Understanding VLDL In Your Lipid Profile Panel:- 

When you are looking at triglycerides levels in fasting stage you are actually looking at how your liver handles carbohydrates (sugar) in your diet.
VLDL (Very low density lipoprotein):- They are what your liver does with the sugar you eat. Liver turns sugar into fat and packages it as VLDL, which in turn changes to LDL (more specifically sdLDL), which ultimately sticks to vessel wall and causes Atherosclerosis. So, if you want to get rid of sdLDL, you need to reduce VLDL which are made up from sugar in the liver.

VLDL is not measured directly but is instead calculated from triglycerides values.
VLDL = Triglycerides value/5

So, more TRIGLYCERIDES means more VLDL.
So, high VLDL in your lipid profile tests indicates:-
2. SUGAR DYSREGULATION (Prediabetes and Diabetes)


Total Cholesterol Interpretation:-

Looking at total cholesterol doesn’t give us a lot of information for predicting heart disease. Body makes 75% of total cholesterol while rest we get it from diet.

Why are your cholesterol levels high?

1 Hypothyroidism
(Lack of thyroid hormones or inadequate amount of thyroid hormones)
As cholesterol is cleared from the circulation by the liver and thyroid hormones increase the expression of LDL receptors on liver cells. If T3 is low, LDL receptors don’t work as well, capacity of liver to metabolize, break down and excrete excess cholesterol is reduced. So, in hypothyroidism we see high cholesterol not because you are eating too much or body is making more, it’s because liver is not clearing it efficiently. Simply correcting thyroid hormones will bring the cholesterol levels back to normal.

2. Blood sugar Dysregulations/ Insulin resistance/ high insulin levels
If you are insulin resistant (as in prediabetes/diabetes), there is hyperinsulinemia (high insulin levels). High insulin upregulates the enzyme HMG CO reductase thereby increasing Cholesterol synthesis. We test for FBS , HBA1C or C Peptide levels, if any of these is elevated, that could be the cause of high cholesterol levels. Managing blood sugar levels, managing insulin levels may help to bring down your cholesterol numbers.

3. Kidney disease or Dysfunctional kidneys is associated with elevation in cholesterol. If we find high cholesterol along with high creatinine levels or other markers of kidney disease, then high cholesterol may be due to kidney dysfunction.

If you are taking statins (cholesterol lowering drugs) by looking at your cholesterol numbers only, then you are a right candidate for a new doctor. We have to find out the reason for high cholesterol and correcting the root cause should be our priority. With statins, we are blocking synthesis of Cholesterol and CoQ10.You need to take CoQ10. Body doesn’t make unnecessary things, it makes it for a reason. Cholesterol and CoQ10 in the body, they are very expensive to produce.

Are We Fighting With the Wrong Guy?

Is cholesterol the cause of heart disease?

New guidelines by the American heart association: They said TOTAL CHOLESTEROL IS NOT SIGNIFICANTLY ASSOCIATED WITH HEART DISEASE.  Looking at total cholesterol doesn’t give us a lot of information for predicting heart disease. Body makes 75% of total cholesterol  while rest we get it from diet. Cholesterol is essential for making a number of critical hormones, including the stress hormone cortisol. Cholesterol is also used to make the sex hormones testosterone, progesterone, and estrogen.  The liver also uses cholesterol to make bile, a fluid that plays a vital role in the processing and digestion of fats.

There are 2 types of LDL 

1. Large buoyant LDL

2. Small dense ( sd LDL-C)

And it’s the small dense type which creates damage. It’s one of the best markers for predicting heart problems.

Best marker for detecting inflammation deep inside the arteries …

Cholesterol is not going to affect inside the arteries unless there is some type of erosion or lesion inside the arteries. If there is any lesion / erosion due to any cause (hypertension, high glucose levels, high insulin levels smoking, junk food), then this sdLDL will penetrate as they are small and dense molecules and can start the process of plaque formation (along with calcium and fibrous tissue).

So, it’s always always better to go for advance Lipid profile with sdLDL values rather than simple Lipid profile .

