Triglycerides Normal But Ldl High

More Important Than Ldl The Triglyceride/hdl Ratio

by Ford Brewer | Sep 11, 2020 | Plaque, Prediabetes & Diabetes

There are few things that humble me more than my complete and utter buffoonery when it comes to HDL lipidology Peter Attia

Its true of all of us. Thomas Dayspring

Thomas Dayspring is a nationally recognized lipidologist. That means hes an expert on cholesterol, fat, and oil metabolism. And Peter Attia is no slouch in this area. If youd like to spend a few hours hearing cutting-edge concepts in this area, try listening to episodes 20-24 of Attias podcast THE DRIVE.

But be warned that video is very technical. Less than 600 people have started even one of these podcasts. We can only guess how many finished the full 5 hours. I did.

Some information wasnt that new. For example, Attia and Dayspring mentioned that the Framingham study indicates that TG/HDL is 5 times more predictive of heart attack risk than LDL.

They also mentioned that lipoprotein particles pass both cholesterol and fatty acids around like hot potatoes. A few of their concepts also seemed to contradict some basics mentioned later in this article.

Why would I focus this article on such simple concepts?

Because the basics of triglycerides and HDL are critical to health. But the complicated version just isnt understandable, let alone actionable.

I did a simple version of the TG/HDL in a video 3 years ago. It was one of our popular videos.

Many people told me the information saved their lives. Chuck Smith is one of those people.

Normal Cholesterol High Triglycerides

Even though your latest physical may have shown that your cholesterol levels are normal, you may still be at risk for heart disease if your triglycerides level is high.

A 20-year study conducted by the University of Washington School of Public Health and Community Medicine found that a pattern of elevated levels of triglycerides, the main form of fats circulating in the bloodstream, even when cholesterol levels are normal, can mean a two- to three-fold increase of deaths by cardiovascular disease.

Blood triglycerides come from two main sources: the food you eat-especially sugar, animal products and saturated fats-and from your liver. Although its not exactly clear how, high triglyceride levels can result in hardening of the arteries or thickening of the artery walls , which can raise your risk for stroke, heart attack, and heart disease.

• Normal triglyceride levels are less than 150 milligrams per deciliter
• Borderline high is 150-199 mg/dl high is 200-499 mg/dl
• Very high 500 mg/dl. A triglyceride level of 150 mg/dl or above is considered a risk for metabolic syndrome-a constellation of conditions resulting from too much fat around the waist-which in addition to raising your risk for heart disease, it can also increase your risk for diabetes.

Does Your Total Cholesterol Number Even Matter

As one of the most ordered lab tests, total cholesterol can provide a high level glance at how your body is handling lipids, or fats. According to the CDC, roughly nine percent of all doctors visits include a cholesterol test.1 So, how should you interpret your total cholesterol value? Is the whole greater than the sum of its parts?

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Why Is High Cholesterol A Problem

Too much cholesterol in the bloodstream can harden arteries and promote fatty deposits within these arteries, potentially leading to dangerous blockages and narrowing over time called atherosclerosis.

If the blood vessels leading to your heart become too clogged, blood supply to your heart is reduced, which can lead to symptoms such as angina . If the artery becomes completely blocked, it can lead to a heart attack and stroke, which can be life threatening.

In 2017, the Australian Bureau of Statistics reported 43, 477 deaths in Australia from heart disease. This is approximately 30 per cent of all deaths in Australia, and most deaths are occurring in those aged 65 years and over.

However, heart disease takes years to develop, so you can take steps to reduce your risk.If you discover you have high cholesterol, have family members with high cholesterol, or are not sure if youre at risk, it is advisable you seek your doctors advice.

Other risk factors for heart disease include increased age, ethnicity, family history, inactivity, smoking, high blood pressure, type 2 diabetes and obesity.If these risk factors are present in your life, its even more important to keep your blood cholesterol levels in check and seek your doctors advice.

can help you begin to assess your risk, but we strongly advise you discuss your risk with your GP as this tool does have limitations it doesnt take your family history into account, for example.

