I’ve been working with an evolving lab that evaluates an extensive panel of cardiovascular and metabolic inflammation markers. Over the course of working with this lab, I’ve learned a very concerning fact: only around 30% of the basic cholesterol panels run show an accurate picture of related risk.

My own results have illustrated this picture. Four years ago, I ran a complete panel including these specialized markers, and the picture was grim. Though I’ve been in good health with optimal weight and decent exercise and diet patterns, I wasn’t especially surprised given my parents’ history of heart disease and high cholesterol. I was hoping that I’d done a better job with my lifestyle habits but apparently that doesn’t take care of it all.

I tried fish oils and niacin but didn’t tolerate the niacin, so I worked through three versions of hormone replacement. Hormone pellets’ lipid lowering benefits increase over a year, so I diligently used pellets for a year, then rechecked. I was excited when I saw that my basic panel had completely normalized!  However, as it turns out, I was one of the 70% whose basic lipids were not showing the whole iceberg, only the tip after all! The fractionated lipid (or Complete Lipoprotein Profile) panel told a more complete and very different story.

I’ll explain some of the findings that show the deeper picture below (and in next blog post too), and some of our tactics to address it.


Some tests included in a Complete Lipoprotein Profile and inflammation markers are discussed here:

  • LDL-P, or LDL particles are the number of actual particles whereas the regularly done LDL -C is the cholesterol transported within the LDL particles. Increased particles are associated with increased cardiovascular disease risk and atherosclerosis even with normal LDL-C. 
  • VLDL particles are triglyceride-rich lipoproteins so may result from familial high triglycerides or other causes, including insulin resistance and diabetes, estrogens, anabolic steroids, or excess alcohol intake. 
  • Lp(a) are lipoprotein particles that are the most atherogenic in the circulation with potential for causing plaques, thrombosis (clots), and increased risk of cardiovascular events. They are an inherited trait and rise with menopause.
  • ApoB is a measure of the number of potential atherogenic lipoproteins (VLDL, LDL) in the blood that can deposit cholesterol into the artery wall. This number is more predictive of atherosclerotic risk and cardiovascular events than LDL -C, especially in younger adults. This has also been linked to decreasing cognitive abilities, dementia, and Alzheimer’s disease.
  • APOE genotype- This is a gene that seems to determine how we respond to dietary fat. If you remember any gene science, you get 1 gene from each parent and there are 3 possible alleles to carry, the 2, 3, or 4 alleles (variations of the gene). The 4 allele is the highest risk for cardiovascular disease and Alzheimer’s. 

In my next blog I’ll tell you about some inflammation markers related to insulin resistance which can show surprising results.