Apo b 100 & apo a1

Our cell membrane is made up of cholesterol. Cholesterol is needed to make up the hormones, particularly stress hormones, sex hormones. Cholesterol is also needed to make vitamin D and also needed to make bile that helps to dissolve fats. Cholesterol doesn’t dissolve in water or blood, that is why it is encapsulated in a protein shell for transport in blood.
LDL takes cholesterol from liver and puts it into the blood and it travels into rest of the tissues. Now what the HDL does? It removes the excess cholesterol that LDL brings and gives it back to the liver for its disposal.

We have around 100 trillion cells in our body. Our body makes 3000mg of cholesterol daily, almost all nucleated cells of our body can make cholesterol.

LDL HDL…nothing good nothing bad…they are just doing their job.
LDL’s job is to deliver cholesterol when the tissues need it. HDL’s job is to collect cholesterol if tissues have it in excess.
So, both these lipoproteins are doing their job, how they can be bad then!!
The appropriate amount of both these lipoproteins is always a good thing. When the LDL is large and fluffy, there is nothing wrong with it. When the LDL is damaged by any kind of inflammation or oxidative stress (high blood sugar, Hyperinsulinemia, and insulin resistance, hypertension, smoking, toxins etc.), it gets smaller in size and more denser. Small dense LDL is a victim of inflammation and oxidative stress, it’s called oxidized LDL, which is bad now.

Go for Apolipoprotein B and sdLDL, actually they are more accurate cardiovascular disease risk markers than LDL cholesterol.

ApoB is considered a more accurate measure of heart disease risk because it is a direct measure. While an LDL cholesterol blood test is a calculation (based on total cholesterol, HDL cholesterol, and triglycerides), ApoB is a direct measure. Every potentially atherogenic particle carries one ApoB, so you’re getting a direct count of all the particles that could contribute to cardiovascular disease in your bloodstream.

Apolipoprotein A1 (APO-A1) is the primary protein associated with HDL. Increased levels mostly indicate a reduced risk of cardiovascular diseases. Estimation of APO-A1 is needed for monitoring the cardiac risk of subjects with a family history of CVD’s and also evaluating the effectiveness of lipid-lowering therapy. 
Apolipoprotein B, commonly known as ApoB, is the main protein found in low-density lipoproteins (LDL). Currently, LDL cholesterol is more frequently measured than ApoB levels because it’s included as part of a standard cholesterol test (lipid panel). And while ApoB is not included in standard cholesterol tests, emerging research indicates that ApoB is an essential indicator of heart health and heart disease risk.
The ratio of apo B to apo A1 (apo B/apo A1) reflects the balance of proatherogenic and antiatherogenic particle numbers.

Triglycerides levels interpretation:-

When you are looking at Triglycerides levels in fasting stage you are actually looking at how your liver handles carbohydrates (sugar) in your diet.

1. One of the commonest causes for the high triglycerides levels are
In the presence of excess glucose, when liver cannot store more glycogen, and rest of the body also can’t store it as glycogen, then EXCESS GLUCOSE ultimately gets converted to TRIGLYCERIDES.
People often feel tired or sleepy after a meal. They are unable to utilize glucose or store it as glycogen. And converting glucose to triglycerides is an energy consuming process.
We test for FBS , HBA1C or C- Peptide (or Insulin levels), cholesterol levels; if any of these is elevated, then you may be having high triglycerides levels also.

2 Low thyroid hormones are also associated with hypertriglyceridemia or high triglycerides levels.

3 Kidney dysfunctions.

4 Drinking alcohol could raise the triglycerides and cholesterol in your blood.

Understanding HDL-C in your LIPID PROFILE PANEL:-

HDL is considered to be good cholesterol. It has many antioxidant and anti-inflammatory properties. Over 75 proteins have been found to be associated with HDL molecule. If HDL is normal or high normal, it’s probably a good thing.

High HDL is seen in excessive exercise and in certain infections.

Low HDL is very common in today’s society. It’s always always associated with other lipid abnormalities.
1.Lack of exercise is the main cause for low HDL.
2. Any sort of Blood Sugar Dysregulations show high LDL-C and Low HDL-C.
3.Diet low in fats (fatty acids), generally results in low HDL.