes sense that they add to the problem and are significantly related to heart disease.
Nice catch Dave.
I have some reading to do.
Cheers.
Lots of great thoughts you add, Tim.
To narrow down (and save time), you said:
“So this seems to tie in with the facts, atherosclerosis is primarily associated with damaged LDL and lower HDL caused by rising trigs.”
Agreed — but why the higher trigs? Obviously, the “excess carbs” have plenty of evidence to back it, although it is variable based on the individual and their body’s context. But overall, I feel there is plenty pointing to maxing out one’s personal fat threshold (PFT) and/or existing metabolic inflexibility, which I see plenty of in my family and some friends. The further one is down the road of T2D on my dad’s side of the family, the easier it is to suddenly have high TG when “cheating” on their diet. This is anecdotal, to be sure, but surprisingly predictable thus far.
Naturally, the other “version” of an atherogenic system is one of a disease state where lipoproteins are modeled for more specific disease-fighting purposes. Siobhan will be posting an article on that in the coming future. 🙂
But in both these cases, I believe the RC isn’t in and of itself atherogenic — it’s a reflection of a system that is broken and/or in need of repair where either uptake by VLDL/IDLs is problematic or they are engaged in a battle to resolve a larger problem in the body.
Right there are two principal streams for higher trigs. One is excess carbs the other is insulin resistance fostered FFA in plasma. This arises through insulin no longer able to contain lipolysis (your PFT is exceeded) so there is a continuous stream of FFA into the liver which causes continuous VLDL build.
I am interested in your comment that RC isn’t atherogenic. There seems to be abundant evidence that VLDL remnants actively compete with oxLDL as an atherogenic agent.
“As reviewed below, there is overwhelming evidence for VLDL and especially for VLDL remnants being major atherogenic lipoproteins [23,24].”
http://sci-hub.tw/https://www.sciencedirect.com/science/article/pii/S0009898105007163?via%3Dihub
Cheers.
I mean that RCs is a blunt measurement in that regard. They don’t offer the best context of the current patient’s status.
For example, I’m actually pretty confident that a perfectly healthy, carb-centric patient who has low trigs would have lower VLDL than that same person on a fat-centric diet. The reason is they necessarily are mobilizing more VLDLs at any given time *relative* to the healthier counterpart version of themselves as carb-centric. So this context, it is simple fuel supply pacing, not an actual deleterious state.
One thing that bothers me is that many authors support the view that lipoproteins get “trapped” in the endothelium. This bothers me for two reasons, 1 Goldstein/Brown showed the entry of cholesterol in LDL is a very choreographed process via receptors, coated pits, invagination, lysosomes etc. Nature is not doing this casually so why should it do it for other lipoproteins. 2. Initial cholesterol deposits appear at the media/intima boundary very far from the lumen, so even if they are “trapped” it is extremely unlikely they can make such a long journey and leave no trace.
Likewise!
This narrative seems like one that has carried over several generations of better understanding in lipidology. Lipoproteins and the entire system that surrounds it is extraordinarily controlled and balanced to degrees I’m still processing.
As I know you know, these things are measured nanomoles — literally millions of trillions. Which makes the Inversion Pattern of my research so unbelievable. That these things are getting added and cleared not through a narrowing of a facet somewhere, but literally hepatic receptor expression control that’s bringing them in and out of the plasma “by hand” (in a sense). Insane!!!
My understanding is that it is commonly asserted that small dense LDL is more atherogenic _because_ it is smaller and can pass through the endothelium easier. VLDL and IDL are relatively huge compared to even large LDL, so the fact they might be even more atherogenic than sdLDL seems to be a point against the “density gradient” theory.
Correct. I’ve talked about this frequently and have questioned why this is an acceptable disconnect with the current assumption of the Response to Retention theory.
Realizing this site is for Keto/LCHF folks mainly, it is a wealth of information. Regarding remnant cholesterol, can you say if it’s important to not ‘just’ those in the LCHF community?
I plugged in numbers (non-NMR) from some of my labs over probably 10 years, and those with the highest remnant values were during an Ornish style pilot study (TC 180). The lowest remnant values were from a period of time where my TC was 300+ eating a lot of saturated fat and protein, but with higher than LCHF carbs still very low triglycerides.
Labs soon on more of a c/p/f ratio of probably 55/20/25. I am new to the site and have not followed any protocols, but am probably a LMHR.
