Enjoying the thread so let me ask this, what do you want to see. You come out of the doctor’s office with your cholesterol test in hand and what results would you love to see for
Any other you might think of
Conversely, what would you not want to see.
As was pointed out at the start, the shift has switched around so much on what are warning/bad signs that many doctors are going to be behind and giving out of date advice. Just curious about your answer and if you two(Mert and Bill) will be in agreement.[/quote]
This is tough because none of the numbers can be taken in a vacuum. Also total Cholesterol does not matter if LDL is good, and LDL does not matter if oxidized and glycated LDL (especially VLDL) is bad.
If you don’t get more than 10 grams a day of PUFA’s and your blood sugar is good and you don’t get more than 25 grams a day of net fructose and you don’t run more than about 15 miles a week or do other comparable high oxidative exercise then you probably don’t have a lot of glycated and oxidized VLDL even if your cholesterol and LDL and triglycerides are high.
You could have a 300 cholesterol and 170 LDL and have zero problem if you
avoid the PUFAs
high blood sugar
aerobic exercise above optimal health benefits (even elite runners who had adapted to aerobic stress started to have increase in heart disease when they averaged over 25 miles a week).
So you definitely want to see a HbA1C that is under 5.7, ideally under 5.3, and probably getting better down to 4.9 and maybe improving down to 4.6 though if the PUFAs and other problems are minimized I’d say that under 5.3 would be great.
If your HbA1C is under 5.3 you reduce your glycated VLDL already even if you have a lot of VLDL particles. IF you don’t eat high omega-6 sources you are unlikely to have a lot of oxidized VLDLs and so honestly the externals are more important to me than the blood test results.
Less than 10 grams PUFA
Less than 25 net fructose
Less than 30% of maintenance calories from carbs plus some to meet post workoutout needs.
Less than 15-25 miles of running, or about 1 days worth of calories burned a week in aerobic activity above a few METS.
- I would definitely want to see an A1C under 5.6, really under 5.3
I would want to see a cholesterol that is not too low and I think 185 is too low. We bring it down to 185 because for most people this will reduce the glycated and oxidized VLDL, but you can virtually eliminate those with diet with a 250 cholesterol.
- So maybe a 200-240 total cholesterol, perfect maybe 220. higher could mean that you have microvascular damage and that the cholesterol is raised to HEAL it, but it is not the cause. I’d rather have a 265 than a 165.
LDL? You need LDL to fight infections if they arise. A very low LDL can mean a chronic infection or autoimmune problem but a high LDL can mean thyroid deficiency.
I would definitely want a total to HDL of 5 or less, and at least 40 HDL, so 200 and 40 or 250 and 50. I’d prefer more like 225 and 65 for about a 3.5 to 1 ratio.
They probably should not even be testing total cholesterol any more except that it might tell you that you have inflammation, but lowering it with a statin is defeating the purpose of cholesterol unless you have blockages already.
So it depends on whether you already have ischemia or not. Without ischemia and with diet in order and stress managed there is nothing wrong with a 250+ cholesterol.
I hope others will chime in. I would say that if your cholesterol or LDL is high the worst thing you can do is try to lower it with cholesterol lowering high omega 6 plant oils because it will just mean that now your LDL particles are high, and also easily oxidized, or to take a statin or even try to lower your cholesterol if you have no ischemia.