Cholesterol

[towser]

I had a recent blood test that came back with a Cholesterol LDL score of 7.0.

I’ve no real feel for how big a deal this is, the covering letter suggest lifestyle changes or statins, I’m reluctant to start taking statins.

So how big a threat is that 7.0 score.

What is the best approach to managing it downwards?

I’m not particularly overweight and I’ve never felt my diet is that bad - I don’t really eat very much to be honest. I have a weakness for cheese but I guess that’s off the menu now!

TIA

[the-norseman]

I got 6.6 the other week, supposed to book an appointment. Instead I have completely changed my diet (gone back to my diet I used to follow when I trained (weights) and competed (BJJ). Hoping in a month or so to get a repeat blood test that shows changes.

[towser]

the-norseman said:

I got 6.6 the other week, supposed to book an appointment. Instead I have completely changed my diet (gone back to my diet I used to follow when I trained (weights) and competed (BJJ). Hoping in a month or so to get a repeat blood test that shows changes.

Assume you’re on a high protein diet - fish, chicken, veg?

Thing I struggle with is snacking and how I replace a biscuit with something healthy and convenient.

[Peterpetrole]

Pretty outdated the NHS on cholesterol imho. It's an essential substance which the body manufactures if you don't consume sufficient quantities.
Weight management is more of a priority for regular folk.

[the-norseman]

towser said:

Assume you re on a high protein diet - fish, chicken, veg?

Thing I struggle with is snacking and how I replace a biscuit with something healthy and convenient.

Yeh basically.

Although I have stopped consuming a lot of eggs and bacon!

[the-norseman]

BMI isn't a great measure mind you.

I used to weigh 120kg (5ft 8) and was morbidly obese , I then lost weight over a 3 year period and ended up at 68kg which was "perfect" in the green on the BMI scale, guess what... I looked seriously ill, literally skin and bones.

I'm 100kg now and a hell of a lot more muscular than I've ever been. But I'm "Obese" again now.

When I think of obese and morbidly obese I think of them men/women you see on American shows where they haven't got out of their chairs for 4 years, not me with a bit of excess belly.

[Tri_Doc]

towser said:

I had a recent blood test that came back with a Cholesterol LDL score of 7.0.

I ve no real feel for how big a deal this is, the covering letter suggest lifestyle changes or statins, I m reluctant to start taking statins.

So how big a threat is that 7.0 score.

What is the best approach to managing it downwards?

I m not particularly overweight and I ve never felt my diet is that bad - I don t really eat very much to be honest. I have a weakness for cheese but I guess that s off the menu now!

TIA

What is your QRISK 3 score please - much easier to advise with that figure to hand.

Edited by Tri_Doc on Thursday 18th September 08:43

[towser]

Tri_Doc said:

What is your QRISK 3 score please - much easier to advise with that figure to hand.

Edited by Tri_Doc on Thursday 18th September 08:43

Hi - I don’t think I was given a QRISK 3 score in the letter that arrived. Unless it’s the statement that my risk of having a heart attack or stroke in the next 10 years was between 10 and 20%.

[brake fader]

I know 2 people who have had great results just by eating whole foods just meat, veg, eggs ,butter, nothing man made and no preservatives and just walking for an hour a day. Both lost weight and blood sugar was reduced along with other skin problems that cleared up.

[g3org3y]

Definitely sure it's the LDL that's 7 and it's not the total cholesterol??

[the-norseman]

I reckon it was total, my total was 6.6


Just noticed that on all of the info sheets they send, they say that the blood test should of been a fasted one for 12 hours, nobody mentioned that to me. I had 2 eggs and 2 pieces of bacon before I went.

[speedking31]

towser said:

... the covering letter suggest lifestyle changes or statins, I'm reluctant to start taking statins.

I was also reluctant to reach for the medicine. I'm not one to reach for the paracetamol when I get a headache. But subsequently research has shown significant other benefits to taking statins beyond lowering cholesterol. I am on the minimum (?) dose of 10 mg / day. Supposed to be beneficial wrt stroke and heart attack avoidance. No side effects noted.

https://www.nhs.uk/medicines/statins/
https://www.venturicardiology.com/think-again-abou...

[Neptune188]

speedking31 said:

was also reluctant to reach for the medicine. I'm not one to reach for the paracetamol when I get a headache. But subsequently research has shown significant other benefits to taking statins beyond lowering cholesterol. I am on the minimum (?) dose of 10 mg / day. Supposed to be beneficial wrt stroke and heart attack avoidance. No side effects noted.

https://www.nhs.uk/medicines/statins/
https://www.venturicardiology.com/think-again-abou...

This. High cholesterol here (with family history too, though no one's popped off as a result yet). 3 years of testing at work showed high cholesterol, incumbent GF and Sister are both doctors so it was a bit of a three-line whip.

No side effects having been on them for 3 months. Test in the next few months to see if they've made a difference.

The most annoying thing is there's no obvious benefit.

[Tri_Doc]

towser said:

Hi - I don t think I was given a QRISK 3 score in the letter that arrived. Unless it s the statement that my risk of having a heart attack or stroke in the next 10 years was between 10 and 20%.