Now I ‘exercise’, but previously was a high level extreme endurance athlete, so that may have something to do with it.
Hi James,
Yes, the research with RCs isn’t actually LCHF-centric anyway. So you can almost say it has more existing context with non-LCHF in its data.
Yes, having low triglycerides (TGs) is key no matter what diet you’re on. And this isn’t because I think TGs themselves are a problem in and of themselves, rather, I think they are reflective of a system that is either having trouble offloading them from lipoproteins (insulin resistance, T2D, etc) or is fighting a disease state (which is hopefully temporary).
And sure, please feel free to share your new labs when you get back. I’d personally love to get a lot more non-LCHF data for our existing data pool. 🙂
I’ve got 16 data points over about 20 years. I can email the sheet rather than post up since it’s tedious to cut and paste. Past high level endurance athlete, several different dietary notes. Worst remnant values on HCLF vegan (TC = 180-196, Remnant = 14-19). None of these are NMR/VAP test. Lowest (TC = 332-355, Remnant = 6 – 7) were on what I considered High Fat, but still lots of endurance exercise. Still waiting on recent values.
I have been on LCHF/#Keto lifestyle for 18 months. Lipid Panel is: Trig 45 mg, Tot. Chol. 257mg, HDL-c 101mg. Non HDL-c 156 mg, LDL-c 147mg, VLDL-9 mg, CHOL/HDL RATIO 2.5. My cardiologist wanted to put me on a Statin. I refused. We did test Calcium Score and NMR lipoprofile. The results were no plague in arteries and low range for CVD. He told me to continue doing what I am doing. And he does not recommend statins for me.
These were my results immediately after an 18 pound weight loss over 6 days [due to an acute illness – flu/pneumonia/sepsis] 0mg/dl remnant cholesterol:
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 169 mg/dL 4.37 mmol/L
LDL Cholesterol: 151 mg/dL 3.9 mmol/L
HDL Cholesterol: 18 mg/dL 0.47 mmol/L
Triglycerides: 173 mg/dL 1.95 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 0 mg/dL 0 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0 >>> Lowest Risk Quintile
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.618 >>> Medium Risk Third
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 116 | Iranian LDL-C: 179
Total/HDL Ratio: 9.39
TG/HDL Ratio in mg/dL: 9.61 | in mmol/L: 4.15
Holy cow! I’ve rarely seen an HDL in the teens!
I hope you’ll come back and ping us when you have a new lipid test. Would be great to compare!
Dave – I’m curious if you’ve done any analysis of RC related to your “Incredible Changes in LDL Cholesterol Through a Simple Diet Experiment?”
The lab results below are from last April (2017) – I was one month shy of my 67th birthday. When I saw my Doctor for the annual physical then, she offered me statins before the blood test, based on results from the previous year – TC 243, LDL 170, HDL 58, TG 75.
I’d read so much about cholesterol that I just blurted out: “Are you kidding?” [She wasn’t.] (I actually had written and posted an article back in 2003 – Statins: Did Your Doctor Tell You?I wish I had asked: “Really? Shouldn’t we re-test first.” Of course, since TC and LDL went up, she might have doubled down on the offer. As it was, she wrote down that I was “allergic” to statins, presumably she won’t ask again and I’m speculating that designation might provide cover should I have a heart attack and someone questions why I wasn’t on statins (“Hey, he said he was allergic.)
I had a couple articles to give her, including the Zoe Harcombe “Cholesterol & heart disease – there is a relationship, but it’s not what you think” as well as the article by Diamond and Ravnskov from 2015 – “How statistical deception created the appearance that statins are safe and effective in primary and secondary prevention of cardiovascular disease.” She said she would read them. I always bring an article or two. it seems backwards that I need to educate my physician: I’d love to find one in my HMO system on the same page vis-a-vis LCHF, cholesterol and health. I later sent her a note “Why I am not concerned about my cholesterol” that included links to relevant articles and a breakdown of all the relevant risk ratios, including HOMA-IR (I had requested a fasting insulin) plus referring her to the particle size test results (also requested by me). I suggested a CT scan for coronary calcium, if she was concerned. I may request one this year – I’d be interested in the results.
In general, I’m not sure how relevant cholesterol results are in telling us our risk factors for anything; though I know Ivor Cummings thinks one of the ratios (TG to HDL? I can’t remember which one) is a good indicator of how much IR we have. I used to ask not to get tested; now after all your work, now I want to get tested: it’s fascinating to see how it changes.
