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Originally Posted by mach8 HI everyone , doc says my Total cholesterol is 257 , HDL 50, LDL 186, trigs
129. My question is ,How do they come up with TC number of 257, I don't know the formula to figure it out. And are these numbers really that bad, I'm still learning about all this. I would appreciate some feedback on this please.
Thanks , Bob |
In general, they directly measure the TC, HDL, and triglycerides and calculate your LDL from those numbers using the following equation:
LDL = TC - HDL - Triglycerides/5
or another way of representing that equation is:
TC = LDL + HDL + Triglycerides/5.
In reality, Total Cholesterol is the sum of the HDL, the LDL, and the VLDL (very low density lipoprotein). Instead of measuring VLDL, they can approximate it by measuring the triglycerides and dividing by 5, but this only works when triglycerides are in the "normal" range. Triglycerides over 400 result in the inability to accurately calculate the LDL.
Now, just how bad are your numbers. For that, you need to look at the various ratios. Let's start with the most common one shown on lab reports and is often listed as the "risk ratio".
Risk Ratio = TC/HDL with the recommended value being <4.0. In your case it is 257/50 or 5.14 which is a bit too high and indicates increased risk of cardiovascular disease.
Another ratio is LDL/HDL with the recommended value being <3.0. In your case it is 186/50 or 3.72, again showing higher than recommended risk.
Another ratio that isn't used very often but probably offers better insight into the actual risks of cardiovascular disease is Triglycerides/HDL. Studies show this ratio to be ~16 times better at predicting future heart disease risk than total choleserol alone. The recommend ratio is <3.0 with a ratio of <2.0 being low risk. In your case, the ratio is 129/50 or 2.58 which isn't too bad. With your essentially normal/good HDL and triglyceride levels, I don't see any immediate concerns, although almost everyone can improve on their diet (cut back on the sugars, refined carbohydrates, and processed foods laden with trans fatty acids) and exercise regimen.
What you likely have is an equal or higher ratio of LDL pattern A than LDL pattern B as indicated by your low normal triglyceride level. Triglycerides are a very good indicater of LDL patterns (particle size) with low triglycerides (<100) being associated with LDL pattern A (large light particles) while high triglycerides (>200) are associated with LDL pattern B (small dense particles). LDL pattern A is essentially benign and imparts virtually no increased risk of heart disease while LDL pattern B, which is small dense easily oxidized particles, poses a much higher risk. LDL can be measured directly and pattern types identifed. In the past, this test was very uncommon, but it is becomming more common nowadays. If you have concerns, I would recommend that you get this tested. Do a search on here or on google for VAP test. Other useful tests are a C Reactive Protein (CRP) test which measures inflammation and is a positive risk factor for coronary artery disease and a homocystein test which is another heart disease risk factor.
Alan
Question? 
Adding some green leafy things also . Iv'e been mostly a meat and potatoes eater. lots of fats and sugars. I'm becoming increasingly aware of the junk that i eat. I'm glad i stumbled on to this site. I appreciate the fact that you and others here are willing to share their insights into this subject. I had the cholesterol test about 4 months ago , I asked what to do , the nurse said add some fish and chicken to my diet . i'm not to fond of chicken , the only seafood i eat is shrimp and lobster, oysters . that wil have to change 
Guess i'll try some salmon in my diet. Oh and i quit going to the fast food dumps. That's about all they said . So i had the test again 3 months later 257 down from 259. what did they expect with very little changes , so they want me to take lipitor without even asking what changes i made . So i set out to find out what to eat etc. 
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