If your QRISK is between 10-20%, and either your total or LDL cholesterol was 7, I'd prescribe you a statin. Sounds like the letter was a chance to have a dialog with your GP surgery - take them up on the offer and see what they suggest (they'll have all the details to hand - BMI, age, ethnicity, smoking/alcohol status, co-morbidities etc) - so much more than just a simple yes/no in reality

[WyrleyD]

Well my Lipoprotein Particle Check results are finally in:

Total Cholesterol : 5.9 (High, ideally 5.5 or less)
LDL: 3.5 (High, ideally 3.4 or less)
IDL-1: 0.6 (Good)
IDL-2: 0.3 (Good)
IDL-3: 0.3 (Good)
Large LDL-1: 0.69 (Good)
Large LDL-2: 0.59 (Good)
VLDL: 1.0 (High, ideally 0.6 or less)
HDL: 1.6 (Good)
Triglycerides: 1.7 (Good)
Non-HDL Cholesterol: 4.26 (High, ideally 4 .0 or less)
Small Dense LDL-3: 0.41 (High, ideally 0.2 or less)
Small Dense LDL-4: 0.36 (High, ideally 0.01 or less)
Small Dense LDL-5: 0.36 (High, ideally 0.01 or less)
Small Dense LDL-6: 0.00 (Good)
Small Dense LDL-7: 0.00 (Good)
Total Small Dense LDL: 1.13 (High, ideally 0.24 or less)
Mean Particle Size: 252 Angstrom (Low, ideally >268)
Lipoprotein (a): 5 (Good)

In summary, the large LDL, HDL and Triglycerides are all good but the Small Dense LDL particles and VLDL are not good. Have discussed it with my GP and decided to give Rosuvastatin a go and will do some more blood tests in 3 months (normal NHS ones and not the paid for Lipoprotein Particle Check) to see how it's going. The high VLDL is probably the result of my Type 2 Diabetes and fatty liver that I've had since 1978.

[g3org3y]

the-norseman said:

I reckon it was total, my total was 6.6

Yes, I'd be surprised to see an LDL of 7 unless it was a legit case of 'familial hypercholesterolaemia'.

Regardless, assuming it's total cholesterol, a result of 7 is high, but it'd be good to know the breakdown of LDL vs HDL.

As was mentioned by Tri_Doc, the decision to treat with statins is a bit more nuanced than just the cholesterol value itself. A cardiovascular risk score taking into account other factors is calculated and decision made on the basis of that.

[towser]

I have a call with my GP arranged for next week I assume to discuss options and details.

In the interim it's given me a bit of a wake up call to be a bit more conscious about what I'm eating so from that perspective it's a "good thing" although I do miss cheese.

[the-norseman]

towser said:

In the interim it's given me a bit of a wake up call to be a bit more conscious about what I'm eating so from that perspective it's a "good thing" although I do miss cheese.

Exactly the same here! my day off binge drinking has stopped. I've had a 10 pack on top of the fridge for about 2 weeks now, I would of smashed that in one night before.

[Elderly]

Peterpetrole said:

Pretty outdated the NHS on cholesterol imho. It's an essential substance which the body manufactures if you don't consume sufficient quantities.
Weight management is more of a priority for regular folk.

/\ This.

Up until …… the mid-80s? cholesterol was targeted because people who had coronary artery disease were found to have high levels of cholesterol; the only problem was that the body was making that (good) cholesterol to protect itself from coronary artery disease - they has cause and effect the wrong way round.

[DaveGrohl]

WyrleyD said:

Well my Lipoprotein Particle Check results are finally in:

Total Cholesterol : 5.9 (High, ideally 5.5 or less)
LDL: 3.5 (High, ideally 3.4 or less)
IDL-1: 0.6 (Good)
IDL-2: 0.3 (Good)
IDL-3: 0.3 (Good)
Large LDL-1: 0.69 (Good)
Large LDL-2: 0.59 (Good)
VLDL: 1.0 (High, ideally 0.6 or less)
HDL: 1.6 (Good)
Triglycerides: 1.7 (Good)
Non-HDL Cholesterol: 4.26 (High, ideally 4 .0 or less)
Small Dense LDL-3: 0.41 (High, ideally 0.2 or less)
Small Dense LDL-4: 0.36 (High, ideally 0.01 or less)
Small Dense LDL-5: 0.36 (High, ideally 0.01 or less)
Small Dense LDL-6: 0.00 (Good)
Small Dense LDL-7: 0.00 (Good)
Total Small Dense LDL: 1.13 (High, ideally 0.24 or less)
Mean Particle Size: 252 Angstrom (Low, ideally >268)
Lipoprotein (a): 5 (Good)

In summary, the large LDL, HDL and Triglycerides are all good but the Small Dense LDL particles and VLDL are not good. Have discussed it with my GP and decided to give Rosuvastatin a go and will do some more blood tests in 3 months (normal NHS ones and not the paid for Lipoprotein Particle Check) to see how it's going. The high VLDL is probably the result of my Type 2 Diabetes and fatty liver that I've had since 1978.

How did you get this particle test done?

I had some blood work done through Thriva a few weeks ago. Much more detailed than the standard stuff but not as detailed as that. I’m interested in getting this level of detail now.

Lp(a) low is a relief and very important.
You’re right to focus on VLDL though, it’s way more important than the pharma industry’s desperate need for us all to look over there at the LDL squirrel.

https://pubmed.ncbi.nlm.nih.gov/38591325/

Graph on page 7 if you want to go straight to the interesting bit.
Highest survival; low VLDL and high LDL.
Worst survival; low LDL and high VLDL.
What medical professional will tell you that?