It’s likely that you’ve had your cholesterol levels checked by your doctor and continue to do so on a regular basis. If you haven’t, I highly recommend that you do so, but with at least one addition to the standard lipid panel!
A standard lipid panel consists of the following (recommended levels according to the American Heart Association) included:
- Total cholesterol: below 200 mg/dL
- High-density lipoprotein cholesterol (HDL or HDL-C): above 60 mg/dL
- Low-density lipoprotein cholesterol (LDL or LDL-C): below 100 mg/dL (for those with diabetes: below 70 mg/dL)
- Triglycerides: below 150 mg/dL.
Many people rely on these numbers to assess their risk for heart disease, so much so that many can rattle off their numbers without a second thought. HDL has become colloquially known as the “good” cholesterol, while LDL has been coined the “bad” cholesterol.
While this is generally true, there is more to the story! There is an additional marker that you should be aware of that has been shown to be a much better predictor of your risk of heart disease, yet most doctors don’t order it unless you ask.
LDL-P (which stands for LDL particle number) measures the actual number of LDL particles circulating in your bloodstream. This differs from LDL-C (often simply referred to as LDL on your bloodwork), which estimates the total amount of cholesterol within the LDL molecules.
As a reminder, LDL molecules are the lipoproteins that carry and transport cholesterol. You can have varying amounts of cholesterol within a single LDL molecule.
In other words, LDL-C tells you the estimated amount of cholesterol, but it does not tell you how many LDL particles it is taking to carry that cholesterol, which turns out to be what matters more in terms of predicting heart disease risk.
While LDL-P is not the only predictor of heart disease, according to research, we do know that it is more strongly associated with risk of cardiovascular disease and atherosclerosis than LDL cholesterol. Additional research also showed that “LDL-P was related more strongly to future [cardiovascular disease] in both sexes than LDL-C or non-HDL-C.”
According to Dr. Chris Kresser and the Journal of Clinical Lipidology, “patients with high LDL cholesterol (LDL-C) and low LDL particle number (LDL-P) are not at high risk of heart disease.” In other words, knowing your LDL number may not be enough to assess your risk! Knowing your LDL-P number in addition to your LDL can help you glean more insight as to your true risk for cardiovascular disease.
According to Labcorp, LDL-P should be under 1000 nmol/L, and is considered very high if above 2000nmol/L. These numbers are based on the Multi-Ethnic Study of Atherosclerosis (MESA).
According to Dr. Chris Kresser (read his 4 part series for lots more info!), the following are some of the top contributors to undesirably high LDL-P levels:
- insulin resistance
- poor thyroid function
- bacterial or viral infections
- increased intestinal permeability (“leaky gut”)
If you are struggling with any of these contributing factors, check out my 12 Weeks to Well program where I can help you rebalance these underlying issues.
If you have never seen a marker for LDL-P on your bloodwork, you should consider asking your doctor to test for it. Another option is to order an NMR LipoProfile® Blood Test yourself through a website such as Life Extension.
Knowing your LDL-P can help you and your doctor decide if a statin is right for you. While statins are generally considered safe, taking a statin to lower cholesterol in someone who doesn’t actually have a high risk for heart disease can potentially do much more harm than good.
Knowing your LDL-P number can help you and your doctor make a more informed decision in regard to treatment and lifestyle changes.
Have you ever heard of LDL-P? Have you ever had your LDL-P tested? Do you have high cholesterol? Do you take a statin to manage your cholesterol? What lifestyle changes have you made and did they improve your cholesterol numbers?
