My first blood test after coming off statins in mid-October, was at the end of November. LDL-C jumped to 3.29 mmol/l from 1.95 mmol/l. Total cholesterol went from 4.09 mmol/l to 5.57 mmol/l , triglycerides went from 0.56 mmol/l to 0.83 mmol/l, but HDL-C increased slightly going from 1.89 mmol/l to 1.90 mmol/l ; total cholesterol/HDL-C ratio went from 2.2 to 2.9 which is still in the desirable range. During this time I also began measuring my ApoB and ApoA-1 levels as I read extensively about this subject and realized it is more relevant than LDL-C levels. The ratio of ApoB/ApoA-1 is apparently more important than the absolute level of LDL-C. My ratio was 0.67 which is below 0.8 as recommended. Furthermore my hs-CRP level which measures low-grade inflammation in the body was <0.3 which was unchanged from the measure when I was last on the statin medication. This is a critical additional piece of information as it clearly indicated that the statin's anti-inflammatory benefits were not necessary in my case due to my optimal lifestyle and diet.
Aside from the fact that the LDL-C measure includes LDL sub-fractions that are harmless, I learned that the LDL-C value itself is calculated and not directly measured. This is why I now put more weight in the ApoB level which is directly measured and includes only the atherogenic components of the LDL-C. Furthermore, I learned that for those with extremely low or high triglyceride levels, the standard Friedwald formula used to calculate LDL-C became less accurate. I found 2 competing formulas that seem to provide a similar result, the Iranian Formula and the Cordova Formula. Using these other formulas my LDL-C value changed from 3.29 to 2.99, still above optimal but significantly lower.
Upon seeing my Nov. 29/16 results my physician called me due to the significantly elevated levels of LDL-C. He asked 'what are you thinking'? I told him that there's a possibility these results were a 'rebound effect' from coming off of the statin medication. He had not heard about the rebound effect. I suggested I would take another measurement in 3 weeks to confirm results. He said since all of my ratios were still in the appropriate range, I could do the confirmation test in January.
So on January 10, 2017 I had my blood chemistry measured again. Here were the results:
Total cholesterol 5.2 mmol/l, down from 5.57, now at the optimal level of 5.2 mmol/l or less.
LDL-C 3.04 mmol/l, down from 3.29 (Friedwald Formula); 2.49, down from 2.99, using Iranian/Cordova formula average; At 2.49 mmol/l I'm within the guidelines for optimal LDL.
HDL-C (good cholesterol) 1.87 mmol/l, down slightly from 1.90 which is an insignificant change and is at optimal levels;
Triglycerides 0.64 mmol/l, down from 0.83; optimal level
TC/HDL ratio 2.78, down from 2.9, both optimal levels
TG/HDL ratio 0.34, down from 0.44, both optimal levels
ApoB 0.99, down from 1.12, optimal is 0.80 or less;
ApoA-1 - 1.51, a decline from 1.66, both results in optimal range;
ApoB/ApoA-1 ratio improved to 0.66 from 0.67, still in the optimal range below 0.80.
I also measured my MPO (Myeloperoxidase) again, which determines the level of low-grade inflammation in your arteries and is a good predictor of cardiovascular risk. it declined to 221 pmol/L, down from 239 pmol/L in Sept. 2016. Both measures indicate a low risk level.
Finally I also got my FMD% score (Flow-Mediated Dilation) which measures the elasticity of my arteries. This is known as the Brachial Artery Responsiveness test. I had it tested using the Angiodefender device. A score of 5% or less puts you at high risk, a score between 5% and 8.7% places you in medium risk, and a score of 8.8% or higher places you at low risk.
In early September of 2016 I did this test for the first time and scored 6.8% which placed me at medium risk. This month my score was 7.9%, a significant improvement in arterial elasticity but still in the medium risk range.
What is interesting to note is that the steady CRP levels, the reduced MPO and the improved FMD% score appear to support the notion that my heart disease may be in the early stages of a reversal. That is, the plaque accumulation in my arteries is diminishing.
Well with the additional corroborating evidence of the MPO and FMD% measures, I feel confident that I have no need to go back on statins. My doctor has seen the current blood chemistry and did not call me so I'm assuming he's satisfied.
A final note - when I did the FMD% measure, they take your blood-work there and measure it on the spot using a special medical device. My total cholesterol came in at 5.07 mmol/l which was down from 5.2 mmol/l done the previous week at the normal blood lab. HDL was 1.86 mmol/l virtually unchanged from the previous week's 1.87 mmol/l. LDL-C was 2.41 mmol/l (Cordova formula) down from 2.49 the previous week. TC/HDL ratio was 2.7, down from 2.9 the previous week.
I will continue to monitor every 6 weeks and continue to refine my diet. I started eating more barley between the last two blood tests, as well as reducing my sugar intake to no more than 3 teaspoons per day. I didn't actually have 3 teaspoons of raw sugar, that is a measure based on the ingredients in various things I have throughout the day. I also methodically eat 1 apple, 1 orange and 1 bowl of blueberries daily, and drink 2-3 green teas, and 2 ginger teas each day. I began using vitamin C supplements, B12, Vitamin E, and increased my Omega-3 fish oil supplements. The full impact of these supplements will not be felt until my next blood test around February 20th.
Stay tuned.
High Cholesterol but high HDL
