Need feedback on my LDL

CeeBeeSlim
CeeBeeSlim Posts: 1,348 Member
in Health and Weight Loss
Hi. I received two very reactions from two docs (one internal medicine and one cardiologist) about my LDL score of 155. The IM doc said it’s high, not too high, no meds needed, suggested ashwaganda tea. The cardio told me that he knows nothing about the tea, wants me to get a cat scan for calcium deposits, and if any there, go on a statin. The cardio think that’s the high LDL is genetic (he treats both my parents, one is on Repatha). How concerning is the 155? The last doc kinda freaked me out with his very cautionary tone. I’m 56, 5’3, no health issues but for some lower back pain, 140, trying to get to 130. Thoughts?

Replies

  • earlnabby
    earlnabby Posts: 8,171 Member
    Get another opinion. How is your total cholesterol? What is your Chol/HDL ratio? There is more to look at than just the LDL. The scan sounds like a good idea so you have a baseline to work from.

    If you can, try to find alternative therapies to statins (and I am NOT referring to tea and other woo). Will losing weight help? Is there an eating plan that will help? Long term use of statins is known for putting a person at a higher risk of developing T2Dm BUT if you need them, you need them. Health decisions can sometimes be a balancing act. Are the health risks with them worse than the health risks without?

    Gather as much information as you can.
  • Luke_rabbit
    Luke_rabbit Posts: 1,031 Member
    If this were me, I would approach it this way.

    1. Figure out if I can afford the CAT scan. If yes, get that done. If no, ask the doctor what lifestyle changes would be recommended if the CAT scan showed that I had calcium deposits.

    2. Evaluate my current diet and lifestyle against recommendations for lowering LDL. Can I make changes? If yes, do so, and get regular follow up blood tests. See if the number improves. However, if I can't make changes or don't see improvements from changes I do make, then try the medication (after looking carefully at risks) and see if that brings about better numbers.

    Good luck.
  • amiller92873
    amiller92873 Posts: 7 Member
    1. yes genetic factor
    2. What is your ratio? Current research suggests the ratio is most important. I have high cholesterol but my HDL is very high and my ratio is good. So I ignore anybody that tries to scare me and push me on a drug I don't need.
    3. Psyllium fiber!! Doc wondered what I did different to lower mine. That was all.
    4. And of course good diet and exercise.
    5. Just my opinion. Do your own research but definitely don't let them freak you out.
  • NovusDies
    NovusDies Posts: 8,940 Member
    edited November 2019
    The calcium test is what will determine if you need to be more aggressive or not. Be prepared to do an echo and a stress test if the calcium test comes back with plaque in your artery/arteries. As it was explained to me the amount of calcium by itself is not a true indicator of the degree of blockage. A moderate or high amount can be "tightly" packed. Where a low amount can be loosely packed. The stress test will show how volume is being moved around.

    If you have blockage but not enough to warrant surgery your cardiologist will put you on a statin to not only lower your cholesterol but greatly lower it. This is meant to pack it down.

    Now keep in mind I am not a medical professional and you are getting information told to me that I have interpreted in my own terms. That is not a reliable way to sort this out for yourself.

  • corinasue1143
    corinasue1143 Posts: 7,464 Member
    Exercise. Fiber. Less sugar.
    I’m not a Dr., so won’t advise about that part.
  • r2cool986
    r2cool986 Posts: 3 Member
    Trust me, no need to freak out. I had the same issue, but you need to look at more than just the LDL to get a better picture of whats going on in your body. I highly recommend watching on Youtube, Dr. Berg explaining how high LDL is not too bad if you take in to account your HDL and total Cholesterol counts.

    Here is the link, https://youtu.be/C6SVB99mJHA
  • psychod787
    psychod787 Posts: 4,099 Member
    r2cool986 wrote: »
    Trust me, no need to freak out. I had the same issue, but you need to look at more than just the LDL to get a better picture of whats going on in your body. I highly recommend watching on Youtube, Dr. Berg explaining how high LDL is not too bad if you take in to account your HDL and total Cholesterol counts.

