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Got my oxidized LDL results

Newcomer introductions, personal anecdotes, caregiver issues, lab results, and n=1 experimentation.
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RichardS
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Re: Got my oxidized LDL results

Postby RichardS » Fri Feb 27, 2015 3:52 pm

Since becoming more of an educated health consumer re. lipid testing, I find myself squarely in the middle of mainstream and alternative advice. IMHO (I could be 100% wrong) I think it's a mistake to think LDL-P doesn't matter and we should just focus on particle size. I also think it's a mistake to suggest the opposite; that small particle size, low HDL/high TGs are OK as long as LDL-C/P is low. At this point, I'm terrified enough to heed everyone's advice :? I want low LDL-P/apoB, low unoxidized LDL, low Lp(a), Pattern A: large and fluffy particles, with high HDL-C/P and low TGs. That being said, I think low glucose and insulin markers trump EVERYTHING followed closely by low inflammation markers.


Well said. I agree.

The idea that Lp(a) is tied to LDL-C/LDL-P/apoB (any or all) is interesting. My LDL-C has been crazy high (130-150) since eating high MUFA, but my LDL-P and apoB have been relatively decent. I tend to show discordancy in the opposite direction of most. That may fit in with your theory somehow... My understanding, however, is that Lp(a) is largely genetic. That makes me wonder is oxLDL may be the same?


The idea is that the percentage of apoB particles with oxidized phospholipids is highly correlated with Lp(a) rather than the raw oxLDL count. Thus, the logic would be that if it is hard to lower Lp(a), the critical part to lowering oxLDL would be to lower overall LDL particles. I have had only transient success with lowering Lp(a), and it is back to where it was around 150 nmol as I am playing around with other dietary stuff. Of course, there is also making sure we aren't taking in easily oxidized or pre-oxidized PUFA's and getting plenty of lipid antioxidants like green tea, olives/EVOO and other protective plants.

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Re: Got my oxidized LDL results

Postby marthaNH » Fri Feb 27, 2015 4:28 pm

From RichardS: "Of course, there is also making sure we aren't taking in easily oxidized or pre-oxidized PUFA's and getting plenty of lipid antioxidants like green tea, olives/EVOO and other protective plants."

This seems to be the most widely-understood and agreed-upon principle among the people I read, but I have to admit that I don't think I am up to speed. Are all PUFA's easily oxidized? Does this mean Omega 6 only? There is a lot of talk about rampant rancid pufas but in a well managed kitchen full of whole foods, is that really an issue? Can rancid fats actually sneak past you? Aren't they strong tasting and nasty?

I assume that most of the "pre-oxidized" pufas are out in fast food land but "easily oxidized" -- is this something that happens in the body? I need a primer, I guess. But I don't want to turn to the same people who think black beans are toxic, because it's all so theory-driven and ideological I find that I just don't trust it.

I do understand the green tea, olives, protective plants part.

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RichardS
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Re: Got my oxidized LDL results

Postby RichardS » Fri Feb 27, 2015 4:49 pm

Martha - I'm not sure how closely linked the issue of oxidized LDL and oxidized dietary fats are, but I've read studies of green tea and olive polyphenols which lowered both oxLDL in humans and helped protect uneaten fatty foods from oxidizing.

PUFA's by their very nature of not being fully saturated are at the highest risk of oxidation both inside and outside the body and why highly saturated fats like coconut, palm and refined lard have long shelf lives and why you should always refrigerate fish oil. I don't think there is a definite formula for determining if a certain food has oxidized PUFA's outside the obvious fast food arena. However, there is a lot of variability among people as to how sensitive their sense of smell is to rancid oils. The casual reading I've done with the original peer-reviewed research suggests that PUFA's from intact fresh foods are least oxidized. Think freshly ground/unheated flax seeds rather than flax oil. Unground flax is very stable because of the protective seed coating. Omega 3's can certainly go bad - just think of the smell of fish that has gone bad.

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RichardS
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Re: Got my oxidized LDL results

Postby RichardS » Tue Mar 31, 2015 5:59 pm

I'm considering getting my oxLDL tested. I just noticed the test availability at Life Extension Foundation. http://www.lef.org/Vitamins-Supplements ... -LDL-Panel
What I'm not clear on is if it is worth spending more for the Advanced ($213) or the Panel ($131) rather than the basic oxLDL ($56). Is it important to know F-2 Isoprostanes or Myeloperoxidase (MPO)? Any thoughts? If oxLDL came back elevated I would be doing serial testing with diet/supplement tweaks, so cost would become a factor.


Advanced Oxidized LDL Panel
Item Catalog Number: LC100035


If you have normal cholesterol levels, you may assume you're not at risk for a heart attack or stroke. But that's not necessarily the case. Nearly 50% of all heart attacks occur in people with "normal" cholesterol levels. That's because dangerous inflammation present in the walls of your arteries is often the primary contributor of risk, contributing to both vulnerable plaque formation and rupture.