– – – – –
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 294 mg/dL 7.6 mmol/L
LDL Cholesterol: 201 mg/dL 5.2 mmol/L
HDL Cholesterol: 79 mg/dL 2.04 mmol/L
Triglycerides: 69 mg/dL 0.78 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 14 mg/dL 0.36 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.18 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.418 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 201 | Iranian LDL-C: 174
Total/HDL Ratio: 3.72
TG/HDL Ratio in mg/dL: 0.87 | in mmol/L: 0.38
Hi Michael,
– No, I haven’t entered the Capstone Experiment data into the report yet. I keep being late for my Big Analysis post on that. Too many things in my inbox at the moment. Meh!
– Sorry to hear about your goarounds with the GP. But obviously, I likewise am educating mine on cholesterol constantly. But to his credit, he’s very receptive. We end up going over my markers for a few minutes, then I show him my “latest” discoveries for the rest of the visit, of which he’s always very curious and blown away. I’m thinking next time I’ll leave him with an invoice for fun.
– I think cholesterol results are actually very relevant — the problem is that they all need to be reinterpreted from this energy model, otherwise they are all potentially missing the single biggest confounder of all. And let’s face it, that’s going to be a massive paradigm shift!
– Killer risk profile, btw! (I meant “killer” in a good way. :p)
Thanks for the thoughtful reply. For my yearly physical this April, I’m thinking I may pay for my own cholesterol panel prior to the visit so I can follow your protocol and get it tested on the HMO’s nickel 3 days later. I’m pretty low-carb most of the time (< 25 g, pretty much).
That’s great! Of course, please consider sharing back the data with us. 🙂
This doesnt look good…got some adjustments to make. Thanks for all your N=1 research. Single individual with enough pasdion can make a difference! Your work is very motivating.
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 254 mg/dL 6.57 mmol/L
LDL Cholesterol: 189 mg/dL 4.89 mmol/L
HDL Cholesterol: 37 mg/dL 0.96 mmol/L
Triglycerides: 139 mg/dL 1.57 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 28 mg/dL 0.72 mmol/L >>> Medium-High Risk Quintile
Remnant Chol to HDL: 0.76 >>> Medium-High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.214 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
This is actually very similar to one of my cousins who snacks on lots of sweets. Not sure if you’re in the same situation, but his lipid panel is nearly identical — it’s kind of uncanny (TC 252, LDL 188, HDL 38, TG 139)
My results (mg/dl):-
TC 287
LDL 189
HDL 85
TG 55
RC 13mg/dl / 0.34mmol/L
RC/HDL 0.15
AIP -0.548
TC/HDL 3.38
TG/HDL 0.65mg/dl = 0.28mmol/L
Btw, im 43, regular gym 4xwk (weights), follow a cyclical ketogenic diet for the past 6 months with 1 xhalfday selective carb load, interestingly all my cholesterol readings are improved in a positive way, TC⬆️, LDL⬇️, HDL⬆️, TG⬇️
Yep — you definitely have the cut points of a Lean Mass Hyper-responder
cholesterolcode.com/are-you-a-lean-mass-hyper-responder/
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 287 mg/dL 7.42 mmol/L
LDL Cholesterol: 189 mg/dL 4.89 mmol/L
HDL Cholesterol: 85 mg/dL 2.2 mmol/L
Triglycerides: 55 mg/dL 0.62 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 13 mg/dL 0.34 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.15 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.55 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 191 | Iranian LDL-C: 155
Total/HDL Ratio: 3.38
TG/HDL Ratio in mg/dL: 0.65 | in mmol/L: 0.28
Can you help me make heads or tails of this? I think it’s good but I get a little stopped up with all the data. The first scores were just before I started LCHF and the second are after about 3+months.
