ApoB number

Has anyone had their ApoB number tested? I am trying to get mine tested. The best my internist could do was to break down my lipid profile which continues to get better and better numbers, although my VLDL size remains too high. My triglycerides are 57, so I don’t understand how my VLDL number could remain that high. My LDL-P,
LDL-C are optimal Everything looks great, but my VLDL number.

From the sources I have been looking at, I have come to the understanding that the ApoB number is the number that we really need to concentrate on.

I realize that 64 yrs of diabetes is hard on one’s body. The Bernstein diet that I followed for 11 yrs during which time I received 2 heart stents was horrible for me, but is great for others with diabetes.

I am just wondering what more I can do so that I don’t have a stroke or heart attack.

I eat a very low fat plant based vegan diet, I exercise for 1/2 an hr twice a day, I am not overweight. My A1c is 4.5, I am in range 95% of the time, and my standard deviation is 21. Most of my readings are under 140.

What else can I do? I really don’t want to be taken out by a heart attack or a stroke at least not in my 70’s. I am 72 now…


Yes, I have been chasing down for the past 2+ years what is causing my calcium to slowly grow each year in my main arteries, especially my LAD. My lab reports show that optimal range for APOb for individuals is <90 so I thought I was doing great as mine has fluctuated between 52-74. I took on a functional cardiologist a couple of months ago that did a complete workup on all my numbers. When I asked her what was causing my plaque buildup, she said it is obvious, plaque will build up in a diabetic with an APOb over 50, news to me.

She says if we can’t get me under 50, then the entire concentration is to move any soft squishy plaque to turn it into hard plaque, but she believes that I can get my APOb under 50 without too much effort.

I just had some pretty nasty surgery a little over 1 week ago, which has a 60-day recovery period, so I am not working on my APOb until about mid-March.

There is a new CT scan with enhanced AI now available that not only measures CAC score but also where plaque is located and how much of it is soft, and how much is hard. I will need to know this to make sure I am progressing at eliminating plaque buildup. I am scheduled for the CT exam on Feb 17, 2023, and those results will be sent to Cleerly for AI enhancement and full analysis. This is not Voodoo science, I have done extensive research, and Cleerly is having fantastic results and outcomes.

Check out their website here:

If you are interested, they can refer you to a couple of cardiologists within a couple of hundred miles from where you live that can do the CAC scan and then interpret their enhanced AI. It is pretty neat stuff and I am sure you will enjoy digging into this,

I will be happy to post my results and progress here, or you can PM me if you prefer.

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Thanks CJ, I hope that you are recovering well from your surgery. I had been wondering where you were.

I will be getting an echocardiogram in a couple of weeks and will be talking with my cardiologist the 1st of March. I will see if he knows where I could get this done. May I ask what your functional cardiologist suggests that you do to reduce your ApoB number?

I know that my cardiologist doesn’t feel like the CAC score would do me much good, since he gives me much more sophisticated tests, but he might be interested in what you are going to have done.

Feel better soon.


I am still in the test stages. Once all the results are in, including the results from Cleerly, she will devise a plan, and I will let you know what she recommends and why. I just know it will be all about getting APOb under 50 as she says no additional plaque will form when I get there

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I always feel that there is more that I can do to stay healthy, so I will be very appreciative of knowing what you learn. Meanwhile I will try to get an ApoB test.

Sometimes though, I feel having had diabetes so very long, that the damage has already been done. Maybe irreversible damage. I was thrilled with my new lipid numbers until I read the VLDL size number.

The ApoB test through UltaLabs is $35 so not too bad.

Thanks CJ, I will go ahead and do this now instead of waiting to see my cardiologist next month.

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I have never heard of it and know nothing about treatment etc. I did find this rather discussion of the condition. I will not swear it is authoritative or useful so take it as offered. With not much conviction.

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Thanks so much Rick. I just did a quick read through and it looks like I am doing everything I can to reduce the ApoB number.

  1. Low fat plant based diet
  2. Daily exercise
  3. Low insulin resistance
  4. Very little alcohol and coffee
  5. Low cholesterol numbers except for VLDL
  6. Normal weight

I will read it again tomorrow. I tend to think my number will be high due to past history, but I shall see.

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That’s the one I have trouble with.


Yes, those are tough to give up. I drink a large cup of coffee in the morning which is half decaf, and I no longer drink wine. Between not eating regular desserts and not drinking wine, socializing is harder than it used to be.

From what I’ve heard and read APOB is your real LDL number, the LDL number we get is a calculated number. I just had mine taken and my LDL was 99 and my APOB was 86. Glad I had my APOB done for the first time.

Are you going to try to reduce your number?
I really need to educate myself about this test! I think we will be hearing more and more about it.

