VERY High Cholesterol (300+) - BUT, my ratio is good???

PDXContessa · January 2013

Just got my cholesterol test results. My total cholesterol has always been high, but now it's the highest ever and I admit, my eating habits have been sloppy as of late. (Cholesterol test was done 3 days after Christmas...maybe this is a factor, too?) However, this has always been the case with all my cholesterol tests - good HDL, good triglycerides, terrible LDL - it's just that I've never been over 300.

Anyway here are the results:

Total Cholesterol: 304 (impressive eh?) ugh
Triglycerides: 58
HDL: 68
LDL: 224

C-reactive protein: 2.1

From the online calculators that I have checked, my ratios are actually good, although my LDL certainly sucks.

Aside from the obviously high cholesterol, my older brother had a heart attack when he was my current age (52), so my doc sees this as a worrisome factor. However, my brother also has high blood pressure and I do not (my BP is usually around 110/70 or lower) and my resting pulse rate is around 65. (I'm not fit...really, I've been a couch potato for the past few years.) My mother also has high BP and high cholesterol. (She was put on high blood pressure meds in her early 20s and her weight has always been at a normal range - her siblings all have high BP, too.)

I'm 52 yo, 5'4" (female) and 148 pounds. My goal is to get down to 125lbs. I'm eliminating grains and trying to transition to a low carb/paleo eating plan. I'm eating almonds daily, avocados regularly, salmon a couple of times per week. I plan to start a vigorous walking regimen, too.

My doctor has wanted me on stains for several years (i've been ignoring her advice) and with the latest test result, she was really adamant. However, I asked her about the possibility of going off them after I have lost the weight and gotten into a regular exercise routine, then re-testing to see if my LDL cholesterol stays under control. She seemed agreeable to the idea.

She wants me on Lipitor 10 mg ASAP. I'm leaving for the pharmacy to pick it up as soon as I submit.

Questions:

Are these numbers odd? It seems like all my other numbers are so good, but the LDL is so bad. Is this just genetic? My c-reactive protein seems to be at an "intermediate level" should I be concerned about this? Since CRP indicates inflammation, does that mean ANY inflammation in the body. I've been dealing with TMJD, along with should and neck pain. Could those issues raise my CRP?

Comments/suggestions welcome. I've been searching for information online, but the info is so conflicting, it's hard to know what's BS and what's not.

I have my full blood-work results available if there are any other numbers I should consider.

TL;DR: VERY High Cholesterol / Good Ratio. What's up with that?

shlevon · January 2013

First, a disclaimer:

The nature of the questions you're asking would best be answered by a medical professional. Relying on internet people to give you (reliable) medical advice is probably not the path of wisdom. This includes me.

That said, I would be curious to see the specifics of your diet (it's not publically viewable). Obviously there can be a strong genetic component to all of this, so bear that in mind.

I will say that your numbers are typical of some (emphasis = some, not all people respond this way) people on low carbohydrate diets (i.e. high LDL, high HDL, and low triglycerides). As to how dangerous this is, it's hard to give a definitive answer, since most research on high LDL implicitly assumes the "usual" case of high LDL that tends to go along with low HDL and high triglycerides. The fact that your C-reactive protein levels are borderline is not totally awesome.

However, before getting carried away in that direction, the obvious question is...how do you eat? I just looked in your profile and you mention moving towards a paleo diet, so I am going to hazard a guess that my thinking above is probably correct. However, specifics (making your journal accessible) would be helpful.

PDXContessa · January 2013

Thanks for your response. Yes. I completely agree that I shouldn't be looking for medical advice on the internet, I'm just really curious about others opinions and experiences. I sent a friend request to you so you can see my food diary.

I have had high cholesterol since the first time it was checked, but my HDL and triglycerides have always been good enough that my RATIO calculated into the desirable range.

My mother was a compulsive dieter, so I've always been "aware" of healthy eating. I try to avoid sweets and refined carbs. I usually eat low fat meats like chicken or fish (and always have). I eat LOTS of salads and avoid all of the fatty toppings that make a salad unhealthy. Desserts around my house have always been an exception, not the rule.

