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What is Apolipoprotein B? Here's What Your ApoB Blood Test Means

Discover why ApoB is an essential indicator of heart health.

Michelle Darian
By Michelle Darian
Jovan Mijailovic
Edited by Jovan Mijailovic

Updated June 17, 2024.

a doctor taking blood from a woman's hand to test apolipoprotein B levels

Apolipoprotein B (ApoB) is the main protein found in low-density lipoproteins (LDL), which are tiny particles that transport fat and cholesterol through the body. The process is necessary because this hormone produces many others that are important for cellular health and function.

Currently, clinicians measure ApoB levels less than LDL because the latter is included in a standard lipid panel test for yearly physicals. But, emerging research indicates that it's actually an essential indicator of heart health and disease risk. [1] Here’s what you need to know about ApoB, the role of DNA on its levels, and how to get your levels tested.

» Get insights into your ApoB levels—including other key biomarkers—and live healthier, longer!

Key takeaways about ApoB

  • ApoB is the main structural protein found in low-density lipoproteins (LDL) and all potentially atherogenic lipoproteins. It assists in moving and clearing cholesterol from the blood.
  • It directly measures atherogenic particles, making it an essential indicator of heart health.
  • High levels indicate decreased clearance of cholesterol from the blood.
  • Genetics highly influence ApoB. It's associated with heart disease, stroke, and overall lifespan.
  • You can modify your ApoB, meaning dietary changes and supplement intake can help improve your levels.

What is Apolipoprotein B?

ApoB is a structural protein found in all potentially plaque-forming particles. [2] A test measuring it shows the concentration of all such particles, including LDL cholesterol and other markers like:

  • Very low-density lipoproteins (VLDL)
  • Intermediate-density lipoproteins (IDL)
  • Chylomicrons
  • Apolipoprotein A

These particles usually harmlessly pass through arteries but can sometimes become trapped in their wall. When it happens, the deposits build up as plaque and restrict the flow—damaging arteries and increasing the chances of blood clots. [2, 3]

» Try a personalized approach to heart health by analyzing your ApoB levels

Note: Knowing your ApoB levels can help you and your healthcare provider further evaluate the status of your heart health and your potential risk for cardiovascular disease. [4]

Reference range for an ApoB blood test

You'll often see ApoB blood test results next to a reference range. Levels that fall outside—too low or high—require a healthcare provider assessment because they may indicate a health concern. Here are ApoB ranges and what they mean:

Normal ApoB levels (40-120 mg/dL)

Normal Apolipoprotein B levels can indicate healthy cholesterol transport and clearance. Those towards the higher end of this range may indicate troubles with removing cholesterol.

Normal ApoB levels
Men66 to 133 mg/dL
Women60 to 117 mg/dL

» Find out what healthy cholesterol levels are and get recipes that help lower elevated levels

High ApoB levels (>120 mg/dL)

High Apolipoprotein B can indicate decreased cholesterol removal from the blood and an increased risk for cardiovascular disease.

What does a high ApoB mean for you? ApoB-tagged particles carry LDL throughout your bloodstream, so elevated levels may mean the body can't remove excess cholesterol from the blood. With reduced clearance, plaque builds up and constricts the arteries, which increases the risk of heart disease. [3, 4] Consult with your physician if this is the case for you.

» Your ApoB levels are high? Understand how to lower cholesterol naturally

Heart disease is the leading cause of death in the US, which is why addressing ApoB and making cardioprotective lifestyle modifications is critical to living healthier and longer. [2, 3]

Low ApoB levels (<40 mg/dL)

If you're wondering can ApoB levels be too low, the answer is yes, but we need more research to establish a standard consensus for the bottom end of the reference range. Currently, 40-50 mg/dL is cited as the lower end of the reference range. [5]

A decrease in ApoB may result from hyperthyroidism, cirrhosis, or malnutrition. However, there are other blood tests used to detect or diagnose those conditions properly. You should always seek proper medical attention and speak with a physician if you have concerns about low levels. [6, 7, 8]

