ApoB is $40 via the lab I used, and obviously worth it. My doc says it's the same as LDLc, which is wrong of course as Dr. Dayspring explains clearly. I don't have the time or patience to explain that to her. #2, that sadly also not commonly tested, is hsCRP - a measure of systemic inflammation - but that's another topic...
Want to concue with Dr. Dayspring that non-HDL cholesterol can be discordant with APOB. In my case, the non-HDL was 70, a good number, whereas the APOB was 100, which is in the risk range. This suggests that I may have a higher number of smaller, denser LDL particles than average. ApoB provides a direct measure of the number of atherogenic particles, while non-HDL cholesterol measures the total cholesterol content in these particles. My results suggest that I have a normal amount of cholesterol distributed among a larger number of particles. Bottom line: get your APOB tested.
Here in the UK, some years ago, standard NHS lipid panels stopped reporting LDL-c and replaced it with non-HDL cholesterol. That sounds like an improvement. Mine was “borderline” and had stains recommended to me. I said I’d first try 6 months of intense lifestyle changes and that reduced non HDL to “normal”However, after a couple of months of relaxing the lifestyle changes (less exercise and slipped on the diet) a routine blood test has shown that I’m borderline once more”. They’ve called me in again. The first time round I was referred to a practice “statins” specialist (NOT) a doctor) who alarmingly stared blankly when I talked about ApoB. This time I will insist on seeing a doctor - but only after getting a private test for ApoB. Thanks for this timely reminder.
11:50 "basically say the big three then are apob, LPa you're going to do that once and triglycerides and if you have those three you can really predict your risk of atherosclerosis. Yep , you pass lipids 101 if you understand that."
I learned about APOB about 2 yrs ago and got the test just for the hell of it, and I'm glad I did, because my score was 100, in the risk zone. This was despite my other cholesterol, which were excellent, including LP(a), so this was a shock. In this I parallel Peter Attia, who also has good cholesterol numbers except APOB. He claims his issue is genetic; perhaps mine as well. Anyway, I started taking 5 mg of rosuvastatin, garlic extract, plant polyphenols, fish oil and bergamotj -- and within 6 mos my number declined to 55, which is quite acceptable. Given that I didn't isolate and test each supplement and the statin, don't know which was most or least effective, if at all. but glad with the result. (By the way, my APOB test cost $30.)
They recently came out with a new heart disease risk calculator. I forget what they call it. It still does not use triglyceride in the calculation which IMO is the best lipid indicator of risk. It should always be around 80 or less. They dont think 300 to 500 indicates a problem.
What's left out of his discussion is the Triglyceride to HDL ratio which is the best indicator of heart disease. Mine for example is 88TG to 60HDL resulting in a number of 1.47 . Anything under 3 is low risk. If one has other risk factors like HBP, smoking, overuse of alcohol then of course the risk goes up. So the standard lipid panel is quite useful regardless of the Apob number.
If the individual is metabolically healthy (blood pressure is less than 120/80, waist circumference less than half of weight, triglycerides less than 150, HDL-C higher than 40 mg/dl, fasting glucose less than 100 mg/dl) than Non-HDL-C is a good marker and should be below 130 mg/dl. If the individual is not metabolically healthy, it means that his LDL particle size may be small, which results in higher ApoB. For those individuals, Non-HDL-C should be below 100 mg/dl due to smaller and denser LDL particles
@carlloeber If you have access to the ApoB test, ApoB should be below 90 mg/dl for individuals without other risk factors. For hypertensive, insulin resistance, or other chronic inflammatory conditions, ApoB should be below 80 mg/dl or even 70 mg/dl depending on the severity of the other risk factors
"... low HDL is the best indicator that you have high ApoB." "if you have insulin resistance with a low HDL cholesterol your apob is through the roof" So high HDL and NO insulin resistance indicates low ApoB?
From Framingham, a study of an entire town in Mass that studied 10s of thousands of people over 70 years, it was found that no one died of heart disease with a total cholesterol under 150. Any comment on that.
@@swites The same Framingham study said three-fourths of the heart attacks in this country occur among people with cholesterol levels between 150 and 300 and half occur in men with levels below 250. So people with 150 are part of the 3/4 but 149 or one number less than 150 is the group with zero? Since money talks the most important value for a life insurance policy is the total cholesterol to HDL ratio. All other values such as LDL, ApoB, particle size, HbA1c, Lp(a) are all less important for the insurance company.
@@eugenefirebird8938 Then explain how these vegetarian diets from slim and fit long term non smoking Chinese vegetarians with low total cholesterol levels taking no medications with a BMI of 22 hurt their cardiovascular health? 2005 article "Vascular Dysfunction in Chinese Vegetarians: An Apparent Paradox?" And remember when George Mann got the arteries of the Maasai who died in the 1970's who had low total cholesterol levels of about 130 mg/dL yet he found they had extensive atherosclerosis.
These values don't show major cause for concern. The Lp(a) is slightly elevated and triglycerides are borderline high, but not drastically. Apo B looks OK. If you have other risk factors or family history you might want a statin to get your Apo B below 70.
If your genes are good, you probably will live to you're 100's. This numbers mean nothing, just bullshit. Humans are obsessed by numbers, it's a money thing! 😢
@@danieltait8564 Thanks for the response. I kind of figured the same. I’m vegan and eat mostly whole food. Nothing really ultra-processed. Unless you count soy milk, tofu, and rolled oats as being processed! 🤣 I very occasionally eat some refined grains, but 90% of the time my grains are whole. I almost never consume any tropical oils, so my saturated fat intake is close to zero. I don’t really want to take statins and I know that my Apo B isn’t crazy high. But I still really would love it to be under 70; just to play it safe and be at more “optimal” levels. Not sure what else I can do to lower it a bit more. I am at the higher end of a health body fat percentage according to my doctor. He says I’m not overweight. But maybe if I drop a couple kgs that will make a difference? I occasionally go out for alcoholic drinks with friends. Maybe eliminating that will help? But we’re taking about only maybe 5 to 10 drinks in a month.
@@markbobich6335 I’m in a similar situation to you.. my apo b was a bit higher than I wanted and my diet was already optimized. Recently, I went on low dose rosuvastatin (Crestor). I’m taking 1.25 mg a day. I literally split a 5mg into quarters. I’ve had zero side effects effects at this dose. This dose also lowers LDL by about 30 percent. If you don’t want to take a statin you could look at taking a Berberine supplement. It’s natural but berberine can interact with other medications and it’s not as effective as a statin.
@@markbobich6335 I’m in a similar situation.. mine is a bit elevated too. I’ve recently gone on crestor 1.25 mg. No side effects and even this low dose can reduce LDL by 30 percent
So how do you put LP(a) in context of ApoB? Or indeed your hierarchical list of best measures ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-wXLvdoZiSUM.html ? Is ApoB a better indicator of risk than LP(a), as the video title implicitly suggests? I would love to know how to interpret and reconcile a top of normal range ApoB absolute measure, but an ApoB/ApoA1 ratio of 0.77, with a 3x normal range LP(a) absolute measure. Asking for a friend!