I'm rather certain there is a genetic component. My mom has had a cholesterol level over 300 in the past and it runs in her family.

I will see my doctor again in 2 months. I'm just hoping to do enough reading and investigating to know what questions to ask her in February.

Cinflo58 · January 2013

HI,
Yes, your HDL looks good but the LDL is very high. I AM NOT SURE WHAT THE PALEO DIET IS BUT SOME CHOLESTEROL LOWERING FOODS ARE LEGUMES; ie cooked dried peas and beans, oatbran (oatmeal) if you use margerine, use Benecol or something with a plant stanol ester, fish, avacodo, olive oil and nuts and seeds in place of other fats. Also lots of fruits and vegetables.

Try a trial of diet for 3-6 months and if that doesn't help you may need meds. But discuss it woth your doctor. I know I hate taking pills but you have to discuss the pros and cons with your MD

emmaobscura · January 2013

I would suggest you have your thyroid levels checked.

PDXContessa · January 2013

@ cinflo58...

Hi...Yes...I'm already eating salmon twice a week. I eat almonds almost daily, etc, etc...
The benecol is a good idea. Thanks!

PDXContessa · January 2013

I would suggest you have your thyroid levels checked.

My doc did what I THINK was a full blood panel. Thyroid (TSH) was .91

shlevon · January 2013

Thanks for your response. Yes. I completely agree that I shouldn't be looking for medical advice on the internet, I'm just really curious about others opinions and experiences. I sent a friend request to you so you can see my food diary.

I have had high cholesterol since the first time it was checked, but my HDL and triglycerides have always been good enough that my RATIO calculated into the desirable range.

My mother was a compulsive dieter, so I've always been "aware" of healthy eating. I try to avoid sweets and refined carbs. I usually eat low fat meats like chicken or fish (and always have). I eat LOTS of salads and avoid all of the fatty toppings that make a salad unhealthy. Desserts around my house have always been an exception, not the rule.

I'm rather certain there is a genetic component. My mom has had a cholesterol level over 300 in the past and it runs in her family.

I will see my doctor again in 2 months. I'm just hoping to do enough reading and investigating to know what questions to ask her in February.

Taking a look at your journal, I agree that nothing really stands out. Some people do hyper-respond a bit to eggs (in terms of increases in LDL), but I'm not sure 3 eggs a day would be enough to jack up your LDL so high. I would be curious to see your saturated fat and cholesterol daily totals (you can change your custom settings to put these in there), I suppose.

My own experience was that I was having eggs (usually 3 a day) daily along with red meat (93% lean) and some butter. Removal of these items and throwing back in oat bran and with a bigger emphasis on healthy carbohydrate intake (fruits and tubers) dropped my LDL by ~80 points in a month. Of course, this is just my own n=1, and it's hard to project what would "work" in your case.

That said, I'd be a little hesitant were I you to jump straight to statins, given that the rest of your values are in line. In the least, I'd probably mess around on the dietary end of things to see if you can't move it in the right direction before resorting to medications. That is, of course, just my own (non-professional) opinion.

PDXContessa · January 2013

Thanks, this is helpful. My saturated fats are usually low and the only high cholesterol food I eat is eggs, but I thought the latest research indicated that consumption of cholesterol didn't change your actual blood cholesterol level? Maybe that's just for "most" people and I am one of the exceptions?? Something to consider.

goad4you · February 2013

I know this is rather late but I thought you might be interested in this link

http://www.marksdailyapple.com/forum/thread4723.html

It can explain everything better than I can but this is the gist of it.

Unless your doctor measured LDL directly using a VAP test, your LDL could be miscalculated because your Trig are under 100.
It is common for cholesterol tests to measure Total, Trig, and HDL directly and then use a formula(Friedewald formula) to calculate your LDL. This usually doesn't present a problem but when Trigs are less than 100, LDL calculations start to get wonky. There is another formula used called the Iranian Formula that does a much better job of measuring LDL when your trigs are below 100.

If you run through the numbers you can see that your doctor used the Friedewald formula to calculate your LDL.
BUT if you use the Iranian formula, your LDL comes out to be 186. That's a 38 point difference!

Anyway, I hope the link helps.

