Triglyceride/HDL Ratio - A Better CV Risk Predictor than LDL? (Part 1) 

I'm 37 my LDL is 59 My HDL is 35 Triglycerides 80 A1C is 4.8 Should I be worried about the low HDL of 35?? I'm not over weight I don't smoke.

I dropped 80 lbs in 8 months. Dr wanted to Rx a statin, oral insulin, BP meds and a CPAP. Asked her to give me 6 months. Better nutrition choices, no alcohol, no sugar, calorie deficit, and intermittent fasting daily exercise. In one year my Triglyceride went from 173 down to 54. HDL went up from 38 to 57. Oh, and didn't completely eliminate carbs other than cut out bread, pasta, not much rice.

After 5 months on keto, my HDL number nearly doubled to 76 while my triglycerides dropped from 76 to 56, so my triglyceride/HDL ration dropped from 1.86 to 0.74. My dr. was so happy with that & the weight I lost he didn't care that my LDL was high. I also got off of 4 hypertension meds, some I had been on for 20 years.

From those of us who lost our jobs and are struggling to feel our families, we so greatly appreciate you giving us this information freely to help us stay healthy! Thank you!

I had a heart attack at 56 two years ago. Helicopter ride, 3 stents, survived. Got CAC score, high. My triglycerides/HDL was around 8x. I then went LCHF, and my ratio dropped to 1.1x, and is in the 1-2 range today. My Mayo cardiologist is fixated on LDL, wants me on PCSK9 inhibitor. No way. To his credit, when I told him about tri/HDL, he looked it up on the internet. I hate statins, they mess with my head, and I consider LDL to be good. sdLDL not so much. Anyway, I am sticking with low carb for life and will remain focused on tri/HDL. Hopefully that'll help me keep that CAC score from growing. My understanding is that stabilizing the CAC score equates to sharp lessening of risk of another heart attack....

The Dogmatic practice of ignoring elevated insulin and treating elevated glucose & cholesterol with medication is a heavily marketed concept in the Medical Community. Thanks for this presentation.

God bless Dr Brewer !!!!!!- I really appreciate your enlightenment in these lectures regarding Triglycerides. Thank you.

Thank you for stating the UK measuring format too.

it’s good that these videos use uk and us units interchangeably

Really appreciate the colored Slides & written explanation, much easier to understand by going back to match hearingv& written word. Hearing language from 50 years ago does not compute as fast in a 73 yo brain. I was very upset with you on Saturday when I could only listen & not see the printed words. A big THANK YOU❤

Thanks for the informative video Dr. Brewer, I've always been health conscience. Thought I was doing the right thing, sounds like to my own detriment. I was wrong. I've been going through a liter of extra virgin olive oil consuming it daily with lemon juice in a shot glass every morning thinking I was cleaning out my arteries! From the sound of it I hope that I have not caused heart damage or plaque buildup in my arteries.

Thank you from the bottom of my "heart" :-)

My TRG was never high at around 60, but my HDL would be around 40. My first physical after 4 months on keto, my TRG dropped to 40 while my HDL went up to 60 making my TRG/HDL ratio under 1.

"we talk about that in just few minutes" is very common phrase used by this doctor !

Ethnicity does play a significant role.

Another great video !! I've recently had my AAA repaired after discovering it 12 years ago. I had to have a Cardiologist do an angioplasty to rule out a blockage but found none and so he oked the surgery for the AAA. I'd like to add that the blockage was 50% in 2002 but clear now as are my caroids that were 49 and 47 % blocked but now are less than 12%. I had a Y branch stent in my aorta and femal arteries and although I was sore for a bit I'm back to working building my sand bag house carrying 50 pound bags up the ladder and I'm 75 now. I've gotten a release from my Vascular surgeon a month ago after 10 months of no workouts and working and not lifting over 10 pounds. She said be prepared to spend 5 days for recovery but was released in 24 hours as my health was excellent after changing my entire lifestyle for the past 20 yrars. I've explained that I worked for Abbotts and don't take meds of any kind and I'm very proactive about my health. I've been watching your channel for years now and admire your no nonsense delivery to us who need direction. Keep the videos coming and touching many lives. GOD bless you.

