The Cholesterol Test You Should Be Getting

Many of us have been told by our doctors that we need to lower our cholesterol levels. But what does that mean, exactly? And do standard lipid profiles really tell us the full story about what is going on with our cholesterol?
In this minisode, Dr. Hyman sits down with Dr. Elizabeth Boham to discuss the importance of cholesterol particle testing. They explore why other cholesterol tests are outdated and why information about particle size and particle number is the only way to know what’s really going on with your cholesterol.
Elizabeth Boham is a physician and nutritionist who practices Functional Medicine at The UltraWellness Center in Lenox, MA. Through her practice and lecturing, she has helped thousands of people achieve their goals of optimum health and wellness. She witnesses the power of nutrition every day in her practice and is committed to training other physicians to utilize nutrition in healing. Dr. Boham has contributed to many articles and wrote the latest chapter on Obesity for the Rankel Textbook of Family Medicine. She is part of the faculty of the Institute for Functional Medicine and has been featured on the Dr. Oz show and in a variety of publications and media including Huffington Post, The Chalkboard Magazine, and Experience Life. Her DVD Breast Wellness: Tools to Prevent and Heal from Breast Cancer explores the Functional Medicine approach to keeping your breasts and whole body well.
This episode is brought to you by Belcampo. Right now, you can order Belcampo’s sustainably-raised meats to be delivered to your door using my code HYMAN at Belcampo.com/Hyman for 20% off for first-time customers.
Find Dr. Hyman’s full-length conversation with Dr. Elizabeth Boham, “Cholesterol Is Not The Cause Of Heart Disease” here: DrMarkHyman.lnk.to/Cholestero...

[@robertpulsin2111]

Try getting your doctor to do any of these tests. My doctor has almost thrown me out of the office for it.

[@evab2132]

Scientific studies proving, people with high cholesterol, but good ratio, lipoprotein( a) live beyond 90. Most recently realy accomplished cardiologists, look at not total cholesterol/ HDL but triglycerides/HDL., plus insulin resistance, homocysteine, lipoprotein (a) , C reactive protein as a indicators for CVD. Statins tremendously damaging mitochondria, killing Q10, in long term contributing to early dementia ,depression, etc. 25% of your cholesterol is in the brain.

[@fatbikemontage2931]

Time to get a new doctor. If they won’t run the correct test, then they are not truly interested in your risk of CHD and CVD and other financial benefits are at play. I would expect many doctors to be unfamiliar with the particle test, but they should at least educate themselves.

[@Aura-us7jl]

Throw your doctor out... get a new one!!!

[@milicamarshastefanovich3312]

Robert, I’m with you. My doctor at Kaiser, thinks I’m nuts for asking about these tests. They don’t know about them, nor do they offer them.

[@robertpulsin2111]

@@milicamarshastefanovich3312 yeah, and she wanted to put me on a Statin, and I told her the only way I would consider a Statin is if we have these tests done first. But of course I probably wouldn't even do it then. :-) When I took up fasting three months ago, she told me she's not on board with these Fad diets! I'm off two blood pressure medications oh, I feel GREAT. I look a lot better.

[@kristineb3671]

Thank you…this is very encouraging. I left my dr’s office yesterday with prescriptions for blood pressure and cholesterol. At 70, i have never had the need for these before. My dr kept stressing “genetics, genetics, genetics”. HDL 62, LDL 136, Triglycerides 98, BPressure 135/80…I am going to put these meds aside, eat better, lose some weight and move more…AND request the Cardio ID…I am overwhelmingly grateful Dr Hyman…I started your Gut Health about 2 weeks ago. 😊

[@BigPictureYT]

An even better metaphor is boats and cargo. The cholesterol is the cargo. The boats are the particle size. You can have a few big boats or many small boats. The small boats can get into places, like the arteries, that big boats cannot enter.

[@robyn3349]

Yes, I don't like the 'dirt' comparison. Rather pejorative.

[@schaef1722]

Sometimes it’s hard to get your doctor to do these comprehensive blood tests but they’re worth getting them done yourself if you have to

[@lawrenceforsley3411]

Conventional medicine is very frustrating in this country. At the age of 60 I have optimal triglycerides (43) and HDL (69) but slightly elevated LDL (110). I am an extremely active CF athlete with an above average resting heart rate and very low body fat % and eat a very healthy diet yet my PA is recommending that I change my diet solely because of the elevated LDL. There was no discussion about my Triglyceride-HDL ratios which are .6 or about the possibility that the LDL level might not be a bad thing given my other results and lifestyle. I have “suggested” that she refer me for particle testing after watching this video. But I suspect the medical advice will not change. Thank you for this video. Well done. 👍

[@pamelaclawson6283]

this information is so very important....im so glad i found it....THX for posting the episode!!

