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Done with lipid profile test, not given medicine. What are the findings?

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General & Family Physician
Practicing since : 2001
Answered : 8418 Questions
my lab report indicate the following: cholesterol 149, triglycerides 67, HDL CHOL., Direct 42, HDL as % of cholesterol 28, LIPOPROT. (LDL) DIRECT 94, VLDL, calculated 13, LDL-P TOTAL CT. 1533, small LDL-P 692, LDL PARTICLE SIZE 21.1, HDL PARTICLE COUNT 26.3, HDL-P LARGE 2.4, LIPOPROTEIN-a 43.5, Lp-PLA2 117, hsCRP 0.2, APOLIPOPROTEIN A1 119, APOLIPOPROTEIN B 86. I am a 46 years old man. For the past years, I have been watching my diet, no red meat, no sugar, and been getting my fats by eating a lot of walnuts and cashews daily for the past year. I am worried because if the high LDL-P total count of 1533. My doctor did not prescribed any medication for me. I am much worried as I am trying to eat right. Could the nuts be the problem? Please your advice.
Posted Wed, 3 Jul 2013 in Hypertension and Heart Disease
Answered by Dr. Michelle Gibson James 1 hour later
HI, thanks for using healthcare magic

Though the total LDL-P is important, the number of small LDL particles is even more important.

Small LDL particles have been shown to predict heart disease. Persons with more small than large LDL have been shown to have 3 times the risk of heart disease.This is because the small particles can easily slip through the cells that line the walls of the blood vessels.Once in this vessels they more easily become oxidised and damage the blood vessel.

Less than 600 small LDL is considered the goal, though the lower the better.
Greater than 850 puts a person at moderate risk of heart disease and greater than 1200 very high risk.

Even though the total LDL particles is slightly increased, the small LDL number is near goal which means the majority of the LDL is large particles which are thought not to as significant.

The small LDL is above the goal of 600.

In addition to the healthy diet you are presently on you can consider losing any excess weight , if any is present
(2) use high fiber diet with flax seeds, oats, psyllium fiber
(3) use foods with omega 3 fatty acids- these increase the size of the LDL slightly- this would include tuna, herring, makerel, sardines, salmon

If after a 3 month period it remains outside your goal then your doctor can consider adding medication to this regimen

I hope this helps,feel free to ask any other questions
Above answer was peer-reviewed by
Follow-up: Done with lipid profile test, not given medicine. What are the findings? 19 minutes later
Thanks for your response. Since last year when my A1C indicated prediabetes, I replaced my snacks which were carbohydrates and sugars with nuts, mainly cashews, walnuts and sometimes almonds. My A1C has now improved to 5.6 and I am not overweight, as a matter of fact I am a skinny person. But now an I have an increase in the ldl-p, should I discontinue the nuts?
Answered by Dr. Michelle Gibson James 19 minutes later
Nuts contain a healthy fat and the body needs a source of fat to function.
Walnuts , almonds and cashews are healthy nuts.You do not need to stop them

If your diet is already full of then you can consider asking your doctor for medication to help with the small LDL level

Please feel free to ask any other questions
Above answer was peer-reviewed by
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