Cholesterol: A Patient Conversation

Well your cholesterol tests came back and they are better than I expected them to be. Your total cholesterol was 210 mg/dL which is on the higher end but not irreversible. Your triglycerides were at 145 mg/dL, a normal level range is anything below 150 mg/dL. Your HDL, or high density lipoprotein, which is good cholesterol, was at 33 mg/dL. 33 is on the low side, the higher the number, the better, so we need to work to get that level up. Now your LDL, or low density lipoproteins, was at 160 mg/dL. Anything below 100 is normal, and anything above 190 is extremely high and you are smack in the middle so you will need to make some life style changes if you want to avoid a stroke or heart attack. What are triglycerides?

Triglycerides are the product of excess calories, sugars and alcohol that get stored in fat cells. Your tests came back at 145 mg/dL, anything higher than 150 mg/dL puts you at higher risk for metabolic syndrome, which can lead to heart disease, diabetes, and kidney damage. “The main features of metabolic syndrome include insulin resistance, hypertension (high blood pressure), abnormal cholesterol, and in increased risk for clotting.” What is cholesterol?

Cholesterol is a waxy, fat-like substance that the body needs to function properly. The body only needs a small amount, so when your numbers start going up, so does the risk for heart disease. When there’s excess cholesterol a thick, hard substance called plaque begins to build up on the walls of your arteries, eventually blocking the blood flow to your heart and hardening the artery, causing a heart attack. A stroke is when blood flow is cut off to your brain. What are LDL and HDL?

LDL, or low density lipoproteins, are bad cholesterol, combines with other substances to become plaque, and eventually clogs arteries. HDL, or high density lipoprotein, on the other hand is good cholesterol. Up to a third of the body’s blood cholesterol is carried by HDL, and helps remove low density lipoproteins (LDL). So the higher the number of HDL, the better. Eating healthy fats such as olive oil, avocados, and peanut oil can help raise HDL levels when combined with a healthy diet. Where is cholesterol produced?

75 % of cholesterol is produced in the liver, but 25% comes from the food we eat. What are the causes of high Cholesterol?
High cholesterol comes from a combination of factors. Eating too much saturated fat, trans-fat and cholesterol. Being overweight, which increases triglycerides and lowers your HDL. Lack of exercise, which can also lower your HDL levels. Family history, some people are predisposed to having a higher cholesterol level because of their genetics. Smoking and some medications can also cause cholesterol levels to be higher than a non smoking non medicated person. What are the treatments for high cholesterol?

Medication, eating healthy, exercising, taking supplements, and an overall healthier lifestyle. What are the side effects of medication for treating high cholesterol? Side effects of statins have not been conclusively proven, but many people that have taken them have complained about muscle pain, weakness, memory problems, decrease in energy and fitness. Patients have also complained about increases in fatigue and sleep problems. Some of the clinical trials showed kidney and liver problems, bleeding in the brain and type 2 diabetes. Statins can also lead to weight gain and raised blood sugar levels. Do the benefits of lowering cholesterol outweigh the risks of taking medication?

Because you have no history of heart disease, heart attacks or stroke, I would not suggest taking any medications at this point. I would suggest making life style changes first, and we can check your levels again after some time has passed. What options exist for a person to try and reduce his/her cholesterol without taking medication?

Since you don’t need medication at this point there will be a few things you need to start doing. Firstly, you need to start watching your portions. Lower your intake of saturated fats and exercise for at least 30 minutes a day for five days. It doesn’t have to be 30 minutes straight; you can break into 10 minute intervals as long as it gets your heart rate up. Also lower the amount of stress in your life.

I know this is a lot of information and a lot of change, but you don’t need to do it all right now, one step at a time. You can start with some walking and eat healthier, and then gradually start walking more or jogging. There’s a lot of information out there if you want to look anything up, or you can contact me with any questions you may have. The best way to avoid a heart attack is to do the things I suggested; exercise and eat healthier.

Citations:
http://www.webmd.com/cholesterol-management/guide/cholesterol-basics http://www.webmd.com/cholesterol-management/ss/slideshow-lowering-cholesterol http://www.webmd.com/cholesterol-management/guide/lower-cholesterol-risk http://www.webmd.com/fda/controlling-cholesterol-with-statins