Thanks for the information!

Here are 3 questions, for everyone's benefit: 1. What is the ideal ratio, and how does it vary based on race or culture/region? 2. When calculating the ratio, should we use TG/HDL or HDL/TG? 3. What other test results should be considered when determining the final ratio, such as T4 and others? Your expertise, and videos, are greatly appreciated.

Ugh.. Lost 80 lbs over the course of 5 years, reversed Type 2 Diabetes, have a current Trig /HDL ratio of .56 (HDL=88, Trigs=49) and my Dr. wants to kill me because my LDL is very high (Type A fluffy). Never had much of a cholesterol problem until I lost all that weight. Ordered my own NMR lipid profile and tried to go over it with my Dr.. His response was, "you probably know more about this than I do." Great, appreciate the honesty but can't get any straight answers in this world of corporate medicine!

Thank you very much for the helpful videos

Terrific discussion & presentation Dr. Brewer! I hope that you are going to cover plaque formation of the endothelial lining at some point. No one has explained why LDL (which is a much larger molecule than HDL) is taken up & deposited in the walls over HDL. Since the HDL molecule is much smaller, you would think that it would more easily diffuse across the membrane & be preferentially deposited. In any event, keep up the great work that you are doing.........Be well & stay safe.........👍👍😉😉

Great video, Thanks.

High TG in the blood is from the liver turning all the excess glucose you eat into fat and shipping it off to be stored. You fix this by going low carb/keto. Good numbers are TG below 80 and HDL above 60. So a ratio of 1.3. Otherwise you are likely pattern B and at risk.

Total cholesterol- 480 Triglycerides- 104 HDL- 64 VLVD CAL-17 LDL CHOL CAL -399. lean mass hyper reponder? 6 months on strick carnivore and havent felt this good in year's.

The easiest way, no matter what the individual measurements are, is to say "The bigger # over the smaller # should be bigger than 2:1, with respect to 3-Glyc and HDL .. focussing on the good stuff (HDL)

Hi Doc, I'm a new subscriber here. I'm truly amazed at how passionate and succinct your videos are! I just had my lipid profile test. I'm from the Philippines and not sure if we have the advanced version of the test. Here are my results: Total Cholesterol: 4.88 mmol/l HDL: 1.38 mmol/l TG:. 71 mmol/l Direct LDL: 3.40 mmol/l VLDL:. 32 mmol/l Our cardiologist said I should take avator/statin to lower it down. I didn't do it cause it felt like it was a shortcut and just couldn't believe that is the only solution. I have no diabetes. I passed my stress test and venus vein tests. I'm 41. I wanted to know if I'm in trouble? I'm doing my usual cardio, hiit exercises every week. Diet is always low carbs because my husband has CKD. Do I really need to take the statin? Appreciate any help pls!

I've read this study before. But, there are some serious exceptions to it. In my case, my TG are below 100, and my HDL is in the 70's. My calculated ratio is around 1.35, which is way below the 3.0 ratio which indicates severe risk for CAD. It's always been around that level. And, yet, at 47, I have REALLY BAD CAD. I don't smoke either. I used to know an older Pakistani guy who had familial hypercholestemia and unreal high TG. He told me his whole story. Great runner too, by the way, and I used to run hills and long runs with the guy. When he was in his 30's, he had a blood test, and the nurses immediately called his wife and told her he needs to get into the hospital ASAP. His TG were literally in the thousands. He also had high cholesterol levels. He said he tried dieting and stopped eating anything with fats or cholesterol, and he said his #'s barely went down 10%. But, he kept trying that and exercising and eventually started Niacin therapy. He did this for 20 years, and finally gave into statins. But, he had a stress echo and carotid IMT and they said his carotids were clean. Not sure what his coronaries looked like, but at 55 years of age, he had no real sign of heart disease. So, anyways, there's always exceptions to these studies.

Thanks

Feb Annual Physical: 96/59 = 1.6 Three weeks ago after 4mo Clean Keto: 57/78 = 0.7 Sweet!

Excellent video. I have already shared with a friend. My Triglycerides/ HDL ratio is under 1.

Excellent information, looking for your next video, Thank you👏😃👍

Very helpful!

