My cholesterol is REALLY high - can i fix this?

[CholesterolHelp]

I just got blood work results & my cholesterol is 11.2. 🙁

My GP wrote in the report that i need to really critically look at my diet & then retest in 4 to 6 weeks.

I am 56, 5ft 9" & currently weigh 12 13. I was 14 5 last year & i have worked v hard to lose the weight. Target weight is 11 13.

My typical day of eating looks like:

Porridge (made 2 thirds water, 1 third low fat milk). In the past week i've added chia seeds & 3 chopped walnuts as they're supposed to help cholesterol

A coffee & glass of water (i used to have fresh orange juice but have cut it out)

Midmorning - a coffee with low fat milk

Lunch: homemade vegetable soup - this varies - spiced moroccan tomato & chickpea, roast root veg, carrott & ginger, minestrone (beans no pasta), veg & red lentil etc
I usually have a slice of organic seeded sourdough with real butter (cut that out now)

Dinner - salmon with veg & new potatoes, chicken salad etc

I drink 1.5 ltrs water & cut out all the crap & 90% less alcohol. That's how i've lost 20lbs so far.

Now i have had the odd fuck it day where i've had a takeaway / wine but truthfully my diet is the best its been ever

I have added a daily benecol drink, ditched the red meat (rarely eat anyway) & the butter. Cheese was long gone to aid weight loss

Can i turn this around with diet? Has anyone here managed?

I'm worried now

I have a skinny, very fit friend in her 60s. She and her husband recently trekked up to Machu Picchu in the Andes for which they trained for months.
She was diagnosed with very high cholesterol a few months back (I think it was about 8?). Genetic, the doctor said.
And there's me, getting on somewhat, overweight all my life, and mine is just just skimming the lower side of the zone where the doctor is suggesting statins...
Sounds to me like losing weight would be a good idea, might lower it a bit, but if the high cholesterol is in your genes you need to take medication sadly.

Mine was slightly elevated before I started HRT but has come back down to a nice healthy level now. I weight train religiously and walk a lot but did make some other small changes which I think have helped. I didn't realise that drinking unfiltered coffee could raise LDL, so I bought a filter coffee maker instead of drinking a whole cafetiere every morning. I have oily fish every day and stick to a high fibre med style diet. I buy beetroot powder (available on Amazon) which I mix into a drink every morning. I've cut out booze completely and have managed to loose my menopausal central fat.

What has it been previously? Or is this your first check and so is out of the blue?

It is very high and I'm surprised you weren't offered statins immediately tbh. I remember someone getting their results during a workplace check and they were sent to their GP immediately with that kind of number.

Here in the UK, NHS GPs used to order fasting cholesterol tests. My GP surgery hasn't requested fasting for years.

https://www.nhs.uk/conditions/high-cholesterol/getting-tested/

"...You might be asked not to eat anything (to fast) for up to 12 hours before the test. But most people do not need to fast."

This thread has just answered something I was puzzled about! I had lifesaving and life altering surgery last month. Before the surgery I had perfect cholesterol levels and a week after the surgery they weren’t perfect! As in the bad ones were high and the good ones were low! I thought it was because I was taking a lot of calcichews and extra dietary calcium as a side effect of the surgery can be low blood calcium levels! I think now that it was because these were the first bloods I had taken in years where I had not been fasting overnight!

You need statins. Don't be afraid of the overblown bad hype around them; most people tolerate them fine and they work.

That level of cholesterol (be it total, HDL, LDL, vldl or whatever) is highly unlikely to be due to diet. If I was your doctor (and yes. I used to be a doctor pre retirement) I'd be looking at other cardiovascular risk factors, testing your blood again to rule out lab error, and referring you to the lipid clinic if it's still high.

If you have a gene for one of the inherited forms of high cholesterol, your children (if you have any) will be eligible for testing too. You would need to be seen in the lipid clinic to find out about this.

Fasting prior to the blood test makes very little difference to cholesterol levels btw. It can affect your triglyceride levels - they are another potential risk factor if raised, but it's perfectly possible to have high cholesterol levels but normal triglycerides (or vice versa!)

Apparently pears are good for lowering cholesterol.

Have there been any past heart problems in your family? I’d make a guess this could be a genetic disorder where your body doesn’t process cholesterol. Possibly hormonal too? PCOS can cause high cholesterol. I would maybe look deeper into other medical causes rather than diet

I might be showing my ignorance here about statins but with a cholesterol reading that high and a diet that doesn’t look as if it can be improved too much why would you not consider using medication to lower it.
I know there is some controversy about Statins but would have thought that in the OP’s case the benefits of taking one would outweigh the risks of not.
OP’s diet looks pretty good to me and perhaps because I’ve been taking a statin myself for a couple years without any obvious side effects I struggle to understand why anyone would want to restrict their diet to such an extent that they end up eating things they don’t enjoy much and lots of very low fat products with an often dubious product list .

That is very high. If you've been on that diet for a year, it really should have come down by now, unless it was ridiculously higher before you started and it is in fact on the way down, in which case that should be visible in your next test.

I wouldn't panic yet. See what the test in a few weeks says. Don't faff about with fasting or any of that nonsense before hand as you want a realistic reading. If it's still very high, then it's likely going to be a specific issue causing it, or genetic. In which case I'm afraid you should accept the statins.

Someone mentioned your thyroid earlier, that's also worth a check. It's very surprising how many issues that little bugger can cause! And I'd ask for the antibody test, rather than just the tsh test they do on the standard blood tests, as that doesn't show everything.

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.

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

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?

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.

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.

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.

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

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.

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

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.

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

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)

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.

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.

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