Hi all , so since yesterday I’m just after some advice and reassurance as previous post you can see my history , I have since then had a liver test and they came back very high as pic shows , I’m now very worried how to bring these all down I’ve been put on 80mg atorvastarin for now and start my rehab tomorrow,,, I’ve quit smoking over 3 months completely started new diet ... although I was a bit naughty with diet before all this I never felt I’m more worse with food than most people so this is all very strange .. plus my age to .. my gp was very surprised with it ,, I just want to know I can help myself to bring this all down and that things will gett better as we go I guess ,, thanks for taking time to read this 👌👍
Very high cholesterol levels - British Heart Fou...
Very high cholesterol levels
Written by
alfiebloom
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52 Replies
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Can I suggest you change the image, you're showing a lot of personal info, DOB, address, NI number!
Thanks think it’s better now 👍
Firstly, your liver all looks fine to me, all the liver tests are within normal ranges.
Your total cholesterol is “high” but nowadays a total cholesterol score (yours is 8.4) is considered worthless in and of itself.
A high Triglyceride score (yours is very high at over 9) is much more concerning. Triglyceride values do change significantly from day to day (can be 2.5 one day and 1.5 the next) so they are hard to measure accurately directly.
The best way to measure Triglyceride levels is actually the Total Cholesterol:HDL ratio. This is because HDL tracks Triglyceride but is a less noisy thing to measure. Yours is 8.4 i.e. very high.
Now, what does this mean? There are multiple types of LDL, large is actually good, small is bad, as is modified LDL. A common type of modified LDL is LP(a) LDL; around 20% of the global population have high LP(a).
It is considered that a TC:HDL ratio over 1.5 suggests you have small dense LDL, a bad type of LDL. Ideally you want it below 1.2
However, the reality is you might have LP(a) LDL not small dense LDL. So if I was you I would try get an LP(a) test, but your GP probably won’t want to as they likely won’t know how to interpret it. If you have a myriad of family history of angina, heart attacks, statin prescription etc. then maybe you can get yourself referred to a specialist such as a local Familial Hypercholesterolemia unit for more specific tests?
My Total Cholesterol was higher than yours 2 years ago. Nothing was done, I considered getting myself a CAC score scan but didn’t get round to it. Then a month ago I had a heart attack. I was put on 80mg Atorvastatin. The day I had the heart attack my total cholesterol was 7. Ten days later it was down to 4.7. So your statin will lower your Cholesterol, but it might not reduce your risks going forward.
I have got myself referred to a FH clinic by insisting I want tests to determine what type of LDL I have. This is because if I have high LP(a) statins will not affect my risk one bit and neither will diet or exercise! Statins are worthless if your high cholesterol is LP(a) LDL and not sdLDL.
I’ve been on Atorvastatin for less than 4 weeks and side effects are starting to rear their head 
am getting tingly arms and legs and back pain, so am actually considering only taking them every other day. After all, my cholesterol is now considered in normal range so why am I still on the maximum dose of a drug that has a high half life ( the amount in my body will be gradually building).
In terms of diet, irrespective of effect on risk factors, switching to a more mediterranean diet and stopping eating sugar, flour, rice and spuds will reduce your Triglycerides and likely make you have a better quality of life.
Exercise will also increase your good HDL so that’s a no-brainer too when you can.
Hi many thanks for your reply it means a lot I’m thinking to see how these statins now go and now starting rehab Tommorow and then exercising more and diet over the next 6-8 weeks then see how it goes with the next blood test ?! Would you think this is a gd way to go !?
Yes the Statins will bring your cholesterol down, which will give you more peace of mind. Longer term try to find out if you have LP(a) though.
Some LP(a) info: health.harvard.edu/heart-he...
Just to correct myself, it’s a Triglyceride level over 1.5 that suggest sdLDL not the TC:HDL ratio.
Hi Ader42 - just wanted to let you know that we need to be careful about offering medical advice to others on the community. We would always ask that people speak to their GP - of course you're welcome to share your own experiences but the community isn't the place to advise others on treatment or test results. For more on this, you can find our community guidelines here healthunlocked.com/bhf/post... Thanks!
Thanks again and hope your getting over your recent events as am I ... but am felling a lot better with this site educating me about ha and liver tests so thanks again ... just to add it was me that asked my gp why I have not been put on statins yet following my heart attack 9 weeks ago , so I’m glad I chased this up .. I would of thought they would of tested me on that while in hospital surly ?! But at least I’m on right track now
Were you given detailed discharge notes when you left hospital? Maybe they sent them direct to your gp? When I was discharged I was given a letter to my gp which had all my blood test results on so I could see my liver was fine, what my cholesterol score was etc. I was also given a less detailed letter for me personally without all the test results.
You might find this video useful:
m.youtube.com/watch?v=9BFRi...
Some people are fond of putting up videos from various internet gurus. I think it's best to take advice from reputable sites like the BHF, NHS etc. There's a lot of dubious stuff out there!
Hi Ader42
Whilst videos can be helpful as guidance I suggest research evidence based information from the BHF and NHS are more reliable sources of information.