[@bernicemoore9146]

Thanks so much for this information. I’m scheduled for a visit with my primary care provider in 2 weeks. I trust that she will gladly order the partial size cholesterol test!

[@circa33]

this was such a great , easy way to understand this...thanks for that

[@CS-pd3rz]

Cholesterol is not dirt, its essential for a healthy life. LDL is not the bad guy, Its essential too.

[@RamonaPereira-yg9uc]

It’s just an analogy.

[@Clarice-rp7mh]

It is an analogy to help the patient understand. I used to use a citibus and riders to help my patients understand how hemoglobin(the bus) has only so many attachment opportunities, iron atoms (the seats on the bus) for the O2 molecules to attach. CO has a higher affinity for attachment to the "seats" so it is allowed to board the bus first, squeezing out the O2. Cigarette smoke, like all smoke, contains CO, robbing the smoker of 02. A pulse ox only measures the % of saturation of the hemoglobin, but can not differentiate how much is saturated with 02 versus CO. For pulmonary patients these numbers are very important and also for a pregnant woman that insists on continuing to smoke through her pregnancy.

[@tylerpaul650]

Thank you Doctors, excellent stuff here.

[@lorier9356]

Just found this video. It's very informative. Thank you.

[@rhondaurb]

Thank you for this great explanation

[@susancorso7186]

I am running to my doctor and asking for the particle test along with my regular cholesterol levels! Great information

[@williamhartzelljr.9080]

Good luck getting your insurance to pay for it.

[@brucefranken4615]

Don't forget Apo-B, as it's the best marker for cardiovascular disease.

[@thegodofyoutube266]

@@brucefranken4615my insurance wont cover it … will cost me 3K

[@bobbader4789]

@@brucefranken4615will insurance pay for that test?

[@Nicksonian]

Particle size doesn’t matter. This video is totally wrong

[@pattiiman989]

Great information!

[@LynnFishmanMeditation]

I was really hoping this video would go into more specifics given its title. Thanks for the discussion..

[@NewToThisIn09]

Thank you for going into depth, Both of my parents had heart problems.

[@cps_Zen_Run]

Not to worry. The genetic portion of heart disease and CVD is not genetic but metabolic.

[@Discuholic]

i am so glad to learn this I was in lipitor for a few years 2010- 13 funny thing was those years I was super active swimming , running and hiking , a few years later another Dr told me to get out of cause I didn't need it he was looking the ratios, nothing about particle size though. Today I am retired and older and not as active, but I do control my diet , sugar intake, low carbs, and walk stay active as much as I can.

[@KPH218]

Thank you for this information

[@Mark-fc7tu]

It's a very important topic that matters to me, thank you for the video. My doctor has informed me that my cholesterol and LDL are high, but I've learned that the test result for LDL is actually calculated based on total cholesterol minus HDL, not measured. He is quite insistent on me lowering my cholesterol (cutting out red meat from meals and fewer carbs, plus eating vegetables, arugula, avocadoes, chicken, fish and seafood), but it's odd that he would talk about medication for lowering LDL without arranging for a more accurate LDL test first... It's a very dubious guideline for medical professionals to follow...

[@brucefranken4615]

How high are your levels? What is your family history?

[@pammuller9204]

Great info!

[@melaniegreene5190]

I am so excited about this newer information on cholesterol. At 70, I have been down a painful and complicated path with statins. Most recently Repatha. Two months ago, once off of Repatha, I got mad and took back my life. In two months, with food choice changes, exercise and supplements, my health is turning around. Labs done on 5/27/2022 versus this week on 8/1/2022 indicates a real health turn, along with just how great I feel. HDL has gone from 60 to 64, triglycerides went from 233 to 114 and now with my first NMR, my IR results show a level of 40. Although, I am not there yet, I am so grateful for this test and the impact in two months of lifestyle changes. I am also extremely grateful for all your KZbin videos and books, which have allowed me to understand my true risk factors. Thank you, thank you, thank you!!!❤️❤️

[@samiam8573]

Keto, Intermittent Fasting, No Sugar, Flour, or Alcohol. Easy peasy if you call and that living

[@katdunn7934]

What is your eating style? My doc and cardiologist want me on Rapatha, since I don't tolerate statin drugs. I really don't want to. I just started IF 6 wks before my well check. All cholesterol high, total 285, trig 113 ldl 136. I try cutting fats, sugars and such. Now I just want to say, screw it, why watch all that when my cholesterol went way up.

[@wellnesspathforme6236]

Look into supplementing CoQ10 or, better yet, begin eating heart on a regular basis -- and only from pasture-raised, humanely treated animals.

[@wellnesspathforme6236]

@@katdunn7934 Statins are a massive hoax, IMHO. The best studies pharma has shows a life expectancy increase of something like 4-14 days. Of course, the doctors aren't told this and most aren't smart enough to ask. And that's average -- many people will die sooner than they otherwise would have died, and have to eat the statin side effects, like muscle wasting and brain shrinkage...