I am 68 and started keto 5 months ago. My first blood test was showing: HDL=123 (some say this is too high) LDL=74 Trig=37 VLDL=8

My HDL is 97 and triglycerides of 54, way less than 1. WOO-HOO. 💪🙏

I'm in my 60's. My triglycerides are 10 times my HDL. No heart disease according to two cardiologists. Imaging of heart and arteries are "Excellent". I'm happy about that but don't know why this is. My parents had perfect lipid panels yet both died from CV issues. I'm the one with crummy lipid tests and clean and clear arteries.

2 years ketovore. My trig:hdl is 68:57 or 1.19. I'm delighted.

My doctor told me my lipid test were good....very good. But my Try/HDL is 6. Im on a diet now. Very good video. Thank you;)

Excellent vid. Thank you.

My heart went out of rhythm and I was prescribed 13 different meds. My triglycerides went to 2150. My cholesterol went to 135, hdl was 29, ldi was in the 50s. My blood sugar was in the 90s. Last doctor visit my triglycerides were at 65. My cholesterol was 159. My hdl was at 58. My ldl was at 99. My blood sugar was 153.

Once my hdl was 42. Then I used to take falax seeds. It reached 69. Now I am in keto diet. My hdl is 108 with triglycerides 48.

great video, just want to mention something else based on my research, this ratio isn't perfect without flaw, there was another index taken BMI into consideration introduced in the past few years called SPISE = 600 × HDL-cholesterol0.185/triglycerides0.2/BMI1.338 looks to be a better indicator for insulin resistance compared with HOMA-IR result, for those who have relatively low TC/HDL ratio but also low TC and HDL number, if you don't eat plant based diet, then you are most likely insulin resistant so you have to look at both not just the ratio. Normally when you switch to a low carb diet you should expect to see TC coming down while HDL goes up above 60, if HDL doesn't then you may have higher insulin resistant problem. Also similar to different types of LDL particles, it seems HDL particles are not created equal too, some people may have very high HDL due to genetics but doesn't necessarily mean it has good protection of atherosclerosis, you may want to do an HDL function panel which isn't a commonly used test

come back when you figure it out. It is more than apparent that you currently do not know!

Interesting video

Ok so to simplify/summarize, what shld the triglycerides / hdl be?? And lowering...processed food consumption will lower that ratio for sure..and refined carbs. There are different types of carbs and diff types of fats.

Great video!! I'm a 60 yr old woman. My levels are as follows: Total Cholesterol-230, TG 60, HDL 74, LDL 146 ApoB is 102, which shows it's 'high'. Will I have to consider getting on a Statin? I hope not! Also, what's my TG/HDL Ratio?Thanks!

My HDL was 60 and my triglycerides 70 my LDL 160 (always been elevated since my youth), and I was 66 when diagnosed with pre diabetes. See there are some of us with almost great number that deviate from the rule. I got familial DM2 trait; I never been overweight, and always followed a moderate approach to health with food and life style. I do not have HTN either. Regardless, here I was been told I was pre diabetic. What a disappointment. After the initial shock, I went on to follow a keto diet with IF two meals a day and increased my exercise routine. My CAC is 0 score. I believe I have the fluffy LDL particle most abundant. I am thinking about an NMR test. But my ratio of t/h is good, and always has been. My dr has been unsuccessful at getting me to accept the statins. I do not think my LDL is a problem. My HDL and trig are even better in 2023 90 and 47. The human body can be very deceiving; we are similar, but not the same.

Interesting. My total cholesterol is ALWAYS high. However, my HDL is always very good. Last test showed 257 total, 167 LDL, 46 TGL and 82 HDL. So my TGL/HDL ratio is below 1 and my Total/HDL ratio is 3.1. I work out a lot and I've always eaten fairly decent. I'm eating a lot better now because my doctor told me that my blood pressure was higher than normal. I try to eat a lot of blueberries, raw broccoli, cauliflower and carrots and at least 1 avocado a day.

