Cardiovascular Health 2025

[RapAdmin]

So I put my numbers into ChatGPT:

If my absolute monocyte measure is 0.50 ×10³/µL, and my HDL is 50 mg/dL, what is my Monocyte to High-Density Lipoprotein Cholesterol Ratio?

Response:

Let’s calculate your Monocyte to HDL Cholesterol Ratio (MHR) step by step carefully.

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Step 1. Write down the given values

• Monocyte count: 0.50 × 10³ / µL
• HDL-C: 50 mg/dL

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Your Monocyte-to-HDL ratio = 0.010

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Step 5. Interpretation (relative to study quartiles)

From the Meng et al. study quartiles:

Quartile	MHR Range	Interpretation
Q1	≤ 0.0064	Lowest risk
Q2	0.0065 – 0.0093	Low-moderate
Q3	0.0094 – 0.0144	Moderate
Q4	> 0.0144	Highest risk

Your MHR = 0.010 falls in Q3, meaning moderate risk relative to that study’s population.

[RapAdmin]

And, the next most rational question:

What are some of the best ways to improve my ratio, given currently best scientific and clinical knowledge?

Excellent question — and you’re thinking about this exactly the right way.
The Monocyte-to-HDL-Cholesterol Ratio (MHR) is increasingly recognized as a composite biomarker reflecting systemic inflammation (via monocytes) and anti-inflammatory/antioxidant capacity (via HDL).
Improving the ratio means lowering monocytes and/or raising HDL, both of which overlap with cardiometabolic and longevity optimization.

Below is a comprehensive, evidence-based strategy set organized by mechanism.

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1. Lower Monocyte Count (Reduce Chronic Inflammation & Myelopoiesis)

Monocytes increase with chronic low-grade inflammation, insulin resistance, and certain stress or immune states.

Lifestyle & Nutrition

Strategy	Mechanism	Evidence
Adopt a Mediterranean or DASH-style diet	Lowers systemic inflammation and leukocyte activation	Multiple RCTs show reductions in CRP, IL-6, and monocyte activation markers
Reduce refined carbs and fructose	High glycemic load stimulates NF-κB–mediated inflammation and monocytosis	Clinical and mechanistic data
Intermittent fasting / time-restricted eating	Lowers inflammatory monocytes and improves immune cell regulation	Animal & early human studies (Brandhorst, Longo, et al.)
Regular aerobic + resistance training	Lowers inflammatory monocyte subsets (CD14++CD16+)	Exercise normalizes leukocyte distribution in metabolic syndrome
Maintain healthy weight / visceral fat reduction	Adipose tissue macrophage signaling drives monocytosis	Strong human epidemiology and mechanistic backing
Sleep optimization	Sleep restriction increases monocyte mobilization	Acute sleep loss data
Manage psychosocial stress	Chronic stress upregulates myelopoiesis	Strong mechanistic data; mindfulness and CBT reduce inflammatory monocytes

Targeted Supplements / Nutraceuticals

Compound	Typical Dose	Key Effects
Omega-3 fatty acids (EPA/DHA)	2–4 g/day	Suppresses monocyte adhesion and cytokine release
Curcumin (bioavailable forms)	500–1,000 mg/day	Reduces monocyte chemoattractant protein-1 (MCP-1)
Quercetin / Resveratrol	250–500 mg/day	Lowers TNF-α and IL-6; may reduce pro-inflammatory monocytes
Vitamin D optimization (25-OH D ~40–60 ng/mL)	Personalized dosing	Modulates innate immune activation
Magnesium repletion	~300–400 mg elemental/day	Reduces CRP, stabilizes leukocyte balance

Pharmacologic Interventions (when clinically indicated)

Agent	Mechanism	Evidence
Statins (e.g., atorvastatin, rosuvastatin)	Reduce monocyte activation independent of LDL lowering	Numerous clinical studies; pleiotropic anti-inflammatory effects
Metformin	Suppresses NF-κB signaling and monocyte ROS	Data in diabetics and longevity models
SGLT2 inhibitors (e.g., empagliflozin)	Anti-inflammatory, reduces oxidative stress	Cardiometabolic outcome trials
Colchicine (low-dose)	Blocks NLRP3 inflammasome; reduces leukocyte activation	COLCOT, LoDoCo2 trials show event reduction

