High cholesterol because high HDL?

[Itstoday]

Hi,
This morning I had my cholesterol levels tested for an NHS study.
My results show I have high cholesterol. I think this may be genetic as my brother also has high cholesterol.

I rarely drink, don't smoke, run twice a week, BP 103/68, BMI 21.6. I eat well (possibly too much butter and cheese?)

Cholesterol results are:
TC 6.49
LDL 2.74
HDL 2.35
Triglycerides 3.08

From what I can tell, my TC and Triglycerides are too high, LDL is fine but HDL seems very high and maybe too high?

I guess statins aren't what's needed as these lower LDL and that's not the issue?

I wondered if anyone else has had results like these? Knows what they mean and if I can reduce my HDL at all?

Thanks

Hello

According to the lab measures I know of, your TC is too high as it should be below 5. Your LDL (bad cholesterol) should be below 3, so yours is within the ok range. HDL is 'good' cholesterol which you don't want to lower! It should be above 1.2, so again, yours is fine.

Your triglycerides are quite high and should be below 1.7. Did you fast before the test though? If you're active and not overweight or diabetic then it's more likely the high result is because you'd eaten before the test?

The best way to improve your cholesterol is to cut down on saturated fat and alcohol and to exercise. It doesn't sound like you have a bad lifestyle at all though so I'm thinking you might get a better result with a fasting test (if it wasn't). If it was a fasting test then you might want to see your GP for advice.

Hope that helps!

Thanks. No it wasn’t a fasting result. In fact I’d eaten breakfast about an hour before!

I might get a further test done to double check the results and take it from there.

It's the ratios that matter more than the totals.
TC / HDL. Yours is 6.49 / 2.35, or 2.8. <3 is considered 'good'

An even more predictive ratio (for heart disease) is TGs to HDL
Yours is 3.08 / 2.35 or 1.3. You only want it to be < 2.

Your ratios are very healthy. Do what you want about your numbers, but your numbers are actually good.

fwiw, DH's TC is about 7.3 (that's fasting), and his ratios are better than OP's His TG:HDL ratio is 0.5. Basically DH is an endurance athlete & so he has conditioned his body to need fat in his blood stream to keep going, has high levels of circulating fat for those 10-16 hour events.

That's what we reckon, anyway. The conditioned-to-run-on-fat theory came from a medic who follows DH on Strava.

HDL is better if higher than lower.

I'd have another test - a fasting one- as your triglycerides seem high. These are easily affected by food and exercise.

The other readings are good.

The best way to improve your cholesterol is to cut down on saturated fat

More complicated than this!

There is a huge debate going on about whether saturated fat is evil.
Many cardiologists poo-poo it.
Amazingly, there is no robust evidence that saturated fat causes CVD. Not when you look at the real evidence.

Some people just produce more cholesterol anyway.

The best way to reduce it is exercise and fibre. The fibre in veg and fruit mops it up.

I have no idea if this is helpful, but I lowered mine by eating a lot more healthy fat and cutting down on unhealthy, plus adding lots of fibre and fruit and veg. I didn't lose weight, either, so it wasn't that.

The thing is though that what you would be trying to lower would be the LDL and mine is already fine. It's the HDL that is high, so lowering of LDL wouldn't help.

My HDL is 2.5 and my doctor is delighted. HDL is better high. PP have already pointed out there seems to be nothing wrong with your HDL/LDL readings.

Not sure about this one.

HDL can be high as it's the good stuff.

You also need a higher ratio of HDL to LDL, so if you lower your LDL the overal ratio will change.

HCP here.

HDL is high density lipids. These are your 'good' lipids/cholesterol. There is nothing wrong with your level.

Your triglyceride is high as are your LDL (low density lipids).

Thanks everyone. I know HDL is good to be high, but something I read said that they can be too high. I think LDL needs to be under 3 so that is ok.

no robust evidence that saturated fat causes CVD. Not when you look at the real evidence.

Except here.
And here.

I'm wondering what qualifies as "real evidence".

Hmmm, I have a genetic condition hypercholesterolemia and my specialist disagrees that high HDL is ‘okay’. He said to me, over time a blockage of good cholesterol has the same effect as that of ‘good’ cholesterol. I am on statins.
All (generic) health professionals I saw before him said it was the ratio- I’d be cautious, before exploring specific circumstances with a specialist

• a blockage of bad cholesterol

A higher HDL is protective. But your tryglicerides suggest you do eat too much butter and cheese, and you said in your OP, and possibly transfats or 'bad' fats/oils/fried/fast foods, etc. Your total cholesterol level is too high also. So...

*triglycerides

Glad you posted - I had the same from a NHS survey thing

My results were:

6.16
3.57
1.84
1.66

But like you have a healthy BMI, exercise a lot, eat well except for possibly too much cheese, don't smoke and don't drink much.

I didn't realise about a fasting test being more accurate.

I had been planning to try and cut down on cheese a bit (to be honest I'm keen to do that anyway because of dairy farming) and go and get it checked by the doctor in a few months

Producing two links to papers doesn't prove your point at all. I don't have time but could find other papers contradicting those.

The latest I heard was from Prof Tim Spector who said that there is not any real evidence that fats & animal fat causes CVD. (If you don't know him and his credentials, have a look.)

It's far more complex than we ever thought. There is more evidence that it's dietary inflammation , caused by our responses to carbs, rather than fat. Many experts have thought for years that sugar and refined carbs are the villains, not fat.

Also, all animal fats are not equal. Fat from grass fed cattle is different from cows fed on grains . Butter from grass fed cows is different.

To see how cholesterol fits into the big picture do your Q3 score www.qrisk.org/three. - my total cholesterol is also a bit high but it’s balanced out by useful stuff like being female, no family history and a healthy BMI

@lljkk This pretty much sums up what I said about the dubious link.

blogs.bmj.com/bmj/2018/12/17/tim-spector-butter-or-margarine-food-religion-challenged/

You really need to repeat it fasted.

I thought Spector was a covid expert. That guy does get around.

I've had problems with high cholesterol in the past , mainly triglycerides, but still not a good ratio. I've tried 3 statins and together with my current one and a diet change, my cholesterol levels are well within normal limits. I don't eat things like sausages or burgers and cheese makes me ill.

www.kcl.ac.uk/people/professor-tim-spector

One of his many areas of work.

Cast your eye over this @lljkk

Former rheumatologist, now Prof of Epidemiology including research into CVD.

I bet England would win the WC for sure if only Tim Spector were playing for them.