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[Lynda07]

Hi ladies

I'm at a loss. My cholesterol last year was 7.2. In February this year it had increased to 8 and I made the decision to stop drinking (as a regular drinker) as my GP said this would bring it down.

I had it re-tested last week and have just had the results and could cry. It's 8.6. I just don't understand how this can be. I don't think it is hereditary although mum and dad are no longer here to ask but I think I'd remember if they were on statins. I've not yet had the break down of good v bad.

My husband thinks I should just take statins as "most people probably don't get any side effects" but the ones I read about are enough to put me off. I feel between a rock and a hard place and because I suffer from health anxiety I'm terrified too. 

I could cut down on carbs and sugar a bit more I know - I'll admit I thought no alcohol would just lower it. But I'm not eating any more carbs or sugar than I've ever done and I hardly eat any meat/processed food.

Any advice would be welcome - mainly I'm trying to work out why it would go up so much in 12 months.

Thank you.

[ATB]

NHS advises cutting down on fatty foods and foods high in saturated fats

Saturated fat is found in:

butter, ghee, suet, lard, coconut oil and palm oil
cakes
biscuits
fatty cuts of meat
sausages
bacon
cured meats like salami, chorizo and pancetta
cheese
pastries, such as pies, quiches, sausage rolls and croissants
cream, crème fraîche and sour cream
ice cream
coconut milk and coconut cream
milkshakes
chocolate and chocolate spreads

Exercise more

Aim to do at least 150 minutes (2.5 hours) of exercise a week.


^ from their website.

What kind of meals do you have? Do you exercise? Need to lose weight? I would remove some foods on that list completely if you have high cholesterol, especially dairy.

[Cassie]

You do really need the breakdown on what your so called "good cholesterol" is compared to the "bad" one. The new take on cholesterol is that its not as harmful as previously suggested and in order to really know for sure there is a special blood tests that one can pay for to do the breakdown of the cholesterol. Cutting back sugar and carbs is essential, healthy fats are essential, butter is now considered a so called healthy fat, compared to margarine. Nuts are great, lean meat, chicken, fish. Daily walking and a glass of red wine is also considered a good thing with cholesterol. The bad press it has got over the years is def changing, esp with the low carb high fat diets that are so popular of late.

[ATB]

Cassie that’s not official advice though, it’s just your opinion. There really hasn’t been a massive change at all in the way proper health organisations treat high cholesterol. It is *not* good to have high cholesterol, it is damaging and fatty foods and saturated fats are still considered harmful. BHF & NHS both still consider high cholesterol a serious risk factor for heart disease. NHS usually tests for LDL, HDL, and total cholesterol as part of a CBC.

[ATB]

Recent meta analysis on alcohol and cardiovascular risk:

The deleterious effect of heavy alcohol consumption has been established by numerous studies, although the apparent beneficial effects of lower consumption are still under debate. Thus, recommendations must be made with caution since no definite conclusions have been made, and it is still a subject of study.

——

While we still don’t know, those with high cholesterol will be advised to take the cautious approach regarding alcohol intake. It is not scientifically clear that a daily alcohol intake is ‘good with cholesterol’ so nobody should take that as established fact yet.

[Gnatty]

Hi Lynda, Please don't beat yourself up too much about your cholesterol readings. You have tried really hard to reduce your levels by yourself - sometimes this works and sometimes it doesn't. Do you have a lot of fibre - _that is supposed to be good at reducing levels. Its true that good fats are very important for our health and at the moment you don't know what your levels are.

Re statins - I know loads of people that take them with no ill side effects. The trouble is there is so much news coverage about them that people almost expect to get muscle aches and pains etc. There was a study a while back which showed that patients taking a placebo had same  symptoms as those taking the real thing:

https://pubmed.ncbi.nlm.nih.gov/34531021/

[Lynda07]

Thanks so much for your replies. Because I'm  anxious this has become a big deal to me so they are much appreciated.

ATB - my plan is to speak to my GP at my appointment this week and say I'd like one more try at lifestyle changes. I haven't paid attention to my diet as I truly thought that stopping drinking would bring it down and I certainly never expected it to go up. So in terms of diet I don't eat a lot of rubbish (cured meats, pastries, cheese etc, I rarely touch) but don't eat as much veg/fruit as I should - my diet has too much white in it - white bread, rice, frozen oven chips. I will admit to craving chocolate since giving up drink - so these are areas I've got to improve in. I do a lot of steps each day but not cardio work so have decided breakfast white toast is to be replaced by 20 mins on my cross trainer. Anything I do has to be sustainable and these things are so I've set up a food and exercise diary on my PC so I can literally see what I am doing in regard to this.

