High Lipids on Latest Lab, but Already Low Fat Vegan

Cholesterol has always been high, and I generally agree with treating symptoms not labs, but General Practitioner wants to go statins right away. I’ve included probably way too much info because I write up my own analysis of my labs every time I get them, but happy to receive any advice questions about non-lipids stuff as well.

Latest labs attached.

General background: strict vegetarian, on b12. no caffeine/alcohol in 8 years. moderate stress, bp 122/75 consistently. Daily meditation/relaxation exercises and stretching. 45 years, caucasian. Work out 7+ days/wk–typically 5-6 weights and maybe another 3-5 cardio.

On TRT for 10 years pretty successfully

100mg/wk cypionate

500ius hcg for 8 weeks on, 8 off

experimented with some peptides: ipamorelin, cjc w/o dac (mod grf), bpc157, bt500, mainly.

semaglutide and cardarine but after labs

planning to run a little deca, clen–but maybe not given lipid profile)

No family history of heart issues, but cholesterol often high.

Bodyfat around 12%.

Melanotan 2 at the moment as well (but started post-labs)

Biggest issues:

1. Lipids not ideal:

LDL of 124 (midrange=100-130) I’ve been as high as 214, but this is high
HDL 55 (mid=40-60) lower than I want
Apo B 111 mid=80-120
Peak LDL size: (mid=218-222) 218.7 low
LDL Particles 2040 - (high=1538)
Medium LDL 556 - high=271

Solution : I’m going to see if I can get an MRI and plaque score to assess arterial plaque and heart health. My new GP who is fairly clueless and overly confident said a stress-test ekg is better. No idea if he’s right yet. He was willing to refer to a cardiologist though. Also willing to refer to an endocrinologist.

2. Estrogen: 48. high=39 maybe a bit more emotional than when it’s lower but no huge symptoms.

Solution: Maybe I’ll do like 1/8th arimidex once every week or two. I’m super sensitive to AIs.

A little surprised discountlabs didn’t include fsh/lh but maybe I did something wrong with the order?

Free Testosterone: 164.5 and feeling about right

Total T: 763

3. CO2 31: (top of range 30). Never really heard of this…but my urine was like 9 ph so it makes sense. Anyone have experience with this? I know vegan diets can be highly alkalizing and the body puts lots of bicarbonate in the blood to balance that high ph. I’ve always been 24-30 on the high end (30 is top of range) so maybe not a huge issue. Maybe clen will help as a bronchodilator.

Urine: Cloudy. PH off charts high (9+)

Interestingly, my kidney markers are all fine: creatine, egfr, bun, albumin, etc. I had a parasite called blastocystis hominis that I think I picked up in Asia many years ago. I’ve read that high urine ph could be a parasite signal (debatable and can’t find a very credible source), so I’m thinking of getting a stool sample test to check. Or else maybe I’m over-thinking this one.

Solution: No idea. I had some kidney stones but it wasn’t a big deal and I think that’s more for acidity. I definitely don’t have a UTI.

  1. Creatine Kinase: 285 (top of range 196) I supplement creatine at least a few times/wk so maybe this is that? I workout a decent amount and I know post workout this number can go up.

Solution: Maybe nothing for now–pretty elevated though.

5. Hematocrit: 48.3 (high=51) but I’d still like it a little lower–particularly given the lipids, so I’ll donate unless someone sees a reason not to. Go to 45 or so.

Solution: I’ll be donating blood again right away.

6. 25-Hydroxy Vitamin D: 24 (low=30) struggled with this pretty consistently. I will start supplementing immediately and realize it has effects on T and other important factors. Supplement.

adding vitamin D supplements 5k iu daily

The rest of my values are very in line and generally around middle of normal. I track trends on wellnessfx.com (but planning to check out other graphing/tracking apps as well.

will get labs done again in 6 months to check the efficacy of these steps.

Nothing really to add but I too had high cholesterol with larger particles way above range. My doc that I use for trt had me go for a calcium score test. I am same age as you and insurance won’t pay for it but it was only $175. Test came back 0. Doc said they are not concerned about the higher number after seeing the test number. They claim calcium score is gold standard for testing.

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I would concur. Although particulate size is also probably more of concern than high LDL. Your HDL is very good IMO. Get a CAC and go from there.

Not a med pro but I am vegan, never smoked, always good cholesterol and a skinny git. Started having chest pains, I thought (I’m a google expert don’t ya know) it was a hiatal hernia. Was given an angiogram and said they’d let my doctor know results within 2 weeks but called me 4 hours later saying don’t do anything physical, we’re booking you in now.

I’d had 3 EKG’s plus bloods and nothing showed anything wrong. I’ve since had an echocardiogram done ( which was also pretty cool) but again it may have pointed towards blocked arteries but not necessarily. As I understand it a stress test ECG is better than a normal one for this but I don’t know enough to say so I agree and push to talk to a cardiologist.

I was also put on statins even though my cholesterol is very good (even on oxandrolone it didn’t get terrible) as they want to use every tool especially initially while the stents settle.
Reading on statins they seem to get a terrible press but this may just be older types (?) or just hyperbole in general, compared to the alternative and a heart issue, I’d pop the pill as I’m sure your dr thinks its needed.

I expect your labs didn’t have fsh or lh as you’re on TRT so they’d both be at or near 0? (if it is a TRT panel?)
Again, not a med pro.

It is about genetics. I also have high ldl. I have started using ezetrol (Ezetimibe) and ldl come down from 200 to 150 in 3 months

I am taking 4 times per week

1st 3rd 5th and 7th day of week

But since your dietary is already good ezetrol may not work on you

Do you have health anxiety?

The reason I ask is your post seems like you are very worried yet your levels are not even concerning.

An LDL of 124 is not even high, statins are usually prescribed once someone is 190+

You APoB matters more than total LDL.

Eat oatmeal, take psyllium husks daily, and retest in 4 weeks, I guarantee your cholesterol will be lower, cholesterol is used in bile production and digestion, it is recycled and reabsorbed but the psyllium husks bind to it and you excrete it, thus lowering your plasma cholesterol and LDL.

I have high Lp(a), I’ve been researching cholesterol for quite some time and also have a CAC score of 0 and a CIMT test showed no plaque.

FYI, CAC score doesn’t tell you if you have soft plaque, it only tells you if it is calcified which is the end stage of atherosclerosis, you want a carotid inter media thickness test; it’s an ultra sound of your carotid artery, plaque usually shows up here first.

Then if your really concerned, a CT angiogram will tel you if you have narrowing or plaque in your coronary arteries.

Statins are NOT needed with an LDL of 124!

Diet will lower that, plus it isn’t even high, most drs wouldn’t even blink at that.

ApoB below 100 is ideal tho, and 50-60 from what I’ve read being the best for disease prevention.

Check LP(a) and homocysteine too, they lead to early atherosclerosis and are much more atherogenic than LDL.