Cholesterol advice

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Good afternoon lovely mumsnetters. Help.

I had a blood test recently to check for arthritis. The test has come back fine, however they have flagged up that I have high cholesterol. I've had a bit of a conflab with the GP as she told me I need to go on statins and I've refused.

Im 5ft 8, just over 10stone, I exercise daily, I rarely drink alcohol, pretty low stress levels due to anti anxiety meds, my diet is pretty good and my total Cholesterol is 6.1.

2 Years ago when it was just under 6 I was scared by the GP telling me I needed to reduce it but was then told by one of the lead GP's at the practice not to worry. Now they're scaring me again. I told the GP today that and she said its all changed....again. I told her its not coincidence that lower fat diets over the years coincide with the higher prevalence of Dementia, to which she poo pooed. Yes, I know she's the professional.

I've been told that higher cholesterol can be caused by inflamatory markers which would coincide with the inflammtion in my joints from the start of arthritis. (GP confirmed this from a recent Xray of my knee).

Can anyone help as Im at my wits end. I try everything to stay healthy.

My tola Cholesterol is 6.1
HDL 1.6
Serum try something 1.0
Serum HDL ratio 3.8
LDL Cholesterol 4.0
Non HDL 4.5

Any advice greatfully received before I volunteer myself to the knackers yard!

@Piggywaspushed I didn't know this. They just told me to re refer in 5 years! Thank you, that's food for thought.

I thought that changes in diet only had a limited effect on cholestorol levels. Although if you are going from a high saturated fat, alcohol fuelled junk food diet to a heart healthy diet then yes, there will be improvements, but if you are already fit and on a good diet, as many of us here seem to be, then where do you go, other than onto statins?

Are there any studies comparing these two groups that are starting from different places and whether statins have a marked effect?

As @AvocadoDevil says, maybe the tests need to be different with more nuanced interpretation of results.

Are there any studies comparing these two groups that are starting from different places and whether statins have a marked effect?

I don't know of any studies but my cholesterol was well within normal (can't remember the numbers). My diet was very healthy and I was fit. They wanted me to take statins because my qrisk was high. I have rheumatoid arthritis and SVT and had just turned 65.
The statins lowered my cholesterol even further despite me only taking half the normal dose.

Work out your risk. NICE guidance is offer statins if risk is over 10%
https://www.qrisk.org

My last cholesterol test was 7.2 but as my risk is still around 5% statins have never been suggested.

DH is on statins despite his cholesterol being lower than mine (surprise blockage/family history of cardiac problems) and the first lot he did struggle with - had joint stiffness and pain immediately, it stopped immediately he stopped taking them - but with the alternative statin he has no trouble at all.

https://www.nice.org.uk/guidance/ng238/chapter/Recommendations#discussions-and-assessment-before-starting-statins

Q risk doesn't include triglycerides, though, does it? My cholesterol is OK, Q risk is about 4 %, but my triglycerides were 3.2.

Literally everyone I know has had to stop Statins!! Some have found they can take the alternative expensive ones, but the first call ones seem to be horrendous.

I use this qrisk from time to time, mine is about 5% at the moment

I get confused about the blood pressure reading bit. I am on blood pressure medication but my last reading (taken ages ago, Im not monitored by anyone) was something like 120/80 or might have been 120/70, something like that

How do you enter that into the boxes?

@soupfiend - you would enter 120 into the box for systolic blood pressure.

My 10 year Qrisk is coming out at 4%

Playing around with the figures, if I had what is considered the high end of high blood pressure (150/100) I could put on 30kg (BMI = obese) and still only be at a risk of 4.9%, or if I put on 50 kg (BMI = morbidly obese), the risk is still only 5%.

Ok thank you. Mine is 4.4%

My heart age is 7 years more than my actual age

Disappointing
Im wondering if its because I tick the box about migraines. I get one every couple of months really.

Dont know if that is indicative of stroke risk perhaps?

My GP said the same recently, but I'm not taking her advice because my triglycerides are low, I don't smoke, my BP is low, I run, I eat v healthily. It just seems so f stupid to tell somebody in my position to take statins.
When I got new skrip for hrt the women's health doc had a calculator tool and she quizzed me and told me that taking statins would lower my risk from 2.4% likelihood of a heart attack or stroke in the next ten years to 2.3%

Lot of GPS see things in groups. As in, if you give statins to one group (50+ women) that group will have fewer heart attacks than the group who don't take statins. But there are no stats for a group who are running, eating fibre, beetroot, broccoli, nuts avocado, et cetera

My cholesterol is "worse" btw 6.9

I completely agree that the advice is out of date. I asked the gp who wanted to put me on statins if she thought that was necessary as I only have that one risk factor for atherosclerosis. She looked at me blankly. I asked if I could be referred for the blood tests that would determine categorically if I did actually have atherosclerosis, c-reactive protein test, lipo a and lipoo b protein. The numbers to these tests would tell you if you actually had atherosclerosis, or not.

I was amazed the gp was so unsupportive. I heard about a more aware gp in another practice and I even tried to change, but without success.

My way of managing it for now is to keep running, avoid sugar, alcohol and just keep my metabolic health as good as it is now.

The stupid thing about statins is that they have a negative effectv on metabolic health.

What is the significance of the triglycerides?