[@wellnesspathforme6236]

Look up Morley Robbins, Dr. Chris Palmer and Dr. Thomas Seyfried. If you feel like your brain is under oxidative stress, start with Dr. Chris Palmer.

[@esthersantostt9549]

Love it. Thank you soo much for this info. Regular doctors do not ask for these test? Important: diet we must follow, please

[@biggstile]

Great topic

[@zacmorri]

so dr mark I'd like to ask that next time you promote inside tracker you mention that the blood tests don't include any of the specific tests mentioned in this video

[@sportbilly6329]

I believe I have FH as well how are the results different? Thanks

[@michaelmastrangelo4665]

thanks for the new info

[@deantsar6246]

Another clip that goes on and on and on.

[@brucefranken4615]

Recent studies show that the level of Apo-B is the major risk factor in cardiovascular disease. Also no need to concern ourselves with ratios.

[@MuhammadTariq-be3gq]

It’s news to me. I never heard of this test before. Thank you Dr Hyman for this podcast.

[@robertpulsin2111]

Right, I'm glad it's getting out to mainstream now. Ten years ago, I had read about this as the first studies came out. I tried to get my doctor, then, to test me for it and he laughed at me and said we don't do that. He claimed that there's nothing that can be done about it, therefore, it's a pointless test.

[@MuhammadTariq-be3gq]

@@robertpulsin2111 You are well ahead of the curve. Great!

[@arnoldfrackenmeyer8157]

Its been around for a long time.

[@vickyburton2434]

Doctors are under the thumb of the ADA and Insurance companies. They are taught to treat symptoms instead of causes. Huge money is made from pharmaceuticals. It is hard to find a doctor who is really well educated on this subject and real nutrition.

[@saidfarid6382]

Hello dear Doctor Thank you so much for your interesting information about Health,i do appreciate your job.I wish you peace and happness under the sky of prosperity. All the best. Take care and have a good time. Your Student from Algeria.

[@Ingridvieira310]

I think the other bit of information that people need to understand and rarely gets discussed is .. why is cholesterol important and why is cholesterol going to the arteries in the first place? The small dense LDL cholesterol are there to try and fix/patch up lesions in our arteries .. well what’s causing these lesions ? THAT’s the KEY !! Once people understand what the “root causes” are .. then it all makes more sense. It’s going to take time for this “Paradigm shift” to happen when it comes to understanding Cholesterol .. but eventually the facts/results will speak for themselves !! Dr. Nadir Ali (Cardiologist), Dr. Annette Bosworth, MD (Dr. Boz) are amazing sources of information and I would highly recommend their videos (not only on this topic but so many others). ✨

[@MrSidReal]

The small dense LDL (glycated) isn't there to clean the lesions, it's part of the problem. That's not to say LDL is bad at all. But small dense is the problem. Low TG and high HDL are an indication that your LDL is of th3 buoyant type and not the small dense

[@lynnetrue4103]

In 2021 as a woman at 65 years old my total cholesterol was 228 and LDL was 150. All other cholesterol numbers were good. I started a heart healthy diet and started walking around my house to lower my Cholesterol #s because I didn't want to start statins. I did not need to lose weight but over the next 5 months I lost 10 pounds and weighed 120 pounds so I had my lipid panel done and wonderfully my total was down to 204 and LDL was 150. So I added low fat dairy and some cheese and cut down on walking, gained a few pounds over a year but kept the rest of the diet the same and one year later total cholesterol is down to 174 and LDL is 104! I asked my doctor for a cardiac calcium CT and have a score of 0! Also my Apolipoprotein B is 74mg/dL and Apolipoprotein A1 is 161 mg/dL both in standard range. The CT cost $100 and the blood tests were covered under my Medicare advantage plan. Do I need to ask for the particle tests or are the Apolipoprotein tests the same as the particle tests? Thank you

[@arnoldfrackenmeyer8157]

Total cholesterol of 228 sounds healthy to me. That's like my numbers and I have zero heart disease. Same age bracket as you.

[@JodyBruchon]

What they call a heart healthy diet is the biggest cause of cardiovascular disease in the United States. Low carb, high saturated fat diets are the only way to go.

[@brucefranken4615]

That's very inspiring. When you get the Apo-B down to those levels you've halted plaque progression and may get regression!

[@stephenkern5784]

My cardiologist yold me a low ldl was "the gold standard" 7 years ago. I have been on atorvastatin since. Ldl went way down but so did my hdl. Now only 37! Good info.

[@davodeewhy]

Excellent. This is the truth. I have had to educate my general medical practitioner. In Australia, focus on the LDL concentration (expressed in mmol/L, not mg/L). It would be nice if the concentration of small dense LDL was a routine measurement in the lipid profile. My LDL has thankfully decreased with statin therapy to normal values after a heart attack. High LDL for the last 10 years was my only risk factor.