So I'm a bit confused... my recent chart shows this: Total Cholesterol: 142 HDL 55mg/dl Hdl/ldl ratio: 1.2 Non hdl: 87mg/dl Triglycerides: 103mg dl Ldl chol calc : 68 Ldl-p size 753/nmol Hdl-p: 30.8 Small LDL P: 123/nmol Ldl size: 21.2nm Lp-ir :

Hi Doc Thanks for video. I noticed at the beginning you do also refer to SI units mmol/L. I have a question regarding this that has been bothering me for some time, have asked other doctors but they never clarify if my thinking is correct. In the example you gave of the patient that has a Trig/HDL ratio of 6.4:1 and I have heard it stated that ideal is 1:1 or at least < than 1.5:1. If we convert the units in your example to mmol/L..... Trigs 216mg/dl = 2.44 mmol/L and HDL 34mg/dL= 0.88mmol/L and now perform the ratio calculation 2.44/0.88= a ratio of 2.77 . So do I conclude when talking about the optimal ratio for Triglycerides to HDL of being 1:1, it is only when the units are expressed in mg/dL ? It is evident that amount of Triglycerides and HDL is the same, it's just the units that change but then depending on which units used the ratio is definitely different.

Wifey has a recent blood test. Her ratio was 1.09. :-)

Great video! A recent blood work reveals: TC 273 HDL 59 TG 58 LDL 208 TG/HDL Ratio 1.0 Please, should I go on statins? Have high blood pressure and suspect FH.

Does low dha cause higher triglycerides? What is dha's role?

Latest lipid profile: hdl-83, ldl-179, tg-81.. Can I do without statins as ratio seems OK..

Sir my Triglycerides are 83.5 Hdl is 48.33 Triglyceride/hdl ratio is 1.73 But my ldl is 142, have any suggestions or opinion.

Amazing video. Thank you very much!

Im confused. Can someone tell me if im high risk or at risk for cardiac issues? Total cholesterol: 223; Triglycerides 62; HDL 74; LDL 134; Glucose 78. I do have hypothyroidism, 37 yr old F, non smoker/drinker, exercise daily, 127lbs, I do intermittent fasting daily. My endocrinologist told me to go plant base to lower my TPO thyroid antibodies since they are extremely high (330).

Hi Doc, could you please interpret my labtest result which is my triglycerides is 0.38 mmol/l, hdl c is 0.81 mmol/l but my ldl is 3.9 mmol/l which is high. Are there any problem with this results?Thank you!

My numbers at the time I was doing lion diet. Note I am on a statin - Cholesterol 110, HDL 66, LDL 31, trigs 64, APOB 45, Non HDL 44. He commented it was the best improvement he’d ever seen. I didn’t tell I had changed my diet to carnivore.

My non -HDL is 2.27, HDL is 1.21, Triglycerides is 0.83, Measured in mmol/L. Non fasting, I ate oatmeal 3 hours before blood test was done. A1c is 5.1, Are these numbers good or bad? I am 50 years old.

Here are my results. Total Cholesterol: 221 Triglycerides: 63 HDL: 50 LDL: 160 I have a good HDL/Triglyceride ratio. Should I be concerned about my LDL or no?

My triglycerides are only 78 and they said I am pre-diabetic, so shouldn’t they be really high? I wish you would let me know your opinion on this please. I already had bypass surgery last year.

Cleveland Heart Lab has a new test called HDL function. It looks at specific proteins found on HDL particles. Can you do a video about that one?

My latest lipid profile is my triglyceride is high ang my LDL is high and my HDL is low what should i do?

Is it possible to have too low of a ratio? My triglycerides are 28, HDL 76 and LDL 120. I was told to get my LDL down but now I’m confused.

I’m 70 years old on keto LDL 160 HDL 133 triglycerides 54 Ratio would be 0.40. Is that correct?

Hi Dr. Brewer, my cholesterol test results are as follows: total cholesterol=263, HDL=85, Triglycerides=53, LDL=169 (Apo A 1.7, Apo B=1.1). My blood pressure is 100/60. Glucose = 90. My BMI= 20.5. I am a 49 years old woman. I’ve been on intermittent fasting (16/8) and low carb diet for the last 2 years. Should I be worried about high LDL? I’am so confused as different doctors have told me completely different things…

My Trig is 205 and HDL is 21 so if I’m calculating it right my ratio is 9.76 holy moly 😮

Great Vid! Im 75 and LDL 117, HDL 34, Trig 135 and these numbers got worse after 7 months of a vegan low fat diet? I did quit statin for 3 months is that it? What is happening?