Ive just checked my last results in March this year, I aim to have them done again in September

Overall cholesterol is still 6 (same as Sep 23)
LDL 4.3 (very high) gone up from Sep 23 when it was 4.1
Non HDL (very high) gone up from Sep 23 when it was 4.5
HDL 1.3 just over ok, gone up from Sep 23 when it was only 1.1 (not a good score)
Ratio 4.6 (they say thats in the normal range) but this is down from Sep 23 when it was 5 and on that test said the normal range is under 4 (which is what I thought it should be)
Triglycerides - 0.78 apparently very good? Down from 0.9 in Sep 23

So I seem to have lots of bad cholesterol, a ratio that is getting better and not much good cholesterol yet. I would like my ratio to be under 4

This is within a timescale where I have lost a huge amount of weight. But also discovered I have underactive thyroid and I read that this also can give you high cholesterol

There's a bit about triglycerides here:

https://www.heartuk.org.uk/cholesterol/triglycerides

My cholesterol was over 9. I’m very slim, vegan, don’t drink any alcohol, and I’m fit. I take statins, which brought it down to 4, but after a year or so, it’s gone up to 6. I am under the care of a lipid clinic at hospital. I have no side effects from statins.

Amazing that you didn't have any calcium build up. I had a level of 12 once but have hyperlipidemia. Will not take statins as they make me achy and grumpy. Have been told that the doctors get some kind of financial incentive in prescribing them. Taking B3 worked well for me and also reduced my blood pressure. Am over 70 now and have been told for at least 20 years that I will have a stroke/heart attack etc. but am very healthy. We all have a totally different physiology and our cells work in such an individual way it's not one fix for all. Good to get a wide range of opinions before deciding.

Here's a really great video where Dr Paul Mason (sports physician) talks about cholesterol, LDL and so on. He specialises in low carb diets.

Apparently the particle count of LDL is what really matters, and whether it is damaged or not. Damaged LDL becomes smaller and more dense. There's a good correlation between the triglycerides measurement, small dense LDL particles and cardiac risk.

There are other factors he also touches on - insulin resistance, B12 deficiency, various drugs, hypothyroidism, haemochromatosis.

He goes on to explain all this using research papers and graphs, so worth watching. In all of it though, the actual cholesterol measurement isn't what needs to be looked at, it's the triglycerides to HDL ratio that's important. If you have more damaged LDL then you are likely to have high triglyceride levels and low HDL levels.

In another video Dr Mason says he likes to see triglyceride levels below 0.8 and the HDL of at least 1.5. From your results OP you said Serum try something 1.0 - that is the triglycerides, so they're a little above 0.8, and your HDL is 1.6, so that's above 1.5 which is good. In your case OP, the ratio would be 1.0/1.6 = 0.625. This is very good and would be no cause for concern!

Disclaimer: I'm not a doctor and would never suggest you should or shouldn't take statins, but the above is info for you to consider!

This is very interesting

I know other posters arent doctors, but for those that have read up a lot about it, why would someone (me) have very very low triglycerides (that is difficult to type out a lot!) but terrible high levels of LDL/non HDL.

Wouldnt that result in me having high triglycerides? If i had a lot of bad fats in my system?

I worked out that your LDL:HDL ratio is 2.5. That's right at the threshold for healthy/unhealthy. I'd want it to be lower if that were my ratio. I wouldn't worry about the total, but I'd want to action on a poor LDL:HDL ratio.

No one on here has mentioned saturated fat. That's where I'd start, consume less of that to see if my LDL:HDL ratio improved. That guy Thomas Dayspring seems to have a cloud of controversy around him so I wouldn't trust anything he says.

I hope you find a good way forward soon.

No one on here has mentioned saturated fat.

Glad you mentioned it! The doctor I referenced earlier, Dr Paul Mason, quoted a paper of a randomised trial of coconut oil, olive oil or butter on blood lipids and other cardiovascular risk factors in healthy men and women (50-75 yrs) after 4 weeks eating 50g daily of one of those three fats.

https://bmjopen.bmj.com/content/8/3/e020167

After 4 weeks on Coconut oil (94% saturated fat), the participants LDL actually fell by whereas those consuming butter (with 66% saturated fat) significantly rose, as shown in the graph. The paper goes into more details but that's a surprising result if saturated fat is so bad!

Plenty of info here with all the scientific data included:

It's probably your leaky valve that is flagging you up for statins, because you're much younger than the usual people eligible. Or do you have family history of heart attacks/strokes?

Without looking at the information, surely that is because one is a plant based fat and the other an animal/dairy fat?

I thought they were different in terms of how they react in the body

It's confusing alright because all of those keto stans insist butter is fine but they're all zero catbs.

I'm not keto. I'm not even low carb as I would have soda brown bread, sweet potatoes, root veg etc

Another person saying get your thyroid levels tested!! Especially with what you say about IBS which was a huge issue for me before my thyroid was under control.

Menopause can raise cholesterol levels too and you're right in the age group for that as well.

I was diagnosed with high cholesterol last year and brought it down from 7.1 to 5 by completely overhauling my diet - no red meat, no butter, no cheese, sort of intermittent fasting where I have a large bowl of overnight oats around 12 noon, no crisps, minimal cake/chocolate, no booze, lots of salmon, avocado, one of those daily yoghurt drinks like Benecol but the cheapie Aldi version which is just as good. I don't think statins are the devil though and would consider them in the future if needed.

It depends what people interpret by low carb. Low carb can be anything under 100g of carbs a day, this is what I have but I have fruit and veg, porridge, the odd bag of crisps

You wouldnt look at my diet and know that I was a lower carber.

Thanks ladies. I saw my usual GP today and he's done my cardiac risk over 10 years and its 3%. He said I dont need statins right now and can switch up certain things in my diet which I'm happy about.