    Here is the link, https://youtu.be/C6SVB99mJHA

    Dr. Berg? Wth? What was your hdl? The ratio is important too.
  • lorrpb
    lorrpb Posts: 11,463 Member
    edited November 2019
    In general, I’d take the opinion of the specialist. That’s their job.

    If your IM is not concerned and you have no other health problems, why did you even see a cardiologist? That’s not typical.

    Either 1-your IM was concerned enough to refer you to cardiology, in which case you should follow his advice, or 2-you were already seeing the cardiologist for another reason, in which case you should take his advice.
    One doctor recommends tea and the other considers your family history and orders objective tests. Which one should you listen to?🤔
  • NovusDies
    NovusDies Posts: 8,940 Member
    psychod787 wrote: »
    NovusDies wrote: »
    r2cool986 wrote: »
    Trust me, no need to freak out. I had the same issue, but you need to look at more than just the LDL to get a better picture of whats going on in your body. I highly recommend watching on Youtube, Dr. Berg explaining how high LDL is not too bad if you take in to account your HDL and total Cholesterol counts.

    You seem to have a sketchy youtube education. Are you actually suggesting that you should be trusted over the OP's cardiologist?

    Isn't "Dr." Berg a Chiropractor?

    If he can crack a back he can crack the myth on cholesterol, right?
  • CeeBeeSlim
    CeeBeeSlim Posts: 1,348 Member
    Thanks Everyone. I will do more research and go for the cat scan. Ugh. Was just confused and then shaken by the “shrug” response of one doc and then the very cautionary tone of the other.

    @earlnabby and amiller92873 - my ratio is 2.78 (259 total, 93 hdl). I’ll have to learn more about what this means.

    @lorrpb - I was accompanying my parents’ to their cardio appt and when we reviewed their cholesterol results, he turned to me (not a patient of his), and asked “by the way, do you ever check yours”. Once I shared what I thought would my ok numbers, that’s when he suggested I see him...ASAP. I’m thinking he knows my folks well and was being extra cautious (?) since he knows I’m their primary caretaker.

    Thanks, All.
  • CeeBeeSlim
    CeeBeeSlim Posts: 1,348 Member
    Ooops -

    @amiller92873 see above. Thanks!
  • Itmustbu
    Itmustbu Posts: 19 Member
    I believe there are 4 or 5 different types of ldl lipoprotein so you need to find out which one is causing your elevated level. Apo b is the one you do not want. Having a high level hdl is awesome. I am guessing you are young and just have naturally high cholesterol

    I would let them do the test but before I took any statin or fenofibric acid I would ask about niacin (vitamin b3)

  • Azdak
    Azdak Posts: 8,281 Member
    Under 100 is considered ideal, over 160 is considered high. In between is more subjective and will depend your individual context.

    In your case, a 93 hdl would likely be considered more protective.

    A cardiologist is likely to be more knowledgeable about lipid issues than an IM doc.

    The scan is an ultrafast ct scan that is looking for calcium deposits in the coronary arteries. It’s used as an initial screening tool because it is easy and inexpensive. However, the relationship between calcium deposits and clinically significant artery disease is not precise. Scores at the extreme ends are more reliable, but it does result in a number of false positives which would likely result in more expensive diagnostic tests.

  • lorrpb
    lorrpb Posts: 11,463 Member
    CeeBeeSlim wrote: »
    Thanks Everyone. I will do more research and go for the cat scan. Ugh. Was just confused and then shaken by the “shrug” response of one doc and then the very cautionary tone of the other.

    @earlnabby and amiller92873 - my ratio is 2.78 (259 total, 93 hdl). I’ll have to learn more about what this means.