What To Think About

• Chylomicrons are another type of lipoprotein that are measured in a different test. Chylomicrons are in the blood and carry fat from your intestine to your liver. They carry triglycerides to your muscles for immediate use. Or they carry triglycerides to fat tissue for storage.
• Having a high cholesterol level increases your chances of having a heart attack. The higher your cholesterol, the greater your chances. An elevated total cholesterol level in younger people is particularly significant, since the narrowing of the coronary arteries usually takes many years to develop.
• Lifestyle changes may help lower blood cholesterol levels and increase HDL cholesterol. Some people have better responses to diet and lifestyle changes than do others. Lifestyle changes might include:
• Quitting smoking.
• Eating healthier by reducing saturated fats and cholesterol in the diet while increasing fibre and complex carbohydrate.
• Losing weight. An improvement may occur if you lose as little as 2.5 kg to 5 kg .
• Being active on most, preferably all, days of the week.

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How Often Should I Get A Cholesterol Test

When and how often you should get a cholesterol test depends on your age, risk factors, and family history. The general recommendations are:

For people who are age 19 or younger::

• The first test should be between ages 9 to 11
• Children should have the test again every 5 years
• Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke

For people who are age 20 or older::

• Younger adults should have the test every 5 years
• Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years

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Table 3110percentiles For Plasma Total High

• Increases in dietary cholesterol and fat raise levels of apoprotein E-containing lipoproteins in the plasma of man.Cole TG, Patsch W, Kuisk I, Gonen B, Schonfeld G. J Clin Endocrinol Metab. 1983 Jun 56:1108-15.
• Heterogeneous properties of intermediate- and low-density lipoprotein subpopulations.Srisawasdi P, Vanavanan S, Rochanawutanon M, Pornsuriyasak P, Tantrakul V, Kruthkul K, Kotani K. Clin Biochem. 2013 Oct 46:1509-15. Epub 2013 Jul 2.
• Review .Sandhofer F. Wien Med Wochenschr. 1994 144:286-90.
• .Bauchart D, Levieux D. Reprod Nutr Dev . 1985 25:243-50.

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What Affects My Cholesterol Levels

A variety of things can affect cholesterol levels. These are some things you can do to lower your cholesterol levels:

• Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level rise. Saturated fat is the main problem, but cholesterol in foods also matters. Reducing the amount of saturated fat in your diet helps lower your blood cholesterol level. Foods that have high levels of saturated fats include some meats, dairy products, chocolate, baked goods, and deep-fried and processed foods.
• Weight. Being overweight is a risk factor for heart disease. It also tends to increase your cholesterol. Losing weight can help lower your LDL cholesterol, total cholesterol, and triglyceride levels. It also raises your HDL cholesterol level.
• Physical Activity. Not being physically active is a risk factor for heart disease. Regular physical activity can help lower LDL cholesterol and raise HDL cholesterol levels. It also helps you lose weight. You should try to be physically active for 30 minutes on most, if not all, days.
• Smoking.Cigarette smoking lowers your HDL cholesterol. HDL helps to remove bad cholesterol from your arteries. So a lower HDL can contribute to a higher level of bad cholesterol.

Things outside of your control that can also affect cholesterol levels include:

How Can I Lower My Ldl Level

There are two main ways to lower your LDL cholesterol:

• Therapeutic lifestyle changes . TLC includes three parts:
• Heart-healthy eating. A heart-healthy eating plan limits the amount of saturated and trans fats that you eat. Examples of eating plans that can lower your cholesterol include the Therapeutic Lifestyle Changes diet and the DASH eating plan.
• Weight Management. If you are overweight, losing weight can help lower your LDL cholesterol.
• Physical Activity. Everyone should get regular physical activity .
• Drug Treatment. If lifestyle changes alone do not lower your cholesterol enough, you may also need to take medicines. There are several types of cholesterol-lowering drugs available, including statins. The medicines work in different ways and can have different side effects. Talk to your health care provider about which one is right for you. While you are taking medicines to lower your cholesterol, you still should continue with the lifestyle changes.

