Cholesterol, what the?

[ACG]

So my cholesterol was super high, 250, I don't have the breakdown of the HDL and LDL, yet, my doctor called me to say it was high and she wants me on a low dose statin. We talked about the side effects which she said were muscle aches. Then she talked about blood in my urine, I've always had blood in my urine, since forever, like in my 20's. During all my pregnancies, etc. (I'm 52 now). Had a urologist perform lots of tests, no conclusion as to why afte all those tests. So today I had to sign a release so that my records from previous doctors can be released to her (I've only seen the current doctor only wice in 2 years and only for physicals).

I don't like the idea of going on a statin.

I can't exercise any more than I do now, 5 days a week. (long rides on weekends, short rides during the week, or rowing)
I don't eat processed food, red meat or lots and lots of eggs or fatty foods.
No history of heart disease in my family, that I know of. Everyone lives to be well into their 90's.
I've lost 15lbs in the last 6 months, went froma size 12 to a size 8.
Don't smoke, never have.
Eat oatmeal almost every day.Eat Spinach 3 days a week. Do like my corn tortillas, eat only low fat cheese, do eat low fat greek yogurt, fat free milk, fish once a week.

The doctor seemed so intense on getting my other records, she didn't discuss the statin issue with me anymore. But I know she will once she gets my other information she'll bug me again to take a statin. I pulled up an old thread on statins, that had some great information, it was from 2011.

Any other advice?

[VeganBikeChick]

Would you really miss meat/dairy if you gave it up altogether? You certainly have a very healthy sounding diet. I'm wondering if you went all plant-based for a month (aka cholesterol-free) how your levels would look. Even if just to avoid going on statins. That being said, sometimes nothing but medicine can treat hypercholesterolemia. Doesn't hurt to try...

[Owlie]

I'd wait for the HDL/LDL breakdown. How are your triglyceride levels?

I am neither a doctor nor a pharmacist, but if you've got a healthy diet and minimal risk factors for heart disease outside the cholesterol (and that depends on your HDL/LDL), then the statin is your choice to take or not. While I'm all for better living through chemistry when appropriate, I'm also all for not taking something if you don't have to. You could try going vegetarian for a month or so, but my guess is that the source of your cholesterol isn't necessarily dietary.

(The risk of muscle issues with statins, if I'm remembering my pharmacology class properly, is pretty low.)

[OakLeaf]

Decent layperson's article here (hhttp://www.npr.org/blogs/health/2013/04/03/176145911/side-effects-prompt-patients-to-stop-statins-cholesterol), with links to research.

There's some evidence that high carb diets contribute to high cholesterol. Might try cutting down on the chips and switch to less processed foods. If you want to stay with the low fat diet, try to cut out stuff like "low fat cheese" and stick with foods that are naturally low in fat.

A lot of cholesterol is genetic, but if yours has suddenly skyrocketed that is a little concerning. What's changed?

[Crankin]

I wouldn't make any decisions until you know your ratio. I have had an elevated total cholesterol since I was about 45 (around 218-220), but my HDL is so good, which gives me a great ratio (from the years of exercising), in the end no one would put me on a statin. So, it gets flagged, but when someone really looks, they say just keep doing what I'm doing. I have no family history of cardiac disease. What I do know, is that eating more red meat and cheese does make it worse. I haven't had it done this year, yet (looking for a new doc). I eat *no* junk food, save for a now very occasional ice cream, and I've upped my fish intake.
My DH has been on various statins for 10 years. He has a family history from hell, had 2 stents put in around 9 years ago, and had been cycling for around 7-8 years when this happened. He did change his diet quite a bit. He has had no side effects at all, with very aggressive treatment.

[Blueberry]

This raises more questions than it answers - but they are definitely many of the questions I would be asking: http://well.blogs.nytimes.com/2014/05/05/a-new-womens-issue-statins/?action=click&contentCollection=Politics&module=MostEmailed&version=Full&region=Marginalia&src=me&pgtype=article

[SheFly]

I have a family history of heart disease and high cholesterol. I have had levels (total) as high as 300, and as low as 180. The past two tests (so one year) have me hovering around 233. Like others have said, that DOES NOT tell the whole story! My ratio of HDL:LDL has improved, despite the numbers getting higher. Like you, I can't exercise more - I ride 10-15 hours per week already. While my diet isn't GREAT, it also isn't terrible. I have been going to the same PCP for years, and she knows me well enough that for ME, this number, and the ratio is OK as is - no statins required. We've discussed it, I've had heart tests, and we agree that we will continue to monitor every 6 months, and keep tabs on where it is.