There is also Heart UK a charity specifically for those wanting to reduce their cholesterol levels.
I am in my second month on a Mediterranean diet (restricted carbs as pre-diabetic) and statins. Everything (cholesterol, BP, HbA1c and weight) is going the right way and no side effects! I think side effects of statins are blown out of all proportion by internet expurts!
I have 3 relatives that have suffered statin side effects, 2 stopped taking them due to the pain. I’m on Astorvastatin and had no side effects for 3 weeks but am now starting to get pins and needles all over especially after waking.
Many, many people have side effects and of course many don’t. You’re lucky.
My husband has been taking statins for 15+ years, a friend has taken them since the 90's and my sister has been on them for a few years, all without any side effects. Why not ask your Dr to change your statin, you may find another that suits you better.
Hardly conclusive evidence that there is a problem with statins. Were they tried on alternative statins/lower doses as I have seen suggested on these pages. There is a new thread about CHD being hereditary - maybe an intolerance to statins in your bloodline.
I have seen you post similar answers but have not seen a reference to research articles on the LDL subgroups to back it up statements like "Total cholesterol is useless!"
Blindly ignoring the many people who suffer side effects and implying they are making it up is absurdly and morally wrong. Some people have side effects, others don’t.
And anyone who does any reading or research on the subject knows full well talk of “Total cholesterol as a measure on it’s own right” is 30 years out of date.
People who only talk of good or bad cholesterol are 20 years out of date.
There are a variety of types of LDL and large buoyant LDL is a good thing, other types of LDL are indeed bad, but so is prescribing statins to the 20% of the population that have high LDL due to LP(a)LDL which statins do not treat whilst ignoring or failing to diagnose the real cause of their problem : Lipoprotein(a).
I would rather go with the advice of current progressive professors and cardiologists and recent studies than the myths perpetrated last century.
Research shows the percentage reporting side effects is 5% - 10%, usually muscle pain. In many cases it was found to be musculoskeletal rather than statin related.
I would suggest anyone reading Ader's posts to actually follow the advice of the BHF on their website. They are completely up to date and rather more reliable!
I would suggest everyone gets as many tests as they can to find the true root of their health issues and ensure they get the correct medical treatment.
I also suggest people should not blindly trust any single person or organisation and should do all they can to keep themselves informed.
Lots of GPs qualified many years ago and got less than 2 hours training on nutrition for example. Doctors are told when they graduate that much of what they have been taught will be proven wrong or shown to be incomplete within 5 years and so they must learn to keep themselves up to date. Sadly many do not.
It’s your health, empower yourself!
Have you considered you might be teaching some forum members like grandmothers to suck eggs? 😊
Coronary artery disease is not the only heart condition that members live with.
Information has to come from reputable sources e.g. the BHF, or for example the guidelines of the ACC/AHA and the ESC.
There is a great deal of misinformation on the internet which unfortunately becomes spread on social media like this site.
I have spent my working life evaluating academic research and I do not trust blindly. I trust the BHF - I don't trust internet gurus one little bit!
Science advances through the scientific consensus, which is a very powerful tool for evaluating evidence, and the best evidence is of course randomised controlled trials.
All the best
in reply to Ader42
Ader42, I am very interested in your comments regarding pins and needles. I have posted previously on this, as I too have experienced them, but it does not seem to be a common problem. I have not seen many, if any other posts on the subject, and my GP was at a loss to explain them - my heart function is good and I exercise to quite a high level regularly. I get them in my hands, forearms, and also just above my ankles, and often more so after exercise. I am now only on Atorvastatin 80mg and Clopidogrel 75mg, having very recently (2 days) been taken off Asprin 75mg. I had 2 stents no HA. Lately, I have not experienced the pins and needles anything like as much, I was going to see how I went on after stopping either the Asprin or Clopidogrel but they have now subsided to the point where I would find it impossible to say if anything specific is causing them. Maybe it is just something in my body that has changed, but I have just got used to it now particularly as they seem to be reducing. Anyway to cut to the chase, I stopped taking the Atorvastatin to see if they were causing the problem, and also if some of the aches I was getting subsided. Guess what, no difference even after 3 months of not taking them. I think I had just got it onto my head that the aches were down to the Statin due to reading too much! Maybe it's because I am 61 and think I am 21 when I am sprinting for the finish at the Park-run again. I also stopped them to conduct a bit of an experiment to see if I could drop my cholesterol down to Statin taking levels through dieting and exercise, as I am quite strictly vegetarian, sadly it did not work as well as I was hoping so decided to go back on them if only in the hope that they prevent any further blocking of my arteries. The GP did suggest taking a couple of vitamin supplements but they made no difference as expected. So, I would think carefully about the Statin if I were you?
Ader42 in reply to
Thanks for the reply. I admit my pins and needles could in fact be being caused by any of the 6 meds I am now on including the Aspirin.
There are a variety of causes of pins and needles.
Just a few off the top of my head.
Diabetes
Neurological problems
Poor circulation
Peripheral artery disease
Raynauds Phenomenon
Pernicious anaemia
Vitamin B12 deficiency if you are on a vegan diet.
