Many of you may have noticed that Evey has been discussing and ordering a lab test called the Advanced Lipid Panel. This test provides a more comprehensive look at cholesterol and heart health compared to a basic lipid panel.
What’s Included in the Advanced Lipid Panel?
Unlike a standard lipid panel, which measures Total Cholesterol, LDL Cholesterol, Triglycerides, and the Cholesterol/HDL Ratio, the Advanced Lipid Panel includes:
Total Cholesterol
HDL Cholesterol
Triglycerides
Non-HDL and Calculated Components
Lipoprotein Fractionation (Particle size and number)
Apolipoprotein B (ApoB)
Lipoprotein (a) [Lp(a)]
HS-CRP (High-Sensitivity C-Reactive Protein)
Lp-PLA2 Activity (Marker of arterial inflammation)
Why Get a More In-Depth Test?
For patients with a personal or family history of high cholesterol, heart disease, atherosclerosis, or metabolic concerns, a deeper evaluation is crucial. One key insight this test provides is the size and density of LDL particles. Small, dense LDL particles are more likely to penetrate artery walls, leading to plaque buildup and an increased risk of heart disease and diabetes.
Breaking Down Key Test Components
LDL-P: Measures the number of LDL particles per liter of plasma.
LDL Particle Size: Distinguishes between large, buoyant LDL (Pattern A) and small, dense LDL (Pattern B). Small, dense LDL is more likely to oxidize and cause plaque buildup.
Apolipoprotein B (ApoB): Indicates the concentration of atherogenic lipoproteins.
Lipoprotein (a) [Lp(a)]: A genetically determined risk factor for cardiovascular disease.
Pattern A vs. Pattern B:
Pattern A: Large, fluffy LDL particles (less harmful)
Pattern B: Small, dense LDL particles (highly atherogenic - tending to promote plaque formation)
A study published in the Journal of the American Medical Association found that a predominance of small, dense LDL particles increases the risk of myocardial infarction threefold, independent of age, sex, and weight. Additionally, research from the Texas Heart Institute has shown that while statins lower overall LDL cholesterol, they do not reduce the proportion of small, dense LDL particles and may actually increase them.
What If My Levels Are Abnormal?
First, don’t panic—this test serves as an early warning system. There are many lifestyle and supplement-based strategies to help optimize your cholesterol profile. Based on your results, Evey may recommend:
Possible Dietary & Supplement Recommendations
Increase Fiber Intake (via diet or supplements like FiberMend) – Helps reduce intestinal cholesterol absorption and increases bile acid excretion.
EGCG (Green Tea Extract) – Lowers LDL, inhibits LDL oxidation, reduces cholesterol absorption, and improves LDL receptor activity.
Plant Sterols – Lowers LDL, converts small LDL B to large LDL A, and increases reverse cholesterol transport.
Time-Released Niacin – Converts small LDL B to large LDL A, lowers triglycerides, increases HDL, and reduces inflammation.
Increase Fish Oil (Orthomega) – Reduces inflammation, lowers triglycerides, and shifts LDL pattern to a less atherogenic form.
High-Quality Extra Virgin Olive Oil (e.g., Kyoord) – Inhibits LDL oxidation.
Resveratrol – Enhances cholesterol transport, reduces oxidation, and increases anti-inflammatory enzymes (PON1 & PON2).
Bergamot – Improves lipid balance by lowering LDL and triglycerides while increasing HDL.
Curcumin – Reduces inflammation, improves HDL, and inhibits LDL oxidation.
Pomegranate – Protects against LDL oxidation and LDL glycation, which is particularly important for diabetics.
Why These Interventions Matter
Unlike medications that target a single pathway (such as statins, which inhibit HMG CoA Reductase, an enzyme involved in cholesterol synthesis), these natural interventions work on multiple pathways, including:
Enhancing cholesterol transport and excretion
Reducing oxidation and inflammation
Improving lipoprotein particle size and density
By following personalized recommendations, many patients have seen significant improvements in their cholesterol profiles on follow-up testing.
Final Thoughts
This test provides deeper insights into cardiovascular risk, helping us take a more proactive and personalized approach to heart health. If you have any questions about whether the Advanced Lipid Panel is right for you, feel free to ask Evey during your next visit!
Notes: *HMG CoA Reductase is an enzyme that plays a crucial role in the body’s cholesterol synthesis. It controls how much cholesterol is produced and is often targeted by statin drugs
**PON1 and PON2 refer to Paraoxonase 1 and Paraoxonase 2 respectively. Both belong to a family of enzymes with antioxidant properties and are involved in the breakdown of oxidized lipids, playing a role in protecting against cardiovascular disease.
***Macrophages act as the garbage disposal of the cell. When they act on lipid molecules, they often cause an increase in inflammation. The NADPH receptors change the way that this occurs and have been shown to slow or reverse atherosclerosis.
****LDL Glycation is a nonenzymatic reaction between glucose and LDL that can lead to atherosclerosis. It is linked to oxidation and is more common in people with diabetes. Some supplements stop this reaction from happening and may help to prevent atherosclerosis.
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