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LipoScience's NMR LipoProfile Test: A Revolutionary, More Accurate Lipid Profile Particle Size Screening


Raleigh, NC-based LipoScience changing the way cholesterol is measured

It seems just about everyone these days is aware of cholesterol because of the relentless (and might I add nauseating) daily barrage of advertisements from the pharmaceutical companies pushing these cholesterol-lowering statin drugs like Lipitor, Crestor, and the like. The television commercials always show examples of patients who say their doctor told them their “high” cholesterol required that they start taking this little daily pill to “go lower” with their numbers. But why does everybody so easily buy into this very simplistic, conventional way of looking at cholesterol as the primary measuring stick for heart health risk?

Oh, come on Jimmy! Everyone already “knows” that you need to keep your total cholesterol below 200 and your LDL “bad” cholesterol under 100 in order to be considered “healthy” and safe from cardiovascular problems. In fact, it’s posted right there on the National Institutes of Health web site, so it’s got to be true, right? Oh really? Wellllll, maybe not.

But, but, but…what about where it says on the NIH web site about how high blood cholesterol comes from the “saturated fat and cholesterol in the food you eat (to) make your blood cholesterol level go up” and that “reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol level?” How does this line up with your oft-repeated message of a high-fat livin’ la vida low-carb way of eating? Ahhhh, how can they get it so wrong on an issue this vital to the health of Americans?

The reason I’m bringing up this issue is because my wife Christine and I had the opportunity to visit a place located up the road from us in Raleigh, North Carolina called LipoScience. They are the first company to commercialize a laboratory test using state-of-the-art NMR spectroscopy systems as a detection method to determine blood cholesterol particle size and number called the NMR LipoProfile® test. I wrote extensively about this unique cholesterol test in the Introduction and Lesson #2 of my brand new book 21 Life Lessons From Livin’ La Vida Low-Carb: How The Healthy Low-Carb Lifestyle Changed Everything I Thought I Knew. This information is too vital for people to miss!

Simply looking at the total cholesterol and even the LDL and HDL as subsets of your lipid profile is shortsighted in light of what we know about the particle number of LDL, known as LDL-P. There is debate even within the LipoScience lab over whether it is the number or the size of the LDL particles that matters the most. But one thing’s for sure: the NMR LipoProfile test is a far superior way to measure your true heart health.

So why does particle size matter so much? Well, it’s elementary my dear Watson. The smaller, more dense the LDL particles are, the easier it is for them to slip behind the arterial wall, build up plaque, and eventually become inflamed to the point that serious problems develop. That’s why you want more of the large, fluffy kind of LDL particles because they cannot penetrate the arterial wall. Wanna know how to prevent your LDL from becoming predominantly the small, dense and dangerous kind and transform them into the large, fluffy and protective ones instead? Yep, you got it — eat a high-fat, low-carb diet.

When you choose a nutritional approach that puts the emphasis on consuming high levels of fat as a percentage of total caloric intake, moderate amounts of protein, and very few carbohydrates, then three things almost assuredly always happen:

1. Your HDL “good” cholesterol will rise above 50.
2. Your triglycerides will dip below 100.
3. Your LDL particle size will be mostly the large, fluffy kind.

These three indicators are a tell-tale sign if someone is eating low-carb correctly or not. If you are consuming too many carbohydrates, then your triglycerides will bear that out by remaining above 100. If you aren’t eating enough fat, then your HDL will dip below 50. And if both of these numbers are significantly off course, then you better believe your LDL particle size will be leaning in the direction of more of the small, dense ones. EEEEK!

It’s hard to believe that a machine like the one shown above are constantly running thousands upon thousands of blood samples every single week to determine the particle size and number for patients all across America at the LipoScience facility. As I toured this massive building full of people in white coats everywhere, I stood in awe of a company that truly understands that there is a better way to test and measure cholesterol than the way we are currently doing it. Unfortunately, they are still stuck on the conventional wisdom as it relates to how to best treat cholesterol issues. But with time and proper research perhaps they will become convinced of the efficacy of livin’ la vida low-carb to work hand-in-hand with their test.

