At work, we have our annual “wellness” exams coming up, and part of that is a blood draw so they can do a standard lipid panel. The results of this “exam” determines whether or not we qualify for a reduced rate on our health insurance.

Since this exam is coming up, I asked the company that administers the exam if I could upgrade my cholesterol test to an NMR test, as it can measure actual particle size and give more meaningful (less misleading) cholesterol information.

Here is my exact request (sent through our awesome HR manager):

Any chance of upgrading my cholesterol test to an NMR profile (or even a VAP ) instead of the standard and typically diagnostically misleading lipid profile (“cholesterol”) test?

Here is the response I got:

As for upgrading cholesterol screening, I would refer this individual to their primary care physician if they want a more specialized diagnostic test. [WellnessCompanyName] performs the standard testing for cholesterol and does not go into the inquired tests. If the participant has questions about their cholesterol they are always welcome to call the coaching line at 1-###-###-#### ext. ####.

I wonder what would happen if more of us who were interested started asking for a more meaningful cholesterol test, even if we had to pay a little extra for it.

Consider, for a moment, the following:

• 50% of all heart attack victims who are admitted to the hospital have normal cholesterol (a normal lipid panel) (Kennel, American Journal of Cardiology)
• LDL cholesterol is composed of several “types” of lipoprotein, of those,  “LDL-P (or apoB) is the best predictor of adverse cardiac events, which has been documented repeatedly in every major cardiovascular risk study” (Dr. Peter Attia).
• The standard lipid panel does not actually measure the various LDL particle sizes. What’s worse, it often calculates the aggregate LDL score instead of measuring it directly.  (This is pretty well known. Here’s one explanation of it.)

Next time they draw your blood for a cholesterol test, which one do you want? Would you rather have one that answers questions, or raises them?

Resources

Without a doubt, the best discussion on cholesterol I’ve come across is Dr. Peter Attia’s 9-part omnibus series, “The Straight Dope on Cholesterol“. If you are interested in learning more about cholesterol, what it is, how it is measured, and what it does for and to us, this is the series to read.