Increasing LDL on OCPs

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Increasing LDL on OCPs

I have a 17 yo F seen by me in August in consultation for elevated cholesterol. In 2013 she had borderline elevated cholesterol at her PMD office, TC 190, LDL 129. She was placed on orthocyclen in May 2014 for irregular periods. There was no lipid profile done just prior to starting the OCPs. She came to me with a TC 238, LDL 160, HDL 70, TG 136 done in July '15. BMI is 96% as well. TFTs, HbA1c, insulin, LFTs are normal. I repeated fasting labs, and now the TC is 268, LDL 194, TG 122, HDL 68, apoA1171, apoB 136 and lipo (a) <10. Family history is very strong for early heart disease on the mother's side. This is the effect from the progestin, correct? OCP should be DC'd or switched I think, but to which one, if necessary? Thanks for your help.

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