The good news is that inflammation can be easily measured to determine your inflammatory status and cardiovascular risk. The Advanced Oxidized LDL panel contains the following tests that check for damage to your arteries, disease development and vulnerable plaque formation and rupture:

F-2 Isoprostanes (F2-IsoPs) are produced when free radicals react with neighboring molecules in a process called "oxidative stress," causing a cascade of damage in our cells initiating destructive pathways which lead to disease. F2-IsoPs may be elevated at the earliest stages of plaque development, and research has shown that people with high levels of F2-IsoPs are 30 times more likely to develop heart disease.1

Oxidized LDL is LDL cholesterol (the "bad" cholesterol) that has been modified by oxidation, triggering inflammation leading to the formation of plaque in the arteries. Why should you get your oxidized LDL levels tested? The facts speak for themselves:

Individuals with high levels of OxLDL are 4 times more likely to develop metabolic syndrome in the next five years.2
Increased OxLDL levels are associated with the presence of coronary artery disease3-5
Levels of OxLDL increase in a step-wise fashion as the severity of coronary artery disease increases.6

Myeloperoxidase (MPO) is an enzyme, released by white blood cells, that measures your body's response to damage in your artery walls and the subsequent formation of vulnerable plaque which is prone to rupture!

MPO oxidizes LDL making it atherogenic, and HDL (your good cholesterol) rendering it dysfunctional. This results in inflammation linked to plaque buildup inside the artery wall. Still not concerned that you are at risk for a heart attack? Read on …

Individuals with elevated MPO levels are more than twice as likely to experience cardiovascular mortality.7
Elevated MPO levels predict the risk of heart disease in subgroups otherwise associated with low risk.8,9
MPO levels are not likely to be elevated due to chronic infections or rheumatologic disorders due to the fact that MPO in the blood is a specific marker of vascular inflammation and vulnerable plaque.

Fasting is not required for this test. Take all medications as prescribed.

Special Note:
This panel requires collection of a random urine specimen at the same time your blood is drawn.

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Re: Got my oxidized LDL results

Postby circular » Tue Mar 31, 2015 6:45 pm

Myeloperoxidase (MPO) is in HDLabs advanced cardio panel, FWIW.

I have wondered about olives sold in clear jars. I assume maybe the oils within the olives is fresh, but what about light oxidation, and heat if they sit in hot trucks? I feel the high polyphenol EVOO may be better preserved. Amphora is in my town :-D. I hear what you're saying about less fat for same polyphenols. I love olives too. Candy!
ApoE 3/4 > Thanks in advance for any responses made to my posts.

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Re: Got my oxidized LDL results

Postby Juliegee » Tue Mar 31, 2015 6:52 pm

Good for you, Richard. I'm hugely in favor of quantifying risk. FWIW, my doc used the Cleveland Heart Labs test. I have NO idea how that correlates with the LEF tests...
http://www.clevelandheartlab.com/wp-con ... -D007c.pdf

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RichardS
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Re: Got my oxidized LDL results

Postby RichardS » Tue Mar 31, 2015 7:24 pm

Julie-LEF was the first site I found that had an easily self-ordered lab test for oxLDL, and I already have an account there. I have an HMO that would not approve oxLDL. I don't know how to get the Cleveland labs ordered.

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Re: Got my oxidized LDL results

Postby circular » Tue Mar 31, 2015 9:03 pm

For some reason my HDLabs shows Lp(a) Mass but not Lp(a) Cholesterol??? It's good, at 11, but of all the results, the Lp(a) Cholesterol is the only one left blank.
ApoE 3/4 > Thanks in advance for any responses made to my posts.

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Re: Got my oxidized LDL results

Postby Fidel » Wed Jun 03, 2015 6:16 pm

Good to hear about the Lp(a) correlation with oxLDL. My Lp(a) came in at 72 nmol/L. When i punched that in to the converter at http://www.vin.com/calculators/default.htm, that equates to 2779.92 mg/dL. The Quest lab considers my result in the optimal range. Julie's lab found her in the optimal range at 8mg/L. That is quite a wide range, so were we tested for the same thing?

As Richard was saying, omega 3's are certainly vulnerable to oxidation and rancidity. The longer chain ones found in fish are even more vulnerable, as DHA for instance has 6 double bonds (the H in DHA stands for hexa meaning 6) while ALA found in plants like flax has only 3 double bonds. Personally i feel better getting omega 3 needs from ALA and letting my body convert what it needs to DHA or EPA, although i do enjoy those Gardein fishless filets which do contain some DHA & EPA.
3/4

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Re: Got my oxidized LDL results

Postby Juliegee » Wed Jun 03, 2015 7:33 pm

FWIW, Fidel- my Lp(a) was 8 mg/dl, not mg/L. That may account for the weird translation.

I'd be careful relying on Richard's hypothesis re. the correlation of OxLDL to Lp(a.) Just to be safe, I'd directly measure if possible. As a 4/4, I'm a total scaredy-pants and fan of quantifying risk factors. My B-Day list used to include shoes, etc; now it's bio-markers, LOL

Also, I totally understand your reasoning for not supplementing with DHA, but you may want to check your serum Omega-3 levels just to be safe given the contradictory information on conversion. Newer research seems to indicate that E4 carriers preferentially metabolize DHA rather than conserve it (where it's prone to oxidation) like the other ApoE genotypes. We seem to have a perturbed fatty metabolism (including DHA) that puts us at higher risk of both CAD/CVD and AD. This phenomenon seems to hold true even for heterozygotes.

Fatty Acid Metabolism in Carriers of Apolipoprotein E Epsilon 4 Allele: Is It Contributing to Higher Risk of Cognitive Decline and Coronary Heart Disease?
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4210928/

If your levels are found to be low, you might consider an algae-based DHA that may be congruent with your vegan diet.


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