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2. Raise HDL Cholesterol (and Improve HDL Functionality)

Lifestyle

Strategy	Effect Size / Mechanism
Exercise (esp. endurance training)	Increases HDL-C and improves particle efflux capacity
Weight loss in overweight individuals	Raises HDL proportionally to fat loss
Moderate alcohol (esp. red wine / polyphenols)	Raises HDL modestly; context-dependent
Smoking cessation	Raises HDL by 5–10 mg/dL within months
Replace saturated fats with mono- and poly-unsaturated fats	Raises HDL and improves functionality (oleic acid, omega-3s)

Supplements / Nutraceuticals

Compound	Typical Dose	Evidence
Niacin (nicotinic acid, NOT flush-free inositol hexanicotinate)	500–2,000 mg/day (monitor liver/glucose)	Potent HDL raiser, but outcome data mixed; use only if well-tolerated
Omega-3 fatty acids	2–4 g/day	Slight HDL increase, improves HDL function
Polyphenols (resveratrol, anthocyanins, green tea EGCG)	—	Improve HDL particle efflux capacity
Taurine (1.5–3 g/day)	Modestly raises HDL and improves hepatic lipid metabolism

Medications (for selected clinical contexts)

Drug	Comment
Statins	Small HDL rise but improve HDL functionality
CETP inhibitors (experimental / discontinued)	Potent HDL-raising but mixed clinical outcomes
Fibrates (e.g., fenofibrate)	Raise HDL modestly, especially in low-HDL phenotypes
SGLT2 inhibitors / GLP-1 agonists	Mild HDL increase; strong metabolic benefits

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3. Integrative Target Goals

Marker	Target / Optimal Zone	Rationale
MHR	ideally < 0.009 (Q1–Q2 zone)	Lower inflammation, better cardiometabolic outcomes
Monocytes	~0.3–0.4 × 10³/µL	Low-normal physiologic range
HDL-C	≥ 55 mg/dL (men), ≥ 65 mg/dL (women)	Optimal for reverse cholesterol transport

With your current values
→ Monocytes = 0.50 × 10³/µL and HDL = 50 mg/dL → MHR = 0.010, sitting in Q3.
Lowering monocytes to 0.35 × 10³/µL or raising HDL to 60 mg/dL would shift you toward ~0.006, in the Q1–Q2 range.

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4. Summary: Evidence-Driven Core Moves

High-impact, low-risk steps:

1. Mediterranean-style, low-refined-carb diet rich in olive oil, fatty fish, and polyphenols.
2. 150–300 min/week of aerobic + 2×/week resistance training.
3. Optimize vitamin D, magnesium, and omega-3 status.
4. Maintain visceral-fat-free waistline and good sleep/stress hygiene.
5. If on a statin (you are, per prior context), it already lowers monocyte activation and helps the ratio.
6. Consider discussing with your physician whether low-dose metformin or SGLT2i (if metabolic markers justify) could further reduce inflammatory tone.

[Bicep]

Very helpful, thank you.

[desertshores]

Yes, the paper is a little confusing. I plugged in this query to ChatGPT5:
“https://onlinelibrary.wiley.com/doi/10.1002/brb3.70896# Analyze this paper and tell me what units they used for the MHR biomarker. Using their methods, tell me the MHR is using an HDL = 53mg/dL and monocytes = 4.7%.”
Using my latest lab results, I got: Answer: MHR ≈ 0.418
I hope ChatGPT 5 is correct because that number is near perfect.

[Bicep]

Very confusing. I used absolute monocytes instead of percent. Admin produced table that basically says the smaller the better and you need to be less than like .01. The graphs show smaller is better too, but are hard to read.

[desertshores]

[John_Hemming]

Reading the topic but not the paper it looks like the absolute number is the key.

[RapAdmin]

Yes, use the absolute monocytes in the calculations.

