An engineer's attempt to understand LDL, ApoB and whether lifestyle can keep the pharmacist unemployed.
If You Are New to This Journey
If you're joining me midway, here's the backstory. My attempt to debug blood sugar has uncovered a few more mysteries in the human operating system. Catch up on the earlier episodes here:If you have already read them, you can skip the history and proceed directly to read my excitement of the upcoming scheduled annual physical test much like waiting for the result of the final exam in my engineering college.
Episode 1: A Journey to Outsmart Blood Sugar (Before It Outsmarts Me)
Episode 2: When Fasting Met Blood Donation: An Accidental Experiment
Episode 3: When Numbers Tell Stories: My Annual Blood Report Meets Twice a Month Fasting
Episode 4: An Engineer’s Dilemma: Should I Debug My LDL or Just Take the Statin?
Episode 5: The Decision: When a CAC Score of 18 Stopped Being Just a Number
Episode 6 - When My Kidneys Filed a 2 AM Complaint for 2 Meals a Day
The Next Bug: Cholesterol
My October 2025 annual blood report introduced a new problem of LDL:
Total Cholesterol: 221
Triglycerides: 104
HDL: 40
LDL: 162
My doctor prescribed a 5 mg statin last year to lower LDL and reduce cardiovascular risk. But my inner engineer wanted to investigate further before approving the fix. Why replace a component before examining the diagnostic logs?
My determination to avoid swallowing a statin every day sent me down a research rabbit hole. Two books that particularly influenced my thinking were Metabolical and Outlive, both of which I recommend reading cover to cover. They offered fascinating insights into nutrition, eating patterns and fasting, and led me to explore two additional health markers: ApoB, which helps estimate the number of potentially artery-clogging particles in the blood, and the CAC score, which detects calcified plaque in the coronary arteries. My inner engineer had discovered two more diagnostic tools to add to the debugging kit!
During my India visit in December 2025, I got both tests done. ApoB came back at 128, and my CAC score was 18. Zero is ideal for CAC, so my arteries had apparently started maintaining their own records without consulting me. Not exactly the performance review I was hoping for!
A Second Set of Numbers
Since blood tests are considerably more affordable in India, I repeated my lipid panel there in December.
| Marker | Oct. 2025, USA | Dec. 2025, India |
|---|---|---|
| Total Cholesterol | 221 | 212 |
| Triglycerides | 104 | 80 |
| HDL | 40 | 46 |
| LDL | 162 | 150 |
The numbers moved in the right direction. Encouraging? Yes. Proof that my dietary experiment worked? No. The tests were only two months apart and performed at different laboratories.
The Experiment Has a Personal Side
Here is the real question behind this experiment: Can I improve my cholesterol profile through lifestyle changes enough to reconsider the need for a statin?
That is why I moved from three meals a day to two and continued my twice-monthly Ekadashi fasts.
But the Ekadashi fasts are about more than cholesterol numbers. They are also my way of honoring my maternal grandmother and paternal grandfather, both of whom lived a very active life and observed Ekadashi fasts twice a month with remarkable regularity. In a small way, continuing this practice connects me to their example. I like to think that while I am trying to keep my body's operating system in good shape, I am also keeping a family tradition alive.
The engineer in me, of course, wants to measure the results. Can these lifestyle changes produce a meaningful improvement in LDL and, especially, ApoB, which helps estimate the number of cholesterol-carrying particles that can contribute to plaque buildup in arteries?
My October 29 annual physical and the accompanying blood tests will be my next checkpoint. Until then, I won't know whether my experiment has worked. The numbers may improve, barely move, or tell me that lifestyle changes alone are not enough. I am hoping for the first outcome, but I have to be prepared for all three.
The Numbers Still Matter
A CAC score of 18 indicates that some calcified plaque is already present in my coronary arteries, and an ApoB of 128 deserves attention. These are not numbers to brush aside simply because I would prefer to avoid medication.
There is another wrinkle: statins can sometimes increase the calcium density of plaque as they help stabilize it. So, a rising CAC score does not automatically mean treatment is failing.
The objective is not to defeat a statin at all costs. It is to reduce cardiovascular risk intelligently, using evidence rather than wishful thinking.
October 29: The Next Debugging Session
My next annual physical is scheduled for October 29, 2026. A logical showdown between my doctor and the engineer in me seems inevitable this time. The doctor has the prescription, while the engineer keeps asking for more data!
This time, I want answers to three questions:
Has my LDL fallen further from 150?
Has my ApoB improved from 128?
After considering all my numbers and overall cardiovascular risk, what does my doctor recommend about the statin?
I will share the results in a follow-up post. Perhaps my lifestyle changes will show measurable improvement. Perhaps the statin will have to join the maintenance team.
Either way, the lab report gets the final say. My spreadsheet can offer an opinion, but it cannot overrule the data.
After all, even the best-designed systems need preventive maintenance. Unfortunately, the human body comes without a service manual, and its warranty for me appears to have expired without notice!
Disclaimer: This is my personal health journey, not medical advice. Lifestyle changes do not necessarily replace medication. Anyone with elevated cholesterol or coronary calcification should discuss their cardiovascular risk and treatment options with their doctor rather than delaying prescribed medication to conduct a personal experiment.
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