[@michellelockert1507]

So fascinating and grateful for this information. Just saw my heart doc and sometimes I wonder if some of these doctors really went to school.

[@Aura-us7jl]

They went to the wrong school 😒

[@thinkingaboutnothing2538]

They don’t keep up with advances in medicine. There’s a lot of new studies that they don’t consider.

[@lindagenovese595]

AMEN!!!!!

[@annamartino5681]

Dr Mark, thank you for this information. Does it matter which insurance your patients have? For example, does Medicare and state Medicaid cover these Tests? If these Tests are not covered by Patient's Insurance, does the doctor who ordered these Tests pay for them with their Career if they work for a hospital, or a specific company? Who would cover these expensive but necessary Bloodwork Tests which Insurance does not routinely cover? Otherwise, if these are the Gold Standard Tests, are they available only to wealthy and those working for companies which insurance is covering these advanced Tests? Did these Advanced Tests now become the Standard Tests similar to what typical Metabolic Blood Panel ordered by Cardiologist only? Can elder people on Medicare without supplemental insurance plans get these Advanced Tests or in other words are these Advanced Tests Mandatory to be covered by Medicare (most likely people who would be getting advanced Cholesterol Tests are not going to be younger if I am not misraken). Can you please make a video on how to get these Advanced Tests and even Vitamins and supplements be covered by Insurance especially for Medicare and Medicaid Insurance patients who are not likely to have extra money to be able to afford these not routinely covered by these insurances)?

[@tracygreen7466]

Thank you, after watching I'm convinced my doctor doesn't care or don't know what he is doing

[@carrieg8779]

My naturopath has been doing these tests for years. I guess that’s why I go to a naturopath and whoby training are functional medicine doctors.

[@EklectikaAaynne]

GREAT INFO . . . summed up @ MM 9:56 . . . much thanks!

[@cooperstravels5725]

Just did my annual physical and blood work. Cholesterol 235, Triglycerides 73, HDL 57, LDL 163. The good news is versus last year my Triglycerides went down over 10pts, my HDL went up over 10pts, but my LDL went up 30pts. My Blood Pressure is 104/70 which is the best it's been in quite a while. My doc gave me a call and said I should go on a low fat diet, take a statin, and I should exercise more. I am currently doing a keto plan which typically raises the LDL for some reason. Seems like 1) I should exercise more, 2) take a detailed LDL test to see if the higher LDL is actually a problem or not.

[@HopeOfJoe]

Dr. Mark Hyman says to ask for an NMR, Cardio IQ, and Lipoprotein to see the size of your LDL particles. Big particles (low test number) equals beach balls that just b I uncle off your arteries,whereas small particles ( high test number) are like golf balls and penetrate the blood vessel much easier. Hope that helps.✌🏻️👍🏻

[@cooperstravels5725]

@@HopeOfJoe thanks for the reply and suggestion, but I would think that if tryiglycerides and HDL and Blood pressure are relatively in line it is unlikely that the LDL particle size would be way out of line? Or is there no correlation to overall decent health and LDL particle size?

[@cooperstravels5725]

@@HopeOfJoe I did that when I was tested back in March. Here are the results: NMR HDL-C = 71mg/dl, NMR Triglycerides = 89mg/dl, HDL-P (Total) = 41.4 umol/L, Small LDL - P = 802 nmol/L, LDL size = 21.3nm, LP - IR score = 34, LDL-P = 2140nmol/L. No idea if these scores are good or bad, but all were coded green (good) except Small LDL - P of 802. , and LDL P

[@boblatkey7160]

Divide HDL into triglycerides and if the ratio is less than 1.5 then you are in good shape! That is a poor man's calculation that multiple doctors were talking about. Also look at fasting glucose and fasting insulin and then look on the Internet as to how to calculate your HOMA-IR. That is a scoring system of your insulin resistance. I am guessing that you are good on both.

[@beck8191]

High ldl is good for you. Less heart attacks less death.

[@cmauro7912]

Our health care system refuses to use the tests that determine what type of LDL you have. This ensures a few extra statin sales. 😂

[@arbiforumnow]

Yes, and ADA dismisses fasting insulin tests! Unbelievable!

[@msk3905]

Sadly completely true

[@devislight]

I did not know this information set and these tests existed

[@markbraxton1289]

The higher the readings the better for me ...

[@Carterofmars]

Low carb, non processed eating lowered my LP-IR score from 65 to 39 in a three month period. My Calc score is 5. 55 year old male that became health conscience only 8 years ago. Prior to that I was American diet processed foods my whole life. I did always walk a lot my whole life as well. Walking was mentally therapeutic, but the side effect may have been the low calc. It's NEVER too late to eat healthily. 👍👍👍

[@tjdinfl]

Yeah, good luck with that. My dr told me we don’t do that test. I’m on the hunt for a dr who will.

