Lipoprotein(a) [Lp(a)]

Lipid Panel

The lipid panel is one of the most important — and still one of the most frequently misread — preventive blood tests: 'total cholesterol' alone tells you less than the ratios between its fractions.

Apolipoprotein B (ApoB)

While a standard lipid panel measures the amount of cholesterol carried in your blood, apolipoprotein B measures something different — the number of particles themselves that can actually penetrate the artery wall. That distinction can matter when a standard lipid panel looks fine but cardiovascular risk remains elevated.

Metabolic Syndrome

A cluster of five risk factors — from abdominal obesity to elevated triglycerides — that multiplies the risk of type 2 diabetes and cardiovascular disease, but is largely modifiable through lifestyle change.

Homocysteine

Homocysteine is an intermediate amino acid of methionine metabolism, linked for decades to cardiovascular and neurological risk — though how much lowering it actually reduces that risk remains a point of controversy in the literature.

Fibrinogen

Fibrinogen is a plasma protein that serves as the final substrate of the coagulation cascade and is also one of the main acute-phase inflammatory proteins — its concentration is assessed both in diagnosing clotting disorders and as an independent cardiovascular risk indicator. This test evaluates clotting function and inflammatory status, distinct from D-dimer, which detects an already-existing clot.

TRT and Cholesterol — How Does Testosterone Affect Your Lipid Profile?

Testosterone therapy usually lowers total cholesterol and LDL slightly, but it often lowers HDL too — which historically raised concern. We explain why these changes rarely translate into a real worsening of cardiovascular risk, and how to read a lipid panel in the context of TRT.

Can insulin resistance occur without being overweight?

Yes — insulin resistance can occur even in people with no excess body fat at all, including visceral fat. We explain the rarer, but real, mechanisms that operate independently of fat: genetic variants in the insulin signaling pathway, chronic sleep deprivation, chronic stress, and physical inactivity.

Ketogenic Diet and High LDL Cholesterol: Is It Dangerous?

On a ketogenic diet, LDL cholesterol rises by tens and sometimes hundreds of mg/dL in some people, and often in lean, metabolically healthy people who chose the diet for their health. The biohacker community calls this the 'lean mass hyper-responder' phenotype and often claims that a high LDL in this setting is harmless. We look at what the evidence really shows: a meta-analysis of randomized trials, the only available artery imaging data and clinical reviews, and which measurements (ApoB, Lp(a), coronary artery calcium) make sense before you decide whether to modify the diet.

October 21, 2026

LDL or ApoB: Which Result Better Predicts Cardiovascular Risk?

LDL-C measures the amount of cholesterol in LDL particles, while ApoB counts the particles themselves, the ones that can enter the artery wall. Usually the two results go together, but in some people, especially those with insulin resistance, high triglycerides or a very low LDL, they diverge, sometimes by tens of percent. We look at what large cohort studies, genetic (Mendelian randomization) studies and the 2019 ESC/EAS guidelines say, when it is worth ordering ApoB, and why not all researchers agree that ApoB always beats LDL-C and non-HDL.

October 21, 2026

Elevated Lp(a): What It Means and What to Do

Lipoprotein(a), or Lp(a), is an LDL-like particle whose level is overwhelmingly written in the genes and barely changes during life. An elevated Lp(a) (above 50 mg/dL, or about 125 nmol/L) affects roughly one person in five and raises the risk of heart attack, stroke and aortic valve stenosis. Diet and exercise hardly lower it, and Lp(a)-specific drugs are only now going through trials; in October 2026 it was announced that the first large drug, pelacarsen, lowered Lp(a) but did not reduce cardiovascular events. We explain how to read the result, what can really be done and why the core of the matter is aggressive control of LDL and ApoB.

October 21, 2026

Familial Hypercholesterolemia: Symptoms, Diagnosis and Treatment

Familial hypercholesterolemia (FH) is one of the most common genetic diseases: it affects roughly 1 in 250-300 people and causes very high LDL cholesterol throughout life. For years it runs without symptoms, so the first signal is often a premature heart attack in a parent or a lipid panel result above 190 mg/dL. We explain how FH is diagnosed (the Dutch Lipid Clinic Network score, testing of the LDLR, APOB and PCSK9 genes), why testing relatives is so important, how adults and children are treated and what about pregnancy.

October 21, 2026

Muscle Pain from Statins: Drug Effect or Nocebo?

Millions of patients stop taking statins because of muscle pain that, according to the first trial ever designed to settle the question, has nothing to do with the drug's pharmacology in 90% of cases. In the SAMSON experiment, participants reported nearly identical pain severity while taking the statin and while taking a placebo. That doesn't mean the pain is 'imaginary' — it means the pill itself, not its active ingredient, is usually not the source.

August 23, 2026

Garlic and LDL Cholesterol: Does It Really Lower It?

"Garlic lowers cholesterol" is one of the oldest folk health tips — and, rare for this category, partly confirmed by meta-analyses of clinical trials. But the devil is in the details: the effect is real (an LDL drop of about 9 mg/dL), yet it applies only to people with already elevated cholesterol, requires supplementation lasting more than 2 months, and has nothing to do with occasionally tossing a clove of garlic into dinner.

August 23, 2026

Eggs and Blood Cholesterol: Does an Egg-Rich Diet Harm Your Heart?

For decades, eggs served as the poster child for a food to "avoid" if you cared about your heart — because of the high cholesterol content in the yolk. The newest, massive analysis combining three prospective US cohorts (215,618 people, followed for up to 32 years) and an updated meta-analysis spanning 1.72 million participants worldwide paints a far calmer picture: eating up to one egg a day shows no significant association with elevated cardiovascular risk. In Asian cohorts, researchers even observed a mild protective effect. This is one of those cases where the scale and quality of newer data shifts conclusions from decades past — not because the old studies were poorly done, but because newer analyses have the statistical power to catch nuances smaller samples couldn't see. In this article, we look at exactly what the numbers show, where certainty ends, and where nuance begins.

August 24, 2026