35M genetically confirmed high Lp(a), elevated ApoB, thin family history. Looking for real experiences before my cardiologist appointment
35M, 6’0”, around 195-198 lbs right now, been lifting and training regularly for years, trying to get down to a lean 185. No history of hypertension, no chest pain or angina, not diabetic, no personal history of any heart disease or previous cardiac events. Family history is really just my grandfather who lived to 93 and had a pacemaker put in sometime in his 70s, nobody else on either side had a heart attack or stroke or anything like that, and the rest of my family doesn’t take care of themselves diet or exercise wise and seems totally fine.
This is my first full panel like this, no previous history to compare trends against, so I don’t know how long these numbers have actually been elevated.
Full panel:
Total cholesterol 181, HDL 46, LDL 116, triglycerides 90, non HDL 135, total chol/HDL ratio 3.9, ApoB 102, Lp(a) 184 nmol/L, LDL particle number 1091, LDL small 182, LDL medium 244, LDL peak size 220.4 angstrom, HDL large 4056, labeled LDL pattern A despite the small/medium numbers being flagged high
hs-CRP 7.1, but I got this draw after about 4 hours of sleep and a hard training session so I know this one is probably inflated and I’m getting it rechecked under normal conditions before reading into it
Glucose 91, HbA1c 5.5, insulin 7.0, leptin 2.0
Testosterone total 513, free 90.3, estradiol 34, SHBG 23, DHEA-S 290, prolactin 19.4 (again drawn after bad sleep and a workout so probably inflated too)
TSH 3.05, free T4 1.1, free T3 3.3, thyroid antibodies both negative
ALT 15, AST 15, ALP 51, GGT 19, total bilirubin 1.4 (this one runs high consistently for me, pretty sure it is Gilbert’s syndrome, confirmed with a genetic test)
BUN 18, creatinine 1.13, eGFR 87
Vitamin D 64, ferritin 119, homocysteine 10.3, zinc 67
Omega 3 total 6.7%, omega 6 total 34.6%, omega 6/3 ratio 5.1, arachidonic acid/EPA ratio 12.1
Diet the last year or two has basically been a pound of ground beef, 3-4 eggs, and a lot of rice almost every single day because it’s easy and hits my protein numbers. I know that is probably a big part of the ApoB and LDL story and I am already cutting the daily ground beef out.
Also ran my raw DNA against this and the Lp(a) number is confirmed by the LPA gene variant (rs10455872), so that part isn’t going away with diet, it’s just genetic. APOE came back 3/3 which I think is the neutral version, not the bad one.
Getting a coronary calcium scan and seeing a cardiologist regardless of what anyone says here, this isn’t a substitute for that. But with barely any family history behind me except a grandfather who lived to 93, I’m trying to figure out how seriously to actually take the Lp(a)/ApoB numbers versus how much the family track record should count for something.
Also curious what people think about the LDL debate in general, I’ve seen people say it’s the whole ballgame for heart disease and other people, especially in the longevity and testosterone spaces, say it’s overrated and even correlates with better cognition and hormones as you get older. Not trying to talk myself out of caution, just want a range of opinions. Same with statins, I don’t think I’m anywhere near needing one yet but curious if anyone with similar numbers ended up going that route or did something else instead.