[@Straightdeal]

Finally, one day doctors will understand which markers are important. We don't have NMR test in South Africa. HDL and Triglycerides the important markers. Mine 77 and 70 respectively (I have converted the mmol/L) to mg/DL). So my Trig/HDL ratio is less than one in mg/dl and 0.39 when you use my mmol/L figures. Trig 0.79, HDL 2.0, which gives a figure of 0.39. The math does not make sense, but that's an issue for another day!

[@Malcolm-Achtman]

When the "experts" speak about the Trig/HDL ratio being less than 1, they are basing that on units of mg/dL. Therefore, always convert your values of mmol/L to mg/dL first. To convert HDL cholesterol from mmol/L to mg/dL you have to multiply by 38.6. An HDL of 2.0 mmol/L x 38.6 = 77.2 mg/dL. But here's the trick. To convert Trigs from mmol/L to mg/dL you have to multiply by 88.5. Therefore, Trigs of 0.79 mmol/L x 88.5 = 69.9 mg/dL. Your Trig/HDL ratio would then be 69.9/77.2 = 0.90, which is excellent.

[@wellinever1558]

The conversion is difficult for SA..we must ask for tgese tests afterall we are the consumer and doing tge paying. Drs do not learn nutrition in tgeor studies the biggest thing they sgoukd be learning as it makes tge most diference.

[@Straightdeal]

@@Malcolm-Achtman That's what I did, but I still don't understand why the two equations for Trig/HDL using mmol/l and mg/dl don't give the same value.

[@Malcolm-Achtman]

@@Straightdeal The two equations don't work because, as mentioned earlier, you need to multiply cholesterol by 38.6 (to convert from mmol to mg/dL), but you must multiply by 88.5 to convert triglycerides from mmol to mg/dL. In other words, it's not a linear relationship.

[@miguelc2840]

@@Malcolm-Achtman It boggles my mind when my doctor says....your Triglycerides are negative 2. -.-

[@rod545]

Should I get the cardio IQ fractionation test or the Cardio IQ subfractionation test?

[@Kelly--]

3:23. 4:30 lifestyle that impacts size of ldl particles. 4:47 metabolic syndrome, insulin resistance, belly. diet changes this. sugar high triglicerides. low hdl men over 40. it should be over 50 if possible. triglycerides over 50 to 70. particle size testing. nmr testing shows insulin resistance score. advanced cholesterol testing. what are their markers of oxidative stress 8:27. 9:55 ask doctor to do particle sized test

[@bbyng7316]

She is right. I dramatically lowered everything except HDL by cutting out fast carbs, sugars, (50mg a day max) and all saturated fat.

[@stevec404]

My 'good' number is so far above average that the automated age calculation kicked it out as improbable! My 'bad' number is bad. Dr. wants me to consider statins. I said I would do research first. With these deatails in hand, I will have enough questions and answers to guide my decision. Thanks.

[@gilliani.4328]

Thanks for sharing this! I was just talking with someone about this issue and a few minutes later this interview popped up. (Is my iPhone eavesdropping???) I will be insisting my doctor give me this test.

[@RockHoppingGranny]

Yes your phone is eavesdropping - I hear about this happening all the time. People taking to a friend about a holiday or product or something and then seeing adverts for it the next day. These are not coincidences.

[@joannpuchir6214]

My guess is yes, it does eavesdrop

[@susanwray6788]

Yes eavesdropping has happened to me several times

[@johngoh767]

Dr. Hyman, what is the best cholesterol lipid test that is accurate? Your advice please.

[@montanamike53]

Should we request a fractionated cholesterol and if so would it provide better information than a regular cholesterol test.

[@12elisa10]

Would be nice to talk about those with FH because that is totally different in terms of particles than for those due to diet, insulin resistant ect

[@thegodofyoutube266]

What is FH?

[@ritastein764]

How about some charts with specific names of tests and specific results, please? They seem nice enough, but how about some real detailed help here. Sort of feel like I wasted 15 minutes of time that could have taken actual test ranges versus what would be good or not good. Fluffy versus dense doesn't help much! I have had the tests, my dr isn't interested, so I am pretty much on my own to discern my next step. For example what would be a good / desirable range for SD LDL-C etc.? Thank you. We want to be educated, please help us!

[@Ruouiji]

Being the 2nd most important molecule in the human system (Next to H2o), Cholesterol is the least of my worries!

[@AmsterDanTheAmerican]

I am a Kaiser Patient in Northern California. Do you know what tests I should be asking them for?

[@DavidDabbs-mz7ht]

Doctor did standard Lipid test and total number was 297. He put me on Lipitor and cardio Dr put me on atenolol they are nuts. I did ratios and all is well. trigs/hdl was 0.7. My glucose was 124 fasting and neither had a comment. I wonder what has health care become.