I have tried fish oil supplements daily, to no avail. I have cut lots of foods, and reduced amounts, all to no avail. For me, it is genetic, and something I need to try to manage as best as possible.

My dad has had 3 angioplasties and a heart bypass. My paternal grandfather died of a massive heart attack at 45, and his wife (my grandmother) the same at 65. My maternal grandfather was a double amputee from arteriosclerosis, and died of a heart attack at 65. It doesn't, genetically, get any worse :D.

My point is, that for YOU, maybe this is OK without going on a statin. Has it been high in the past? Can you talk to your doc to see what alternatives there might be - like changing your diet more, and then re-testing in 6 months? I would wait until you had ALL of the numbers before making any decisions, but remember that ultimately, the statin is YOUR choice.

SheFly

[GLC1968]

Did your doctor recommend statins without having the LDL/HDL breakdown as well? If so, I'd find a new doctor. Assuming they DID know the numbers, it's important that you know them too before making a decision like this.

My chol is well over 200...probably about 250 or so. My triglycerides barely register (less than 45) and my HDL is so high that the ratio is significantly better than 'optimal'. Additionally, my LDL particle size is large, meaning that it's not the dangerous type. If I'd gone off my total only and started taking statins, I'd be adding a crazy risk, screwing up my beautiful lipid profile and wasting money for zero reason. It is very important to know the whole story and do your own research. Many doctors today are still touting the 'lower your cholesterol at all costs and avoid all saturated fats'....ideas that are outdated and frankly, in many cases (not all, mind you), flat out wrong.

This blog post (Chris Kresser) links to the 2014 study where they compiled all previous data and analyzed it again:
http://chriskresser.com/new-study-puts-final-nail-in-the-saturated-fat-causes-heart-disease-coffin

[Catrin]

I concur with GLC, those numbers are very important. My chol is currently 230, not far from GLC, but my HDL is very high, my ratio literally couldn't be better and, as well, my triglycerides are only around 40. There is a lot more to look at than a single number.

Interestingly enough, when I was on a conventional American low-fat diet - my chol. was much lower, certainly. However my ratio was horrible, my trigs were very high, and my HDL was virtually non-existent (at one time it was 5). More and more research is coming out regarding the interaction of all of this. Don't go on the statins without more information. Perhaps that will prove to be your best choice, but perhaps not. If you doc isn't interested in providing more information - and I do encourage you to get the test where they look at the LDL particle size, find a new doctor who will.

[ACG]

Well people, you have been a wealth of information, so I thank you. Found lots of great articles.

I'm still waiting for my actual numbers, called the doctors office to get my numbers, waiting for a call back. I just want my numbers so I can go from there.

Will keep you posted.

[ny biker]

Well people, you have been a wealth of information, so I thank you. Found lots of great articles.

I'm still waiting for my actual numbers, called the doctors office to get my numbers, waiting for a call back. I just want my numbers so I can go from there.

Will keep you posted.

If you don't feel your current doctor is knowledgeable enough, make an appointment to review the full results with a cardiologist. I recently had an EKG and echocardiogram which found a couple of anomalies, and I was not able to get a good explanation of the results from the people at the primary care office who ordered the tests. I got a copy of the written report and took it to a cardiologist, who was able to explain them and assess what they meant in the context of my lifestyle and overall health history.

Good luck.

[BikeDutchess]

I had borderline cholesterol for years, and my LDL was not great either, but I resisted going on statins for a long, long time because my HDL was great and my Framingham risk score was low. It was not until I had some in-depth lipoprotein testing done, including particle testing, that I agreed that a statin made sense, especially in conjunction with my developing pre-diabetes. The specialist who tested said that with my lipoprotein pattern, it would be very unlikely that more exercise and nutritional modification would get the LDL to appropriate levels (and while not a sports fanatic, I wasn't exactly a couch potato either). The additional testing can be very revealing.

[Helene2013]

Reopening an old thread since the info is still good and why opening another one. hihi

We (hubby and I) had cholesterol tests done in March and it came up sooooo high for hubby that doc wanted almost to put him on statins. Mine was borderline and she wanted a recheck in 3 months' time. There was no way we'd go on Lipitor or the like before making serious changes to our life styles. Now...we can't excercise more than we actually do. So it needed to be on the food side.

