cholesterol levels -- statin or diet?
xrj22
Posts: 217 Member
I just got my cholesterol labs back. Total cholesterol 268, LDL 180, HDL 67 (at least something is OK), trig 113. I admit that I am 40 lbs above my ideal weight, and my diet hasn't been good recently. But these look really bad and pretty shocking. I haven't talked about them with my doctor yet. I really want to try to do this naturally. I am crazy to ask for a chance to do that first. Or, am I just destined for a statin? (56 y.o. female, otherwise healthy if that makes a difference).
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Replies
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You definitely are not “crazy” to try lifestyle changes first. And chances are that your doctor will be very pleased for you to make those changes, because they have benefits beyond just lowering your cholesterol.
Just be sure to get your lifestyle change advice from reputable sources, not some rando on the internet. (It’s not lost on me that I am a rando on the internet, advising you on lifestyle changes)
If your insurance covers it, it’s worthwhile to consider talking to a registered dietitian.
Exercise is also important, and has wonderful benefits for lowering your cholesterol levels too.
You may want to seek advice from someone who is a personal trainer, but be sure to ask what certifications they hold. Some are better qualified than others.
And, in the end, after you have done all that, and are continuing those lifestyle habit changes? If your medical professional still advises a prescription to help lower your cholesterol? Go for it.
My 2¢ anyhow4 -
Work on diet for 6 months then re test.5
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If your medical professional advised statins then use them and try the lifestyle changes you might find you can stop the statins in a few months after making those changes.
Safer to take them if they say you need them.0 -
Total cholesterol for the US population was much higher back in the 70's for example and today we have more heart disease despite better medications. What someones LDL is is not a very good indication (proxy) of heart health simply because there's many other factors that are much more important. With the decrease in total cholesterol over the decades with most always being LDL, heart disease should have been reduced as well if one was to believe they are correlated. Also studies show that most people that have had a heart related event have LDL levels within the acceptable levels, which is a little confusing if one was to believe higher cholesterol was progressive and caused heart disease.
To actually see if you have any plaque (disease) you can request from your Doctor to get a CAC (coronary artery calcium) score and then you'll know for sure. Just to be clear, unless the arteries are compromised and have had some injury from inflammation that creates a lesion the probability of heart disease is in the lottery ticket neighborhood of probably not going to happen. Your triglyceride level of 113 also does not indicate that the phenotype of LDL that is more atherogenic is prevalent which are the small dense LDL particles, so that is a good thing and considering most people's HDL in the US is under 40 your HDL at 67 is actually considered protective against heart disease. If a person wants to reduce their risk of heart disease then consuming more whole foods with an emphasis on quality protein and reducing the amount of sugar and refined carbs that are actually the causality for inflammation would be some pretty basic and foundational advice for our overall health in general and not just for the heart and this is only in relationship to the diet and not other lifestyle interventions that also contribute to lower the probability of increased heart disease.
Score of 0: No calcium detected, indicating a low risk of heart disease.
Score of 1-99: Small amount of calcium, suggesting mild heart disease risk.
Score of 100-399: Moderate amount of calcium, indicating a moderate risk of heart disease.
Score of 400 and above: Large amount of calcium, suggesting a high risk of heart disease
Unfortunately we have been programmed to think LDL causes heart disease and have accepted that statins are one of our only hopes at reducing our chances of dying of heart disease which statins when we look at absolute risk as opposed to relative risk, do pretty much nothing to actually reduce that risk. A few years ago there was a push by the pharmaceutical industrial complex to have children automatically take statins based on the idea that early prevention could help to reduce the progression of heart disease. Fortunately regulations of that nature need to go though rigorous testing and cooler heads prevailed (actual science) to the chagrin of Pfizer and Merck and AstraZeneca.
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tomcustombuilder wrote: »Work on diet for 6 months then re test.
Second.0 -
Weight-loss alone could improve your numbers. Diet could too.
Not that they're that disastrous anyway (high HDL and normal trigs).0 -
I don't have recommendations, but do have anecdote.
I was in a similar situation, except that it had been a problem for quite some time. I kept telling my doctor I didn't want to take the statin. (I thought I'd already given up enough cognitive bandwidth to chemotherapy, and statins have a potential for brain fog.) I tried various changes in what I ate, tried some supplements, was very active exercise-wise. None of that moved the blood test results more than trivially.
Cholesterol tested in November 2014 at 230, HDL 45, LDL 146, VLDL 39, triglycerides 193. Cholesterol ratio was 5.1, considered to be elevated risk. (Those weren't my highest numbers ever, either.)
Finally, I committed to losing weight, to see if that would help. By November 2015, I'd lost around 50 pounds. Total cholesterol was 176, HDL 65, LDL 95, VLDL 16, triglycerides 82. Ratio was 2.7, considered ideal. (That VLDL level was actually below the lab's normal reference range.)
There had been great improvement - numbers almost all within in the normal range - by halfway through weight loss, around June of 2015.