Some people with familial hypercholesterolemia may receive a treatment called lipoprotein apheresis. This treatment uses a filtering machine to remove LDL cholesterol from the blood. Then the machine returns the rest of the blood back to the person.

NIH: National Heart, Lung, and Blood Institute

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Consult A Doctor For Your Ldl Hdl Ratio Problem

High LDL HDL ratio and low Triglycerides can be caused by a lot of reasons. If you take LDL HDL ratio and Triglycerides blood tests and the results are higher than 3 Ratio for LDL HDL ratio and lower than 0 mg/dL for Triglycerides, your physician may recommend more tests to figure out the problem. You might also get these tests if your physician thinks you have some other disease.

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The American Heart Association Recommends

All adults age 20 or older should have their cholesterol checked every four to six years. If certain factors put you at high risk, or if you already have heart disease, your doctor may ask you to check it more often. Work with your doctor to determine your risk for cardiovascular disease and stroke and create a plan to reduce your risk.

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Medications May Be Needed For High Triglyceride Levels

Sometimes, healthy eating and regular exercise cant lower high triglyceride levels. This may be the case, for example, if you have familial hypertriglyceridemia or if you already have heart disease. Your doctor may prescribe medication such as fibrates or nicotinic acids. Drugs to help lower high blood cholesterol may also be prescribed, if necessary.Suggestions for managing high triglyceride levels with medication include:

• Always take prescription medications exactly as instructed.
• See your doctor if you are having side effects from the medication. Known medication side effects may include indigestion, diarrhoea, fever or muscle problems.
• Dont assume that medications will somehow overcome the hazards of an unhealthy lifestyle. A healthy diet, regular exercise and maintaining an appropriate weight for your height are the most important management strategies for high triglycerides.

Which Medicines Can Lower Triglycerides

For some people, good habits may not be enough. Medication might be needed. The decision for you and your doctor can be complicated because other health conditions are usually involved. Several types of medicine can improve levels. They include:

• High doses of omega-3s are needed to lower triglycerides and should be taken only under a doctors care. Epanova, Lovaza, and Vascepa are prescription forms of omega-3s.

Your doctor may also prescribe a class of drugs called âstatinsâ that lower cholesterol. Examples include: atorvastatin , rosuvastatin , and simvastatin .

You may feel side effects from these drugs. Be sure to talk it over with your doctor or pharmacist.

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Low Levels Are Usually Protective

It is well known that high triglycerides are dangerous, but little is known about the influence of low levels on health. Studies suggest that in healthy people, low triglyceride levels are beneficial. Low triglycerides are also good for people with diabetes and might also be protective against heart attacks .

One study even suggests that the lower a persons triglycerides are, the less likely they will be to die from any cause. In this study, almost 14k people were followed for 24 years. The scientist found that levels below 89 mg/dL thats almost twice lower than the borderline-normal value of 150 mg/dL were associated with a 41% lower risk of dying than high levels

So can your levels ever be too low to do any harm?

We still dont have any definitive answers, but we can look for some clues.

Consequences Of Low Hdl High Triglycerides

Cholesterol gets deposited easily in the blood vessels of these patients and the build-up of cholesterol cannot be cleansed out efficiently due to low level of HDL cholesterol. Consequently, these patients are at very high risk for narrowing of the blood vessels.

HDL cholesterol and triglyceride level serves as an extremely useful test to diagnose Insulin Resistance Syndrome. If your HDL is low and/or your triglyceride level is high, you have Insulin Resistance Syndrome.

Low HDL cholesterol has been known to be a strong risk factor for coronary artery disease for a long time. In 1977, the results of the famous Framingham Heart Study were published in the American Journal of Medicine. In this study, HDL cholesterol was found to be the most potent lipid predictor of coronary heart disease.

