Back in 2015 after being on a Paleo diet for a little over a year my cholesterol was up but I wasn’t too concerned about it at the time. I kept on Paleo and even went hard-core Wahls Paleo Plus/Keto for a while last fall. In 2016 my cholesterol numbers were again high but my doctor wasn’t concerned, same thing in early 2018. Each time my values were up but ratios looked good, no inflammatory markers and I was showing low risk of cardiovascular disease on the NMR profile. Then in the late fall I started having some weird symptoms and went in for blood work. What came back cholesterol wise wasn’t too much of a surprise in the standard lipid panel but it was the new advanced markers that were a bit scarier.
This test ran the normal numbers but also checked ApoB, ApoA, Lp(a) and Lp-PLA2 none of which I’d ever even heard of before. My ApoB and Lp(a) numbers came back as Critcal High, not something you really want to see. Here are all my numbers just to put theme out there:
Total Cholesterol 295.7 mg/dL. 100-199.0 High LDL-C 207.9 0-99 More than double HDL-C 93.0 >39 Good number Triglycerides 42.9 0-150 Good number ApoB 109.4 <60 Critical High ApoA 216.6 >120 Lp(a) 79.6 10-29 Critical High Lp-PLA2 206.7 8-644
Yes, I have high cholesterol still but it had been higher and the doctors were not worried. This Lp(a) number though is the worrisome one, it is one of the best predictors of atherosclerosis, something I don’t want to deal with. I learned about the dangers of high Lp(a) from Peter Attia in his cholesterol series of articles and a specific deep-dive podcast into Lp(a). Not a good number to have be in the Critical High range.
My naturopath suggested we try time-release Niacin, specifically a product called Endur-Acin. I found a no-flush Niacin at the local store and thought I’d try it and asked her about it, she insisted on Endur-Acin. A bit of research shows why – in one study it was found that the wax-matrix form of Niacin in Endur-Acin does indeed lower cholesterol while the no-flush type does not. So, I ordered the Endur-Acin and a home cholesterol tester from Cardio-Chek so I could monitor things a bit by myself. I also decided to take some Omega3 and CoQ10 along with the Niacin.
At the same time I got off a strict Paleo diet and went to Wahls Diet which allows gluten-free grains along with a ton of veggies and protein. Basically I started eating oatmeal most days a week for breakfast and swapped my coconut milk lattes for Oatly oat milk lattes. I also cut out coconut oil and began using olive or avocado oil and drastically cut back on the amount of ghee I was eating. I got on 500mg of Endur-Acin every night along with some Omega3 fish oil and CoQ10. I did this for a month and retested with my home device and also, at the recommendation of my new MD, did a real test. In a month my numbers were:
Total Cholesterol 198 Normal! LDL-C 114 Close enough to normal HDL-C 57 OK, a bit lower than I would like
So, in a month I dropped my numbers to normal range. Since then they have continued to drop, at my last home test two weeks ago I had dropped another 20 points for total so I’m assuming I’m around 180. I have to say, the numbers even impressed the new MD I’m seeing and I’m pretty happy with the progress I made for very little effort really.
After a month I cut the 500mg of Endur-Acin to 250mg each night and will continue that through February and then re-test with the home kit. If I’m still dropping or holding steady I will cut out the Endur-Acin and wait a month and then test again. We will do a full panel sometime in April to see what my ApoB and Lp(a) numbers look like. In theory Lp(a) is mostly genetic but I don’t have the bad genes for it at all and really don’t have any of the bad cholesterol/high atherosclerosis gene markers after digging deep into my 23andMe data. I have found a few people who lowered their Lp(a) by diet and supplements, including Niacin. One had pretty dramatic results but did go pretty much vegetarian to do it, I’m not going back there. I’m hoping that the dietary changes I made and the Niacin are enough to do the trick. If the numbers are still high then maybe I look into a cardiac calcium scan to see if I’ve developed any issues yet, I assume the answer is no given the amount of hiking I do.
Next up, another round of MRIs to see if there is any progression in my lesion and hopefully no new lesions. Also digging into some hormone issues that came up as part of the same blood work which is more or less what I was expecting to find. I ran a new full hormone panel last week and assuming it didn’t get stuck in the blizzard on the way to the lab I hope to have the results back this week.