While we were there, the LipoScience people were very generous to offer a free NMR LipoProfile screening for both Christine and me. I already hate needles and Christine is used to them growing up as a preemie as well as that IVF cycle we went through a couple of years ago. To make matters worse, my vein rolled so they had to jab me twice. But I wanted to have my blood tested so bad I sucked up the pain. This was just too important NOT to have done.

So, what were the results? Here were my numbers:

Total Cholesterol 351
LDL-C 278
HDL-C 57
Triglycerides 79
LDL Particle Number 2130
Small LDL-P 535
LDL Part. Size 22.0
Large HDL-P 10.9
Large VLDL-P 0.4

Most physicians would look at this with big bug eyes and write a prescription for a statin drug so fast you wouldn’t be able to blink before he handed it to you! But despite my “high” total cholesterol of 351 and LDL of 278, take a look at my HDL and triglycerides. The numbers were 57 and 79 respectively and basically a ratio of 1:1. Low-carb diet research Dr. Jeff Volek from the University of Connecticut says it’s this triglyceride/HDL ratio that is more important than total and LDL cholesterol ever will be.

Although my particle number of 2130 is considered “very high” for this test, the particle size of the small LDL-P was just 535 of that — considered “low” according to the test. Additionally, the LDL Particle Size of 22.0 nm is indicative of the “large” fluffy kind and the Large HDL-P and Large VLDL-P numbers I had put me in the “low risk” category. In other words, 1595 of my LDL particles were this protective kind and the graph was off the charts. Meanwhile, the small LDL-P number was less than half of the “goal” that is considered desirable. The numbers were well within the safe range. WOO HOO!

How about Christine’s numbers? Although she’s not been as strict about low-carb living as I have over the past six years, I give her credit for stepping up her eating habits in recent months and was anxious to see what improvements she has made as a result of livin’ la vida low-carb. Here’s her results:

Total Cholesterol 183
LDL-C 113
HDL-C 47
Triglycerides 113
LDL Particle Number 1262
Small LDL-P 722
LDL Part. Size 21.2
Large HDL-P 9.5
Large VLDL-P 0.6

Despite the fact that her HDL and triglycerides are just outside that over 50 and under 100 benchmark, her total cholesterol and LDL look fantastic and I’m sure her doctor would be pleased with these numbers. Her small LDL-P was higher than mine at 722 despite the fact her total LDL particles were about half of mine at 1262. This put her in the “moderate” range for the small, dense LDL. But her LDL is predominantly the large, fluffy kind as well and she’s doing a brilliant job of keeping the trend moving in the right direction.

If you’d like to learn more about why “Most cholesterol tests by your doctor are virtually meaningless,” then be sure to pick up a copy of my new book and read Lesson #2! And tell your doctor you don’t want to settle for the Berkeley Heart Lab test anymore and instead you want an NMR LipoProfile test. They can order it directly from LabCorp for you and it will give you all the information you’ll ever want or need about your lipid health. Got questions about your test results? Although I’m not a doctor or medical professional, I’d be happy to help you with interpreting the results once you get them back. E-mail me anytime at livinlowcarbman@charter.net.

DISCLOSURE OF MATERIAL CONNECTION: http://cmp.ly/2

  • Adam

    Great post. Very informative. Good job Jimmy.

  • Paula

    Oh Jimmy! It looks like your numbers are going in the wrong direction!

    Your LDL particles are up by more than 50% from your last test, and your small LDL is now over 25% of the total, in contrast to almost nothing the last time. Have you had a chance to speak to Dr Volek and Dr. Westman about how to address these high, deteriorating values?

    By the way, Berkeley HeartLab measures Apo B. This is a different measure than NMR’s LDL particle number, but it also indicates the number of atherogenic particles. You might want to look into this before you advise people to tell their doctors that they don’t want to “ . . . settle for the Berkeley Heart Lab (sic) test anymore.” (My only connection with Berkeley HeartLab is that I’ve been getting my blood work done there recently.)