Good for you for getting it done!

Marilyn, your cholesterol numbers are all excellent except for VLDL. Normally VLDL is high if triglycerides are also high. Your VLDL seems incompatible with that triglyceride of 57. The only thing I can suggest is to have the test taken again.

I know! I just don’t get it. I wonder if it could be a mistake. I had my cholesterol profiled a few years ago and my VLDL was 50 then. Since all of my other numbers are much better now, you would think that the VLDL number would reflect that. Actually my Triglycerides were lower then. I wonder if the fact that I have two stents makes the number higher than it would ordinarily be. I have had the stents for 13 yrs now.

I have been reading more about the ApoB test and am wondering why CJ’s doctor thinks that a number below 50 is a good number for people with diabetes. I am wondering how she came up with this number.

  1. She claims with an APOb below 50, plaque can no longer build in the arteries. On my next visit, I will certainly push her for more information and background. I, like you, am still learning all about APOb

  2. Before starting up with this new Cardiologist, in August 2022, I met with the chief lipidemiologist at Joslin and gave him my CAC scans. He implied that I was somewhat obsessed with my numbers and that Joslin would not usually make any changes to anyone in such good control overall. Still, if I insisted, he said he was up for the challenge and that the answer lies in the APOb.
    I found it interesting that Joslin has a deep primary interest in diabetes, and controlling Cholesterol and Atherosclerosis is not essential as long as those numbers are within an acceptable range. This session triggered my basis for seeking a proper cardiologist, eager to prevent heart events, not just deal with events after they happen. It took me over 3 years to find one in the Boston area.

On a side note, I knew I was headed for trouble three years ago and met with one of the top cardiologists in Boston, and he also said I was overreacting. He said I was in great shape and to come to see him when I have shortness of breath, chest pains, or worse. I told him I live almost 100 miles from Boston, and with such an event, I would be DOA. He, like pretty much all cardiologists, is great at fixing broken hearts but doesn’t deal in preventive measures. The tide is starting to turn, but it turns very slowly as fixing hearts is a hugely profitable business, and there is virtually no money in preventive actions. I am told 70% of cardiac events are preventable.

I wouldn’t have even known about the ApoB test, if I didn’t follow a doctor/scientist on You tube who I really think is bright. He interviewed a lipidologist who agreed with the doctor that the ApoB is the most important number to know for everybody who is interested in watching their health. I would think that is especially true for folks with diabetes since most of us die due to heart attacks and strokes.

I like to be proactive or rather I have learned to be. It isn’t in my nature to ignore my health.


Heart attacks and strokes can happen in your 70s regardless of whether you have diabetes, your diet or lifestyle. They are also related to buildup in your arteries, trauma, stress and your parents.

There is literally nothing you can do to eliminate the possibility of a stroke or heart attack and as a POD you have a higher statistical probability of either than an otherwise identical person without.

Every lab test is correlated with a statistical outcome. Risk factors don’t apply to individuals and you aren’t a group of 10,000 people. A 50% chance of a stroke means that half of a group will die. No one knows for sure who will not be in that group.

What is certain is that everyone dies from something.

What else you can do is to live the best life you can, be the best person you can be, cope with whatever life presents, stop worrying about what you can’t prevent, and be grateful for each day that you get.

Although this is true, it has also been demonstrated that
90 Percent of Heart Disease is preventable, and 80 percent of premature heart attacks and strokes are preventable. Until recently, how to optimize those percentages has been somewhat of a mystery beyond the macro level of “lead a healthy lifestyle”, “exercise”, “healthy diet” and “stop smoking”.

As the general population is aging, many of us are looking to live long, healthy, productive lives, and the information and tools, and medications are now available to micro-manage certain parts of our health that were just not available until very recently.

I am in my mid 70’s, and insulin-dependent, so right in that high-risk group. My mother turns 101 this weekend, still living alone, and there is no way I am going to let her outlive me as long as I do everything possible to optimize my own health.


Pstud123, As a person with diabetes, there is plenty that I can do to live a longer life. Yes, many people in their 60’s and 70’s die, but my parents both lived until they were 89, so my older sister,who doesn’t have diabetes, will most likely live at least until she is 90. I am aiming to try to live as long as I can.

Many PWD die when they are a lot younger than 60, but many don’t. I think being educated about diabetes and working hard to keep decent glucose levels plays a big part in how long a person lives. I think diet and exercise can also be very important. Yes, I already have heart disease, for a variety of reasons, but that doesn’t mean that I am going to sit back and not work on living as long as I can. Hopefully I will be lucky enough to make it until I am at least 80. If not, at least I will have given it my best.