how much does the lipid panel move just from losing weight
#bloodwork 2025-01-30
Thursday42 messages9 participantstimes are UTC
Highlights from this day
- swirl_not_shake — then measure both and stop arguing with me about it 22:51
- peak_split — pulling it out so nobody has to scroll for it again 22:58
- peak_split — and for the bigger question of whether any of this matters, SELECT is the one that moved the needle 23:00
- swirl_not_shake — the trial population is the trial population. people forget that constantly 23:05
the most useful thing i did was get a full panel before i started. everything since has been comparable
not a chat question
alt and ast coming down as you lose liver fat is common and is a good sign
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nice a1c
if a result frightens you, that is a conversation with a clinician. we will help you read it, we will not tell you it is fine
baseline, three months, then twice a year is what i settled on
anyone have before and after numbers they are willing to post
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my b12 is borderline, supplementing or eating differently
apob is the better marker and it is harder to get. i track both because i can only get one reliably
[edited]too early for a1c
fake_trackingapob is the better marker and it is harder to get. i track both because i can only get…
while im here coming back after 14 months, what changed in your numbers
an isolated lipase a bit over range with no symptoms is usually nothing. lipase with severe pain is not
my LDL-C is 2.6 and my doctor is happy, so why do you all keep going on about apoB
because LDL-C is a mass measurement and apoB is a particle count
you can carry the same cholesterol mass in a few large particles or in a lot of small ones. the second is worse
and in exactly our population — high triglycerides, low HDL — the two disagree most
disagree how much
the four cases
| Pattern | LDL-C | apoB | What it means |
|---|---|---|---|
| concordant | normal | normal | no argument to have |
| discordant, high trigs | looks fine | high | more particles, each carrying less cholesterol |
| discordant, other way | looks high | normal | fewer, larger particles |
| during active weight loss | unstable | steadier | why people prefer apoB mid-cut |
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ok but is there a trial where apoB changed the treatment decision
the genetic and epidemiological case is strong. a trial that randomised people to apoB-guided versus LDL-guided treatment is not something we have
which is a fair hit on us, not on the marker
so it is inference
inference from several directions. the same is true of most of lipid practice
i am not moving off LDL-C until my lipidologist does
then measure both and stop arguing with me about it
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this is a genuine disagreement and it does not resolve in here. it has not resolved in the literature either
as a newcomer this is confusing
it should be. anybody in here who sounds certain about lipids is overselling
pulling it out so nobody has to scroll for it again
good thread, leaving it up
and for the bigger question of whether any of this matters, SELECT is the one that moved the needle
so the drug itself does cardiovascular things
in that population, with established disease, yes. it does not follow that it does the same for a 30 year old with none
the trial population is the trial population. people forget that constantly
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on that we agree entirely
so what do i actually ask for
back to your original question — ask for apoB alongside the standard panel and keep the LDL-C. nobody has to lose
fine
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logged as unresolved. as usual
is that a thing in here
it is the healthiest thing in here
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