9-26-17:
Total Cholesterol: 243 mg/dL 6.28 mmol/L
LDL Cholesterol: 159 mg/dL 4.11 mmol/L
HDL Cholesterol: 73 mg/dL 1.89 mmol/L
Triglycerides: 55 mg/dL 0.62 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 11 mg/dL 0.28 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.15 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.484 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 159 | Iranian LDL-C: 129
Total/HDL Ratio: 3.33
TG/HDL Ratio in mg/dL: 0.75 | in mmol/L: 0.33
1-26-18:
Total Cholesterol: 277 mg/dL 7.16 mmol/L
LDL Cholesterol: 178 mg/dL 4.6 mmol/L
HDL Cholesterol: 86 mg/dL 2.22 mmol/L
Triglycerides: 63 mg/dL 0.71 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 13 mg/dL 0.34 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.15 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.495 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 178 | Iranian LDL-C: 150
Total/HDL Ratio: 3.22
TG/HDL Ratio in mg/dL: 0.73 | in mmol/L: 0.32
Your scores come in close to a Lean Mass Hyper-responder, suggesting you are lean and/or athletic. Check out this article (and browse many of the comments below it): http://cholesterolcode.com/are-you-a-lean-mass-hyper-responder/
Hi, these were my figures from five years ago – note that I get an error in the calculation – measurements were done in mmol/L (European) so probably because of lack of ‘precision’.
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 252 mg/dL 6.52 mmol/L
LDL Cholesterol: 151 mg/dL 3.9 mmol/L
HDL Cholesterol: 112 mg/dL 2.9 mmol/L
Triglycerides: 35 mg/dL 0.4 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: -11 >> Lowest Risk Quintile
Remnant Chol to HDL: 0 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.86 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 133 | Iranian LDL-C: 90
Total/HDL Ratio: 2.25
TG/HDL Ratio in mg/dL: 0.31 | in mmol/L: 0.14
The mmol/L to mg/dL conversion should’ve handled that okay. But this does come up from time to time.
Hi again,
whereas these are my more recent values (albeit two years old) following taking my doctor’s advice that as a peri-menopausal woman I should eat more carbs!
Consequence was I have gained 6 kg (currently 57 kg/164 cm, BMI 21) as a 54 year old peri-menopausal woman eating LCHF since at least 2005.
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 302 mg/dL 7.81 mmol/L
LDL Cholesterol: 159 mg/dL 4.11 mmol/L
HDL Cholesterol: 109 mg/dL 2.82 mmol/L
Triglycerides: 62 mg/dL 0.7 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 34 mg/dL 0.88 mmol/L >>> Medium-High Risk Quintile
Remnant Chol to HDL: 0.31 >>> Medium Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.605 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 181 | Iranian LDL-C: 149
Total/HDL Ratio: 2.77
TG/HDL Ratio in mg/dL: 0.57 | in mmol/L: 0.25
Interesting. You still have great HDL and TG, but indeed there are more VLDL/IDLs as indicated by your higher Remnant Cholesterol of 34 mg/dL.
It could be because I’ve now got RA. Well I had it before obviously silently, but now it’s a lot more obvious, though it’s still not that bad.
RA?
Sorry, rheumatoid arthritis.
New figures from last week : non-fasted though (but after a high-fat/low-carb breakfast)
Seems better – my doctor still wants me to change my diet though and/or go for tests.
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 302 mg/dL 7.81 mmol/L
LDL Cholesterol: 162 mg/dL 4.19 mmol/L
HDL Cholesterol: 120 mg/dL 3.1 mmol/L
Triglycerides: 115 mg/dL 1.3 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 20 mg/dL 0.52 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.17 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.377 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 159 | Iranian LDL-C: 167
Total/HDL Ratio: 2.52
TG/HDL Ratio in mg/dL: 0.96 | in mmol/L: 0.42
Ah! Looks a lot better. But next time you should try it 12-14 hours fasted. Here’s why: https://www.youtube.com/watch?v=ZQHztlN1Yls
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 379 mg/dL 9.8 mmol/L
LDL Cholesterol: 297 mg/dL 7.68 mmol/L
HDL Cholesterol: 65 mg/dL 1.68 mmol/L
Triglycerides: 66 mg/dL 0.75 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 17 mg/dL 0.44 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.26 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.35 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 301 | Iranian LDL-C: 256
Total/HDL Ratio: 5.83
TG/HDL Ratio in mg/dL: 1.02 | in mmol/L: 0.45
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 252 mg/dL 6.52 mmol/L
LDL Cholesterol: 120 mg/dL 3.1 mmol/L
HDL Cholesterol: 129 mg/dL 3.34 mmol/L
Triglycerides: 61 mg/dL 0.69 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 3 mg/dL 0.08 mmol/L >>> Lowest Risk Quintile
Remnant Chol to HDL: 0.02 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.685 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 111 | Iranian LDL-C: 89
Total/HDL Ratio: 1.95
TG/HDL Ratio in mg/dL: 0.47 | in mmol/L: 0.21
I a 50 year old male, non-smoker, no medications-just a few supplements, no blood pressure issues or diabetes. CAC was 0 at 44 years old and now it is 10, sadly even with the above profile since age 44 and doing everything right I still developed a CAC score. I have a hs-crp of 1.7 (marginally elevated) but a lot of financial stress in my life. Think stress has a lot to do with CAC IMHO.
