Help - cholesterol panic

[SunnyC41]

Hi guys, can anyone offer some input?

45 year old female. Don't drink or smoke. I'm around a stone overweight and my chocolate addiction means that my diet really isn't great.
Just found out my cholesterol is 6.9
HDL is 1.4
LDL is 4.9
(Not sure about triglycerides yet)

History of heart disease on both my parents' sides.

What do I do? Less fat? Less sugar? Fewer eggs?

I'm panicking and filled with more than a little self-loathing (regretting all that chocolate now).

Thanks in advance.

In a nutshell, yes I think so. I can't remember the precise details - I was out for lunch with DH and steering clear of all the high fat items on the menu, which led to the conversation about how you'd manage in France, at which point I asked AI about cholesterol levels there. We were both surprised when the answer came that the UK has higher levels, so I delved deeper and asked whether that was based on statin use (based on the conversation I'd had with my GP, who said they were vigorously encouraged to prescribe them, which she was sceptical about and reluctant to do) and the answer was - yes, spot on, and a whole lot more detail about a controversial book that was published in France in the early 2000s I think, essentially saying that statins were evil (I'm massively generalising!) and advocating for more of a lifestyle approach. I think this may have changed the emphasis for treatment in France, and that they may have a higher threshold for 'high cholesterol'?

I was on my phone and don't want to be one of those people in a restaurant so just skimmed through the information, but that was my takeaway. Those were the two prompts I gave the google AI search tool if you wanted to look into it for yourself. It was quite an interesting alternative to our approach.

There is. I check labels on everything I buy now and avoid anything with high saturated fat. It’s not that difficult. It’s cheese I miss most but I have it when I eat out.

I have total 6.6. Good ratio Hdl/ldl and low triglycerides. I take no statins and never will. Diet is only minimally helpful for anyone. I had a cardiac calcium CT scan with that high total reading and got a zero calcium score, which means no calcium deposits in the arteries. I know there are other reasons plaque might form, but the result is good enough for me.

Now where's that chocolate.

As other risk factors for cardiovascular disease, make sure your Bp and Hba1c are ok too.

Mine is high too. I'm addicted to chocolate and need to minimise it. My diet isn't that bad overall though as my meals are textbook, so I think perimenopause has a lot to do with why my cholesterol is high.

I’d consider a statin if I were you

Lots of family members had heart attacks in their 50s, which obviously worries me, but they were drinkers and smokers. Statins seem to have a bad rep but perhaps they're inevitable at some point.

I've been told to take plant sterol supplements. Have a google- they're apparently very effective in reducing cholesterol.

@Specialneedsnightmare thanks! Will look into it. Not sure if there's any point in asking for a FH test to see if it's mainly hereditary rather than lifestyle. Anyone had this test?

I have. My Dad passed the faulty gene on to my and my 2 bros. Mine was done via screening at Manchester Royal, where my Dad had his consultant and I’m now under their care too.

I was flagged as my Dad and my brothers were confirmed as having the mutation. Not sure how easy to arrange/request if you don’t already have it confirmed in your family history.

I tried plant sterols and they made no difference to my cholesterol, I'm now on the DASH diet for prediabetes and I've lost a stone and a half with very little effort. I'm waiting for my next set of blood tests to see if its had any effect on my cholesterol and blood sugar.

Oh that's disappointing but I guess no one thing will work for everyone. I'll see if they make any difference to me. My A1c text showed I'm only a point away from being prediabetic so I'm very conscious of that as well.

I reduced mine by cutting out all biscuits, cakes, puds and sweets, replacing cows milk with unsweetened soya, using Benacol spread and also eating porridge At the time this got it down from 6.3 to 4.9. which the Dr was very happy with.