[DeStrider]

My numbers are right there with you @RapAdmin. 0.6 Monocytes and 58 HDL. Something feels off as I am doing most of the interventions that they suggest and yet we are both in the third quintile. Something smells fishy.

[John_Hemming]

My monocytes tends to be in the range of 0.2-0.3 and HDL in your units around 70. Whether the ratio is more useful than looking at the individual levels or not I don’t know. I do have particularly low WBC most of the time and sometimes with a recent dose of rapa my total WBC goes below 2.

Sadly I don’t have much data from prior to when I started biohacking.

[LaraPo]

My MHR is 0.0044, which is very low. Is it a sign of low inflammation?

Monocytes absolute: 0.42 times10^9/L
HDL cholesterol: 95 mg/dL

[RapAdmin]

@DeStrider

My numbers are right there with you @RapAdmin. 0.6 Monocytes and 58 HDL. Something feels off as I am doing most of the interventions that they suggest and yet we are both in the third quintile. Something smells fishy.

I tend to agree. I suspect that perhaps the ezetimibe and bempadoic acid are making things a little more complex here, and perhaps resulting in misleading numbers. I ran out of Ez and BA recently and redid my blood tests and I’ve dropped (by this calculation) down to the 2nd level of risk (“low to moderate risk”)… but my LDL-C went from 46 to 89. I’d rather have the lower LDL-C…

[desertshores]

@DeStrider

0.6 Monocytes and 58 HDL

What does 0.6 monocytes represent? In my results, it is expressed as a percentage, which is required to make the calculation. Does 0.6 represent 60%
The equation needs absolute monocytes.
Mine -

My MHR calculated by ChatGPT5 (paid thinking mode.

Your MHR (using HDL = 53 mg/dL; absolute monocytes = 573)

1. Convert HDL to mmol/L:
   53 mg/dL × 0.02586 = 1.3706 mmol/L. NCBI
2. Express monocytes in ×10³/µL:
   573 cells/µL = 0.573 ×10³/µL.
3. Compute MHR:
   4.MHR = 0.573 ÷ 1.3706 ≈ 0.418*.

Answer: MHR ≈ 0.418 (unitless ratio, using monocytes in ×10³/µL and HDL in mmol/L).

Note: If your lab already reports “absolute monocytes” in ×10³/µL (e.g., 0.573), use that directly in step 2

[desertshores]

I think the problem lies in using the correct units. Using the units you provided and plugging it into the formula results in=
To calculate MHR using the provided values:

Given:

• Monocytes = 0.600 ×10³/µL
• HDL = 53 mg/dL

Step-by-Step Calculation:

1. Convert HDL from mg/dL to mmol/L:
   Formula: HDL (mmol/L)=HDL (mg/dL)×0.02586\text{HDL (mmol/L)} = \text{HDL (mg/dL)} \times 0.02586HDL (mmol/L)=HDL (mg/dL)×0.02586
   53 mg/dL×0.02586=1.3706 mmol/L53 , \text{mg/dL} \times 0.02586 = 1.3706 , \text{mmol/L}53mg/dL×0.02586=1.3706mmol/L
2. Calculate MHR using the formula:
   MHR=Monocytes (×10³/µL)HDL (mmol/L)\text{MHR} = \frac{\text{Monocytes (×10³/µL)}}{\text{HDL (mmol/L)}}MHR=HDL (mmol/L)Monocytes (×10³/µL)​
   MHR=0.6001.3706≈0.438\text{MHR} = \frac{0.600}{1.3706} \approx 0.438MHR=1.37060.600​≈0.438

Final Result:

MHR ≈ 0.438

[desertshores]

@LaraPo

My MHR is 0.0044, which is very low. Is it a sign of low inflammation?