[@VictoriaBaer]

It's not health care it's death care or drug care

[@annamartino5681]

Your fasting Glucose should be ideally 85, it's nearly double. You could be at high risk and should really follow at least your doctors advice. Most likely on KZbin you can benefit from Intermittent Fasting which you may want to try religiously until your weight is ideal and your glucose test is 85. Most likely you can benefit from seeing an Endocrinologist and a Dietitian as well in addition to your Cardiologist and your doctor. You should also thank your doctors who care for you.

[@charlesincharge3404]

You working on lower that glucose #?

[@markridgemr]

I saw this vid and asked my doc about it. My next bout of labs will include a Lipo-Protein analysis.

[@alanmunro5068]

How are these tests know in the U.K.?

[@harrynickel8691]

Butting heads with my GP now. He sent me to a Cardiologist due to an increase on my LDL. They have my wife scared.

[@bakingbunny198]

Watch dr paul mason

[@terry2346]

So how do you get your HDL up if vigorous exercise and diet(avoiding sugar and other carbs) does not? Are there any other things to do to help? I am currently on keto diet and VERY happy with the benefits (wt loss and BS control and increased energy and A1C of 6 for a type 2 diabetic, but still worry about the low HDL -- ~2.8 to 3.0.

[@dan4091]

I have to eat a very meaty diet to get my HDL up, of course Total and LDL also goes up along with it (but Triglycerides get very low) and my doc pushes statins at me

[@reginamay2767]

I asked my doctor for this yest and he said it was a very complicated test and pricey.

[@tammybott9968]

I had these tests done. I just told my doc I wanted advanced cholesterol testing. No problem. My insurance even paid for it. I found out reassuring things; optimal particle number, optimal peak size, and Pattern A. Paternal side of family has heart disease issue. I’m hoping my numbers mean I dodged a genetic bullet. OR maybe it’s a few years of avoiding processed foods/sugar and lots of the GOOD saturated fat.

[@F_T2D_Drew]

What did your doctor say about the results?

[@tammybott9968]

@@F_T2D_Drew Basically just told me excellent results and keep up the good work. I know from dna testing that I an a apoe2/3 and I clear fats well. Might be more genetically lucky than hard work. But I do walk daily and eat whole foods. My macros are roughly 30% fat, 15% protein and 55% complex carbs.

[@abdelilahbenahmed4350]

May I ask you what is "good" saturated fat ?

[@tammybott9968]

@@abdelilahbenahmed4350 I really think it comes down to your genotype regarding all nutrition. Yet, most people do not know their APOE genotype for example. My sat fat comes in grass fed whole milk and butter and small portions of grass fed/finished animal protein. So. I eat a relatively high sat fat diet and my Advanced lipid panel is stellar. I clear fats well. My husband, who eats the same diet as I just got his results from the advanced lipid panel and they were very bad. We do not know my husbands APOE status because he just is not interested I. Finding out. Based on his results I believe he must be carrying 1 or 2 copies of the APOE 4 allele which would mean he does not clear fats well. So. Looks like I’m going to need to modify his diet from that of my own. What a pain.

[@abdelilahbenahmed4350]

@@tammybott9968 Thx Tammy for your answer. Anyway, a scientific research cited by Dr BARNARD shows that reducing saturated fat is an effective strategy for Alzheimer's (and dementia in general ) prevention.

[@JohnQuackenbushDC]

WHY IS THE TRANSCRIPTS BUTTON MISSING FROM YOUR VIDEO? Transcripts are great to make notes from!! Great video but to make notes I had to pause and replay to key in my notes.

[@alfredpcg9051]

Something outside, how to reverse heartbeat of > 90 to reduce back to normal?

[@dt76sf]

I’m on a Low Carb diet and intermittent fasting. Lost 25 lbs. My LDL is going up but all my other markers are falling inline. Dr is concerned about my LDL. I asked my Dr about options for blood tests and he said there are none. I’m getting a Calcium scoring CT scan to make sure my arteries do not have buildup I’ve heard that folks like me may have elevated LDL but as you state here that I may have the less harmful LDL not the small particle LDL

[@SuperLuckao]

When u cut out carbs ur xholestrol goes up. Usually carbs mop it up. Eat more fibre or eat oats to.mop it up. But all people on low carb experience higher cholestrol

[@scosal7100]

She should drop the dump truck analogy. It's not providing the clarity she wants to give.

[@emb74]

I have heard about particle size for 15 years and have yet to be tested for it.

[@MsTony1402]

The only cholesterol test we get here in the UK is whether they can successfully push statins on you. No way will you get a test to measure particle size even if your traditional cholesterol figure are very high.

[@tammybott9968]

I guess that might be one of the benefits of not having a national healthcare. I didn’t pay a dime for my extensive bloodwork. Very good insurance. BUT. I’m aware of the detrimental cost to society at large not having national healthcare as well.

