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My blood test results. Are they in-line with LEF guidelines?

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 Posted 7/19/2013 3:48:08 AM
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Tom, I would go to the fundamentals first and see if there are big abnormalities. I recollect once I asked the same question to a doctor (total and free E2) and if I should also test the full estrogen panel (estrone, estradiol and estriol). The answer was, if I recollect well, to test first E2 as the others easily are converted from E2 (not sure if I recollect well tough, to check..). For the total and free E2 i recollect he saying that is an important test in men for testosterone, not estrogen. I was never offered more from my lab for E2 but if you wish to have peace of mind and additional costs are not huge you might do it as well. I wish I could answer precisely for aromatase, but I guess that the enzyme activity will be inferred by the other hormones values. What LEF offers as hormone panel for men looks to me good enough. I think I only added progesterone and cortisol in my list.

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 Posted 7/19/2013 4:02:03 AM
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This article looks comprehensive enough (btw it looks confirming about the E2 conversion path to E1 and E3 recollected in my previous post)

http://www.lmreview.com/articles/view/select-the-right-hormone-test-for-your-patient-using-bio-identical-hormone-/
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 Posted 7/21/2013 11:40:03 AM
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Thanks Albedo,

I ask my doctor about the VAP cholesterol test,. His response was that even though it's a very detailed test, there's isn't anything clinically that can be done to address those fine subsets in the cholesterol panel. At this particular time he doesn't offer that test. As science improves and we find out ways to intervene beyond HDL and LDL, than that deailed VAP test will come more significant.

At this particular time his recommendation and my focus is to lower LDL cholesterol and raise HDL cholesterol.

-Tom.

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 Posted 8/18/2013 7:47:58 AM
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Hi Tom,

This is my first post post. 

You could purchase Mark Houston's book "what your doctor may not tell you about heart disease". He will outline the actual risk factors for heart disease and explain why the "big 5" (elevated blood lipids, diabetes, obesity, smoking and hypertension) are not risk factors. This will put you in a position to educate your low information physician. 

Mark's book will also provide some information to help you better under lipid oxidation.  I must say that I am very suprised that you are unaware of the VAP test, the significance of the various cholesteroler carrier proteins and their impact on heart disease yet you have spent a considerable amount of time researching small, rather obscure studies in support of your "case against dietary fats".

May I suggest you also run homocystein. If this value is low, combined with your low crp and if you have an appropriate distribution of cholesterol carrier proteins in the VAP test, then your risk of heart disease is low. Otherwise there are many options to correct the problem. 

I also want to comment on the hormone side but don't have time. I will do that separately. 
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 Posted 8/18/2013 5:47:21 PM
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Welcome to the Forums, Jim C.

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 Posted 8/19/2013 5:41:40 AM
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Hello Jim,

Concerining the VAP test, I knew of it but had done no research on it. Most people and doctors dont have much input on it partly because at this time there isnt anything we can do to contoll/modify those subsets in the VAP test pharmacologically or nutraceutically, or nutritionally beyond what we already know how to controll/modify with current HDL/LDL modification protocols. 

I do belive one day I will be vindicated for my stance on processed dietary fats and disease. Regardless if some of the studies are in the infancy stage and/or hypothetical,  the scientific facts remain - Fish oil especially is highly susceptible to oxidation due to its high level of unsaturation. Peroxide levels of many brands on the market today have been shown to be abnormally high. Malondialdehyde, one by product, is toxic to cells. Most people today are inundated with oxidized lipids, most notably polyunsaturated fats, in their diet that they overwhelm the innate antioxidant system, even with high levels of exogenous antioxidants.  These are the facts, however you wish to swallow them.

Thank you for the reply. I will look into that book.

-Tom

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 Posted 8/19/2013 11:15:37 PM
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Hi Tom,

I appreciate your tenacity in standing your ground. Just one quick comment on this point. What you are saying may  be true when evaluated in the lab or animal models, however fresh, pure omega 3 fatty acids don't have the impact you are suggesting. On the contrary, most properly conducted studies show a positive impact on health. 

