My cholesterol is REALLY high - can i fix this?

You need a referral to lipid clinic.
7.5 is the cut off for familial/genetic issues.

Why has your GP not prescribed you statins?

As well as statins, you could try sterol tablets. (A supplement). I buy them on Amazon. It’s the same or similar to what’s in Benecol (which does reduce cholesterol) but is much cheaper. Here’s an article. Note the dose:
https://www.heartuk.org.uk/healthy-living/flora-proactiv-2#:~:text=Nutritional%20scientists%20have%20found%20that%20sterols%20and

A fasting cholesterol that high is very likely due to an underlying condition or genetics. Mine was 8 and although I’m obese, my doctor said you don’t see levels like that just owing to lifestyle, statins have taken it down to normal levels.

You need to follow the Portfolio diet for 3 months.
https://www.heartuk.org.uk/dietary-patterns/portfolio-diet Metabolic studies demonstrated a 35% drop in LDL cholesterol which is comparable to that of first-generation statins1,
Say YES, when it asks if you are a health professional.

You might have familial hypercholesterolemia. Ask your GP.

I should add that I have a family history of heart disease & early pre-eclampsia in pregnancy, so was almost waiting for the high cholesterol & blood pressure, which only started after the menopause - this is fairly common.

I started Atorvastatin & it bought my cholesterol down from 5.9 to 3.8 within 8 weeks.

It was a no-brainer for me. And no side effects at all.

I agree with the PP who suggested finding out your LDL:HDL ratio.

Doesnt sound dietary or weight based to me as you've lost weight and your diet is good. Sorry to hear about the waterbased/low fat milk porridge!!!

Get on the statins.

That's a healthy diet. It's really incredibly difficult to make much impact on cholesterol by diet alone.
Statins have a lot of urban myths about them, almost conspiracy level. They work though and vast majority of people have zero side effects.

There is a possibility you have a genetic condition called familial hypercholesterolemia. This should be considered in anyone with a TC over 9mmol/l. More likely if you have a first degree relative (mother father siblings) with heart attack or stroke below the age of 60yrs. You should be referred.for genetic testing and if positive the rest of your family ( siblings children uncles aunts etc ) should also be tested. Diet only contributes about 20% to your cholesterol level, your liver makes the rest.. you probably need cholesterol lowering meds. Statins are effective and, despite the bad press, are generally well tolerated. (CVD specialist)

The odd Thursday night isn't going to cause that. Your diet is already pretty good.

OP, any dietary change & weight loss is only going to reduce your cholesterol by about 10-15%.And it would be different if your diet was poor, but it’s not.

Personally, I’d be requesting a statin with that level.

Ask them to check your thyroid one of the side effects of low thyroid function is high cholesterol

I have a cholesterol that is not ideal for me as I have previously had a heart attack. It is very much normal for anyone else.

I have not eaten red meat for years - I do not have milk or cheese. I have oats, oat milk, benecol, walnuts, oily fish etc. - doing everything right. I am on bempedoic acid which lowers cholesterol.

The docs say that there is little I can do as my liver simply makes too much cholesterol. If yours does not come down with diet you might be in the same boat and they will add in meds.

It could be genetic, Have you been referred for testing for familial hypercholesterolaemia ?

A total over 7.5 implies familial hypercholesterolaemia (genetic) You may be able to bring the value down by 2-3 points with diet & exercise, but it’ll still be awfully high. Where we are we refer for genetic testing if >7.5 and people get out on one, often 2 cholesterol lowering meds.

I have high cholesterol, courtesy of my father, who died from a heart attack at 63... my sister needed a carotidectomy at 65 and mine was diagnosed mid 40s, although I suspected it might be the case due to milia on my eyelids... a classic symptom, If you are able to, look at your family and see if there is a pattern of heart attacks and strokes in your family, or if you have Celtic, Dutch heritage and the ginger gene, these are all pretty decent genetic indicators. For me it is the Celtic gene, plus an armful of blood with which the geneticist confirmed it.

When I was initially diagnosed, I went through my diet with the practice nurse... 30 mins of being berated by her, despite me having a fairly decent diet, to her closing with, "Well in all honesty, your cholesterol is so high that your diet will not be the driving factor, but we have to warn you..." Yes, I did have a TIA about five years ago, but drugs for the most part control it now and I still eat a pretty good diet and exercise regularly. However I know my levels freak out people who failt to read my history, and that is on them, not me.

Have you been screened for familial hypercholesterolemia? It’s an inherited genetic condition that causes high cholesterol.

If you had this diet and exercise alone won’t help your cholesterol, it would require statins.

Blood cholesterol generally doesn’t come from dietary cholesterol. It’s made in our bodies. The highest my cholesterol was was when I was a vegetarian for 20 years. I ate a lot of carbs and processed food, also drank a lot of alcohol and cholesterol is made is the liver so any stress on the liver will impact that.

It was lowest when I ate a high protein, high healthy fat (think avocado not Big Mac), high fibre diet and cut out a lot of the carbs. Also cutting out alcohol.

At those levels, I would be exploring familial hypercholesteraemia. Anyone else in your family with cardiac issues young?

Which is definitely a start but not enough. So many people freak out about cholesterol based on insufficient information.

You don’t need to be terrified. If it’s still high next time, they will put you on statins which work well. But stressing about it is absolutely counter-productive.