Waves Karelena! Kudos; GOOD advanced lipid panel, etc. Your genetic propensity for high functional HDL should serve you very well. You've already narrowed in on one important area to work on- homocysteine, but I'll toss out a few others for consideration.
I'm a little surprised by your high VLDL. Here's a current link on VLDL from Mayo:http://www.mayoclinic.org/diseases-cond ... q-20058275
High levels of VLDL cholesterol have been associated with the development of plaque deposits on artery walls, which narrow the passage and restrict blood flow.
The best way to lower your VLDL cholesterol is to lower your triglycerides. Losing weight and exercising regularly are key, and you might also want to avoid sugary food and alcohol in particular.
In my experience, lowering refined and starchy carbs is of huge help here. I agree with Stavia that you need to be careful not to replace them with lots of additional dietary fats given that your LDL-P is decent (for a 4/4) but borderline- you certainly don't want to push it in the wrong direction. You may consider substituting MUFAs for SFAs (EDIT
: I originally had MUFA/SFA switched- sorry
) as they may allow you to safely up fats a bit and freely increasing non-starchy vegs. Exercising and going slightly HYPOcaloric could also be useful.
Moving in that direction will also knock your A1c down. (Did you notice that even Dr. Bredesen moved his target from 5.5 to 5.0?
Also, given your borderline Lp(a) it might be good to consider niacin.
It was wonderful to spend time with you and your sweet husband. I'll look forward to continuing our E4 climb together