We cut everything that was bad fat (chips, bacon, etc). We truly wanted to see if 3 months would make a difference in the numbers. She also wanted us to test for our api-lipo. If after all this the numbers stayed high, then we'd seriously think statins. But not before working hard at this "test".

Our numbers kept going up at every testing over the years.

So we did the test just 2 weeks ago and finally got the results. We are clear!!! In the safe zone. Both of us. The total is almost to mid-point but still too high for me and our Apo B is perfect, although we could be a notch lower.

But doctor is very happy that we opted for changing our food habits instead of going for the simple way: a pill!

In the process, I lost 12 pounds and hubby lost 7 (he does not really have much to lose but still did). Targeting another 20# for me but I may be pushing it a bit.

So yes, sometimes, changing your food intake choices, can improve your ratios. It is not easy. It would be so much more fun to munch on fried chicken, chips, etc...but being healthier weighs more on my scale than some of the food I had to drop....with the pounds I had over. :)

[Crankin]

Update on my situation with this. I did find a new doctor and had a physical last fall. My total cholesterol is even higher, but my HDL is even higher and LDL is the same. She in no way mentioned statins after hearing my lifestyle and family history. After the visit, I decided to forgo all red meat in my diet. I still eat chicken and fish, as well as some dairy, but I would say my diet is vegetarian 4/7 days. So, we will see how a year of this goes. I didn't eat that much red meat, but I did eat it. Upped the veggies, too.

[ACG]

Ladies, it's nice to know I'm not alone.
I lost 15 more pounds since doc visit a year ago.

And after my shocker I did some research and made a few changes. My doc didn't push me to be on drugs. I'm not a meat eater, I eat it but not every day. Maybe 2-3 times a week, not really a red meat eater either.

Hubby likes to fish, so we eat fish 1-2 times a week. I have lowered the amount of dairy I eat to almost none. I never was a chips/French fry kinda person. I went back to my spinach salads and have loaded them up with lots of other cut veggies or eat some kind of veggie soup for lunch.

My gyno suggested that due to my age and changing system, which is 1-2 periods a year, that there were multiple studies about cholesterol and menopause and this could explain the rise in cholesterol.

What it means? Well I gotta go back and get re-tested after my year of living with the changed diet, and I'll probably always have to watch and avoid high cholesterol foods.


http://www.everydayhealth.com/specialists/menopause/manson/qa/menopause-and-cholesterol/index.aspx

http://www.post-gazette.com/news/health/2014/07/15/Women-and-cholesterol-Study-sees-link-with-menopausal-changes/stories/201407150005

[Helene2013]

Thank you. Interesting articles. I am there myself at 52, last period was in October last year. Before this, it was on/off for a few months, lasting a day or 2. Cholesterol was always in the good, but higher range.

I always worked out (for the past 3 years I train about 6 days out of 7 and it is not light training), generally ate well - but too much of sweets/desserts. hihi Rarely red meat. I'm no steak person. Ground beef in spaghetti sauce but that is about it. Rarely a burger. I'm not into much fish (white non smelly one is fine but other than that, I just can't get it down the throat!), but lots of chicken white.

I only cut the "sugar" and no good fat and it seems to work as I did lose some 12 pounds since March. My cholesterol numbers did not go down drastically though. I checked the last result with the one of March (so 3 months ago) and it has improved. But no dreaming in colour that I can't go back to "dessert" and junk food or I'll be right back to square one. The good thing is that my apo-lipo B is right in the middle range. This is the test the doctor wanted done. It is an extra and not done automatically with the standard cholesterol check. More expensive to our plan (we are covered under this) and still something fairly new here as testing. Our genetic is bad on that side so she said it would be good to know. Those results to her would be more important than the total cholesterol. It'd give her an idea if our arteries are blocked, or carriers are at work. Ideally, you want the result number as down as possible. So being mid-range is normal, but I still would like to see it lower. It would means less chances of getting particles traveling and sticking to arteries. (wow... this is getting too technical I think). hihi

I'll keep working at this and go back late next spring to see how we did for that past year. It will probably be a life battle for hubby and I. The silence disease as they call it. Hoping by then to have another 10 pounds down. In no hurry to get there. Slowly but surely and still enjoy life instead of cutting down and then crashing into any food.

But I'm glad the doctor took the time to call us and meet us about it. Raised the flag even if we all hate getting news that something is wrong with the blood panel. We are lucky enough to have the time/tools to change our habits. Some will never see it coming, or take the steps to improve. I want to grow old...and active and healthy. If possible! At least it's my goal.