I think I’m reassured. I recently switched to LCHF and I feel great. Was hoping my LDL would go down, b/c I’m a physician and am working through the “LDL BAD” brainwashing. Total 283 LDL 195 TGs 70 HDL 71 So remnants are 17
Ah yes, I feel for you. I find it easier to explain my research and work to laypeople more than medical professionals (ironically). There’s a near religious zeal regarding LDL and it’s presumption of deadliness in your line of work.
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 265 mg/dL 6.85 mmol/L
LDL Cholesterol: 191 mg/dL 4.94 mmol/L
HDL Cholesterol: 45 mg/dL 1.16 mmol/L
Triglycerides: 145 mg/dL 1.64 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 29 mg/dL 0.75 mmol/L >>> Medium-High Risk Quintile
Remnant Chol to HDL: 0.64 >>> Medium-High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.15 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 191 | Iranian LDL-C: 220
Total/HDL Ratio: 5.89
TG/HDL Ratio in mg/dL: 3.22 | in mmol/L: 1.41
48 year old man, this was a blood panel my cardiologist ordered when I came in asking about getting a Coronary Calcium CT (which he doesn’t believe in). In the days prior to the blood draw I had been eating one fairly large meal per day with a monster 800+ calorie BPC – 4 TSBP coconut oil, 2 TBSP heavy cream, 2 TSBP butter). I work at night, 12 hr shifts, had been up all night prior to the blood draw at 10AM. Had consumed nothing other than my BPC which I finished at work at 9PM the night before the blood draw.
Been Keto since November 16, 2017, went relatively “off-plan” the week of Christmas through New Year’s Day, back on Keto fairly strict ever since. I struggle keeping my protein intake down on the moderate side. Down 30 pounds since November 2017.
Brand new to the idea about remnant cholesterol, not sure I like seeing that I’m high risk, please interpret, thanks Dave!
Hi Roberto–
— Per my instructions with the Feldman Protocol, I don’t like coconut or MCT oil as they are metabolized differently due to having more short and medium chain triglycerides. They also seem to regularly come up as a confounder with lipid tests.
— Out of curiosity, why do you make that huge BPC over just doing real food? I don’t know of many who ingest a lot of their fat calories in liquid form, so it’s hard to compare it to. Makes for an interesting N=1 though. 🙂
— Given what you’re also saying about trying to keep your protein low, it sounds like you might be chasing higher ketone numbers. My own .02, protein isn’t a good thing to intentionally limit. I’m not particularly pro-protein boosting, per se, just that I’m not pro-protein limiting either. If you find it hard to do, you might be doing too much to make that change.
— Grats on the weight loss!
How long would you recommend someone lay off the MCT oil or coconut oil before the blood draw?
Your doctor may not like Calcium CT’S because this test is flagged by insurance companies as expensive, and the dr gets downgraded by the insurance company. He has to show “just cause” for the request of a Coronary CT. Most doctors are controlled and decision making is influenced by big insurance.companies.
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 220 mg/dL 5.69 mmol/L
LDL Cholesterol: 136 mg/dL 3.52 mmol/L
HDL Cholesterol: 65 mg/dL 1.67 mmol/L
Triglycerides: 96 mg/dL 1.08 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 19 mg/dL 0.49 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.29 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.189 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 136 | Iranian LDL-C: 138
Total/HDL Ratio: 3.38
TG/HDL Ratio in mg/dL: 1.48 | in mmol/L: 0.65
54 y.o. female followed a low fat diet for 22+ years.
Took statin for 10 years until reaction in 2012, stopped statin.