    Good luck with reversing this trend in your numbers.

    THANK YOU for your comments, Paula. However, with all due respect, my numbers are fantastic according to Dr. Westman and my small LDL-P is still pretty amazing. No, it’s not the microscopic amount that it was 18 months ago when I had it tested, but I have gained a few pounds as I’ve noted often in previous posts. That said, I’m very pleased with my triglycerides and HDL cholesterol which Dr. Volek says is much more important than any of these other factors most people consider essential to heart health. Thanks for your concern, but Jimmy Moore is doing just fine.

    –Jimmy

  • Patrik Hägglund

    Hi Jimmy,

    You wrote: “And tell your doctor you don’t want to settle for the Berkeley Heart Lab test anymore and instead you want an NMR LipoProfile test.”

    To me, the Berkeley HeartLab test (http://www.bhlinc.com/clin_sample.php) looks at least as advanced as the NMR LipoProfile test. Can you elaborate?

    It’s nothing more than a personal preference for the kind of information you get from NMR LipoProfile test. That’s all. If you like Berkeley, then stick with it. :)

    –Jimmy

  • Vince Frieden

    Jimmy,

    Thanks so much for this piece. I’ve been scouring the internet for vindication, and I think you’ve delivered it.

    I was first tested for cholesterol two years ago and had an HDL of 32 and an LDL of 125. My doc wanted to put me on a statin, I decided to try low-carb instead.

    A year later, I came in with HDL of 50 (up 18) and Triglycerides 41 (down 17), but my LDL rocketed to 212. He wants to test me again in a couple months, because the results were so wildly different, and, I’m sure, push statins again.

    Your article has provided me some ammunition and an option for really getting to the bottom of my cholesterol situation. Thanks!

    You are quite welcome, Vince! The urge to put people on statins by doctors is simply astounding with all we know about lipid health now. I included much more about this subject in Lesson #2 of my latest book if you’re interested in learning more.

    –Jimmy

  • P.

    Jimmy,

    It is wonderful and encouraging to read your article.

    For the last few years I am going through the LipoScience NMR LipoProfile testing with my doctor’s advice, since my total cholesterol number is high.

    My numbers are:
    Total Chotesterol (calculated): 287
    Total calculated, LDL-C: 211
    HDL-C: 68
    Triglycer.: 41
    LDL-P: 1881
    HDL-P (total): 33.4
    Small LDL-P (Sticky): 126
    LDL Size: 22.1
    In Insulin Sensitivity/Resistance test I am at a Low risk.

    Although my doctor told me I am at a low risk for CVD and accordingly I am not taking any medication, my wife is concerned about the higher fluffy portion of my cholesterol. I am also thinking if I need to bring down the fluffy cholesterol to reduce the total choles number. I would appreciate if you can please give your opinion on my profile.

    Also how can I contact Dr. Westman and Dr. Volek (if you have their email addreses) for their advice? I would appreciate your opinion and feedback in this regard over email. Thank you very much.

    THANKS so much, P.! CONGRATULATIONS on your rockin’ lipid numbers. WOW! Your HDL is above 50 (SUPER!) and your triglycerides are well below 100 (OUTSTANDING!). These are the primary numbers to be concerned with and you’re doing fantastic. You DON’T need to do anything differently. I’m proud of ya!

    As for finding a low-carb physician to consult, go to my “List of Low-Carb Doctors” blog to find one near you, including Dr. Westman. Dr. Volek is a PhD, not an MD.

    –Jimmy

  • http://s Greg F

    Jimmy says “If you are consuming too many carbohydrates, then your triglycerides will bear that out by remaining above 100. If you aren’t eating enough fat, then your HDL will dip below 50. ”

    Hi Jimmy, do you have a reference for this claim regarding fats and HDL levels? I believe in low carbs, but also low fat protein sources. It seems that bacon and sausage would be counterintutive to any diet or food regime. Do you have any targets for macro nutients? An example might be, for a 200# male targeting 10-12 cals per pound, (2000-100 cals (25g of carbs), 1900-640 cals of protein (1g per lbm or so, 160 grams total), leaves 1260 cals of fat or 1260/9 (140g). rough macros would be 62% fat, 33% protien and 5% carbs. Is this what you consider enough fat.

