across a site such as yours which tells everyone everything that they need to know. I have

bookmarked your site. Can anyone else suggest any other related topics that I can look for

to find out further information?

I do wonder what "optimal" means for blood lipids in relation to disease risk, and whether it's the same as optimal for athletic performance. I know that somebody with 100 triglycerides is healthier than 200, but is 20 better than 40? since almost everybody is far out of the healthy range, there is a gaping lack of research on this.

I do a crossfit-type workout once in awhile, and those are ok while fasting. I also do fieldwork that involves carrying a moderate load for 10-15 miles. I have found that while fasting, my endurance is fine at a slow pace, but it's tough to go fast for hours while hungry. my theory is that once glycogen is depleted, fueling muscles from stored fat is slower than from snacking on carbs.

I have no idea what my macro ratios are. I don't count anything, just eat real food and try to have days where I eat little to no carb. Of course, there's the fasting as well.

Not sure what optimal would be. I like to do my workouts hungry, and in fact, the few times I've eaten within a few hours of exercise, I always feel lousy.

I've heard about the coconut oil/milk in coffee. Got to give it a try.

TC 246, TG, 77, HDL 66, LDL-calc 156, TC/HDL ratio 3.7

My 2007 results (from a health food store setup)
TC 230, LDL-calc 146 (121 with the recalculation), HDL 72, TG 59, TC/HDL ratio 3.19.

Paula's point about this new formula being more applicable to those with higher TC is a good one. Either way, the only thing that concerns me about cholesterol (assuming my TG stay low and my HDL doesn't drop) is not having enough cholesterol; because low is associated with other serious health conditions I'd rather not have, esp in women and the elderly.

I calmly told my endo I've investigated my cholesterol numbers and that my LDL pattern was most likely the non-atherogenic large fluffy pattern due to my low carb paleo-ish diet. Furthermore, my HDL always hovers around 70 at least, and my TG have dropped from nearly 200 on my old high carb WOE to always under 80, creating a great ratio. If he was worried, I was happy to take a direct LDL measurement or a VAP/NMR to satisfy him. He dropped the subject.

In the past few years I've learned to be a bit more assertive when it comes to doctors. Often they will run the detailed tests you want (VAP, NMR, 25 (OH)D D) for example, if you simply ask. So ask. If they won't, ask why. If it's a cost difference, offer to pay the difference. Sometimes that's enough to get them to write up the order and you don't have to pay anything. In other words, be a slightly squeaky wheel and get some grease. But don't be annoying. Even if you do have to pay something, it could be worth it to have the more detailed information (information that could get the doc off your back about a statin Rx). Often, doctors will order tests if for no other reason than to "humor" the patient. My sister's and her kids' doctors did this with the Vit D test (I suspect my endo does this, too) and were shocked when they turned out to be seriously Vit D deficient. I'll say it again – the squeaky wheel gets the grease. But make it a small squeak; the loudly squeaky wheel sometimes gets replaced, too.

If any doctor wants to prescribe an Rx for statins or other serious meds for lipids, I would definitely insist first on the full lipoprotein testing with Lp(a) and Apo B (some blood lipid abnormalities won't respond to statins anyway so a statin wouldn't make a difference). The test isn't that expensive that it should make a difference to an insurance company that would pay out for an expensive lifelong statin Rx. Statins aren't candy; hold out for the detailed test before agreeing to even consider an Rx.

And finally, another strategy to get the info you want if your doctor won't humor you or cooperate, is to go around your doctor and either go to another doctor who will order the tests you want or just get the test done yourself (of course, you may not be reimbursed for it if it's out of network, so it pays to shop around). In a few states patient self-testing is made extra difficult (NYS is one that comes to mind that thinks patients are dolts – NYS law requires a Dr order, and CA has some regulatory hoops to jump through, too, but in CA the hurdles are a bit easier). I've gone outside my HMO network to see other doctors several times and then I take the the lab slips to my HMO lab (my insurance covered them), but the results go into my HMO records, too, in addition to being faxed to my non-HMO doctor.

Also, there are numerous labs that will work with patients to directly test at competitive rates – http://www.mymedlab.com is one (no affiliation, but some friends have used the lab with satisfaction). Dr. Davis's Heart Scan Blog offers some self-ordered tests at competitive rates through ZRT labs. And it's private, so you don't even have to share the info with your insurance company or doctor.

and last week:
TC 239 TRI 66 HDL 41 LDL 185

If I use Stephan's formula that leaves me with LDL 160, which is still in the "high" category. Of course my doctor was "very concerned" about the LDL rise and wants to retest in 2 months. No, he won't do the NMR – just the same old standard test.

It's becoming increasingly clear that the same old standard test just doesn't cut it for large segments of the population.

This formula gives me 102 LDL if I did it correctly, almost the same as the 99 they calculated. I think my TRIGs were a little higher than yours, that may have been what threw it off.

I'm sure I'm not eating enough good fat. Thanks.