» Understand hyperthyroidism and what high and low TSH levels mean

Knowing your ApoB level provides additional insights when interpreting other cholesterol markers like triglycerides, high-density lipoprotein (commonly called the “good” cholesterol), LDL, and total cholesterol. Because we can find ApoB in all plaque-building particles, higher levels often coincide with elevated LDL. That said, inconsistency between ApoB and LDL cholesterol levels is possible. [9]

» Learn how LDL particle size and ApoB can impact your risk for cardiovascular disease

ApoB is a direct measure of atherogenic particles, providing a count that could contribute to cardiovascular disease. In contrast, LDL cholesterol is an indirect calculation based on other lipid measures rather than a direct particle count. [10]

» Go beyond your total cholesterol number and unlock a deeper understanding of your heart health

Do genetics influence ApoB levels?

Studies show that genetics contribute substantially to ApoB levels, as it's a highly heritable trait. Studies show that those who had the predisposition were more likely to develop heart disease. [11]

When looking at our own customer data, this association holds true. In fact, our customers with the trait in the bottom 10% of risk had an average ApoB level of 67 mg/dL, which is well within the optimal zone. On the other hand, those in the highest-risk category averaged 100 mg/dL.

» Select InsideTracker's DNA add-on to analyze 16,907 genetic markers that can affect ApoB levels

How can you measure your ApoB levels?

Clinicians don't currently measure ApoB as part of a lipid panel test, and many insurance companies don't cover it—especially for preventative screening. But, depending on your healthcare provider, where you live, current cardiovascular risk factors, and your insurance, you may be able to get a test through your primary care provider.

» Measure your ApoB for a comprehensive view of your cardiovascular health

Get your personal health analytics dashboard

Since ApoB is a critical marker of health, a cardiovascular indicator, and can be impacted through lifestyle choices, InsideTracker Ultimate Plan monitors this biomarker. [2, 4]

Our science team has collected research on ApoB for over a year and can now confidently say that it offers more context to other lipid markers and creates a more detailed analysis of your heart health. The team established an optimal zone for ApoB levels within the reference range, which will support your LDL cholesterol.

» Discover science-backed ways to target the optimal ApoB levels and support healthy cholesterol

How can you lower ApoB levels?

Like other cholesterol markers, ApoB levels are modifiable by lifestyle habits—meaning, nutrition, lifestyle, and supplement modifications can help improve high levels. Here are a few of the most common science-backed ways to improve elevated ApoB levels:

  • Reduce foods high in saturated fat: Eating foods high in saturated fat is associated with elevated ApoB levels. Aim to reduce intake of red and processed meats to support ApoB levels. [12]
  • Opt for sources of unsaturated fats: Unsaturated fats, also known as “healthy fats,” support optimal cholesterol and ApoB levels. Aim to incorporate olive oil, avocados, and flaxseed that are rich in it. [13, 14, 15]
  • Eat fiber-rich foods: Soluble fiber is an important nutrient that contributes to optimal cholesterol and is critical in supporting ApoB levels. Oats and beans are two excellent food sources of fiber. [16, 17]
  • Try out a new supplement: Certain supplements can also help. Studies show that taking a psyllium husk or plant sterol supplement can reduce elevated ApoB levels. Artichoke extract and spirulina may also help. [18, 19]

» Know your ApoB levels and take targeted action to lower them

How long does it take ApoB levels to change?

The time it typically takes to see movement in your ApoB level will depend on multiple factors, such as your current level, your lifestyle habits, your willingness to adopt them, and your ability to stick to them. That said, the studies show that ApoB levels can be notably modified after approximately three months. [14, 19, 20]

» Measure your ApoB and get personalized, science-backed health guidance

Measure your ApoB for a complete heart health picture

As more physicians incorporate ApoB into standard lipid panels, patients may soon have a powerful new tool for monitoring cardiovascular health and making adjustments to keep their arteries clear.

» Optimize your ApoB levels for better heart health

Continued medical research can unlock more precise metrics for diagnosing, treating, and preventing life-threatening conditions. In the era of personalized medicine, measuring this multitalented protein may be the key to reducing heart disease rates.