New Study: Higher Cardiac Plaque Calcification in High Intensity Athletes

Carson said:
@rlb

My LP(a) is 12. Redid LDL and it is 112 (down from 118).

Test notes: Values greater than or equal to 75 nmol/L may indicate an independent risk factor for CHD, but must be evaluated with caution when applied to non-Caucasian populations due to the influence of genetic factors on Lp(a) across ethnicities.

Doc says that's good. Above 75 indicates the CV plaque is "stickier" and will build on artery walls more quickly. Doc also noted that while my calcium score isn't zero, he looked at images and it's distributed equally in multiple locations, not all deposited in one spot. So, overall he says just keep doing what you are doing and we'll retest in 5 years.
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Glad you’ve got the all-clear. Going back to the doc in a few weeks myself to hopefully get the same!
 
iman29 said:
So partially prompted by this thread, the other part just my own commitment for 2025 to do more regular health things for myself, I went for an annual physical last Thursday. Generally I don't go to my PCP that much since when I end up with a cold or sinus infection I end up at a walk in place since it's so hard to get a quick appointment with him. But since my PCP is also my Gastro doc, I have some medical history there.

He told me I am much healthier and in better shape than many 53 year olds he sees, especially my RHR and my weight. He and I were surprised my BP was around 130/72 which he said was the high end of where it should be, and last May my BP was 124/68 when they did my vitals for the colonoscopy.

He gave me an order for a full blood panel and said we will do the bloodwork first before we consider if a CT is needed for Cardiac calcium, he acknowledged that based on my high levels of cardiac activity it could be something to check: " unlike a lot of people your age, basically you are doing a stress test every time you ride" were his words. He was fine either way if I wanted to do it he would gladly write it up and review the results. and he did confirm not covered my insurance usually but it doesn't cost more than $100. But first he was interested to see the bloodwork results and see if anything else is a red flag. He mentioned statins but didn't have the opinion that it should be the immediate thing we do which I felt was good as maybe some diet changes, etc... can help. And before we do that, he would send me with the CT results to a cardiologist first to get more feedback.

I've known him for over 20 years and even if I don't go to see him regularly, he knows I used to be around 300lbs at one point in my life, and much less healthy before I started riding 15 years ago so seems for now we are on the same page.

Bloodwork this week then more to follow.
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well at least I am good at procrastinating, I finally went for my full bloodwork/urinalysis panel yesterday. It probably wasn't the best idea to go one day after riding 84 miles in the heat and humidity but I can talk to the doc about it when he calls me.

I haven't spoken to him yet, but Labcorp sent me the notice my results were ready so I was scrolling through it all. Overall all of the results look good only the Creatinine is just on the border of normal to high; might be because I got a bit dehydrated Sunday?

Relevant to the original conversations on here, the only other item out of range is my LDL (108) which is also just slightly beyond the border of the Normal range. Based on the total Cholesterol (194 - just below borderline) and the very good level of HDL (71 - the good one) I am not sure if this is something he will flag for any follow up treatment like a Statin. Im not convinced I need to go on one right away since my numbers are only on the borderline. I think I still want to do the cardiac scan to gather more info and get a cardiologist consult before I agree to anything with statins from my GP. I just turned 54 this weekend so I don't know how these things all factor together just yet.

Interestingly enough, my coach for my Cancer charity ride was just recently asking me about my historical HR stats and my max HR, since he observed that my RHR avg (45) and training progression the last 3 months has been terrific especially when he's giving me these FTP type interval sessions.

This should all make for a good discussion with my GP. More to follow.
 
iman29 said:
well at least I am good at procrastinating, I finally went for my full bloodwork/urinalysis panel yesterday. It probably wasn't the best idea to go one day after riding 84 miles in the heat and humidity but I can talk to the doc about it when he calls me.

I haven't spoken to him yet, but Labcorp sent me the notice my results were ready so I was scrolling through it all. Overall all of the results look good only the Creatinine is just on the border of normal to high; might be because I got a bit dehydrated Sunday?

Relevant to the original conversations on here, the only other item out of range is my LDL (108) which is also just slightly beyond the border of the Normal range. Based on the total Cholesterol (194 - just below borderline) and the very good level of HDL (71 - the good one) I am not sure if this is something he will flag for any follow up treatment like a Statin. Im not convinced I need to go on one right away since my numbers are only on the borderline. I think I still want to do the cardiac scan to gather more info and get a cardiologist consult before I agree to anything with statins from my GP. I just turned 54 this weekend so I don't know how these things all factor together just yet.

Interestingly enough, my coach for my Cancer charity ride was just recently asking me about my historical HR stats and my max HR, since he observed that my RHR avg (45) and training progression the last 3 months has been terrific especially when he's giving me these FTP type interval sessions.

This should all make for a good discussion with my GP. More to follow.
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I had a blood draw a few years ago right after a long hot week of riding in VT. It skewed my liver enzymes a bit and the PSA score. But not LDL/HDL. A few weeks later and after 48 hours of rest before blood work, liver and PSA were normal.
 
