▲ 2 r/Cholesterol+2 crossposts

5 month of diet changes, LDL dropped but apob remains unchanged

I have drastically reduced saturated fat and added fiber since I found out about my LP(a) in March’26.

March’26 vs Aug’26

LDL-C: went from 112 to 97

Triglycerides: 59 to 44

HDL: 60 to 53

ApoB: 88 to 86

TC: 186 to 163

LP(a): 191 (tested only in March)

HbA1c: flat at 5.2

hs-CRP: from 0.3 to <0.2

I am confused as to why ApoB barely moved even though LDL-C and Triglycerides reduced and my diet is pretty clean (so hopefully not fueling small particle count while reducing total cholesterol volume). I understand that a portion of ApoB is related to LP(a) that is fixed and will not reduce from diet changes. I am asking why the rest of the ApoB did not reduce as total cholesterol reduced by 12%.

Anyone dealt with something similar? Especially if diet didn’t move ApoB much.

I am finally considering statin or ezetimibe to get ApoB to be less than 60. I don’t think I can do any more diet related intervention. Based on limited reduction from diet on ApoB, is one better than the other? I am predisposed to type 2 diabetes based on family history.

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u/LIberIRA — 4 days ago