advice on cholesterol

Hi everyone,

I am so completely confused as to what to do, if someone has any advice it would be much appreciated.

I am 31 years old, extremely physically active (I race bikes), no history of family heart problems or stroke, vegetarian, I am 5’10’’ and weigh about 135-140 but I seem to have persistent high cholesterol.

My last numbers were:
Cholesterol. 230
HDL 54
Cholesterol/hdl ratio 4.3
Triglyceride. 73
Ldl. 161

I took statins for a bit and the numbers when a little bit down but man did they make me feel horrible.

I have read studies that state such ideas, conclusions. Some seem to believe that folks like me should not take the drugs and others say I am about to die. My current doctor, (whom I like a lot) seems to be in the you are going to die camp but my last doctor (who I also liked) said we should not start drugs yet.


Thanks in advance

Looks like you have most of the lifestyle stuff in order, and only the LDL may be a problem. You may want to look at the ATP-III guidelines in context with any possible risk factors you may have: http://www.nhlbi.nih.gov/guidelines/cholesterol/index.htm

The only lifestyle thing to consider is what kind of fats you are consuming. Trans-fats from hydrogenated oils tend to raise LDL, as do saturated fats (common in dairy fat and coconut and palm oil, plus non-vegetarian sources like red meat). Replacing them with unsaturated fats from things like nuts, avocados, non-hydrogenated vegetable oil other than coconut and palm oil may help lower the LDL.

If you are an extremely physically active bicycle racer, then it is unlikely that you are carrying much excess body fat that you can lose to improve your blood cholesterol numbers (for inactive or less active people, it is possible to to be within the normal weight range or even underweight but with too high a body fat percentage, a condition called "normal weight obesity" in academic papers and "skinny fat" in fitness circles).

Another thing that may be worth considering if using drugs is a possibility is a more extensive blood cholesterol test which checks HDL and LDL particle sizes (large buoyant is better than small dense for both) and a few other things like Lp(a) (lower is better).

Here is just my opinion. Your ratios are very good. Your cholesterol to HDL and Hdl/LDL is very good. I know a lot is said by individual numbers but I don't believe your body works individually. Your Tri is very good and your weight. If I was a doctor I would say keep up the good work. My cholesterol is 161, my LDL is 117 but my HDL is 31 so my ratios are higher than yours. People say wow I wish my cholesterol was that low but my ratios are not that great. I am 5' 6 " 148 and play a lot of tennis and I'm 57. I believe the ratios are the most important numbers. Keep up the good ratios.

52Ken,

Ratios.......absolutely.

Thanks
I see you agree with me. lol

Originally Posted by brettsmith1536

... I am 31 years old, extremely physically active (I race bikes), no history of family heart problems or stroke, vegetarian, I am 5’10’’ and weigh about 135-140 but I seem to have persistent high cholesterol.

My last numbers were:
Cholesterol. 230
HDL 54
Cholesterol/hdl ratio 4.3
Triglyceride. 73
Ldl. 161

The first thing I think of when I see your great HDL and Triglyceride levels, is that somehow, someway, the total Cholesterol number is wrong.

You seem to be doing everything right, have an excellent weight for your height and demanding exercise.

What is your confidence level about your Cholesterol test? Have you had your Cholesterol tested by more than one lab, or more than one doctor? A doctor's number one goal is PROFIT. If a doctor can get even a healthy patient to return on a recurring basis, it adds to their bottom line. Whether it be the health of your body, or the health of your car, let the buyer beware!

What have been some of your previous Cholesterol readings, and how long ago?

Thanks so much guys for all your advice!

@ the question about the lab, I really don't know. It's a well known hospital in the Detroit area but I have no clue if it's good or bad. At the end of this week I'm going to go get it checked again-I'll go someplace else this time.

I don't think you can rule out a genetic component. I also had no problem with weight, exercised regularly, ate very well (a health nut, really!) yet still came up with less than desirable numbers. Heart disease and high cholesterol is rampant in my family.

I chose to go the alternative route, as I have with all my health issues, and very quickly my numbers changed for the better. My ratios have been very good. The last one, a month ago, was 2.8, which indicates below average risk.

Since your ratios are not too bad, have you considered making lifestyle changes to help your body regulate normal LDL and HDLs? Things like exercise, weight management, low-sodium, low-calorie diet which includes plenty of fruits and vegetables may naturally help to improve cholesterol levels, without having to take statin. Doctors also recommend fish oil supplements to help regulate healthy cholesterol levels.