Today I got my VAP test result to read back, the doc didn't even know how to read it, as a matter of fact, he didn't even know it was in the file, and after he told me he wanted to send me for blood tests, he looked embarrassed when I told him they should be in the file already! I took the tests on October 22, 2007 and he didn't even read it before seeing me!

When I was questioning him about the LP(a), and small and big particle ldl he asked me three times if I worked for a cardiologist, instead of trying to understand the report with me!

Anyway, I had worse results now than last year when the standard test showed

ldl-157, hdl-83, total cholesterol-257, TRI-88

VAP Results: LDL-178, HDL-68, TOTAL-276 TRI-132

LP (a) 10
LDL-large buoyant-Pattern A

HDL-2 (large buoyant) 19
HDL-3 (small dense) 49

It's good that I have the big pattern ldl, but the hdl is less of the good kind and more of the dead kind.

MY c-reactive protein os 0.1 and homosysteine 5.5.

He said I should be treated , then I asked about Niaspan and he said I could try it, but then I said maybe I will try over the counter slow release niacin first. When I came home an analyzed the report and noticed my ldl isn't the dangerous kind, maybe I don't need anything anyway. The doc didn't even know to take that into consideration.

I was thinking that I might be consuming to much fish oil (1100 mgs. daily)
in addition to eating walnuts, almonds, and peanuts during the day, it may be raising my ldl as well as the hdl.

I take plant sterols and policosanol everyday.

Boy, you really don't know anything about your blood fats from the standard test!

Does anyone think with the combination I have, that if I cut down on the nut and fish oils I don't need the niacin with large particle ldl?

Thanks!

I strongly agree that the VAP test is so much more useful than a standard lipid test. I still find it odd that doctors prescribe regular tests anymore. As for reading it, any half-decent doctor should be able to read the test results. I mean, it's relatively straightforward info.

Regarding your LDL, look at the report and you'll see a little graph thingy (at least my report did). How far to the large particle size does the little arrow point? If it's almost all large LDL particles, you are in good shape. If it's sorta in the middle, but still predominantly large, it's still decent, but not ideal.

Your c-reactive protein and homosysteine are at real nice levels. How were your IDL and VLDL numbers?

Based on the info posted, trying 500mg Niaspan might not be a bad idea. Your LP(a) was a little elevated, if I remember correctly (is 10 used as a high marker for VAP tests)? Niacin should move some of your HDL to HDL-2 and might help lower your LP(a) too. And it'd lower your LDL and triglycerides some, as well. It could be worth a shot.

I don't think 1100 mg of fish oil would have that large an effect on on your LDL levels. I assume you are referring to total omega-3 intake, but regardless, usually a person has to go to 3 grams (omega 3) + or so to start seeing LDL rise, and that's only in some people.

An excessive nut intake could be raising LDL, I suppose. Just try raw or dry nuts, not the type covered with lots of oils.

Policosanol probably isn't doing anything at all, at least according to the Mayo Clinic's testing. Sterols could be helping, but stanols might be the better option. I know some doctors aren't fans of sterols, since they can be absorbed into the blood stream.

Hope this info is of some help.

Thanks so much for your reply. The IDL-C is 20, even with the test marker,
VLDL-C is 30, even with the test marker, remnant lipo (IDL+VLDL3) is 38,
higher than test marker of 30. VLDL-3 remnant lipo is 18, higher than test marker of 10.
All my LDL is Pattern A, large bouyant, and the LPa test marker is 10 even with mine.

Before I started taking sterols and policosanol, my ldl was 191, TC-300, so since I got the ldl down to 157 last year and HDL to 83, and TRI to 88, I figured they were working. I was thinking something happened in 2007 to throw it off and was blaming eating too much fish and nut oils daily. I even joined a pool in 2007 and got more exercise than the prior year when the numbers were better, I don't get it? I was just thinking when the numbers were better I ate own bran or oatmeal almost morning, I cut back on doing that.

Do you think Niaspan is better than getting over the counter immediate release niacin at this point? Is 500 mgs of Niaspan the lowest dose?

Happy Holidays.

I figured they were working. I was thinking something happened in 2007 to throw it off and was blaming eating too much fish and nut oils daily. I even joined a pool in 2007 and got more exercise than the prior year when the numbers were better, I don't get it? I was just thinking when the numbers were better I ate own bran or oatmeal almost morning, I cut back on doing that.

Do you think Niaspan is better than getting over the counter immediate release niacin at this point? Is 500 mgs of Niaspan the lowest dose?

Happy Holidays.

Since your LDL is all nice and fat, I'm not sure you need to be concerned about it. As for the difference between your last test and this one, I'd simply chalk it up to the VAP being much more accurate. Quite often regular lipid tests underestimate LDL levels.

Oat bran might make a small difference though. No harm in eating it again. And probably no harm taking policosanol and sterols... but I just wanted you to be aware of the data out there. All the positive data on policosanol came from studies in Cuba. When it was tested outside of that country, most of the results showed it no better than a placebo.

500mg Niaspan is the smallest dosage they sell, I believe. Since some of your markers were near the top of the upper ranges, or slightly above, trying Niaspan might be worthwhile. It's one of the few (if only) things that can lower LP(a). You can alternatively try IR niacin, but just be prepared for a bit of a flush. I've tried both... 100 mg IR niacin made my face red, ears itchy, etc. 500mg Niaspan and, at most, I have a slight tingly feeling for a brief period. And I think that only happened once or twice.