DD has cholesterol over 20mmol!

[Pernickety1]

My teenage dd had a cholesterol test a few years ago which showed slightly raised cholesterol around 7 so had a follow up test last year where it jumped to 16. She’s had another one come back at 21 and LDL of 18! Her HDL is very high though, also above the reference range, and triglycerides and CRP (inflammation?) is normal which is good. I don’t know what’s going on but we get genetic test results back soon. Neither her dad or I have high cholesterol though and there’s no family history of cardiovascular disease either. Does anyone else have cholesterol this high? I’m scared she could have a heart attack at any moment. What questions should I ask the doctor? She’s not on any treatment yet but feels passionately that statins and other medication pose more harm than good - so I’ll have an impossible task if they want her to start those! She’s done lots of research into this and feels that a low carbohydrate high fat diet is healthiest. I don’t understand the science behind it at all but I’m trying to be supportive with her food decisions. Is this the right thing to do? I thought people with high cholesterol were supposed to eat a low fat and low meat diet? That’s all she seems to eat at the moment... She tells me the medical consensus is slowly coming around to the fact that carbohydrates are more of a problem and the polyunsaturated fatty acids (especially seed oils) aren’t good for the heart like we’ve been told. Is this true? How long can someone have such high cholesterol without problems? If anyone has familial hypercholesterolemia or just very high cholesterol I would really appreciate hearing whether you have remained healthy without any treatment. Thank you.

My uncle had huge high cholesterol levels and managed to get it down with diet alone, (fat free) but your daughters are even higher than his.

Could something else be causing it? It really high, what genetic issue would cause high cholesterol?

I would be getting proper medical advice about her diet and not just letting her research herself, it's great that she is so interested but she needs a real doctor advising her.

Good luck.

When did they start testing cholesterol for children?

Keto (low carb, high meat, high fat) works for many people, and gives crazy high cholesterol in some others. Her research has been all about the positive aspects, no doubt. Tell her to look into "keto high cholesterol". Headline hit for me on Google is "... There appears to be a small subset of people who experience increased cholesterol levels on a low-carb diet, especially a ketogenic diet or a very high fat version of paleo. This includes increases in Total and LDL cholesterol..."

She's almost certainly going to have to switch her preferred diet out for a much less fatty one, and she won't like it!

I have inherited high cholesterol (hypercholesterolaemia) although it's never been that high. I saw a lipids specialist at the hospital who was of the opinion that I would never be able to reduce my high cholesterol through diet alone because of the nature of the condition; it's not that you one is ingesting too much cholesterol but the body's production of it is faulty. If I were you, I'd press for a referral to a lipids consultant when your daughter gets her result back- she needs specialist advice to manage cholesterol at those levels. (I do take a statin).

What is her health like apart from this? Is she a healthy weight? Is she carrying any weight around her middle? Has she had her glucose tested too?

She's not going to have a heart attack or stroke tomorrow, cardiovascular disease isn't something that happens overnight. Fayrazzled's advice is good, seeing a specialist is a very good idea and will hopefully balance Dr. Google! I agree that the likelihood of needing statins (at least) is high. The good news is that there are lots of new anti-lipid drugs coming onto the market, so it should be possible to get her level down to a normal level.

I also have hypercholesterolemia and have got mine down with a combo of statins and a diet low in saturated fat but high in good fat. I also have 3g benecol per day (the little drinks)

lots of avocado, rapeseed oil, almonds, oats, salmon, mackerel, edamame, peas, lentils and avoid saturated fats.

Don't go low or no fat entirely as that causes gallstones. Just make sure fat is mostly monounsaturated.

I should have made it clearer - she’s already under a lipid specialist and we see him again soon. It’s the latest results and the fact that the appointment is approaching that’s made me post. We didn’t discuss medication last time as we were still waiting on the genetic test results but they should be back by now. I was hoping someone else might have been in her situation with such high numbers and might be able to help me prepare for what to expect from this appointment. Like, if she has FH (familial hypercholesterolemia) is the advice typically to take a statin and eat a low-fat diet or has anyone been told by their doctor it’s safe to do otherwise? And if she doesn’t have FH does she still need statins? It doesn’t help that my husband has been on statins in the past and had muscle pain and fatigue, it’s just given dd more ammunition to argue against taking them. Also dd gets a bit embarrassed discussing things like her eating habits with other people and it wasn’t brought up last time. She won’t be happy if I mention it but I feel I should. If it was your dd would you go against her wishes?

If diet is relevant I'd expect the specialist to bring it up, which would be much better than you doing so. If he or she doesn't , you'd have to be prepared to.

justasking

It’s not uncommon in full blood works as it’s better to detect familial cholesterol earlier to monitor.

Op. I’m the same as your dd, I had to be tested after my dads heart attack. I’m now 40 and my hdl levels are still high. I’m not remotely close to needing statins and am considered as low risk as it gets for a heart attack.

As long as she loves a healthy lifestyle and never ever ever smokes then this should not cause her any issues