    @lorrpb - I was accompanying my parents’ to their cardio appt and when we reviewed their cholesterol results, he turned to me (not a patient of his), and asked “by the way, do you ever check yours”. Once I shared what I thought would my ok numbers, that’s when he suggested I see him...ASAP. I’m thinking he knows my folks well and was being extra cautious (?) since he knows I’m their primary caretaker.

    Thanks, All.

    Thank you for sharing the context. Genetic LDL is a thing, so since he knows your genetics he chose the more cautious approach. It makes sense to follow through. Either you find out out there’s nothing to worry about, or you find out you there’s a potential risk that should be addressed now to help prevents future problems. It’s a no-lose situation aside from the time and co-pays for the test.
  • corinasue1143
    corinasue1143 Posts: 7,464 Member
    I’m guessing the cardiologist is seeing the “whole” picture, including your parents complete history. I’m from a very small town, and my family Dr. started talking to me about high blood pressure when I was 15 and my dad had a heart attack. Not seriously, just a little “this is where you don’t want to be like dad. Rather, learn from him.” I haven’t had high blood pressure or heart trouble yet. I’m 70. But I started making small adjustments very early to prevent it. I hope the cardiologist wants to do the same for you.
  • psuLemon
    psuLemon Posts: 38,428 MFP Moderator
    LDL doesn't have a strong correlation to heart attacks or other issues.

    What does your triglycerides, CRP, a1c, and fasting glucose look like?

    I have high ldl (never less than 99), and so do both my parents. There is no cvd or heart attacks in my family.
  • psuLemon
    psuLemon Posts: 38,428 MFP Moderator
    psychod787 wrote: »
    r2cool986 wrote: »
    Trust me, no need to freak out. I had the same issue, but you need to look at more than just the LDL to get a better picture of whats going on in your body. I highly recommend watching on Youtube, Dr. Berg explaining how high LDL is not too bad if you take in to account your HDL and total Cholesterol counts.

    Here is the link, https://youtu.be/C6SVB99mJHA

    Dr. Berg? Wth? What was your hdl? The ratio is important too.

    I won't watch Dr. Berg because i cant stand his videos, but if the general premise is that there are different types of LDL and alone, its not a good indicator, I would agree. Especially if a person doesn't have a family history of heart attacks, and their triglycerides, a1c, CRP and fasting glucose are good.
  • goldthistime
    goldthistime Posts: 3,213 Member
    CeeBeeSlim wrote: »
    Thanks Everyone. I will do more research and go for the cat scan. Ugh. Was just confused and then shaken by the “shrug” response of one doc and then the very cautionary tone of the other.

    @earlnabby and amiller92873 - my ratio is 2.78 (259 total, 93 hdl). I’ll have to learn more about what this means.

    @lorrpb - I was accompanying my parents’ to their cardio appt and when we reviewed their cholesterol results, he turned to me (not a patient of his), and asked “by the way, do you ever check yours”. Once I shared what I thought would my ok numbers, that’s when he suggested I see him...ASAP. I’m thinking he knows my folks well and was being extra cautious (?) since he knows I’m their primary caretaker.

    Thanks, All.

    I'm happy to hear you are getting the cat scan to check for calcium. My husband has a genetic condition (same as Bob Harper of Biggest Loser) such that he has an elevated lipoprotein(a). I mention it because Repatha is one of the drugs they use to treat it (you mentioned it in your first post). I follow a forum for people with elevated Lp(a) and they have led me to believe that the calcium score is your most accurate predictor of CVD risk.

    Hoping yours comes back zero, and you and your cardiologist can relax.
  • earlnabby
    earlnabby Posts: 8,171 Member
    CeeBeeSlim wrote: »

    @earlnabby and amiller92873 - my ratio is 2.78 (259 total, 93 hdl). I’ll have to learn more about what this means.

    Anything under 5 is considered normal range for the ratio so your number is a good one. Definitely read more about what it means to you in conjunction with everything else.

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