[shootingstar]

I've known people personally who are skinny...and have high chloestrol. So weight is not always a factor at all.

[Crankin]

Helene, not sure what the terms app-lipid a/b mean. Is this another way of referring to HDL and LDL? Without knowing the ratio of HDL/LDL your total # doesn't mean that much. My total was 250 :eek: last fall, but my HDL (good cholesterol) is so high at 90 that it makes my ratio really good and it can also bump up the total number.
Just wondering if this is referred to in a different way in Canada, or these are other proteins that I don't know about.
I am not one who craves sugar, but I have made a concerted effort to decrease it even more. I got laughed at the other day at work, when I refused a piece of very good cake celebrating a colleague's upcoming wedding. I'd say I have dessert once a week in the summer, because I do occasionally eat soft serve ice cream, and less at other times of the year. There are no sweets in my house, except fruit. I haven't eaten junk food (chips, fried foods) on any regular basis in 35+ years, when I had to lose 25 pounds. It worked, so I figured what good would that stuff do me? I am even more convinced that sugar causes inflammation, which can cause issues in the arteries, with all that I read, so it's not so hard for me to do this. However, I don't get dogmatic about it. I will not be restricting myself while on vacation that starts later today, especially as it includes 4 days of city walking and 6 days of hard cycling.

[Helene2013]

Crankin,
It is apo-lipo (known also as Apo B). I googled quickly a link for you so you can understand better. It is a "deeper" test - just blood drawn too to complete the basic blood panel used for cholesterol testing.

https://labtestsonline.org/understanding/analytes/apob/tab/test/

Our numbers seem to be different also. We don't read the 250, etc.

Total HDL/LDL is one reading. Then you have that Apo B one that is even "better" to understand where you truly are at. At least from my understanding with the doctor's discussion we had.

The total HDL/LDL is getting to be less and less a reference, at least from what my doctor said. I don't know much about all those numbers but know that we are in the right bracket. Just too high into that ok bracket so we will keep working at it. My total is at 4.1 (and max to reach to keep on "safe" side is 5.2)

the numbers in Canada are like this for basic testing. Have not checked for USA
http://www.statcan.gc.ca/pub/82-625-x/2012001/article/11732-eng.htm

[Crankin]

Thanks for doing the research for me! So, it is something different, but related. I think I will ask to get this done in the fall. My HDL/LDL ration is in the excellent category, despite my high total #. But, my LDL is borderline acceptable and my triglycerides are just OK. Like ACG, I can't exercise any more than I do, or there will be other health consequences and my diet, while always been good, is now just where I want it. Don't think I can deny myself any more than I do. I would take a statin if I had to. I have an irrational fear of CV disease.

[Boeo]

Much of the "scientific" research in favor of statins is flawed and fraudulent. The most reliable evidence has long tied statin use with memory problems, muscle disorders, liver damage, cataracts, nerve damage, pancreatitis, erectile dysfunction, brain dysfunction, diabetes, and with an increased risk of cancer and higher mortality (statins only somewhat reduce the risk of non-fatal heart attacks).

The physiological mechanisms of how statins do serious damage are also well understood, such as by their impairment of oxidative cell metabolism, the increase in inflammation and cell destruction, the lowering of cholesterol and steroid hormone production, the promotion of pancreatic injury, etc. - rather thoroughly explained in this scholarly article on how statins, and a cholesterol-lowering popular diet pill advertised by Dr. Oz, promote diabetes at How Statins & Garcinia Cambogia Side Effects Raise The Diabetes Risk (http://www.supplements-and-health.com/garcinia-cambogia-side-effects.html)

Yet despite of the existence of that scientific knowledge, the medical business and the public health authorities keep ignoring it and continue to recommend statins to diabetics and make claims that they have a low risk profile despite that they are also significantly linked to cancer and higher mortality (just look at the propaganda put out by the Mayo clinic on statin drugs: "the risk of life-threatening side effects from statins is very low"). And because of such medical propaganda, few people are aware that the medical claims of benefits of statins are mostly based on flawed and fraudulent "scientific" studies conducted by people with vested interests.

Also, older people with HIGH cholesterol live longer than those with low cholesterol levels (see above mentioned article for numerous scientific study references confirming this).

Because the cholesterol-heart disease theory, or rather medical dogma, is wrong, the use of statins is also wrong by logical extension. Statins have almost no real benefit in the very vast majority of users. They do more harm than good. It's a "scientific" scam.