Several other studies including the Coronary Primary Prevention Trial , the Multiple Risk Factor Intervention Trial , and the Lipid Research Clinics Follow-up Study further confirmed the strong relationship between low HDL cholesterol and coronary artery disease.

Raising HDL cholesterol reduces the risk for heart attack. A 1% increase in HDL cholesterol is associated with a 3% decrease in risk of heart disease. This impressive role of HDL cholesterol in preventing heart attack was shown in the famous Veterans Affairs HDL Intervention Trial . The results of this study were published in the New England Journal of Medicine in 1999.

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How Often Should My Triglycerides Be Tested

If youâre a healthy adult, you should get a lipid profile every 4-6 years. Children should have it done at least once between the ages of 9 and 11, and one more time between 17 and 21. If youâre making changes to your diet or taking medication for high cholesterol or triglycerides, experts advise you to get a lipid profile afterward.

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High Cholesterol: Prevention Treatment And Research

Cholesterol is a natural component in everyones blood. However, when you have too much of this fatty substance, its considered hyperlipidemia, hypercholesterolemia or high blood cholesterola major risk factor for heart attack, heart disease and stroke. About 71 million Americans have high cholesterol.

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Normal Cholesterol With High Triglycerides What Is That

When measuring total cholesterol levels, low-density lipoprotein , high-density lipoprotein , and triglycerides are used in the measurement.

For adults, standard cholesterol levels are:

• Less than 200 mg/dL is desirable
• Between 200 – 239 mg/dL is considered borderline
• Over 240 mg/dL is considered high

How Are High Triglycerides Found

A blood test called a lipid panel measures triglycerides and cholesterol. You should have this test after fasting for at least 12 hours.

Adults should get this screening test every five years or sooner. If you have diabetes, a family history of high triglycerides, or other risk factors, you may need screening more often, according to the National Cholesterol Education Program Guidelines 13).

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Lowering Your Triglyceride Levels

Making some simple lifestyle changes can go a long way in helping bring down your triglyceride levels, including:

• Losing weight. Dropping just five to ten pounds can help lower your triglycerides.
• Avoiding sugary and refined foods. Stay away from simple carbohydrates, such as sugar and foods made with white flour.
• Eliminating trans and saturated fats. Trans fats are found in fried foods and commercial baked products like cookies and crackers and saturated fats are found in meats. Instead, choose healthier monounsaturated fats found in plants, such as olive, peanut and canola oils, and fish high in omega-3 fatty acids, such as salmon and mackerel.
• Limiting alcohol consumption. Alcohol is high in calories and sugar and effects triglycerides. Even small amounts of alcohol can raise triglyceride levels.
• Maintaining regular exercise. Regular exercise can increase HDL cholesterol levels and lower LDL cholesterol and triglyceride levels. Aim for at least 30 minutes of physical activity on most days of the week.

If making some lifestyle adjustments isnt enough to control your triglyceride levels, a medication may be necessary. Talk with your doctor to determine the best course of action for you to ensure a healthy heart.

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High Cholesterol High Hdl Low Triglycerides

Dr T

Question:Answer:

There are 2 kinds of LDL cholesterol, A and B, of which B is associated with heart disease.Most labs calculate LDL as follows:

LDL = Total Cholesterol HDL triglycerides/5.

This doesnt explain the difference between LDL A or B .

Studies have shown that there is a strong correlation between a low triglyceride/high HDL level and LDL pattern A .

On the other hand, a high triglyceride/low HDL level is strongly associated with LDL pattern B . Thus high triglycerides are an independent risk factor for heart disease.

From this you can calculate that in your situation a high LDL is mostly Type A , confirmed by a high HDL and low triglyrerides and that therefore there a very low risk of heart disease.

Having high cholesterol may still be healthy if good cholesterol levels, triglycerides, and other markers of cardiovascular health are good. You can calculate this here. People with high good cholesterol levels and low levels of triglycerides may actually be at a lower risk for heart disease than people with normal cholesterol levels who have lower levels of good cholesterol and higher levels of bad cholesterol.

Hope this helps,

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