My readings are Triglyceride - 1.2. HDL - 2.0. Non HDL - 6.6 and the other (can't read my notes - Calc. LDL I think) is 6.0. From what I can make out my ratio is 4.3 (it looks like I have to divide total cholesterol by good) - and I've read above 6 is bad. I think (Dr needs to confirm) under 2.3 is ok for Triglyceride and my HDL at 2 seems ok. Of course I can't deny that overall 8.6 is high and what I really don't understand is why it's rising so fast.

I'm 9 stone 3 so not overweight. I've tried to work my Qrisk out but not sure what "Standard deviation of at least two most recent systolic blood pressure readings (mmHg)" means - without putting that in my risk, from what I can see, is 6 - but I'm sure with such high cholesterol that must be wrong.

Gnatty - some fibre but probably not enough but am hoping I can improve on this as well. I appreciate your comment about people you know who take statins with no side effects - I guess that is where I will end up, I just want to have this one last shot diet wise. I had heard about that study. I have an obsessive fear of all medication which doesn't help.

Again, I really do appreciate your replies.

Lynda

[ATB]

Good luck with your plans, if you still have room to move within your lifestyle then it seems like a good decision to try and remove all possible contributing factors before agreeing to statins. I agree with others that if all else fails you may need them and it would be on balance perhaps a greater risk not to. A high fibre diet is absolutely the way to go, maybe focus on adding nutritious foods, rather than on thinking, oh what can’t I have. Fill up your plate with fruit, veg, whole grains, legumes, nuts, seeds, fish if you eat it, and you’ll want to eat the not so good things less. I love Pinterest for recipes, I think taking time to make new and varied, really delicious recipes is a good distraction when trying to change your diet and get healthier. I like cooking though and I know not everyone does. Best of luck!

[Lynda07]

Thanks ATB. I don't mind cooking actually but lack imagination. I've got two of the Fast 800 recipe books and they have some delicious recipes and I forgot all about Pinterest. I sometimes think if I could get over this irrational fear of medication, my life would be so much easier.

[ATB]

Not irrational at all, I totally understand it and you’re absolutely not alone. It’s totally fine to feel the way you do. It’s common. You can figure this out and resolve this for sure, just take a breath and take it day by day. It’s really easy to be overly self critical, imagine your friend came to you with these concerns, you would understand right? Do something nice for yourself tomorrow and try to avoid thinking about your cholesterol or what you need to be doing for a day. Just a nice calm day with no worry about your health. One day won’t make anything worse but it might give your mind a little break to relax.

[Lynda07]

Such good and kind advice ATB. Thank you so much.

[Hurdity]

You do really need the breakdown on what your so called "good cholesterol" is compared to the "bad" one. The new take on cholesterol is that its not as harmful as previously suggested and in order to really know for sure there is a special blood tests that one can pay for to do the breakdown of the cholesterol. Cutting back sugar and carbs is essential, healthy fats are essential, butter is now considered a so called healthy fat, compared to margarine. Nuts are great, lean meat, chicken, fish. Daily walking and a glass of red wine is also considered a good thing with cholesterol. The bad press it has got over the years is def changing, esp with the low carb high fat diets that are so popular of late.

Cassie that’s not official advice though, it’s just your opinion. There really hasn’t been a massive change at all in the way proper health organisations treat high cholesterol. It is *not* good to have high cholesterol, it is damaging and fatty foods and saturated fats are still considered harmful. BHF & NHS both still consider high cholesterol a serious risk factor for heart disease. NHS usually tests for LDL, HDL, and total cholesterol as part of a CBC.

It's not Cassie's opinion - it is as stated on the BHF website - and where the lay person's terms "good" and "bad" cholesterol are used
https://www.bhf.org.uk/informationsupport/risk-factors/high-cholesterol

It specifically says: "If your total cholesterol is high, it CAN mean that you have a lot of bad (non-HDL) cholesterol in your blood. A high level of good (HDL) cholesterol can help keep that bad cholesterol in check and remove it from your body." (my capitals).

The article also says:
"There is no specific target cholesterol level because your doctor is looking at your overall risk of developing heart and circulatory diseases"

So whilst the general health advice you gave ATB is excellent re diet and exercise - we should be guided firstly by the ratio of HDL:LDL, as well as our Qrisk score which the GP should be calculating from our readings.

Only after that has been carried it will it be necessary to decide whether further treatment is required.

I also have personal experience of this and quoted my figures some while ago in another cholesterol post. I have high total cholesterol but my ratio is fine as is my Qrisk score ( also takes into account age and blood pressure amongst other things - can't remember exactly) so my doc says no action needed but to test every couple of years.

Hopefully Lynda007 your doc has done this by now?

Great that you're not overweight and as long as you make some changes to your diet as you are suggesting - re fruit and veg which should form a substantial part of a healthy diet, and increase your cardio exercise, then you are doing the best you can for yourself.

