15 year old with cholesterol of 5.4

[Loving-life]

Hello everyone. I am posting this to see if anyone has any answers. My 15 year old niece (sisters daughter) has been told she has a cholesterol reading of 5.4. 🤔 It was the same when she had it took last year. She is a healthy and very active teenager, also a pescatarian. We have a strong history of heart disease in our family. Grandad, father and uncle all dies of heart attacks and strokes at young ages and i had a heart attack at 42. Is this a normal reading for a teenager as i know guidance levels tend to differ with age? Or should there be a referal due to family history? If anyone has experienced the same or similar i would love to hear from you. She has not been put on any medication . Thank you.. 😁

[MichaelJH Heart Star]

Hello and welcome to the forum! I am not medically qualified but would regard that as high for a teenager leading a healthy lifestyle (I am assuming junk food only as a treat and no smoking). Her parents need to talk with her GP and highlight the family history. Ideally it should be brought down without medication but medication is better than an early heart attack!

[Loving-life in reply to MichaelJH]

Thank you michealjh for your much appreciated prompt reply. I Think my sister is hitting a wall with gp. I am waiting to see a a copy of the reading and i will be making an appointment to see him with her. I dont like this being left as my bp was erratic at her age and want to prevent a ha or worse for her. You were right no junk food, smoking or drinking. I am.under a lipid clinic at our hospital to manage my cholesterol as i cannot tolerate statins and i have a defunct PCSK9 gene so have to have special medication to bring mine down. And im a very active, follow a plant based diet, have no salt and my cholesterol was reading 10 even on high dosage statins. Statins unfortunately dont necessarily work for everyone, this is where proper testing comes in. Hence why im a little annoyed why her gp is being vague. Thank you again

[LJR1985]

Hi there

One of my friends has high cholesterol as a family trait and she has been fighting it with diet for a number of years. She is now 30. She will be going onto medication for it to bring it down because by all accounts it seems to be genetic and therefore out of her control. Certainly worth a conversation with the GP with that family history.

[Loving-life in reply to LJR1985]

Thank you LJR1985 ,Thats really interesting, has your friend been tested to see if they have familial hypercholesterolemia, if not i recommend them getting genetically tested as she wil need alternative medication to control it. This is usually carried out by a specialist lipid nurse at a hospital. Take care.

[MichaelJH Heart Star]

Where high cholesterol is generic it is often caused by a mutation in the LDL receptor gene. Unfortunately the majority with this condition are only diagnosed after a cardiac event, usually at an early age. You should ask the GP to screen for this.

[Loving-life in reply to MichaelJH]

Thank you, good call, wanted to see the results to see what each marker was showing. Going to ask them to carry ouy same checks i had. Going to be a battle i think if the dr isnt on the same wave length. Again the fact shes female tends to get overlooked. Its mad, surely if heart disease is strong in the family it shouldnt matter what sex you are. I was dismissed constantly as i was female under the age of 50. Not until a woman goes through the menopause do they then consider it maybe your heart!? Thank you and take care

[NorthantsSteve]

Hi. This article might help: ucsf.edu/news/2010/08/4434/.... It’s from 2010 but implies at that time that Doctors we’re reluctant to treat young people with sub optimal cholesterol levels. I guess that hasn’t moved on much. It also says that the jury is out in terms of statin treatment for young people but that high cholesterol levels do predict heart issues.

Knowing this might help your relative push the Doc to take the situation more seriously.

[Loving-life in reply to NorthantsSteve]

Thank you NorthantsSteve for looking up this article for me. It amazes me when young adults show signs that they are not kept on the radar, especially where there is family history!? Surely It would save the patient and our struggling nhs time, worry and money....

Thank you again, enjoy your day.

[Sususulio]

Again no personal experience but this is a link to NICE guidelines and identifies 9.0 as level for under 30 yrs investigation

nice.org.uk/guidance/cg71/c...

[Loving-life in reply to Sususulio]

Oooh bless you susieag for going to the trouble of looking out this reference for me. Very much appreciated. Have a lovely day 😁.

[Wildhoney]

Hi, I have FH and have unfortunately passed it on to one of my daughters who is now 14, she had her cholesterol measured a few years back and it was around 8. My lipidologist is happy to wait until she gets a little older before treatment. Different hospitals have different guidelines for treatment and at what age. I would certainly think given your family history that she should be checked out although my understanding of how the FH gene works would suggest that if you have it then your brother/sister will not and therefore cannot pass it on to their child. It seems a little irresponsible of a GP not to want to investigate all possibilites though. I had a heart attack at 37 because of an unknown high cholesterol level, not great, but at least it alerted me to my condition and subsequently to my daughters. Forewarned is forearmed as they say. Good luck.

[Loving-life in reply to Wildhoney]

Thank you wild honeym Wow similar to me i was 42 when i had my ha. Still shocks me now. Are you on the repatha injections for FH?

[Wildhoney in reply to Loving-life]

Hi again. No not on Repatha, a bone of contention at present as my lipidologist wants me to manage my Cholesterol through weight and statins. Last appt my LDL was actually high enough to qualify for the drug but as it was only marginal (3.4) I was told losing a few pounds would help. I know there is the cost element here too but I run every day and keep as healthy as possible but at nearly 49 losing weight isnt always easy (I'm 6'3 and 15 stone so not overweight) Are you on Repatha? if so I'd be interested to know your figures before and after being on it. I have my annual check up in a couple of weeks and would like to go in with as much info to argue the case as possible. Thanks.

[Loving-life in reply to Wildhoney]

I will send this though messages as i expect our conversations will be continuous.

[jimmyq]

I have just noticed that if you go to the home page of this site (icon under the BHF logo) there is a link to BHF cholesterol advice.

To add to that I would recommend that you watch the film "Forks Over Knives". It is on Netflix, YouTube and a website of the same name. It is about medical dietary research, including a massive study of 800,000 Chinese people. You might find it helpful, I did.

[Loving-life in reply to jimmyq]

Hi Jimmyq, good to speak to you again, I have watched the programme on your recommendation a month or so ago and it changed my whole approach to eating. Will sit down with my niece and watch it. That you for the link! Much appreciated. Take care

[Midgeymoo17]

As has been pointed out before there is definitely a genetic condition that can cause high cholesterol even in teenagers- and its worth considering: (the website is normally pretty accurate but I can not grantee it as I do not have the condition).

medlineplus.gov/ency/articl...

Equally another thing to consider - and I am not trying to point a finger- look carefully at what she is eating and how it is cooked. It is very easy- for example- to think she is eating mashed carrot and thats healthy. However- if the carrot has been mashed with butter (or carrots cooked in butter)- they taste great, look healthy but have the devil hiding in the detail. Diary products are another wonderful one.

As I said not trying to point a finger- but it is worth looking at the detail either way as if she has the hereditary issue diet will be part of the solution.

[Loving-life in reply to Midgeymoo17]

Hi midgeymoo17 thank you for your reply. It's on my list, I must admit she's the best eater in my sisters family and very conscious of what she eats. She sets a good example, I've even tried to catch her out , not succeeded yet 😃. And she only drinks water! Not the flavoured stuff either. So thought I'd put post on forum to see what replies come up. Thank you for taking the time to reply. Take care

[Hidden]

Hi there - looks like you've had quite a few replies already but just thought I'd help to clarify a few things.

A total cholesterol reading of 5.4 in an otherwise healthy person isn't usually something to be concerned about, but it's important to understand what this reading is made up of. Some people with a high overall cholesterol actually have quite a lot of 'good' cholesterol, so this is quite positive despite the 'overall' being above 5. If the total is mostly made up of 'bad' cholesterol then this can be more of a concern, but an overall reading of 5.4 still isn't deemed as 'high'.

When someone has a family history of heart and circulatory diseases, especially if they've occured at a young age, then the usual guidance on living a healthy lifestyle applies. A GP may consider statins (even if cholesterol is normal) as they have been proven to help prevent heart attacks and other conditions, but this is usually when the person is in their 30s or 40s.

It's different for a family who has a diagnosed genetic disorder, such as familial hypercholesterolaemia (FH) as we can start medications from around the age of 10. You also find that in these cases it's impossible for cholesterol to be reduced to a normal level with diet and exercise alone as the body is wired to produce too much bad cholesterol.

A 'defunct' PCSK9 gene is often associated with FH, so if your sister or other siblings haven't been tested then they can ask their GP to refer them, but with the understanding that genetic testing for FH across the UK is quite patchy and they may not be funded. There is some research to say that people with a faulty PCSK9 gene but with a normal cholesterol level still have a higher lifetime risk of heart and circulatory diseases.

I hope this helps,

Chris

[Loving-life in reply to Hidden]

You have been most helpful chris thank you. Your reply was very clear and my sister is now a bit clearer in understanding it all. Thank you again and take care

[Hidden in reply to Loving-life]

Very happy to help - if you have any more questions please feel free to reply or give our Genetic Information Service a call on 0300 456 8383 between 9am and 5pm Monday to Friday.

Take care, Chris

[Loving-life in reply to Hidden]

Thank you.