As far as the VAP test is concerned, there are many strategies we can implement to modify the various fractions. For the sake of time and space i will only mention a few. 

Omega 3 fatty acids
Increases HDL-2
Increases LDL particle size
Decreases LDL particle number

Niacin
Shifts LDL-B to LDL-A, reduces LDL particle size
Reduces lipoprotein a
Lowers apoliproprotein b
Increases HDL-2B


So, you run the VAP test, make the necessary adjustments and possibly order additional tests.

Earlier I mentioned that you could educate your "low information physician" after reading Mark's book.  This was not meant to be arrogant or condescending.  When he told you that the VAP test provides detailed information he was correct.  Unfortunately when indicated that there are no therapies to alter those fractions he erred.  He is essentially treating you with medical protocols that were valid 20 plus years ago. We have made serious advancements in the last 1 to 2 decades in our understanding of heart disease that alters and or updates these protocols.  

You are not alone in this.  Many, many physicians are not up to date and it's seriously impacting the health of the nation in terms of the degenerative diseases. 

What really makes this all pathetic is that you don't need to be in Geneva at midnight to find solid, properly conducted studies to prove my point.
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 Posted 8/20/2013 3:57:03 AM
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Tom. (7/21/2013)
I ask my doctor about the VAP cholesterol test,. His response was that even though it's a very detailed test, there's isn't anything clinically that can be done to address those fine subsets in the cholesterol panel......At this particular time his recommendation and my focus is to lower LDL cholesterol and raise HDL cholesterol. - Tom.
 
VAP is indeed a detailed test and perhaps your doctor does not know that it also includes measurement of Lp(a). Lp(a), is also known as "the widowmaker", because people have good/regular/normal cholesterol profiles and some die of first-time heart attacks. There is something clinically that can be done about elevated Lp(a)...niacin. Ask your doc for Lp(a) and if he doesn't do that either, if you're in the U.S., call your insurance company an find out who is your "in network" laboratory and just get the doctor to write the Lp(a) on a prescription (with diagnosis code) and bring that to the lab. Go here http://www.atherotech.com/ to read up on the VAP.
 
Also, as far as modifying your VAP profile through nutrition, if I'm not on fish oil (I did a 90-day washout), VAP says my particle size is small dense (bad), but when I'm back on fish oil, the particle size changes to large. That's my experience, not sure it holds true for everyone. But I think it's wrong to say categorically that "there's isn't anything clinically that can be done to address those fine subsets in the cholesterol panel."  
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 Posted 8/20/2013 10:45:09 AM
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JimC (8/20/2013)


Fresh, pure omega 3 fatty acids don't have the impact you are suggesting.



That may be true if one could guarantee that every batch is devoid of lipid peroxidation end products, which we cant . In fact studiess show many are. There may not be a study using LPEP's consumed in fish oil with direct elevation of plasma LPEP's and/or cellular toxcicity, that doesnt exclude it.  However, I have read numberous antidotes from  consumers of fish oil who experienced elevated plasma MDA when tested. The biological complicafions of cellular death occurs over a long expanse of time, often a lifetime of consumption seen in advanced age. Many, if not all the current fish oil studies are relatively short term,

As far as the VAP test and my physician,  I wish I coud find a progressive doctor.

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Seize every opportunity to put your best foot forward.

Anything worth doing is worth doing well.
If you don't stand for something, you will fall for anything
If everything seems under control you're just not going fast enough. - Mario Andretti
You can't expect to do business today, with yesterday's tools, and be in business tomorrow. - Author Unknown
------------------------------------------------------------------------------
The case against dietary fats >>  CLICK HERE
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 Posted 8/20/2013 6:33:46 PM
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Thanks. 

The atmosphere here is very welcoming and civilized. I have given Tom a bit of a hard time in a post and he remained very gracious. 
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