Cholesterol (again)

[Crankin]

I think I've written about this twice, but now I am a bit frustrated.
Had my physical 2 weeks ago, and went for the fasting cholesterol blood work last Friday. Just checked my results on line, and nothing I am doing is working. My bad cholesterol (LDL) is now in the "high range," after years of being borderline. My good cholesterol (HDL) is through the roof good, and it went up (which is good) 20 points. The total went up 10 points, maybe driven by the HDL. It is so high that I don't want to state the number, but it is about the same as it was before I started cycling, was 20 pounds overweight, and had been slacking on the exercise.
I stopped eating red meat (beef, pork, veal) about 15 months ago. I would say 80% of my meals are vegetarian, the rest have fish or poultry. I rarely eat dessert and have a very limited amount of sugar in my diet. No soda or other inflammatory things. I eat avocado, blueberries, and nuts in small amounts daily, as well as a glass of red wine about 5X a week. You guys know how much I exercise... about 30-40 hours a month. The only thing I can't control is the amount of sitting I do at work, 3 days a week. I get up every 45 minutes, between clients, but I don't think people want a therapist who is standing up!
My PCP wasn't even going to test for this this year, but I said I wanted to see the results of my dietary changes. I am glad I inisisted. No history at all of heart disease in my mom's family, and even in my dad's family, my dad had a heart attack at about age 84. He had smoked for 65 years... his dad had a heart attack at about 60, but he was overweight, smoked, and drank a lot of hard liquor. That's it.
I am going to call to make an appointment to talk to my doctor, but I have been freaked out by heart disease since I was in my 30s and my uncle (by marriage) died of a heart attack at age 52. He had the family history from hell, so it's not the same, but I am trying not to catastrophize this, picturing my arteries closing up.
I would take meds if it's suggested, but every doctor I have seen has said no, because my ratio is good.
Just venting.

[emily_in_nc]

Crankin,

I can understand your frustration, but everything I've read lately says that the ratio and the total HDL is much more important than the total number. Some folks (and sounds like you are one of them) can do everything right and still end up with high cholesterol just based on their unique body chemistry, and no matter what you eat, how much you exercise, etc is not going to change that much. I'm no doctor, of course, but I suspect you have nothing to worry about. Hope your doctor agrees!

[OakLeaf]

I agree with Emily. Not a bad idea to talk it over with your doctor, but I wouldn't worry in the interim.

I know you don't eat a lot of carbs, even though you didn't mention that - what I've read lately is that it's carbohydrates, simple carbs especially, that are the biggest dietary driver of "bad" lipids. There's a lot of genetics involved in the totals, and as long as your ratio is so good, I wouldn't worry.

Hang in there.

[Helene2013]

shoots. that is always frustrating and I hear you on this as we do have cholesterol hubby and I but we are now in the upper normal range with changes we brought to our lives. But what our doctor ordered was a blood test (it is not automatic in my province anyway) to check how much fat is "attached" to your arteries. That is the newer test they do for those at risk. And our results were perfect. She was not worried about our numbers any longer but we still have to watch so keep the numbers there.

[Crankin]

Oak, I am not so rigorous on my carbs now, but it's probably 80-90% or more complex carbs when I do have them. The only time I have white anything (bread especially) is in a restaurant. When I stopped the Paleo I went back to eating the way I had for years, except now I eat no red meat.
I am going to ask about more specific blood work and maybe a consult with DH's cardiologist.

ETA: Got an appt. next Wednesday

[ny biker]

I agree that the ratio and high HDL are good signs, from what I've read. I hope things go well with the cardiologist.

[Catrin]

Those are both good signs, I've the same thing myself. The only way that I seem to be able to have enough good HDL is to have higher LDL.

Good luck with the consult and keep us posted!

[emily_in_nc]

Also, triglycerides are important. If yours are low, that's a good sign.

No matter what I do re. diet and exercise, I always have amazing cholesterol (so far): high HDL, low LDL, low overall, and low triglycerides. And my 81 year old mother does as well, so that's where I think genetics makes a big difference, especially since my mother eats a low-carb, meat-intensive diet, and I eat a low-meat, high complex carb, Mediterranean-style (but not exactly) diet. And she exercises almost not at all!

In this particular case, I think I won the genetic lottery.

[Crankin]

Sounds like you did, Emily. My mom had high cholesterol in the years before she died at 67, but it was driven by her liver disease.
My report didn't seem to have triglycerides, I will need to go back and see. I remember they were just Ok at one time, awhile ago.
My appointment next week is with my PCP, not the cardiologist. I am going to ask her first. I don't need a referral, so if I don't get what I want, I will just make an appointment with the one DH sees. It's a new young guy, and he knows his stuff. My PCP seems to, also, but I would rather be aggressive with this, than not.