Re alcohol - you didn't say how much you drink as a regular drinker but drinking a very small amount and not daily unless you have beem medically advised to drink none at all - the effects should be minimal. I can't take large wuantities of alcohol but I limit any alcohol to Fri, Sat Sun and would have no more than two small drinks before or with eve meal. My glasses of wine are actually half glasses etc. Of course you may feel better after giving up compoletely but I've managed to keep to this 3 days per week for some years ( Christmas and holidays are the exception !)

As for "breakfast white toast is to be replaced by 20 mins on my cross trainer. " - I'm not sure whether you mean you are cutting out breakfast completely? Hopefully not - it's a very important meal, though having it later, after exercise is also excellent, if your lifestyle/working areranagements allow for this.

For breakfast I either have grapefruit, then oats/museli with fruit, possibly followed by boiled egg ( if attending zmuba class), or fruit, yougurt, two boiled eggs. Sometimes egg, baked beans and mushrooms as the cooked breakfast. I've put on weight recently so try to replace the whole meal toast and marmalade which I love, with a boiled egg instead. I tend to have breakfast as late as possible, depending what I'm doing, so if at home - then 9.30 - 10 ish.

Hope this helps and you manage to make healthy changes without worrying too much and that you have been reassured by your doc re Qrisk?

No way I want to take statins, ever - and I am late 60's...(not that its been suggested yet...)

Hurdity x

[ATB]

No I stand by what I said and how I interpreted Cassies comments about there being a massive change in how cholesterol is viewed and dietary comments made. There isn’t a huge change. The ‘ bad press’ cholesterol has had still exists. The LDL & HDL ratio has been important some time, since I studied nutrition years ago, and it is part of a standard CBC with the NHS. *She has listed those figures here already*.

This is the NHS basic guide:

Result   Healthy level
Total cholesterol   5 or below
HDL (good cholesterol)   1 or above
LDL (bad cholesterol)   3 or below
Non-HDL (bad cholesterol)   4 or below
Triglycerides   2.3 or below


Your GP is meant to discuss with you your individual goals because you may have other risk factors or considerations and as per Nice guidelines do that QRisk score with you, as I understand you’ve tried to do that yourself but I would ask your GP.

Based on the NHS guide, Lynda’s total is too high, HDL not too bad at 2, Non HDL is too high at 6.6, LDL too high at 6, triglycerides are ok.
For clarity: Non-HDL cholesterol
Your non-HDL cholesterol is your total cholesterol minus your HDL cholesterol. It’s all the 'bad' cholesterol added together, including your LDL cholesterol. Ideally it should be as low as possible.

Lynda’s is too high at 6.6


Overall a GP is right to be concerned but hasn’t followed the guidelines for QRisk, or maybe has but hasn’t pointed it out? That would be something to ask about. If there is room to move on the foods they suggest we limit, then it seems like a sensible thing to do either way.

Hurdity, you don’t appear to have read Lynda’s other comment where the ratio is included. My main point was that cholesterol being ‘not as bad as previously thought’ is not true at all. Certainly with the figures Lynda added here, her GP has clearly seen that the Non HDL result is a concern.

[Lynda07]

Hi ladies

Firstly, Cassie, apologies for not thanking you for your original reply.

Hurdity, I think my ratio is 4:3 if I am calculating it correctly and I have read under 6 is ok. I will be asking my GP to calculate my Q Risk when I speak to her next week. (My appointment was moved from Friday to next Wednesday unfortunately). Last time it was done, a few month ago, it was under 10 and if it’s still around that I certainly won’t be taking statins even if my overall cholesterol is high.  I’ve done a lot of reading myself this week and am not convinced they would be the way forward for me. With regard to alcohol, I find it easier to stop than cut down to be honest so I’ve not had a drink in months.

Breakfast wise, on the mornings I exercise I plan on a smoothie late morning- I just cant eat after exercise, I get stomach ache. I’m also interested in intermittent fasting.

Diet wise, just a few days in of quite major (good) changes and I am so surprised at how much better I feel already. My husband even says I look brighter. Interestingly, I’ve been sleeping really badly of late which surprised me as you are meant to sleep better if you don’t drink. But I had been eating milk chocolate at night instead of having a glass of wine. Coincidentally or not, by having a few squares of dark chocolate instead, I have slept so much better.

ATB, I will definitely be asking for the Q Risk score and hopefully it will be low. The more I research the more I want my GP to look at the ‘whole picture’ - I will report back.

Thank you all for your comments.

Lynda

[ATB]

Sounds like a good plan. Considering how many GPS don’t follow the NICE guidelines for menopause & HRT as well,  I guess we shouldn’t be too surprised yours hasn’t followed them for this, but they’re there for a reason. Just a shame patients are the ones looking them up. It’s wrong yours is suggesting looking at statins if they’re not following guidelines in the first place.