My basic labs plus fasting insulin and Lp(a)

[Ruth]

I would appreciate any thoughts/suggestions regarding labs I just got done with my new primary care doctor. Besides the basic labs, she added Lp(a), which I hadn't asked for, and fasting insulin, which I had asked for but wasn't sure she would be able to order. Nice! Here are the results, with Kaiser's standard range to the right of my result:

Lipoprotein (a) 35 mg/dL <=30 mg/dL
Insulin <2 uIU/mL 4 - 29 uIU/mL
Hgb A1c % 5.2 % 4.6 - 6.0 %
ESTIMATED AVERAGE GLUCOSE 103 mg/dL 85 - 126 mg/dL
VITAMIN D, 25-HYDROXY 100 ng/mL 20 - 79 ng/mL
TSH 2.19 uIU/mL 0.40 - 4.20 uIU/mL
Cholesterol 202 mg/dL <=239 mg/dL
Triglyceride 60 mg/dL <=499 mg/dL
HDL 71 mg/dL >=50 mg/dL
Low density lipoprotein calculated 119 mg/dL <=159 mg/dL
Glucose, fasting 93 mg/dL 60 - 99 mg/dL
Creatinine 0.57 mg/dL <=1.11 mg/dL
AST 16 U/L 10 - 40 U/L
ALT 15 U/L 0 - 36 U/L

I omitted the CBC numbers as all were in line and I assume not germane to apoe4 usually. My total cholesterol and triglycerides are defintely up from when they were last tested in 2014 (169 and 45, respectively). I think this is the result of too many paleo and non-paleo treats and indulgences... Definitely room for improvement there. Although maybe also aging/apoe4 issues coming into play as well? My vitamin D has never been this high, or near this high. I've been supplementing a lot (6.000 IU a d day) and making an effort to get sun/outdoor time/forest bathing, and obviously I overdid it.

The main concern is the Lp(a) number being elevated. Does a slight elevation mean anything, or is it like being a little bit pregnant? That result wasn't available yet when the doctor and I spoke about the labs on Friday, and her office called me today to schedule a telephone appointment to talk to her about it when she's back from vacation in a couple of weeks. So I have some time to do some research before then. I will definitely get a NMR test, too, just to get a fuller picture.

Thank you for your thoughts/ideas!

[Stavia]

Here's my 2 cents
1. The trig variation is not significant. They vary from hour to hour. They are both significantly under 100, it's fantastic!
2. You are oversupplementing D3. Why did you decide to take 6000U a day?
3. IMO the slight elevation of lp (a) is not clinically significant. Genetic disorders affecting CVD risk usually have much much higher levels. Its not like a little pregnant. This level is IMO unlikely to contribute significantly to your CVD risk and is unlikely to be the result of a significant genetic issue here.
Remember if one spreads the net too wide and indiscriminately does tests, one will turn up at least 5% insignificant slightly out of range results. The ranges are artificially set at 95% of average people.

[KatieS]

Thanks, Stavia, I was just about to reassure about the borderline lp(a).

My lp(a) is over double the norm and despite niacin, l-carnatine, vitamin C, lysine & proline, it has only nudged up. Supplement "success" seems to be able to lower it marginally. The only consolation is that my mom runs the exact same number (78) and has never had any cardiovascular problems other than HTN & slightly high cholesterol, Rx controlled for decades, so I'm onboard with her Rx.

[Ruth]

Stavia and Katie, thanks so much for your replies! I appreciate the reassurance and perspective regarding the Lp(a) result, and lab results in general. Very helpful to remember.

Stavia, regarding the high Vitamin D: I feel a bit foolish as I had been taking large doses of a particular multi vitamin supplement per the Walsh protocol, but neglected to re-test and check-in as promptly as the physician whom I had consulted had advised me to do. Time just got away from me and I guess I didn't have a healthy respect for what large doses of supplements can do. I have now cut back to half the amount he had recommended (so now 3,000 IU) and am waiting for my consult with him regarding it. I also now see the danger of sort of trying to doctor yourself with minimal oversight.... Lesson learned!