[@jodyjackson5475]

Yah sounds like things up here in Castro country

[@perugino25]

Socialized medicine as it is here in the US control by the Insurance and pharma!!!!! I pay my own testing. I do not trust doctor anymore unless is a functional doctor who most likely do not accept insurance ...it is about having money which I better expend it in quality food and lifestyle choices; you would minimize your probabilities to end in the hands of athese doctor's losers

[@Ayyeliki]

@ChrisW but if you have TG and HDL, that ratio gives imp info, too!

[@wellnesspathforme6236]

@@tammybott9968 >>I didn’t pay a dime for my extensive bloodwork.

[@markweatherall7437]

I've just had my traditional doctors cholesterol test done 2 weeks ago and he said the result was higher than what he would like at a total of 5.7 I walked out of doctors office concerned especially when I live a healthy lifestyle.

[@walkingwithbenedict]

Is the small dense LDL the VLDL. # on the LabCorp test?

[@TES-bt8sv]

How does LDL particle size relate to your ApoB level?

[@Fetherko]

I have read dozens of books about cardiovascular health in the Cuyahoga County library system. This is the first I heard about particle size or dump trucks. My reading includes your book, Dr. Hyman. Something doesn't make sense.

[@charlesincharge3404]

Replay it and listen closely. It makes tons of sense.

[@jimsgardenproject3507]

How do we factor in genetic C? How do we find out if it’s genetic rather than lifestyle??

[@matthewrogowski8526]

What about the class III and IV LDLs that don't get absorbed by the cells as easily, oxidize due to length in circulation, attract antibodies, clump together, and form the notorious inflammazones that stick to, damage, and inflame the endothelial lining; and when inflamed, the endothelial cells emit platelet activation factor which makes it permeable to lipoprotein particles and macrophages?

[@jeanharhai8260]

Will the test results change overtime or health issues?

[@tangotogo1]

So what are the best "Numbers" you want to see on this particle size test?!

[@kareng7024]

What is the cost for these tests?

[@michaelberman3648]

Doesn’t the overall “reactivity” or propensity for oxidation correlate with LDL particle size? Isn’t true that what is causing the lowering of particle size is the redox potential on the surface of each of these lipoproteins? Can some sort of a redox test illustrate the level of potential danger between the lipoprotein surface (degrees of molecular damage) and how it reacts with various chemical functional groups which can describe a certain type of food, or the functional groups along the surface of an arterial inner lining? You also touched upon NMR or nuclear magnetic resonance which I know can determine various 3 dimensional structures of molecules. But how does NMR actually measure or determine the particle size of a lipoprotein? Are you utilizing COSY or C13 magnetic coupling to determine first the overall density of the particles? Which then can indirectly determine the overall particle size based upon the overall calculated densities? I am not certain about exactly how that is exactly done. Can you please elaborate upon my first & second questions? Thank you very much.

[@1aliveandwell]

While listening to a Cummins vid on YT, talking about skinny fat people (look skinny, but have visceral fat which they said could find on ultrasound or maybe it was GGT lab) and often have high LDL but good ratio of HDL/Triglycerides... What might be helpful or if need changing?

[@maremacd]

It’s very sad that these MDs have bought into the social media “broscience” regarding cholesterol. Particle size is insignificant according to cardiologists. Particle NUMBER is the factor you need to be concerned about. They touch on this in the video but continue to focus on particle size. That’s why practicing cardiologists recommend knowing your Apo B number. And saturated fat is the primary dietary contributor to particle number.

[@t.h.nguyen5193]

What about stress? I have a healthy diet but went through a lot of stress. How soon can one retest the blood test?

[@billf23351]

At 7:43 of the video Hyman made a big boo boo. He improperly said that "The easy cheap way to determine if there is Insulin Resistance is by taking the Triglyceride / HDL Ratio, and if it's over 1.0 that's not great." Well Triglycerides should be < 150 and your HDL should be > 39. So, my Triglycerides are an amazingly terrific 48 (99% booze free) and my HDL is a normal range 44. So, my ratio of Triglycerides / HDL is 1.09 (48/44), which is over a ratio over1.0! So, noticeably Hyman at times carelessly shoots from the hip, absent any follow up corrections. Bottom line, I most certainly am not Insulin Resistant, regardless of his cheap easy mistaken calculations!

[@sharonabdalla3250]

i tried to get 2 different doctors to order LDL particulates/ oxidized LDLs and neither would order it despite multiple requests! I'm so frustrated. I even said I would pay for it out of pocket even though I have great insurance. How can I get this done???

[@lindabennardo2561]

Look online for testing that you can order yourself and hopefully you can find it - I have used Ultalabs. Time for doctor number three.