My triglycerides and vldl are very low, in too healthy range but ldl is high wats science behind it

I just got my lipid test results back. Everything looks great except my HDL is only 32. My total cholesterol was 94. I have never had low HDL. I suspect the statin the cardiologist insists I take because my LDL and total was very high once. I’ve always been able to bring that right back down by drinking more water, less sweets, no fried or fast foods and fewer carbs.

I am 65. TG 57 HDL 60 A1C 5.8 ========= A year ago: TG 227 HDL 41 A1C 5.8 ======== Any questions? I didn't think so.

hello, wonder if i get some direction how to manage this: age 57, male , BMI 25, a1c 6.1 (prediabetes?), HDL 65, LDL 178, total chol 256, Trig 42. i eat very healthy, diet low in sat fat and high in olive oil and sardine, almost daily. not on any meds other than vitamins. confused about how to manage this mix bag of blood work result. thanks!

My wife has less very low triglycerides and high HDL but her HBA1C is 6%. Her Tri to HDL ratio is less than 1. Her calcium score is Zero

Hi Doctor here are my cholesterol HDL-110 Triglycerides-64 LDL- 214 Non-smokers, no overweight Mi doctor wants to put me on statin. I don’t want to. Please help me

Is it possible to have a Triglyceride to HDL ratio that is too low? Mine has been as low as 10triglycerides/85 HDL. i have gotten my triglycerides up some so now the ratio is about 35triglcerides/75 HDL. Is that a good ratio?

53 total cholesterol 161 HDL 44 ldl 99 triglycerides 92 . Ratio 3.7 is that good

My HDL/TGl was tested at less than 1…that test was completed at the University Hospital where I was being treated for a heart attack! Please advise

My LDL is 226 everything else normal should I be concerned?

It's a little confusing to me when talking about particle size being larger with higher density. It seems the reverse would be true unless density is exclusively related to size and mass correlates directly. My understanding is that the small sized particles are the dangerous ones that penetrate the endothelium and form plaque, but intuitively it seems that the higher the density, which look to be the smaller, would also be more tightly compacted; especially when you call larger particles "fluffy," which implies a lower mass/specific gravity. So, how is it that in this case, the higher density (HDL) are smaller than the LDL and yet, the "good cholesterol"? Do they contain different fats? Do the "fluffy" have lower mass? If the smaller the particle, the more dangerous it is (at least with LDL) and if triglycerides are the very low density version and smallest size, how it it that their density is the lowest? If so, the correlation between size and density is inverted. Which is it? By the way, my TG/HDL is 1 (79/79) but my LDL cholesterol is 223. I'm 65, weigh 190 at 5'11" 22% body fat, resting heart rate in the low 50's, but yet I have a CAC score just above 100, which I think might be because of most of my years believing consuming saturated fat was worse than sugar. My CAC score was taken two years ago. I'm wondering what it is now and if much reduced simple carb consumption in recent years (plus higher M-7 K2 consumption) will show a reduction. What do you think? Might take longer, or reversing calcium at this point isn't possible? Maybe 100 isn't anything to worry about? By metabolic syndrome assessment standards (bad results in 3 of the 5--blood pressure, waist circumference, fasting insulin, TG/HDL and fasting glucose) my numbers are outstanding. With all we seem to be learning in recent years (as well as able to test) with easy access to a wide variety of varying quality data, the subject is fascinating and, hopefully, revealing. Another stat I heard about the vaunted Framingham Study that is similar to the TG/HDL screen was that when segmented by those without any degree of metabolic syndrome, the relationship between mortality and LDL is reversed--the higher the LDL, the lower mortality. Further evidence that we still don't really understand the importance of the relationship of all the variables (nor the number) contributing to heart disease. Optimizing what we know "today" is the best we can do. What's most encouraging to me is how much and fast we are learning about those variables.