Carson said:
I had a blood draw a few years ago right after a long hot week of riding in VT. It skewed my liver enzymes a bit and the PSA score. But not LDL/HDL. A few weeks later and after 48 hours of rest before blood work, liver and PSA were normal.
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That’s what I figure this lines up with my theory on the liver results.
 
iman29 said:
well at least I am good at procrastinating, I finally went for my full bloodwork/urinalysis panel yesterday. It probably wasn't the best idea to go one day after riding 84 miles in the heat and humidity but I can talk to the doc about it when he calls me.

I haven't spoken to him yet, but Labcorp sent me the notice my results were ready so I was scrolling through it all. Overall all of the results look good only the Creatinine is just on the border of normal to high; might be because I got a bit dehydrated Sunday?

Relevant to the original conversations on here, the only other item out of range is my LDL (108) which is also just slightly beyond the border of the Normal range. Based on the total Cholesterol (194 - just below borderline) and the very good level of HDL (71 - the good one) I am not sure if this is something he will flag for any follow up treatment like a Statin. Im not convinced I need to go on one right away since my numbers are only on the borderline. I think I still want to do the cardiac scan to gather more info and get a cardiologist consult before I agree to anything with statins from my GP. I just turned 54 this weekend so I don't know how these things all factor together just yet.

Interestingly enough, my coach for my Cancer charity ride was just recently asking me about my historical HR stats and my max HR, since he observed that my RHR avg (45) and training progression the last 3 months has been terrific especially when he's giving me these FTP type interval sessions.

This should all make for a good discussion with my GP. More to follow.
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doc mailed me a letter basically said everything is normal despite the few items I saw in my online chart/results.

I will give the office a call and request the Calcium scan and see what it comes back as. Im not super worried because there's no significant history of cardiac issues in my family, but for $100 its good to check on this given the collective factors.
 
Red Mosquito said:
I had my CT scan today and my calcium score came back as 0, which I was obviously really hoping for. So, it seems I am in the clear in some regards. I just need to understand my elevated LDL and what to do about it, which is hopefully not a statin. It was 192, which is crazy to me given my mostly healthy eating and level of exercise. Stress is the one variable I seem to have the least grip on so I've got work to do there.

I never did do a deep dive on the coffee and LDL, but some light research suggests that theory has legs. I've switched to filtered coffee which is supposed to mitigate the risks. I've also been taking berberine and red rice yeast, and today the Mrs. found a study that shows this is effective at lowering LDL. I'll link it here when she sends it over. Also, she found a study that shows people on a keto diet have elevated LDL and no atherosclerosis. While I am not keto, I did spend most of the month prior to my physical eating very little carbs. So I'm hopeful that between the diet and coffee my LDL was a bit of a fluke, and with some changes and supplements it will go down. I'm still planning to see a cardiologist due to some family history of heart disease, and to see what other testing can be done.

One final bit of info, I grabbed this book Outlive: The Science & Art of Longevity which does a great job of explaining the role of cholesterol and the whole atherosclerosis process. It also talks about this one specific type of LDL called LP(a) which basically turbocharges your artery damage, so I'm also looking to understand if I'm impacted there as well. I'm intrigued by the conflicting ways cholesterol is treated. Some guidelines go by LDL/HDL ratio, and by that regard I'm well into the green. On the flip side you have absolute numbers focused on LDL which triggers you as "at risk" and thus on the pharma teat. I tend to view this approach skeptically for that reason, and also because I tend to look at things more holistically vs through a narrow lens. Still, I will talk to a Dr. and see what they say.
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I had my initial visit with a cardiologist back in April I think, and he was agreeable to letting me try my own thing for a time to get my LDL down, vs jumping striaght to a statin.

Since then I’ve eliminated the French press coffee and have been taking berberine and red rice yeast. I haven’t done much diet wise, other than try my best to keep it “clean” during the week and enjoying myself on the weekends. However, that’s not too far off what I’ve been doing for a while now, so it didn’t feel like a big shift. I’ve also restarted weight training so I know that’s also a meaningful factor.

I re-did my bloodwork this week and my LDL was 115, down from 192 in February. I’m pretty happy with that, and despite being in the “elevated” range, I don’t have concerns about it. Coupled with the other factors like LDL/HDL ratio (115/81=1.42 which is ideal), my 0 calcium score, and lipoprotein A at 10 (optimal is <75) I’m going to keep on doing what I’m doing.

I have a follow up in October which includes a stress test just to round out the big picture. I’m interest to discuss this with the doc and see what his take is. I know he was personally going down a similar path for himself so I’m interested to compare notes.
 
Nolabean said:
Just an fyi for anyone looking to get a calcium score - rwj Somerset and Monmouth medical center will do it for $49 with a rx from your doctor
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That’s good to know, I think I paid $80 at the joint Hunterdon/AHS facility on 22 in Bridgewater.

In a system where bloodwork is $125 when insurance pays but it’s $600 when it’s out of pocket, I’m surprised how affordable this is. (Fake numbers, but you get the point)
 
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