[@user-qr4uh2wj9l]

I paid for a cardiology IQ test and took the results to my doc. He then ordered the alipo...test. shows I have a genetic inclination to higher lol. My inflammation markers are high, even on a wfpb no oil diet for a year. I am on a low statin 3 x a week and working up to 500 of niacin.

[@doctorpete1]

Why is it that all MD's aren't using the proper tests?

[@chintansurana9017]

If the aggressive target for triglyceride is 70 and that for HDL is 60. These numbers are good as Dr. Hyman says. The ratio Dr Hyman talk about around the 7:60 mark will be over 1, which he says is not great. I’m confused.

[@KAT00035]

I’m a 58 year old woman. Even in my 20’s my HDL was always too low. I work out daily. Since January I’ve been eating lower carb, and avoid all processed foods. I was eating 1600 calories a day and not losing weight, so I went up to 1700 and lost a few pounds. My doctors always tell me I need to work out more. I always respond “more than everyday?”, and they look at me as though I’m lying. My husband started eating the same way I have been eating since January, and lost 23 pounds over 3 months. I hover around 7-8 pound weight loss, but very slow.

[@brucefranken4615]

More recent science shows us that HDL level is not significant.

[@bobbader4789]

@@brucefranken4615source?

[@viola6928]

What kind of cholesterol test must I have done

[@gregl2249]

They need to slow down and repeat the names of the tests and where to go to get these tests done

[@btomas225]

I've been told that Quest does not do particle testing under any name (NMR or Cardio IQ)....

[@alicjaalicja6522]

I am 45 and GP is advising me statins for high cholesterol, I am devastated

[@billf23351]

Do 3 things...1. learn to regularly do resistance training at the gym. 2. Stop eating crummy processed and sugar laden foods (as she said) 3. Stop consuming alcohol beverages. Try that 3 months and get tested again. What have you got to lose besides bad habits.

[@diannechristino]

I literally just emailed my doctors office adn the response was, "there is not way to measure particle size"... I'm livid.

[@barbsdee3831]

I live in the uk and I don’t even get a triglyceride score! HDL and LDL only 🤦🏼‍♀️

[@corikyle3882]

I am in Canada and my Doctor won't order this. She said they use a different standard. I'm not at risk she says even though my LDL is a little elevated. My triglycerides are really low. I have lost 55 lbs since last year and changed my diet and went low carb because I was prediabetic. My A1C is high normal now so that's why I watch my carb intake. In Canada we cannot order our own blood test for an advanced lipid test for particle size. At least that I can see. It is so annoying!!!!

[@lauragarofoli78]

I really need to find a functional medicine doctor in Central Massachusetts. I've been on BP meds for a few years now, and it was clearly a result of IR and sleep deprivation. I fast, I eat keto, and averaging over 6 hrs of sleep a night now (up from 3), but my BP is still higher than it should be (139/88 at last home reading). It's so frustrating, and my current doctor (traditional medicine) is closing her practice, so this would be the perfect time to find a functional medicine doc.

[@paullevine6849]

Check out this book by Stephen T Sinatra, MD, METABOLIC CARDIOLOGY. Bottom line supply your body with nutrients the cellular structure of your heart needs to function right. Through food and suppliments. L carnitine, d ribose, magnesium, coenzyme Q10

[@SeriouSXXFireworks]

Isnt dr hyman located in mass lol

[@lauragarofoli78]

@@SeriouSXXFireworks OMG I had no idea!

[@mmagic3534]

Hi Laura A (somewhat hidden) place to start understanding BP, is what is going on metabolically, at the cellular level in our bodies. Do yourself a favor and put "The Sodium Potassium Pump" into a search engine and begin to read and understand its fundamental nature regarding your health. (Also, I like "The High Blood Pressure Solution" by Richard D. Moore MD, PHD.) There is a lot we can do on our own before we have to shell out big bucks to see a doctor. I recommend that you see a good nutritionist eventually, however, because we really are what we eat. A wise person once said, it doesn't matter how fast you are going...it is the direction you are headed".

[@PhilipRaines]

I do an advanced lipid panel at least every other year. My docs still think good fats are bad, lol. I eat keto friendly and intermittent fast with one meal a day. There are very few people that i would trade blood with......lol

[@mindinterceptor]

Can you recommend a doctor in Orlando who is a proponent of this type of test. My current doctor doesn't seem to care about this.

[@pvaz80]

I recently switched GP due to wanting to address some high BP and tachycardia symptoms quickly and after my original GP kept prescribing acid reflux meds. I started seeing Dr Daniel Mora-Rivera with Orlando Health at 5540 E Grant St, about 15 minutes north of OIA. He was willing to order a Cardio IQ Advanced Lipid Panel test from Quest. Best of luck.

[@daviddelguercio8458]

He said the tryg and Hdl ratio standard wrong. If it’s over 2 it’s not good. If it’s under two it’s considered optimal