Just to add, if you do test positive for the genetic mutation you will be strongly encouraged to go on statins, regardless of what your cholesterol levels are, as a means of better controlling it. Statins weren’t enough for me, I’m also on Ezetimibe. From Feb 2023 when my LDL was 5, it’s now below the threshold they want it to be for people with FH (1.8) and only need checkups and bloods annually instead of every 6 months.

I was diagnosed with higher cholesterol than you a few years ago. Combination of genetic issues, menopause and underactive thyroid. I did lower it considerably by completely overhauling my diet - no red meat, no dairy other than fat free yoghurt and semi-skimmed in coffee only, no pastries, minimal fried foods. Lots of good fats in salmon, avocados, nuts. It worked, but for me it wasn't really sustainable so I am now on statins which have worked really well and no side effects.

The "cholesterol myth" book is written by an alternative medicine advocate and his claims have been debunked by many medics both here and in the US.

Trust what reputable sites like the NHS, British Heart Foundation, Center for Disease Control in the US say about it. Not some quack who just wants to flog books.

I live in France and started on statins last year. Two different GPs recommended I take then as did a specialist I saw. I know lots of people taking them so it's not my experience that they don't prescribe them easily.

That's really interesting - just goes to show that AI isn't a hugely reliable source of information! Thanks for adding your actual experience.

@Seaoftroubles that's really encouraging, thanks. Hopefully I can follow your lead.
@LaliqueSaltGrinder Thanks for the info on the book. Yeah, tried and tested info is what I need right now rather than anything that'll steer me in the wrong direction.
@gillefc82 this is really helpful to know, thank you. If you don't mind me asking, how old were you when you started the statins? Have you had any side effects? There's so much conflicting information about statins but I suppose for some of us they're a no-brainer.

I started on them just over 3 years ago (atorvastatin 20mg) and I’m 44 now. As I said, in order to bring my levels under the threshold I also have to take another medication, Ezetimibe.

I haven’t had any side effects thankfully but am in the throes of peri, so struggling in other ways! 😂

I also take Nattokinase as a supplement which has some reports of supporting cardiovascular health, keeping arteries clear etc. Not entirely convinced but my DH wanted me to try it and as long as it wasn’t conflicting with any of my meds, was quite happy to try it and keep him quiet!

Hope all goes well with your call.

Look up Dale Pinnock on YouTube, I think he goes by The Medicinal Chef. If you sign up for his emails he sends out recipes to deal with all sorts of health factors, inflammation being one. The recipes are easy and appetising and he explains in detail what the health benefits are.

The medical profession can’t make up its mind about cholesterol levels so I wouldn’t get too hung up on numbers, but you can improve your diet easily enough as a first step.

The French (somewhat less CVD than Anglo countries) is about their diet (being relatively high in saturated fat & cholesterol high foods) not about the cholesterol levels in their blood.

OP, you haven't mentioned exercise once. How many minutes of physical activity do you do each week? PA can affect cholesterol levels a lot, too.

People without familial hypercholesterolemia can affect their cholesterol levels within 2-3 weeks with diet, btw, if they are strict about it.

There is only so much you can do with your diet if it is genetic - but I would cut out daily chocolate if you can, follow the portfolio diet for 3 months and ask for a retest and see what it says. You may be surprised by how much you can move it. I paid for a Lp(a) test which is a good indicator of your genetic risk (your GP may offer it, mine didn’t).

I’m on my 2nd lot of statins - didn’t get on with the first lot and now trialling another (but also getting side effects annoyingly).

What is the DASH diet please?

There's a lot of negativity around statins and I'm not really sure why. I'm on 20mg and for the first time in my adult life I have levels in the normal range. No side effects at all. I have always followed a healthy diet, exercise etc with no effect on levels. Everyone in my family seems to have high cholesterol so I'm pretty certain there is a genetic link for me. My doctors have agreed (in France) and I was referred to a specialist to check the arteries in my neck weren't already narrowed with plaque and she strongly recommended taking statins before damage is caused and putting me at risk of stroke.

This is completely wrong.