To calculate MHR with the given values:

Given:

• Monocytes = 0**.42 × 10⁹/**L
• HDL = 95 mg/dL

Step-by-Step Calculation:

1. Convert HDL from mg/dL to mmol/L:
   Formula: HDL (mmol/L)=HDL (mg/dL)×0.02586\text{HDL (mmol/L)} = \text{HDL (mg/dL)} \times 0.02586HDL (mmol/L)=HDL (mg/dL)×0.02586
   95 mg/dL×0.02586=2.4517 mmol/L95 , \text{mg/dL} \times 0.02586 = 2.4517 , \text{mmol/L}95mg/dL×0.02586=2.4517mmol/L
2. Convert monocytes from ×10⁹/L to ×10³/µL:
   0.42×109 cells/L=0.42×103 cells/µL=0.42 ×10³/µL0.42 \times 10^9 , \text{cells/L} = 0.42 \times 10^3 , \text{cells/µL} = 0.42 , \text{×10³/µL}0.42×109cells/L=0.42×103cells/µL=0.42×10³/µL
3. Calculate MHR using the formula:
   MHR=Monocytes (×10³/µL)HDL (mmol/L)\text{MHR} = \frac{\text{Monocytes (×10³/µL)}}{\text{HDL (mmol/L)}}MHR=HDL (mmol/L)Monocytes (×10³/µL)​
   MHR=0.422.4517≈0.171\text{MHR} = \frac{0.42}{2.4517} \approx 0.171MHR=2.45170.42​≈0.171

Final Result:

MHR ≈ 0.171

[desertshores]

I don’t think your query to ChatGPT got the correct answer.
Using my query, your results are:
To calculate MHR with the given values:

Given:

• Monocytes = 0.50 × 10³/µL
• HDL = 50 mg/dL

Step-by-Step Calculation:

1. Convert HDL from mg/dL to mmol/L:
   Formula: HDL (mmol/L)=HDL (mg/dL)×0.02586\text{HDL (mmol/L)} = \text{HDL (mg/dL)} \times 0.02586HDL (mmol/L)=HDL (mg/dL)×0.02586
   50 mg/dL×0.02586=1.293 mmol/L50 , \text{mg/dL} \times 0.02586 = 1.293 , \text{mmol/L}50mg/dL×0.02586=1.293mmol/L
2. Calculate MHR using the formula:
   MHR=Monocytes (×10³/µL)HDL (mmol/L)\text{MHR} = \frac{\text{Monocytes (×10³/µL)}}{\text{HDL (mmol/L)}}MHR=HDL (mmol/L)Monocytes (×10³/µL)​
   MHR=0.501.293≈0.386\text{MHR} = \frac{0.50}{1.293} \approx 0.386MHR=1.2930.50​≈0.386

Final Result:

MHR ≈ 0.386

[RapAdmin]

But those numbers don’t seem to really make sense given the research study ranges (or we are all way high in the range, which seems unlikely):

Here is how my blood tests convey the monocyte measures:

From the Meng et al. study quartiles:

Quartile	MHR Range	Interpretation
Q1	≤ 0.0064	Lowest risk
Q2	0.0065 – 0.0093	Low-moderate
Q3	0.0094 – 0.0144	Moderate
Q4	> 0.0144	Highest risk

[LaraPo]

Thus is what I get:
• Monocytes absolute: 0.42 ×10⁹/L
• HDL cholesterol: 95 mg/dL

Since MHR is a unitless ratio, you can directly divide:

\text{MHR} = \frac{0.42}{95} \approx 0.00442

Why It Works

Even though monocytes are in \times 10^9/L and HDL is in mg/dL, the ratio is used as a relative marker, not a strict molar comparison. It’s meant to reflect the balance between inflammatory cells and anti-inflammatory lipoproteins, so the units are left as-is in clinical practice.

[LaraPo]

I also recalculated MHR for your numbers and got the following:

Let’s calculate your Monocyte-to-HDL Ratio (MHR) using the values you provided:

Your Inputs

• Monocytes absolute: 0.50 \times 10^3/\mu L = 0.50 \times 10^9/L
• HDL cholesterol: 50 mg/dL

MHR Formula

\text{MHR} = \frac{\text{Monocyte count}}{\text{HDL cholesterol level}} = \frac{0.50}{50} = 0.01

Result

Your MHR is 0.01

Interpretation

An MHR of 0.01 is considered low, which generally suggests:

• Low systemic inflammation

[DeStrider]

Here’s the lab report for monocytes. I have both a percentage and absolute numbers.