Cholesterol Q for the Docs. in the house
 

A couple of weeks ago I got my annual physical. My PA said that everything looked good except that my Folic Acid levels were a little low, so now I take 400mcg each morning to get that back in check, She also said that my cholesterol levels looked very good as well etc... I want to better understand where I stand on my cholesterol levels, so I would like you to rank the shown levels below based on a 5 point scale.

1- Bad/at risk
2- Below average
3- Average
4- Above average
5- Excellent

Here were my results:

Total Cholesterol= 178
Triglycerides=118
HDL=53
LDL=101
VLDL=24

Thanks in advance,

SG

Get health insurance!!!! :)

So now you're a Doctor? Ok, you have a choice, Dr.Doolittle or Dr. Suess :nanana:

*Snap* the sound of latex gloves...:rofl:

Your LDL (Bad) Cholesterol Level

The lower your LDL cholesterol, the lower your risk of heart attack and stroke. In fact, it's a better gauge of risk than total blood cholesterol. In general, LDL levels fall into these categories:

LDL Cholesterol Levels

Less than 100 mg/dL


Optimal

100 to 129 mg/dL


Near Optimal/ Above Optimal

130 to 159 mg/dL


Borderline High

160 to 189 mg/dL


High

190 mg/dL and above


Very High

Your other risk factors for heart disease and stroke help determine what your LDL level should be, as well as the appropriate treatment for you. A healthy level for you may not be healthy for your friend or neighbor. Discuss your levels and your treatment options with your doctor to get the plan that

With HDL (good) cholesterol, higher levels are better. Low HDL cholesterol (less than 40 mg/dL for men, less than 50 mg/dL for women) puts you at higher risk for heart disease. In the average man, HDL cholesterol levels range from 40 to 50 mg/dL. In the average woman, they range from 50 to 60 mg/dL. An HDL cholesterol of 60 mg/dL or higher gives some protection against heart disease.

Soooooooo basically u're risk is very low assuming u do not have diabetes, family history or smoke. Drinking a beer a day also helps(or some form of alcohol)

So 'she' put on gloves and asked you to cough? ;)

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SG, any family history of heart disease? Yes, the lower the LDL, the better. However, since you are NOT on lipid lowering agents and you have those numbers with diet & exercise, you are doing fine. The folic acid being low is interesting. Avoid ETOH. Your HDL is higher than most guys (HDL > 40 for men is recommended). Higher HDL is cardioprotective. Continue a low fat, low cholesterol diet...if I have more info re: age, weight, ht, waist size, then I can give you the stats your want re: cardiovascular risk. Keep up the low cholesterol diet. Your trigs are great as well (fatty acids).

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Also, what is your blood pressure and fasting sugar levels? If your BP & fasting sugars are normal & no family history, then your numbers are decent. Just keep those lipids in check.

BTW, my LDL is in the 70s.

Nope HE did the asking. :rofl: :rofl: :rofl: :rofl:

I was hoping she would, my PA is very cute ;) Didn't happen. I was also surprised that my prostate wasn't checked.

Thanks Doc! No family history of heart disease. I'll PM you more stats. What is "ETOH" ?

Blood pressure average = 132/82

What is the code/term to locate my fasting sugar levels on my lab report? Is it the Glucose, Serum level? If so it's 118 and marked as High on the report. The PA hand wrote "non-fast" next to that number???

Ethyl Alcohol, i.e., booze.

:beerchug:

Thanks for your information, it is appreciated !

Depending on the lab (nowadays it is mostly Quest Diagnostics and a small percentage of blood work is done by Lab Corp), the normal blood glucose (sugar) in the serum reading is 65-99.

Now, if you fast for 12 hours or so, it definitely should be between 65-99. If you have a fasting blood glucose of 100-125, then you have Impaired Fasting Glucose which is a pre-cursor condition before developing Diabetes Mellitus. (Bascially, I tell them your have "pre-Diabetes" and it is not a matter if, but when you develop Diabetes Mellitus Type 2).

If you have two fasting blood glucose at or greater than 126, then you are defined as having Diabetes. If you have one random glucose level at or above 200, you are diabetic!!

I would definitely make sure you follow up with primary care physician re: glucose level.

There are several treatment options.

The other question that brings to mind is that if there is a family history of Diabetes Mellitus?

If you do have Diabetes Mellitus, it is definitely increases your cardiovascular risk by at least twice normal. If you have Diabetes Mellitus, then the goal is to get your LDL cholesterol down to 70 or less to reduce cardiovascular risk. Also, there are several other medications you'll need (Aspirin a day, cholesterol-lowering meds, diabetes medication, special type of blood pressure medicine such as an ACE-Inhibitor or Angiotensin Receptor Blocker to both lower your BP and protect your kidneys from damage from diabetes. Then you'll need your eyes checked yearly, etc., etc.) The goal is to control the Diabetes before it controls you and do damage to your organs.

Also, patient age 40 and above should have a digital rectal exam to check the prostate. PSA blood screening is done usually at age 50 and above unless you have a family history of Prostate CA, then it may be done earlier depending on what age your father got the Prostate CA. Blacks should probably get PSA screen starting at age 40 and above as well as the rectal exam.

SG, I suggest that after following with your PA re: fasting glucose level, I would feel more comfortable if you actually had a chance to discuss all your findings and questions with an actual physician (no matter how cute your PA is). ;)

I assume she wants to check your fasting glucose level. However, if you fasted for your cholesterol/lipid numbers, then you must have fasted for your glucose. If you truly fasted (no food or drink, except water) for 12 hours or more and your glucose leve is 118, then please see your Primary Care Physician!! (See above post for the reason).

SG:

I've become an expert on this stuff lately because my dad had a heart attack a few months ago, and now he is going through the process of changing diet, taking medication, and trying to do as much as he can to use natural therapies as well.

From looking at your numbers, they look pretty good to me. I don't think you have to worry much at all. Your cholesterol might be on the higher side of average, but it's certainly not "high". If that worries you at all, try taking "omega 3" (fish oil) supplements daily. That usually helps to lower your LDL and raise your HDL a bit. But you don't need any drastic changes.

SG, with no risk factors, your lipids look good. I am with K, lets get a good fasting blood sugar
and ask her for a Hemoglobin A1c to look for recent increases in blood glucose.

Will do, thanks. I have an appt. on May 14th and I'll ask for that test to be added to my bloodwork :thumbup:

Thanks Eric! Actually, from everything I have read and heard from the Docs here, my LDL levels are at the Optimal level, and better than average. The Omega3 sounds like a good suggestion to me :)

SG. My site has some very high purity Omega 3. Purity is the key for this
group of supplements.

I'll check it out, thanks again :)