Cholesterol - management of high cholesterol

My high cholesterol levels were picked up in my 20’s

My diet was incredibly clean, drank little alcohol, exercised 5 times a week and raced 3 out of every 4 weekends.
At the time I had no risk factors, didn’t smoke and never have being one of the big ones. So we decided just to monitor me.
I actually marginally increased my unsaturated fat intake as I was eating almost zero fat and my levels dropped slightly.

Over the years my cholesterol crept up, diet and exercise weren’t as good and my Mum developed high blood pressure, another risk factor.
So in discussion with the doc I opted to go onto a minimal statin dosage.
I don’t suffer from any muscle aches and I am supposed to have annual blood tests (note to self I’m overdue testing) to check not only my cholesterol levels but also my liver function as one of the side effects.

So far so good

I don’t believe the fat % numbers but I don’t have much else to go on.

My guess on body fat would be closer to 25% but I do not carry it evenly like when I was younger.

I’ve talked it over with my wife and am going to do the following, some because it has some medical backing, some because it feels the right thing to do, and some because I know it generally makes me feel better. Thanks for all the input on here, it has been helpful.

  • Go and see the cardiologist I have been referred to - won’t cost me anything and they should know a lot more than me. Worst case they recommend something I don’t want to do, best case they do more thorough testing and help clarify the situation
  • Change my diet, I’ve done it before on a major scale and know I have a minor intolerance to certain foods. Even if I make some tweaks, regardless of it impacting my cholesterol, it will generally help my energy levels and help me train/recovery. I do have to take care about weight loss though, that is what stopped me continuing with a number of the changes last time. Reviewing what I currently eat I am unsure I can drop much saturated fat but sugar can probably come down a touch.
  • Train more often, might have to tweak intensity down and plan it better (I have been terrible at using TR for a number of reasons, am at crunch time on renewal now).
  • Cut down on the small amount of alcohol I have. Since a job move I hardly drink anyhow as have to drive most days, but that odd evening where I have a few can be cut out, at least for 3 months to see if it makes a difference.

Roll on January, let’s see if small changes actually make a difference and what might come up from the medical experts…

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Was reading a couple studies in regard to own situation, but could be applicable to you as well.

It seems that in men without metabolic syndrome and other risks (no exercise, drinking, smoking, etc), TG/HDL is a better predictor of heart events than the standard LDL/HDL ratio.

Your TG/HDL ratio is 1.11.
Your LDL/HDL ratio is 2.88.
(the studies use mg/dL)

According to both ratios, your risk is even lower than the low-risk group (@3.74 and 2.29 respectively).
(My TG/HDL ratio of 0.97 put me at even lower risk!)

This is thought because low TG+high HDL (or low TG/HDL ratio) is associated with the composition of LDL which has altered to contain more large-particle (low risk) than small-particle (high risk).

Things like this demonstrate that a standard lipid test provides only a very basic but also very incomplete starting point. Before any kind of meds regime is prescribed, a much more detailed investigation should be undertaken.

Good luck. :+1:

This is fascinating and new knowledge to me, thanks for mentioning it.

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Latest numbers are in:

HDL 1.5 > 1.46 mmol/L
LDL 4.34 > 4.30 mmol/L
Trig 1.67 > 2.99 mmol/L

Apart from Triglycerides virtually unchanged. I don’t know how quickly trig can change or what specifically causes it to raise, but we had been away the weekend and I had eaten pretty damn badly. Can it be a short term blip?

Either way diet already changed and snuck in an extra moderate but short workout tonight.

Will see the cardiologist and what testing they may do and take it from there. Cheers again for info.

Absolutely. I’ve seen swings of 100+ mg/dL in only a week or so. Trig’s are almost exclusively diet dependant and can vary widely, as you’ve seen.

Trigs can respond pretty quickly to alcohol intake, so if part “eating badly” just prior included a lot more booze than normal you should expect to see trigs rise.

Eating badly was just that, a lot of red meat and fried food over the weekend whilst we were away.

I had maybe 5 beers of the previous week (some non-alcoholic).

Either way it isn’t reflective of my typical diet.

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LDL Cholesterol is causative or cardiovascular disease. Lowering your exposure to high LDL as soon as possible should be your #1 priority. Don’t believe all the BS you read on the internet from some web “guru”. You can lower your cholesterol yourself by:

  • Reducing Saturated Fat Intake ( Butter, fatty meats, Coconut Oil, etc)
  • Increasing Fiber - Have a cup of Black beans as one of your carbs during the day, eat a bowl of oatmeal, apples are high in pectin
  • Replace Saturated Fats with Unsaturated fats will increase HDL and lower LDL.
  • Eat a single Brazil nut every day,

If you can’t get your level to normal range with lifestyle interventions then it is time to look at a Statin. Statins CAN have side effects, but you never know until you try one, I believe around 10% of people have issues. Recent studies have actually shown that the benefits of lowering LDL cholesterol don’t have a floor - the lower the better for prevention of cardiovascular disease.

Put your #'s in this calculator to get your risk for having a heart attack

Everyday that goes by with your LDL @ 167 your are damaging your arteries.

Listen to your doctor - give statins a try in indicated, they are life saving drugs and may just save your life if well tolerated.

If you feel the need to hear an expert then listen to guys like Spencer Nadolsky, Ron Krause, Tom Dayspring(excellent). But don’t listen to any of the diet camp crazies, not saying they are all wrong, just they all have a slant that reinforces their narrative and you don’t want that.

My $0.02.
FYI - I am a 51 year old male

Cheers

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Best thing you can do is adopt a vegan diet. My cholesterol dropped significantly after just 6 weeks. it wasn’t particularly high to start with but dropped significantly with most of the drop in LDL cholesterol which is the bad kind. also cured my restless legs which had been a nightmare for years and my recovery after exercise is so much better.

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Agree with this, I tested mine along with family members, we eat HCLF vegan and my last tests showed (theirs very similar):

Tot Chol - 3.13 mmol/L - Optimal
LDL - 1.35 – Normal Range, but lower than optimal
HDL - 1.49 – optimal
Chol Non HDL - 1.64 – Normal
Chol/HDL ratio - 2.1:1 – Normal, little under optimal
Tri - 0.63 – Optimal

Have eaten the same for the past 4.5years and unfortunately never tested beforehand, though I was 15kg heavier, ate heavy meat and cheese and never exercised, so it would have been interesting to compare.

I do bloodwork every 4-6 months and follow my cholesterol (type 2 diabetic which puts me at risk for heat related stuff). My #'s were higher when I first started and my last test showed: HDL 1.5
LDL 1.34
Tri .8
What worked for me was basically following a method of eating called the plate method - which is a very heart healthy way of eating that works well for diabetics and other humans too. I used to eat a junky sort of diet and when I switched to a non processed way of eating with lots of veggies it made a huge difference as does all the intense cycling.
As others have said if it is genetic - there is not likely anything you are going to do to effect it in a big way. But eating smart is always going to help.
I take a stating daily and will for the rest of my life even though my Dr. tells me I have the best APO B in all his practice (20) and he attributes this to all the cycling above all else.
Be careful with the suggestion to go veto as someone suggested above. I am not arguing that it may have helped the poster - but it doesn’t work for all - and in my case my #'s went straight into the toilet. returning to a more balanced and sensible way of eating got my #'s right back in line.

Keep in mind that the genetic component cannot be addressed by diet changes. It’s easy to test for: get a blood test, cut all sources from your diet for a month, and test again. If your levels reacted, you have some diet leverage. If they didn’t, you don’t. Doesn’t mean you should disregard improving your diet for other reasons, of course.

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FWIW: