How to lower your cholesterol

drugs-or-diet-resizedHave you had the “cholesterol talk” with your doctor? You know, the “it’s-time-to-put-you-on-Lipitor-or-another-cholesterol-lowering-medication” talk.

A couple of years ago, my primary care doctor told me it was time to consider a cholesterol-lowering statin drug. My cholesterol had been creeping up over the years and was at a level that put me at increased risk of coronary artery disease – a heart attack.

But like many people who have no known heart disease, I balked at the idea of taking a cholesterol-lowering drug every day for the rest of my life. So, I wondered if there were any alternatives for people like me, with rising cholesterol levels, who want to stay away from a life-long regimen of medications and avoid developing heart disease.

It came as no surprise when David H. Wiener, MD, director of clinical operations for the Jefferson Heart Institute, told me to start with diet and exercise.

Alternatives to statins and other medications

First, Dr. Wiener stressed that it is critical to distinguish between people who have had a heart attack or are known to have coronary artery disease for whom maintaining low cholesterol levels is critical. But for people like me, he said, who don’t yet have heart disease, there are some good options to try before turning to statins or other medications.

If you fix your diet – reduce the amount of saturated fats you consume, increase your fiber intake to between 5 grams and 10 grams a day, and make other heart-healthy food choices – you can reduce your cholesterol level by 15 percent to 20 percent, Dr. Wiener explained. Add in weight loss – often a result of combining better diet and exercise routines – and you can push your numbers down even further. Lose 10 pounds and you could drop those cholesterol totals an additional 5 to 8 percent!

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In large doses, vitamin B3 – niacin – can lower cholesterol, but for the prescription doses needed to work, niacin often causes flushing and itching.

Many people wonder about dietary supplements, and there are lots that claim to help with this problem. Most don’t work, Dr. Wiener said.

And the one that impacts cholesterol, red yeast rice, has many of the same properties as statin drugs and can cause similar side effects. For that reason, Dr. Wiener cautions patients against taking red yeast rice supplements without consulting a doctor and getting regular blood checks for liver problems.

Another popular supplement – fish oil – doesn’t have a major impact on cholesterol but can help heart health for some people.

So there is hope. I’ve managed to get my cholesterol down into the “good” zone by losing weight, improving my diet and exercising regularly.

Cholesterol Levels: What The Numbers Mean

Can’t get your HDL and LDL straight? There’s an easy way to remember which is which.

HDL, your “good” cholesterol, is made mostly of protein and a small amount of fat. It helps move cholesterol out of your body. To remember this, the “H” in “HDL” can stand for “higher.” The higher your HDL, the better.

LDL, your “bad” cholesterol, is made mostly of fat and a small amount of protein. It can cause hardening of the arteries. To remember this, the first “L” in “LDL” can stand for “lower.” The lower your LDL, the better.

Below you’ll find what the numbers mean. Highlighted are the levels you should aim for to be at a lower risk of heart disease.

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What Do My HDL (Good) Cholesterol Levels Mean?

The Level What It Means
60 mg/dL and above High HDL (lowest risk of heart disease)
40 to 59 mg/dL The higher, the better (lower risk of heart disease)
For men, less than 40 mg/dL Low HDL (higher risk of heart disease)
For women, less than 50 mg/dL Low HDL (higher risk of heart disease)

What Do My LDL (Bad) Cholesterol Levels Mean?

The Level What It Means
Less than 70 mg/dL Low LDL (optimal goal if you’re at very high risk of a heart attack or death from heart attack)
Less than 100 mg/dL Low LDL (optimal goal for people with heart disease or diabetes)
100 to 129 mg/dL Near or above optimal levels
130 to 159 mg/dL Borderline high LDL
160 to 189 mg/dL High LDL
190 mg/dL and above Very High LDL

What Do My Total Cholesterol Levels Mean?

The Level What It Means
Less than 200 mg/dL Desirable (lower risk)
200 to 239 mg/dL Borderline high (higher risk)
240 mg/dL and above High blood cholesterol (more than twice the risk of desirable level)

What Do My Triglyceride Levels Mean?

As you get older and/or gain excess weight, your triglyceride levels tend to rise. Triglycerides are the most common type of fat in your body and are also a major energy source. Having high triglyceride levels may increase your risk of developing coronary artery disease. Very high triglycerides may even lead to pancreatitis.

The Level What It Means
Less than 150 mg/dL Normal
150 to 199 mg/dL Borderline High
200 to 499 mg/dL High
500 mg/dL and above Very High
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Cholesterol, fat, and statins

The take home message I want to leave you with is how rapidly changeable cholesterol values can be. Dave Feldman’s data has shown that eating fat three days before can markedly alter your total and LDL cholesterol numbers. Eating fat five days before can bring about huge changes in your LDL particle number.

Given that cholesterol levels and particle numbers can change dramatically in just a matter of a few days, why in God’s name would anyone want to go on a statin because of a cholesterol reading that is a little high? Depending upon what you eat, it may drop like a rock in a couple of days.

Statins are not benign drugs. They come with a host of side effects, occasionally fatal ones. You end up having to have your liver monitored closely, which requires extra trips to the doctors. Which are expensive. And that doesn’t include the expense of the drugs. You risk developing diabetes (females in particular) muscle aches and pains and memory loss. Plus, at this stage, no one knows what the long-term overall effects are on cholesterol-dependent tissues such as the brain, for instance.

And how many people are taking them right now based on just one single cholesterol reading that was a little high.

It’s a choice you’ll have to make along with your physician. I just think you need to have all the facts at hand before you even consider taking the statin plunge.

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