Thank you Niner to share your experience on this. I have few questions:... My HDL particle size distribution was "the good kind", skewed toward the larger end. (Figuring that out was the main reason I wanted to get the VAP test in the first place.) That might be due to my relatively low carb diet. I just got back the results from a heart scan, and I had a Calcium score of ZERO! That's pretty good news, and does tend to validate my current diet. The odds that I'll be adopting my doctor's "heart healthy" high carb, high PUFA, low SAFA diet are now precisely zero.
I'm still taking 500mg of extended-release niacin twice a day, and am tolerating it reasonably well. I just dropped the NSAID I was taking with it to suppress flushing, and things seem ok, but I probably need to double the dose of the niacin yet. I dropped the 10mg Lipitor due to muscle pain. I have a bottle of a newer hydrophilic statin called Livalo (pitavastatin) that is supposed to be a lot better with respect to side effects, but I haven't started it yet. I think that given the state of my coronary arteries, I might nuke the whole statin idea.
I still have some concern that the atherogenicity of lp(a) is more of a problem for cerebral arteries than coronary, and have a couple pieces of family history that back that up: My younger, healthier brother had some carotid plaque show up on ultrasound, and there's a history of stroke and TIA's on my mother's side. I'd like to get a carotid ultrasound to see what's going on there.
- Wasn't particle side relevant to LDL rather than HDL in the VAP test? I assume I also succeed to skew LDL toward pattern A (large) with a low carb diet. I think that was the most important change I made as also reflected in my low TG level.
- Is it the first time you test your calcium score? I also have it low (3, not zero unfortunately) but I am happy at least to have it maintained so after 5 years. It is recommended to always test the calcium score on the same machine.
- Have you checked any change in your homocysteine and liver enzymes after supplementing with high doses of niacin? I am also considering this. I am giving a try with RYR before possibly use niacin (or a statin). Fortunately my lp(a) seems in check.