Please Critique My Lipid Panel

I just got the results of my first lipid panel after going Bulletproof/Primal/paleo/low-carb for a number of months now. I don't have any pre-diet change results to compare it to. I read extensively all the varying views and heard a lot of stories about how individuals' numbers changed in every direction. While I am not worried about my numbers (nor is my doctor) I'm not sure they are as stellar as I was hoping for - but I don't really have a good grasp on what is ideal.

Please, let me know what you think or link me to articles that lay some reasonable (non-conventional wisdom) ranges.

I am male, 29 years old. 6'2" and about 165 lbs.

My results as just appeared in my MyChart app are listed below (note, my doctor does consider “good fats” saturated and monounsaturated – he is anti-vegetable oils. Blood was taken after a 12 hour fast):

Comment from Doctor's office:
Your cholesterol is a bit up, but that would reflect a lot with the good cholesterol. I would suggest looking to eat the healthy fats only in diet. I would continue to focus on vegetables and fiber, and would continue excellent exercise practices!

Component Results (Value / Std Range):
Cholesterol, Total: 267 / 0-199
Triglycerides: 109 / 0-150
HDL: 80 / 40-60
LDL Calculated: 165 / <100
VLDL Calculated: 22 / Not Established
Glucose: 90 / 70-99



  • ACH85ACH85 ✭✭

    Where and how did you find a doc so awesome? Serious question. 


    I would say you have good numbers, though using only these metrics, I might want to reduce LDL. But these metrics aren't all that useful. You measured total LDL cholesterol, irrespective of the number of particles of LDL. (Though you did get the VLDL breakdown.) It is LDL particle count that seems to be best correlated with heart disease, along with inflammation. So while at first blush you could reduce LDL, all that LDL could be in a relatively small number of larger particles, not leading to a heart disease risk. If you're super low carb or low carb without carb refeeds, LDL may come down a bit with a moderate increase in carbs. 


    I'd take the doc's advice and not worry much beyond that. If you want a deep dive on cholesterol, I recommend Peter Attia's "straight dope on cholesterol" blog series or less-in-depth YouTube video by the same name. 

  • Thanks for the reply. This was really just your basic insurance covered blood panel test. I figured I should start a habit of a yearly physical.

    After further searching I found some ratio guidelines - do these look valid and something I should strive towards? If so my numbers look good.

    HDL:Total Cholesterol should be greater than 0.24

    Triglycerides:HDL should be less than 2

    HDL:LDL great than 0.4 is great

    About my doctor, I couldn't be happier so far. I saw him once a number of years ago (before going Bulletproof / low carb high fat) because I quickly needed a physical before a hernia surgery. I didn't love him or hate him, but he came well reviewed in your conventional doctor review sites. Fast forward to a few weeks ago, been Bulletproof for a little while - but less than a year - figured I should start doing yearly physicals but dreaded having a cholesterol talk with a CW doctor (wasn't sure what my numbers would look like). Searched online for a paleo-minded doctor in the Cincinnati area but couldn't find one. Just said whatever and made an appointment with him again. Had to do the new patient interview since it had been so long. He started right in with how doctors have been misleading about saturated fats and gave me a talk about good fats and why to avoid vegetable oils and white flour and sugar. Then started to talk about exercise, sleep, and then even mediation - his four pillars of health. At this point I had not said anything. I was just trying to hold back a huge smile. I eventually told him a bit of what I've been up to with my nutrition. He loved what I was doing an said to keep it up.
  • ACH85ACH85 ✭✭

    In the absence of better metrics, yes, I think the ratios are a reasonable guideline. Sounds like you got really lucky with your doc. 

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