A1c 6.0 (has been consistent for years, even 3 months following keto with IF fasting)
Wheat belly diet plus added daily egg in 2014 (arthritis & jaw pain disappeared)
Open heart bypass Feb 2017
3 stents Sept 2017
AUG 2017 PALEO
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 241 mg/dL 6.24 mmol/L
LDL Cholesterol: 126 mg/dL 3.26 mmol/L
HDL Cholesterol: 54 mg/dL 1.4 mmol/L
Triglycerides: 308 mg/dL 3.48 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 61 mg/dL 1.58 mmol/L >>> High Risk Quintile
Remnant Chol to HDL: 1.13 >>> High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.395 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 125 | Iranian LDL-C: 278
Total/HDL Ratio: 4.46
TG/HDL Ratio in mg/dL: 5.7 | in mmol/L: 2.49
SEPT 2017 PALEO/KETO BEFORE STATIN
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 249 mg/dL 6.43 mmol/L
LDL Cholesterol: 150 mg/dL 3.87 mmol/L
HDL Cholesterol: 58 mg/dL 1.5 mmol/L
Triglycerides: 207 mg/dL 2.34 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 41 mg/dL 1.06 mmol/L >>> Medium-High Risk Quintile
Remnant Chol to HDL: 0.71 >>> Medium-High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.193 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 150 | Iranian LDL-C: 227
Total/HDL Ratio: 4.29
TG/HDL Ratio in mg/dL: 3.57 | in mmol/L: 1.56
NOV 2017 STATIN & KETO WITH IF FASTING
-==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 242 mg/dL 6.27 mmol/L
LDL Cholesterol: 130 mg/dL 3.37 mmol/L
HDL Cholesterol: 46 mg/dL 1.2 mmol/L
Triglycerides: 151 mg/dL 1.7 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 66 mg/dL 1.71 mmol/L >>> High Risk Quintile
Remnant Chol to HDL: 1.43 >>> High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.151 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 166 | Iranian LDL-C: 203
Total/HDL Ratio: 5.26
TG/HDL Ratio in mg/dL: 3.28 | in mmol/L: 1.42
DEC 2017 NO STATIN, NO FRUITS &
STOPPED FASTING 3 DAYS BEFORE TEST
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 166 mg/dL 4.29 mmol/L
LDL Cholesterol: 94 mg/dL 2.43 mmol/L
HDL Cholesterol: 55 mg/dL 1.42 mmol/L
Triglycerides: 85 mg/dL 0.96 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 17 mg/dL 0.44 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.31 >>> Medium Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.17 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 94 | Iranian LDL-C: 96
Total/HDL Ratio: 3.02
TG/HDL Ratio in mg/dL: 1.55 | in mmol/L: 0.68
FEB NO STATIN, NO FRUITS &
DID NOT STOP FASTING 3 DAYS BEFORE TEST
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 220 mg/dL 5.69 mmol/L
LDL Cholesterol: 136 mg/dL 3.52 mmol/L
HDL Cholesterol: 65 mg/dL 1.67 mmol/L
Triglycerides: 96 mg/dL 1.08 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 19 mg/dL 0.49 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.29 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.189 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 136 | Iranian LDL-C: 138
Total/HDL Ratio: 3.38
TG/HDL Ratio in mg/dL: 1.48 | in mmol/L: 0.65
MAR NO STATIN, NO FRUITS &
STOPPED FASTING 3 DAYS BEFORE TEST &
ADDED MORE FISH OIL TO DIET
Hi Sally! Thanks for adding all this great data! It’s like a long story that’s coming to a happy ending. 🙂
Thanks, Dave.
Thank you for your work!
I forgot to add I had a calcium scan back in 2002 and 2005. My numbers were horrid! I searched everywhere for information. Doctors told me to just keep taking my statin and follow a low fat diet. Well we know how that worked out!
It took 3 different hospitals before a top US hospital thought they could help my condition. (Right before my open heart I stopped eating my egg a day and within 6 weeks my jaw pain returned!) They performed open heart on my LAD but told me my RCA was shot and there was nothing available to bypass. They suggested a full metal jacket of stents (after 6 months following my open heart recovery) the plan was they would go down the RCA to keep it open.
I continued my daily egg diet and know it helped because they ended up only placing 2 stents on the RCA. The doctor said “oh there must have been some miscommunication following your previous angiogram”.
During the angiogram I could hear other people in the room discussing things and then they entered the other leg to have a look around! Next day, I met another patient who said “they are telling me to start eating an egg a day!” This hospital is rated number 8 cardiac hospital in the US and my surgeon is the director of cardiology.
Wow — that’s an incredible story! Glad to see you’re still with us!
Dave,
I seem to be hitting a wall and experiencing a lack of stamina i.e. energy since bringing my cholesterol numbers into target range. I follow a KETO diet along with IF daily fasting with vitamin supplements and will start tracking my macros. Morning blood sugar level has dropped from 110 to 95 after 1 hour of daily exercise. Are you aware of others experiencing this issue and is it just an adjustment period that is needed?