Eight, almost 9 years later, all those numbers have stayed solidly normal. At my last appointment, my doctor called my cholesterol numbers "phenomenal", and said she wished everyone's were like that.
Pretty much all I did was lose weight. I obviously changed portion sizes and frequencies of some calorie-dense foods to lose that weight, but I still was eating the same range of foods. (I was already eating primarily whole foods, but too much of them.) I didn't materially increase exercise, because I was already active. I didn't start taking relevant new supplements, or make any other relevant change that I know of.
Obviously, I can't say this will happen for others, but I think this at least illustrates that it potentially can happen. I think I don't have familial hypercholesterolemia (genetic tendency to high cholesterol), which I'm sure is relevant.
Losing weight, improving nutrition, and getting regular exercise are all potentially useful interventions that can lower cholesterol. I'd also say that losing weight and getting regular exercise (which I'd started doing about 12 years earlier, in my late 40s) caused really major quality of life improvements other than the cholesterol improvements, besides . . . some of which I never would have predicted, until I experienced them.
No matter what, all of those interventions are worth doing, and if your experience is like mine, they'll be big improvements (after they settle in, since there can be some challenges along the route, of course).
Best wishes!
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AnnPT77 THANK YOU for sharing! That is really inspiring.2
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Re diet:
Since then, however, research has shown that most of the cholesterol in our body is made by our liver — it doesn't come from cholesterol we eat. The liver is stimulated to make cholesterol primarily by saturated fat and trans fat in our diet, not dietary cholesterol. But a large egg contains little saturated fat — about 1.5 grams (g). And research has confirmed that eggs also contain many healthy nutrients: lutein and zeaxanthin, which are good for the eyes; choline, which is good for the brain and nerves; and various vitamins (A, B, and D). In fact, just one large egg contains 270 international units (IU) of vitamin A and 41 IU of vitamin D. One large egg also contains about 6 g of protein and 72 calories.
https://www.health.harvard.edu/heart-health/are-eggs-risky-for-heart-health0 -
Retroguy2000 wrote: »Re diet:
Since then, however, research has shown that most of the cholesterol in our body is made by our liver — it doesn't come from cholesterol we eat. The liver is stimulated to make cholesterol primarily by saturated fat and trans fat in our diet, not dietary cholesterol. But a large egg contains little saturated fat — about 1.5 grams (g). And research has confirmed that eggs also contain many healthy nutrients: lutein and zeaxanthin, which are good for the eyes; choline, which is good for the brain and nerves; and various vitamins (A, B, and D). In fact, just one large egg contains 270 international units (IU) of vitamin A and 41 IU of vitamin D. One large egg also contains about 6 g of protein and 72 calories.
https://www.health.harvard.edu/heart-health/are-eggs-risky-for-heart-health
This has been known for over 50 years and it's because dietary cholesterol is hydrophobic and just can't be deposited into the blood stream directly and the reason why dietary cholesterol has little effect on our blood levels.
In the lining of our small intestines are what's called chylomicrons which are a type of lipoprotein (which carry cargo) and the dietary cholesterol is transported through the lymphatic system then through to the blood stream and eventually to the liver where it's then taken up. If someone consumes a lot of cholesterol the liver makes less and if a person doesn't eat any or very little the liver makes more, pretty simple. The quality or type of the manufactured cholesterol in the liver as it pertains to HDL and LDL are primarily lifestyle and genetic factors and not based on dietary cholesterol and the USDA removed the restriction for cholesterol in 2015 finally and considering no other Country ever had a mg daily restriction on cholesterol they probably thought they better reconsider the actual science, and old science at that.1 -
Look in to Hibiscus tea. In some double blind studies it has been shown to be as effective as statins at lowering cholesterol. Definitely follow your doctors advice and take any advice they give you, BUT adding some tea can't hurt. Also super high in anti oxidants so helps with many health measures0
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Trust your instincts. That inner voice.. that hints to what is right for you. If that voice tells you.. "lose weight and try eating the right foods.. then recheck before going on a lifetime drug." I'd listen to that. Or if the voice tells you to take them..that they are needed right now.. do that.2
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As someone who takes a statin, I would definitely say work on diet, weight, exercise first if you can and with the support of your doctor.
I did that and lost some weight. Numbers barely moved and went on a low dose statin. Then quit smoking, started exercising regularly, weight was stable and numbers dropped significantly. Cut dosage, checked in six months and numbers back up. So back on small dose again. There are hereditary issues with high cholesterol for me.
What I am saying is try it but know it might not work for you. But it might work great. Just make sure whatever you choose is something you can do consistently for the long term.2 -
All These comments were so helpful. I'm nearly 73. My LDL number came back at 290. My Dr. Appt. is tomorrow and I know he is going to suggest medication. I absolutely do not want to do that, but I don't want to have a stroke, either. I could not sleep last night. After reading your comments I now have a plan and feel so much better about making changes to reduce the LDL number. Thank you.5
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