    Thanks
    Greg

    • http://www.livinlavidalowcarb.com Jimmy Moore

      My source for the info is Dr. Mary Vernon as well as virtually every low-carb study to come down the pike. An ideal low-carb diet is one that is high in fat (75% of total calories), moderate in protein (less than 20% of caloric intake) and very few carbs primarily from green leafy veggies. Calories aren’t as important as the quality of the food you consume.

  • S. Moore

    Thanks for the blog Jimmy. I have learned a lot that I really needed to know. I’m looking forward to reading your book.

    • http://www.livinlavidalowcarb.com Jimmy Moore

      Never stop learning the lessons of livin’ la vida low-carb! :)

  • Arthur

    I need some help in making an intelligent interpretation of my number:

    Total Cholestrol: 271
    LDL-C: 182
    HDL-C: 60
    Triglycerides: 147
    LDL Particle No: 2,327
    HDL-P [Total]: 39.8
    Small LDL-P: 1281
    LDL Part Size: 20.9
    Large VLDL-P: 1.5
    Large HDL-P: 1.5
    VLDL Size: 46.7
    LDL Size: 20.9
    HDL Size: 8.5

    Insulin resistance: H 62

    My doctor wants me on statins, but have no other health issues e.g. blood pressure (108/68), no blockage, hardening of arteries, etc. age +60. High fiber diet.

    Thanks, Art

    • http://www.livinlavidalowcarb.com Jimmy Moore

      Hey Arthur, I’m not a medical professional and cannot offer any medical advice. But I can tell you my thoughts about your results.

      1. Your HDL cholesterol is fantastic because it is above 50 which is indicative that you are eating ample amounts of fat in your diet. If you continue to consume more fat, especially saturated fat, then that “good” cholesterol will only continue to rise.

      2. Your triglycerides are a bit elevated landing at 147 and your target is to get those below 100. The best way to see triglycerides plummet faster than anything else is by taking high-dose fish oil and reducing your carbohydrate intake. If you do that, then there’s no reason why your numbers won’t be under 100 in no time.

      3. Your LDL and total cholesterol are pretty much irrelevant, but they are why your doctor wants you on a statin drug. However, as I recently blogged about earlier this year, most doctors seem clueless about understanding cholesterol and how to best treat it because they’ve never been taught any other way other than pharmaceutical answers. I won’t tell you whether to take a statin drug or not, but you don’t need it (or the accompanying joint and muscle pain that is sure to come if you do along with a depletion of CoQ10 in your body).

      4. Your LDL particle ratio of small LDL-P which is the kind you DON’T want to have is over half of your total LDL particles. Raising your intake of fats while reducing your consumption of carbohydrate will bring that small LDL particle number down significantly. It looks like you are on the right track with your plan, but don’t skimp on consuming fat while reducing the carbohydrates. You’re doing fantastic!!!

      Hope this helps! Read Lesson #2 of my latest book 21 Life Lessons From Livin’ La Vida Low-Carb for more information on this subject.

  • Carolyn Wilson

    I just had my numbers checked
    LDL-P 2070
    LDL-C 131
    HDL-C 49
    HDL-P (total) 40.2
    Small LDL-P 1090
    LDL size 20.4
    Large VLDL-P 20.3
    Small LDL-P 1090
    Large LDL-P 1.0
    VLDL size 55.2
    LDL size 20.4
    HDL size <8.3
    LP-IR score 83
    triglycerides 336
    total cholesterol 247
    I am already on a lipid drug and now the doctor wants to put me on another one. I can hardly walk when I am taking this drug.
    What can I do? I don't want to go on another drug.