I read where I Cardiologist said olive oilwas good for your Heart

Hi doc, I was told that I need meds based on this but I am only 25 and it is a low Triglyceride/HDL ratio. What dyou think? Total Cholesterol: 289 Triglycerides: 43 HDL: 80 LDL: 200

Hi Dr , my HDL was 48 before keto (two months back) now it is 36 . Triglycerides went to 68 from 100. LDL went up from 110 to 134. Why my HDL not increasing Actually it decreases... please reply I am confused should I continue keto or go back to old carbohydrates rich diet. There is plenty of coconut oil in my diet in keto . Is that a problem. How some people have above fifty range HDL ..how to increase HDL

Since going on a keto diet my labs have improved tremendously. My LDL is slightly high at 136 but I'm not worried about it because I would bet it's mainly the large type LDL. My cholesterol is 200. HDL is 54 and Trigl is 48. Should I be worried?

Is there a link between high Lipoprotein (a) and Gilberts Syndrome? Does high Bilirubin have an anti-inflammatory effect on cardiac health?

Hello doctor My HDL 53 Triglyceride 133 LDL 135 LDL/HDL ratio 2.6 How is it?

My measurements are in mmol/L in the UK. Can you convert to your units? My Triglycerides =1.55 mmol/L. HDL=1.62 mmol/L. LDL=4.77 mmol/L. TRY:HDL 0.95? Is that ok?

my LDL is 2.76 my Trig/hdl ratio is 0.76 my total chol is 4.68 my Trig is 0.54 my hdl is 1.67 vldl 0.25 i had a ct scan due to dizziness the othrr day, they saw Intimal Calcifcations on both vertebral arteries and cavernous segments. Im worried.

We use MMol here, when i convert the results and run the math, i get different ratios!??

I am 46, My HDL is 51, Triglycerides 80, and LDL 171. Should I be worried? My fasting glucose is 81.

Hey Ford, I'd like if you could present a chart showing optimal curves on HDL, LDL and tryglycerides. You know from someone who has a 1:1 HDL/Trig. I think you're videos are great. Keep up the good work. An observation I might make, is that when it comes to body composition there is a gender distinction for obvious biological reasons. I think this is where men can get away with much less than women. I would argue that no man of 20% body fat or above can be truly healthy. Whereas a women (of reproductive age) can be 30% BF and still be quite metabolically healthy. I intuitively suggest that all men should aim for BF 15% or below (no lower than 8%) for optimal health. And this would be regardless of age. And this is not to overlook the importance of minimizing visceral fat for all. PS, as an aside, I had a friend and former student who contacted me recently to say he had had a heart attack. It appears it was silent, or he didn't know that's what it was. Anyway, he had stents put in. I'm sure they put him on a low fat diet with statins. I sent him a couple of your videos; particularly one about reversing atherosclerosis. Haven't heard back since. He was a geoengineer (retired). I thought he might geek out on this stuff. But maybe he just doesn't want to think about it?

Nice Video...bit confused on my results... Triglycerides of 88 but total Cholesterol of 298. Does a lower Triglycerides have an effect on LDL/HDL numbers?

These are my numbers: TRIG 58 HDL 80. Ratio : 0.7 Is this OK?

My total cholesterol is 10.2 😢us 394.4 I think I’m a lean mass high responder on keto. My hdl triglycerides ratio is great. 0.8 they wanna put me on statins. I don’t smoke or have high blood pressure or pre diabetes. I don’t know what to do.

You have a PhD. Academicians save lives. I wish all doctors had training as scientists. Knowing science stuff doesn't make a scientist. Doing science does that.

Dr. Brewer - Will you elaborate more on Remnant Cholesterol or it is already covered in one of your other videos? This is a subject that I'had never known anything about until now. My RC# is 22 and my Tg/Hdl ratio is 1 (108/108). My primary doctor wants to put me on Lipitor 40mg, I want to make sure this is the correct course for me. My LDL is high at 182, in perfect health otherwise. Please advise. Thank you in advance.

52 slender and muscular HDL 85 Tryg 139

Thanks for the video. I was informed that my HDL is low because my TC is so low 105 that the need for lots of HDL is not needed to do its job . Please comment.

Hello. What is considered a good range for Tri/hdl ratio?

Is there a U CURVE study on LDL?

Sorry...which ratio is good...? And which ratio is bad...? Triglyceride/HDL ratio. Thank you?