Dr. Pihowich, ND, and Dr. Fleury, ND, from True Potential Health in Saskatoon talk about cholesterol testing:
Let’s look at why standard Cholesterol Testing to avoid heart attacks is not enough:
Standard cholesterol testing Standard testing, again, may or may not tell you if you’re at risk of a cardiovascular event. Standard testing is only accurate when it is concordant with NMR LDL-p. Furthermore, there are lots of things that can raise cholesterol which, again, may or may not correlate with increased risk event. Cholesterol naturally goes up with menopause, and stress. Cholesterol is the precursor to pregnenolone. Pregnenolone is the substrate for sex hormones and sex hormones. If we’re stressed, we need more stress hormones to maintain our sympathetic response, so the demand for pregnenolone, and thus cholesterol, goes up so we make more of it.
So what cholesterol tests are the most useful to assess your risk for heart issues?
So if we’re to test anything, it should probably be Lp(a) and either ApoB or LDL(p). Lp(a) is mostly influenced by genetics and when it’s higher it equates to more inflammation that can contribute to atherosclerosis. You want you levels to be less than 30 milligrams per deciliter (mg/dL). ApoB is one of the main protein constituents of LDL, and there is typically one ApoB per LDL particle, so it can be used as a surrogate marker for LDL-p. LDL-p is the actual count of LDL particles. Either way, a target of ApoB less than 90 mg per dL (0.9 g per L), or an LDL-p of less than 1000 nanomoles per L.
To sum cholesterol testing up:
Normal cholesterol panels look at Triglycerides, LDL-C, HDL-C, and Total Cholesterol. They do not look at the number of particles of LDL, which is important when properly assessing risk of atherosclerosis. Again, the “LDL-C” vs “LDL-p” are very different, and tell us the total amount of cholesterol being carried by the particles, versus the total number of particles carrying the cholesterol. The latter is very important to know. With LDL-p you’ll know what your true risk is, and how much you’ll need to focus on diet, lifestyle, or medication as treatment.
If you’re worried about your cholesterol levels, book an appointment to have your results
Written by Dr. Kahlen Pihowich at True Potential Health Services in Saskatoon, SK.