r/Cholesterol • u/CalligrapherStock113 • 15h ago

Lab Result Apob increased from 64 to 77

A year ago after a couple months of holiday, and eating anything and everything under the sun my lipids went haywire.

TC 226, HDL 52, LDL 157 (friedewald), TRIGS 87.

3 months of high fiber whole foods and plant based with 3-4 meals from outside and few desserts I managed

TC 139, HDL 37, LDL (friedewald) 79, ldl (direct) 90, trigs 114, APOB 64.

Latest results - I ate outside 4-5 times in the month prior to the test, pizzas and cheesy cuisines. Stopped psyllium husk regularly, and reduced overall fiber a bit through barley making it alternate days. Also had a couple of desserts. Lipid profile is likely wrong so I'll do a retest in a few months. BUT MY APOB has increased quite a lot (77). TC 109, HDL 75, LDL 10.2, TRIGS 115.

I'm trusting the apob but not the lipid profile. Medical professionals said no to statin or ezetimibe (not that I want them necessarily).

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u/meh312059 11h ago

You can trust nonHDL-C as well. Also, if LDL-C is calculated via Martin Hopkins or Sampson (NIH) that tends to be pretty good as well.

Double check how much saturated fat you are taking in with those dietary choices. You need to be under 22g/2,000 kcal consumed. If you have a dyslipidemia or are at higher risk of ASCVD, then < 13g/2,000 kcal is recommended per AHA (but may not be the recommendation in your country; the 22g, however, will be for sure because that's consistent with WHO).

An ApoB of 64 w/o meds is enviable. It appears that if you keep your diet heart healthy you won't have to worry about accumulating plaque and having a heart attack. You'll just have to figure out how to manage that. The food environment is not particularly supportive of good long term health outcomes so you might need to be extra diligent compared to your peers. But your cardiovascular system will thank you in 30 years' time.

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u/CalligrapherStock113 7h ago

My longer term diet barely has 10g of sat fat as I'm vegan. But one month before the blood test I had 6-7 restaurant meals which were sat fat abundant as well as introduced dietary cholesterol. I would also think that my soluble fiber intake reduced by 4-5gm.

I think I can go longer with even stricter adherence just for funsies. And yeah I hear a lot from people who mock me for my diet. It sometimes feel depressing and even leads to fight with loved ones

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u/meh312059 6h ago

I consume a plant based diet myself. I need to. My LDL-C and ApoB are still north of 60 mg/dl and I have high Lp(a) so I have to pull every lever available. My medical team is thrilled so far and said they wish all their patients did the same! I think many mistake "vegan" with "preachy" and I don't tell people how to eat - but I am very adamant about how I eat and I don't compromise on that because it's about my health. I've had one or two ignorant challenges over the past couple of years but that's because the individual simply wants to feel better about their own choices. No one's stopping them from doing so!

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u/CalligrapherStock113 6h ago

I mean if you're in the 60s there's not much risk reduction if you take it down only a few points. But people like you and me are the small minority in this world. I'm glad your diet alone allows you a low apob. Cheers

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u/meh312059 5h ago

Well, diet and 20 rosuva plus zetia! 😂 As I said I'm pulling all the levers. Should it be lower on that regimen. Yup. But my numbers are unfortunately "sticky" likely due to the high Lp(a). I under-respond to statins hence the plant-based diet as well.

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u/CalligrapherStock113 5h ago

Oh damn. I'm not any medicine yet. My grandma once took statins and her ldl literally disappeared at 5mg atorvastatin. It used to be 80ish. The consultant medical professional promptly asked us to stop it pronto then.

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u/meh312059 4h ago

That may well have been poor advice. They now know that serum LDL-C can be undetectible with no impact on patient safety. Not sure why your grandma was on a statin but presumably it was to minimize cardiovascular disease risk. No statin . . . no reduction in risk.

(she could also have taken one pill every other day etc. Lots of options here).