NOV
Total Cholesterol: 242 mg/dL 6.27 mmol/L
LDL Cholesterol: 130 mg/dL 3.37 mmol/L
HDL Cholesterol: 46 mg/dL 1.2 mmol/L
Triglycerides: 151 mg/dL 1.7 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 66 mg/dL 1.71 mmol/L >>> High Risk Quintile
Remnant Chol to HDL: 1.43 >>> High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: 0.151 >>> Highest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 166 | Iranian LDL-C: 203
Total/HDL Ratio: 5.26
TG/HDL Ratio in mg/dL: 3.28 | in mmol/L: 1.42
DEC 2017 NO STATIN, NO FRUITS &
STOPPED FASTING 3 DAYS BEFORE TEST
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 166 mg/dL 4.29 mmol/L
LDL Cholesterol: 94 mg/dL 2.43 mmol/L
HDL Cholesterol: 55 mg/dL 1.42 mmol/L
Triglycerides: 85 mg/dL 0.96 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 19 mg/dL 0.49 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.29 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.189 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 136 | Iranian LDL-C: 138
Total/HDL Ratio: 3.38
TG/HDL Ratio in mg/dL: 1.48 | in mmol/L: 0.65
Often when I hear it described as you did, I suggest making sure you’re getting enough electrolytes. I’ve found I need a lot more sodium (5g) potassium (1g) and magnesium (1g) when on keto. But when I don’t get these in adequate amounts, I often feel run down and puny.
Hi Dave,
Yes, thanks that was my issue! It is amazing what a difference it makes. My stamina is much better.
BEGGINING OF KETO (Oct, 6, 2017)
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 224 mg/dL 5.79 mmol/L
LDL Cholesterol: 100 mg/dL 2.59 mmol/L
HDL Cholesterol: 69 mg/dL 1.78 mmol/L
Triglycerides: 100 mg/dL 1.13 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 55 mg/dL 1.42 mmol/L >>> High Risk Quintile
Remnant Chol to HDL: 0.8 >>> Medium-High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.197 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 135 | Iranian LDL-C: 140
Total/HDL Ratio: 3.25
TG/HDL Ratio in mg/dL: 1.45 | in mmol/L: 0.63
AFTER 4 MONTHS (Feb, 9, 2018)
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 304 mg/dL 7.86 mmol/L
LDL Cholesterol: 198 mg/dL 5.12 mmol/L
HDL Cholesterol: 89 mg/dL 2.3 mmol/L
Triglycerides: 84 mg/dL 0.95 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 17 mg/dL 0.44 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.19 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.384 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 198 | Iranian LDL-C: 181
Total/HDL Ratio: 3.42
TG/HDL Ratio in mg/dL: 0.94 | in mmol/L: 0.41
Wow — love seeing that progress in the risk factors!
As soon as I have my APO’s levels Inwill share here.
Congratularíamos for your job
Oct 6, 2017
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 224 mg/dL 5.79 mmol/L
LDL Cholesterol: 100 mg/dL 2.59 mmol/L
HDL Cholesterol: 69 mg/dL 1.78 mmol/L
Triglycerides: 100 mg/dL 1.13 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 55 mg/dL 1.42 mmol/L >>> High Risk Quintile
Remnant Chol to HDL: 0.8 >>> Medium-High Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.197 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 135 | Iranian LDL-C: 140
Total/HDL Ratio: 3.25
TG/HDL Ratio in mg/dL: 1.45 | in mmol/L: 0.63
Feb, 9 2018
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 304 mg/dL 7.86 mmol/L
LDL Cholesterol: 198 mg/dL 5.12 mmol/L
HDL Cholesterol: 89 mg/dL 2.3 mmol/L
Triglycerides: 84 mg/dL 0.95 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 17 mg/dL 0.44 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.19 >>> Lowest Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.384 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 198 | Iranian LDL-C: 181
Total/HDL Ratio: 3.42
TG/HDL Ratio in mg/dL: 0.94 | in mmol/L: 0.41
*** At this point I was amazed with my TC and LDL numbers. I decided to perform a NMR Lipid profile test ando to stop eating egg (but keeping in a low carb)
NMR LIPO PROFILE:
RESULTS:
LDL-P: 1746 nmol/L (No. of particles)(ref. 1016 – 2185 nmol/L)
LDL (low size): 225 nmol/L (Size; ref.: 123 – 441 nmol/L)
LDL (medium size): 451 nmol/L (Ref.: 167 – 465 nmol/L)
HDL (higher size): 6567 nmol/L (Ref. 4334 – 10815 nmol/L
LDL pattern: A
Feb 23, 2018 (one week without egg)
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 211 mg/dL 5.46 mmol/L
LDL Cholesterol: 122 mg/dL 3.15 mmol/L
HDL Cholesterol: 71 mg/dL 1.84 mmol/L
Triglycerides: 86 mg/dL 0.97 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 18 mg/dL 0.47 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.25 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.278 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 123 | Iranian LDL-C: 120
Total/HDL Ratio: 2.97
TG/HDL Ratio in mg/dL: 1.21 | in mmol/L: 0.53
Hi Haroldo–
Nice data! Would be interesting to get a few people to do this egg removal as an experiment to see if this applies to others.