MorgueBabe · February 2013

Some people just naturally have high Cholesterol, regardless of their diet.

Mine is high. I don't eat red meat, I rarely eat anything fried, I eat no dairy. I'm on a huge egg kick now, but last I had it checked I wasn't. My mom and dad both had high cholesterol as does most of family.

You just may be one of those people that matter what you do diet wise, you are just going to have high cholesterol.

neanderthin · February 2013

More current studies are showing the vast majority of people that actually do have heart disease have LDL in the normal to low range.....under 100. The other factors that are also prevalent in that group are low to very low HDL, high triglycerides, high C-reactive protein, high blood pressure and LDL cholesterol that are classified as low dense ApoB type. The average VAP test is pretty useless for disclosing what type of LDL a person has. Getting an NMR test as opposed to a VAP test will show how many particles of LDL you have and current scientists seem to agree that LDL-P (particle) is a better indication of threat.

kanstulpants · February 2013

I would do some research on women and statins before you take any. There is not a lot of evidence that women receive the same benefits that men do from statins.

Some studies (Jupiter) show a risk reduction of about 50%, which sounds impressive. But what that really means, is that 2.1% of the women in the non-statin group suffered heart attacks or strokes, while only 1.1% of women in the statin taking group did.

http://www.reuters.com/article/2012/01/31/us-statins-idUSTRE80U1GN20120131

So, is it really worth the potential side effects when it really only lowers your risk by about 1% ?

shaquila11 · October 2013

I would STRONGLY suggest seeing a holistic physician if you haven't already. I agree that there is very likely a strong genetic component, but I think you could very likely benefit from some balancing. If your TSH is want you say it is you are definitely on the low side if you look at a functional range. you are not "clinically" low, but it is far from the ideal for optimal health. Hormones being off could certainly be part of the problem. My husband has genetically high cholesterol and his gp wanted to put him on statins at 29 years old! Needless to say we went for a 2nd opinion at Sherwood Family Medicine (HIGHLY reccommend them) and have seen great results. Judging by your name, you are in the portland area... might be worth the jaunt. They have both MDs and naturepaths on staff and all are amazing! We went with an MD because it is covered by our insurance but she still does tons of work with hormone balancing, food sensativities, etc and always tries natural approaches before drugs whenever possible. Our family has never been healthier!

CarynMacD · October 2013

My doctor has wanted me on stains for several years (i've been ignoring her advice) and with the latest test result, she was really adamant. However, I asked her about the possibility of going off them after I have lost the weight and gotten into a regular exercise routine, then re-testing to see if my LDL cholesterol stays under control. She seemed agreeable to the idea.

She wants me on Lipitor 10 mg ASAP. I'm leaving for the pharmacy to pick it up as soon as I submit.

VERY High Cholesterol / Good Ratio. What's up with that?

In 2010 my total cholestrol was 8.3%. My doctor initially sent me to a nutritionist to see if "diet" would help lower it. I trained hard for a year and watched my diet. I went from 77Kgs to 65Kgs and got my cholestrol down to 6.5% - Not enough!

You see, it seems like those of us who are genetically pre-disposed to high cholestrol may not be in a position to lower our cholestrol adequately with diet and exercise alone.... even though it does help. I eventually went onto statins at which time I thought "Yay! I can eat what I want." What a huge mistake!

After being on the statins for a while, not watching my diet, and putting 8Kgs of the 12 I lost back on my cholestrol only came down to 5.5%. This was around July this year. My doctor could see, just by my sheer size, that I had not kept up with my healthy living lifestyle and said it is a common mistake that most people make. Statins alone are not the fix, exercise and diet are key too.

I am getting it tested again at the end of November. So far I have lost 13Lbs, my goal is to loose 31Lbs by then (but I think that goal is a little unrealistic). Even if I get down by 20Lbs by then I will be happy and eager to see what my cholestrol reading is then.

Bottom line..... If you are genetically pre-disposed to high cholestrol, exercise and diet may not be enough, statins will be beneficial, but still keep up with correct eating and enough exercise as the statins alone will only have a small effect. I do recommend both, statins and good diet & exercise.

VERY High Cholesterol (300+) - BUT, my ratio is good???

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