    • http://www.livinlavidalowcarb.com Jimmy Moore

      THANKS Carolyn! I’m looking at your numbers and have a few concerns about them that won’t be fixed with a statin or other cholesterol drug. Your triglycerides are 336 which tells me you may be eating way too many carbohydrates. Reduce your carb intake to 20g immediately and that number will plummet to below 100 in very short order. Your HDL is okay at 49, but could be better. Eating more fat, especially saturated fat, will make that number go well above 50. These are the two key numbers in getting your small LDL-P number to shrink which is currently about half of your total LDL particles. Take a high-dose fish oil supplement and consume a high-fat, low-carb diet to make your numbers come back into line without the need for a prescription drug. Check out my http://lowcarbdoctors.blogspot.com site to find a low-carb friendly physician who can help you with this.

  • Linda

    I recently started metabolic diet – I tested as meat (mostly beef) type. I started new diet with 40% protein, 30% fat (butter, coconut oil, etc) 30% carb (veggies and limited fruit- no grains). Have been on Lipitor for about 5 years and started on Nattokinase about 3 months ago. My metabolic diet advisor wants me off statins and suggested NMR testing. I found your website during my research. Here are my recent numbers after being on and metabolic diet for about 3 weeks. My cardiologist is not impressed with Nattokinase and wants me to stay on Lipitor. What are your thoughts?
    LDL-P 1396
    LDL-C 90
    HDL-C 43
    Trig 169
    Chol total 167
    HDL-P total 30.4
    Small LDL-P 738
    LDL size 20.7
    LP-IR score 52

    • http://www.livinlavidalowcarb.com Jimmy Moore

      Your HDL should be above 50–eat more fat to raise it!
      Your triglycerides should be below 100–eat less carbs.

      You can do this!

  • Anne

    Hi

    I was wondering if your numbers get better the longer you fast before drawing blood (beyond the 12 hours,say 16)

    • http://www.livinlavidalowcarb.com Jimmy Moore

      I wouldn’t think it would make that big a difference.

  • m.miller

    WHY HAVEN’T I HEARD ABOUT THIS BEFORE?  MY INTERNIST ONLY KNOWS ABOUT STATINS –  I HAVE HAD PROBLEMS WITH THEM  –  I AM VERY INTERESTED IN THIS INFORMATION  –  HOW CAN I FIND AN INTERNIST THAT IS KNOWLEDGEABLE ?? MM/P.B.G.,FL.

  • Anonymous

    Thanks Terry! The science supporting LDL particles has been clear–the more small-LDL particles in your blood, the higher the risk of penetration through the arterial wall. That’s why people who eat a high-fat, low-carb diet are somewhat protected from this because most of their LDL is the large, fluffy kind that cannot get through. I don’t suppose anybody has verifiably determined what the maximum number of tolerable Small LDL-P are, but I’m not gonna be the guinea pig to find out! :)

    • Jeff

      Jimmy, I think Terry’s question is quite valid. When is an LDL particle considered “small”? IOW, is the size of LDL particles on a continuous scale or is there only two different sizes of LDL particles (i.e., large and small). If these particles can vary in size (i.e., a continuous scale), then how was the difference between “large” and “small” determined?

      • Anonymous

        When it falls into Pattern A on an NMR LipoProfile test. The difference between small and large is the difference between getting heart disease and not.

        • Jeff

          Yes, I understand that’s the way the test characterizes it and how the test results relate to heart disease. But my question is different. Let me ask the question in a different way. When looking at the size of all LDL particles in the blood, are there:

          1. Only two different sizes, large and small (binary distribution) or…
          2. Do they vary in size ranging from very small to very large (continuous distribution)?

          Thanks…

          • Anonymous

            1. No, there are larger large and smaller large and there are larger small and smaller small LDL. But the size falls into generally one of two categories: Pattern A or Pattern B based on the size difference.

            2. Ostensibly…yes.

  • Marlies

    I’ve had the Lipoprofile Test done. Turns out I have 1604 H. My Internist put me on  statin. It’s not working too well for me. Can I manage my health just staying with the high-fat, low-carb diet?

  • Helmericks

    I don’t know how to interpret my results.  Can you help me understand?  Looks like I have large and small particles.