Thanks for any feedback you can provide!
Total Cholesterol 305
Non HDL Cholesterol 241
LDL Chol 211
LDL Medium 726
ApoB 157
LP PLA2 190
HS CRP <0.2
HDL Chol 64
Trigs 144
Chol/HDL ratio 4.8
LDL pattern A
LDL Particle 2167
HDL Large 5253
LDL Peak Size 218.7
LDL Small 300
Lipoprotein (a) 40
In looking at this lab, I’m curious if you weren’t fasted before having it. We’re you at least 12-14 hours water fasted? (No meals, no coffee, etc — only water)
I’d need to know that first before adding further thoughts…
I did fast after dinner. The only thing I had was water in the morning.
No coffee
Okay, gotcha. The reason I asked is that your Trigs seemed a tad higher than I’m used to seeing with this kind of pattern, particularly with your HDL being that high (a good thing).
Overall, this looks pretty standard for a hyper-responder. You’re a solid Pattern A with LDL-P at 2167, yet small LDL at 300. Lp(a) looks good at 40. LP PLA2 of 190 is even a little lower than I’m used to seeing with hyper-responders (mine is usually low 200s).
I ran your risk profile for Remnant Cholesterol and AIP, but those slightly higher TGs reduce your LDL slightly since it’s a calculated number (Friedewald). So I’m going to go out on a limb and guess that if you were to retest, I’ll bet it would show your TG lower, your LDL higher, and your Remnant Cholesterol lower (and thus better risk profile).
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 305 mg/dL 7.89 mmol/L
LDL Cholesterol: 211 mg/dL 5.46 mmol/L
HDL Cholesterol: 64 mg/dL 1.66 mmol/L
Triglycerides: 144 mg/dL 1.63 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 30 mg/dL 0.78 mmol/L >>> Medium-High Risk Quintile
Remnant Chol to HDL: 0.47 >>> Medium Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.008 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
Friedewald LDL-C: 212 | Iranian LDL-C: 236
Total/HDL Ratio: 4.77
TG/HDL Ratio in mg/dL: 2.25 | in mmol/L: 0.98
Hi Dave,
This is fascinating – thanks for exploring these cholesterol rabbit holes!
Um, what’s the “atherogenic index of plasma”?
–==== CholesterolCode.com Report v0.8 ====–
Total Cholesterol: 367 mg/dL 9.49 mmol/L
LDL Cholesterol: 259 mg/dL 6.71 mmol/L
HDL Cholesterol: 87 mg/dL 2.26 mmol/L
Triglycerides: 101 mg/dL 1.14 mmol/L
–CHOLESTEROL REMNANTS–
Remnant Cholesterol: 21 mg/dL 0.54 mmol/L >>> Medium-Low Risk Quintile
Remnant Chol to HDL: 0.24 >>> Medium-Low Risk Quintile
Go to https://tinyurl.com/y8hokam2 for more on Cholesterol Remnants
–ATHEROGENIC INDEX OF PLASMA (AIP)–
AIP: -0.297 >>> Lowest Risk Third
Go to https://tinyurl.com/ycccmmnx for more on Atherogenic Index of Plasma
–CONVENTIONAL MARKERS AND RATIOS–
HiFriedewald LDL-C: 260 | Iranian LDL-C: 244
Total/HDL Ratio: 4.22
TG/HDL Ratio in mg/dL: 1.16 | in mmol/L: 0.5
Ah yes, I see you corrected on this comment here: http://cholesterolcode.com/remnant-cholesterol-what-every-low-carber-should-know/#comment-14935