CobaltBlue

Jamie, I edited your text down a bit to respond to a few points.

I was 35, overweight, alot, my TC was 190 or so (medicated), but my HDL was 24, LDL <100, and TG above 600 mg/dL (when not medicated). I thought I was getting away with something, beating the game, fooling myself. Then, I had a heart attack.

I changed my eating habits, lost weight and started daily exercise. My TC dropped fast to less than 100 mg/dL total, but has since risen a bit, primarily due to increased HDL. My recommendation is that yes, lose weight, that will certainly help the TG come down (less backed up in the blood) and if you exercise, it will reduce it further, and start to shift the relative amounts of LDL/HDL to a more favorable ratio, regardless of fat intake. Weight loss will also benefit that.

You may be in the same boat as many of us (that are prone to metabolic syndrome), characterized by high TG, low HDL, and what would appear to be normal to optimal LDL levels. However, there is a good chance that if you look at the particle sizes all your lipoproteins, you will find that they are small and dense (higher risk). Other common symptoms are hypertension, and finally, onset of type II diabetes. Knowing now what I was too foolish to consider then, I would have tried to reverse the trends before I rolled the dice with my life. I wish you success in finding the strength to do what needs to be done to keep yourself healthy and minimize your risk.