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Old 11-21-2008, 10:53 AM   #1
Jim Rodgers
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Help interpreting lipid level numbers

I just got back from an appointment with a dietician. I was told to see one when I had bloodwork done when I met my new doctor (that took a few years when I moved up north; I used to have to travel 3 hours to see my old family GP!) Anyway I won't have another appointment with the doctor until she's done with new patient intake, I'm guessing sometime in the new year.

I went to the dietician in hopes of getting some info on my bloodwork results, but she's not allowed to comment on the values. Since I was told to go see a dietician I figured it was because I had high cholesterol or something so I asked for the results which she is allowed to give me. I figured I would go online when I got home and figure it out for myself but the numbers I have don't make sense to me when I compare them to other results found on the internet. They don't seem to be blood values--are they risk assessment numbers or something?

Any help would be appreciated.

The numbers:
Cholesterol 6.47
HDL 1.80
LDL 4.31
HDL Ratio 3.6
Triglycerides 0.80
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Old 11-21-2008, 02:27 PM   #2
Daniel Freedman
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Re: Help interpreting lipid level numbers

Canada and the US use different units, which may explain the web-based confusion. There was a further re-calibration within the Canadian units in April 2007, which resulted in a 12% increase in triglycerides and about a 6% decrease in LDL values.

I'm comparing your results to mine. From what I can tell, you look shockingly normal. Your total cholesterol and HDL cholesterol may be ever so slightly on the high normal side, but the other (more important) numbers look really low.....which is good. But you really do need a doctor to interpret the results -- as part of a total clinical picture. It's possible to get too hung up on blood work, and many people fall into that trap. Blood work is just one indicator of overall health. Waist size and and Fran time are also important, IMHO.

Last edited by Daniel Freedman : 11-21-2008 at 02:45 PM.
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Old 11-21-2008, 03:20 PM   #3
Jim Rodgers
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Re: Help interpreting lipid level numbers

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Originally Posted by Daniel Freedman View Post
Canada and the US use different units, which may explain the web-based confusion. There was a further re-calibration within the Canadian units in April 2007, which resulted in a 12% increase in triglycerides and about a 6% decrease in LDL values.

I'm comparing your results to mine. From what I can tell, you look shockingly normal. Your total cholesterol and HDL cholesterol may be ever so slightly on the high normal side, but the other (more important) numbers look really low.....which is good. But you really do need a doctor to interpret the results -- as part of a total clinical picture. It's possible to get too hung up on blood work, and many people fall into that trap. Blood work is just one indicator of overall health. Waist size and and Fran time are also important, IMHO.
Thanks a lot! That makes sense now...

I'll definitely consult with my doctor on her interpretation of the results. She won't be able to see me for a while, but I thought if I could get a heads up from the dietician I'd be able to "cram" for my next blood test. Looks like the boatloads of salmon and trout I eat are paying off already though!

(If waist size and Fran time are indicators I may be in serious trouble! jk)

Hate to trouble you or anyone else out there, but might you know of a link that will put my Canadian numbers in perspective for me? I'll do a search but any recommendation would be appreciated.
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Old 11-21-2008, 03:48 PM   #4
Daniel Freedman
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Re: Help interpreting lipid level numbers

Not aware of any online sources for Canadian numbers.

And "cramming for the exam" may not be a great idea. I remember a nurse taking by blood pressure for a physical. She told me of another patient who proudly boasted going for a long walk just before his physical, so he'd get a good score. The nurse said she gently pointed out that going for a long walk was a good idea. But it would be even better if the patient went for a long walk EVERY day!

Blood tests are just a snapshot in time. And they are just some indicators and markers -- among many others -- of some components of overall health. Which is not to say blood tests are irrelevant. But perspective is useful. Th real goal is not good numbers, but good health.

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Old 11-22-2008, 05:26 AM   #5
Patrick Haskell
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Re: Help interpreting lipid level numbers

I'm sure there's more data in there that can be gleaned, but my understanding is that the most effective predictor of heart disease, metabolic syndrome and the like is the triglyceride to HDL ratio. You want this number under 2. Yours is under 0.5, so I'd say you're doing great. I'd also say that I've gotta eat more fish, because that profile looks excellent.
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Old 11-25-2008, 12:52 PM   #6
Jim Rodgers
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Re: Help interpreting lipid level numbers

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Originally Posted by Patrick Haskell View Post
I'm sure there's more data in there that can be gleaned, but my understanding is that the most effective predictor of heart disease, metabolic syndrome and the like is the triglyceride to HDL ratio. You want this number under 2. Yours is under 0.5, so I'd say you're doing great. I'd also say that I've gotta eat more fish, because that profile looks excellent.
Thanks for the response. I'm starting to think the appointment was made because of my high-normal total cholesterol but I'll find out for sure. I'm glad to hear my ratios appear good though.
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Old 12-11-2008, 06:10 AM   #7
Dan Stickler
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Re: Help interpreting lipid level numbers

Jim,
I am a surgeon but I now specialize in fitness and nutrition and we do quite a bit of cholesterol management for our clients. I can not tell you how to interpret the Canadian numbers but to be honest, I am not a big fan of standard cholesterol testing. The standard testing will miss 60% of people at risk for heart disease. There is a test that is much better which we use all the time, it is called the VAP test. It was developed out of the University of Alabama, Birmingham and it will pick up over 90% of people at risk. It looks at 17 variables of the cholesterol and even picks up on genetic risk factors. The test is reasonable even though most insurances will not cover it. You can generally find online resources that will run it for 85-120 dollars. Be careful though some of these places will charge additional fees for interpretation. I will not treat a client without the guidance of this test.
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Old 12-11-2008, 09:09 PM   #8
Robert Pierce
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Re: Help interpreting lipid level numbers

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Originally Posted by Dan Stickler View Post
Jim,
I am a surgeon but I now specialize in fitness and nutrition and we do quite a bit of cholesterol management for our clients. I can not tell you how to interpret the Canadian numbers but to be honest, I am not a big fan of standard cholesterol testing. The standard testing will miss 60% of people at risk for heart disease. There is a test that is much better which we use all the time, it is called the VAP test. It was developed out of the University of Alabama, Birmingham and it will pick up over 90% of people at risk. It looks at 17 variables of the cholesterol and even picks up on genetic risk factors. The test is reasonable even though most insurances will not cover it. You can generally find online resources that will run it for 85-120 dollars. Be careful though some of these places will charge additional fees for interpretation. I will not treat a client without the guidance of this test.
First, the VAP test is not really a "test," it is a panel of tests, 15 as I recall.

Second, what does it mean for a test to "pick up over 90% of people at risk?" Of those who have not had an event, 100% are "at risk," to one extent or the other, right?

You need to know the sensitivity, specificity, positive predictive value, and negative predicitive value of the test. The predictive value of the test depends on the pretest probability, or prevalence, of the disease. That is the likelihood of you having the diseae before you know the test result. Know your pretest probability, and ask for those numbers.

Third, when the normal ranges for a test are set by using a bell-shaped curve of normal people, in which 2.5% are outside of range on one end, and 2.5% are outside of range on the other end of a particular test, you have a statistical likelihood of an abnormal test on a normal person 5% of the time. Multiply that by 15, and now you can see that a normal person is actually statistically more likely than not to have at least one test come back abnormal.

Finally, before you do a test, ask yourself, does it pass the "pick your nose test?" You don't pick your nose unless you know what you are going to do with it. Don't order the test unless you know what you are going to do with it. Is it going to alter medical therapy? Change your workout habit? Change your diet habits? If not, why get it?

One more thing:
Quote:
People with a family history or an existing condition of diabetes, high blood pressure or heart disease - or who are already taking cholesterol-lowering medication - are candidates for the comprehensive VAP Test.
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Last edited by Robert Pierce : 12-11-2008 at 09:11 PM. Reason: add a sentence
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Old 01-01-2009, 10:02 PM   #9
Jim Rodgers
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Re: Help interpreting lipid level numbers

I'm not sure what to say about these arguments. I have no real data other than the Canadian numbers that I've posted. It would seem that these numbers are merely high-normal. I live a relatively active lifestyle and have a diet that consists of mainly whole foods--this sounds good. However I come from a long line of Northern Irish pork farmers with a history of heart disesase.

I appreciate all your input but I feel that all I've offered up to this point is conjecture. I will post more info as I get it later in the New Year and would really love to hear your opinions when I have more informative data.
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