Trapped nerve
Cut out red meat, I had already done it before my heart attack and I was pleased that mine had dropped so much. Sadly post heart attack it wasn't enough but with the statin it is now acceptable.
Did you switch the red meat for something else? If so it’s more likely that the thing you switched to was good for you than the red meat being bad. For example chicken breast contains Niacin which lowers cholesterol. Niacin is sometimes used instead of statins. It’s also worth remembering that dietary cholesterol at most only ever accounts for 15% of the cholesterol in your body. The liver makes most of it, so cutting dietary cholesterol by itself is ineffective, and can even lower your good HDL.
Btw, you might find this useful:
naturaleater.com/science-ar...
You may want to read what the BHF have to say about Aseem Malohtra & his dietry views
bhf.org.uk/informationsuppo...
Thx. Always good to have balance. If Malhotra was your London cardiologist and advised you would you do as he advised?
Don’t we tell everyone on here to not question their GP let alone their cardiologist?
My cardiologist was quite happy for me to be on a keto diet for example, I thought he’d tell me to change but I’ve made subtle changes of my own accord (more veg, even less flour).
We all have to take some personal responsibility for our own health.
We take full personal responsibility for our health by discussing it with our medical team. And having discussed this diet extensively we're more than happy to follow the bhf guidelines as we have for the last 22 years.
You might be interested in this research from Kings College London
We all need an individual bespoke approach to our Cardiology care including diet.
kcl.ac.uk/news/spotlight-ar...
However the Mediterranean diet has been shown through research evidence to be beneficial overall for many.
I’ve been on statins for years and luckily no problems. The high dose after a heart event is normal Importantly statins work. If the type you are prescribed trouble you tell your gp and change it. Do keep on a healthy diet and exercise. The BHF has really useful pamphlets.
Hi, read with interest your posts. I had a heart attack at 37, although not as severe as some on your feed, had two stents fitted. My overall cholesterol was 11 at the time of the event! This was over 12 years ago and since I have been on various statins ending up with Rosuvastatin along with a cocktail of beta blockers and blood pressure pills, they made a difference and I suffer no side effects. I would always advise to take the drugs and not worry about pins and needles etc, although this may be uncomfortable it is better than suffering another event. Exercise and a healthy diet are vital although we all lapse sometimes and keeping it going over years can be difficult as our lives change. The benefits of a healthy life are obvious not just for our heart health but overall. After several years of statin taking I was referred to a Lipidologist, as my cholesterol was still stubbonly high, and they did a genetic test for FH, as has been mentioned on your feed. They found a mutated gene which proved this is what I suffered from and I am now treated accordingly. I have recently been put on a twice monthly injection of Repatha which has brought my overall Cholesterol level to 2.0 and my LDL to 0.8, so very effective. As others have mentioned it may be something to mention to your doctors. Is there a history in your family of heart problems as this may be an indicator? I appreciate that you get bombarded with advice and info which is quite alien to you but as someone who has lived with this for a while I'd say try not to stress!! It becomes quite normal after a while and the drugs are all very effective. So to sum up a long post. Ask about FH next time you see a doctor. Regards.
I absolutely agree about the FH test, given Alfie's cholesterol and history. Incidentally I have a friend whose FH was diagnosed and treated decades ago - his father died very young but he himself is now retired with no problems. Drugs and healthy lifestyle do indeed work! Congratulations on your LDL lowering.
Repatha is a PCSK9 inhibitor and so can also be used to treat high LP(a)LDL.
About 30% of people with FH have high LP(a) and about 20% of people globally (including those without FH) have high LP(a).
Best to get referred to a FH clinic if you can to test if you have FH or LP(a)
Hi Alfie,
I too am a relatively young HA survivor (52). Same as you, whilst I was overweight and ate the wrong things I wasn’t the type you’d imagine heading for a heart attack. Even the paramedics said I was the least looking like a heart attack they’d ever seen. I was told my previous smoking habit was the biggest culprit, even though it’s over 5 years since I stopped. Genes also play a massive part, and this is something I may explore for my children’s sake.
I’m on the 80mg atorvastatin too. Aches and pains? Possibly? From the statin? Or from the increase in exercise? Unbearable? Definitely not. The bisoprolol has made me generally cold, especially my hands - hunting through the freezer definitely requires warm gloves these days.
I’m sort of following the med. diet, definitely eating less, and virtually no rubbish. Some of this isn’t particularly pleasant. Some of it is ok.
The alternative is definitely not ok.
in reply to Sillyfroggy
I am surprised at your comments about the med diet not being "particularly pleasant"? What do you mean exactly? There are some fantastic, delicious vegetarian options as well as a host of things that a med diet can contain, no offence but I think you are putting out an incorrect and not very encouraging message. Are you saying you enjoy eating rubbish? I have some fantastic suggestions for cookery books if you are interested!
Sillyfroggy in reply to
I meant giving up my cakes, biccies and fast food isn’t particularly pleasant!! Ned diet is lovely. Lack of the bad stuff is not!
Sillyfroggy in reply to
And yes, I did enjoy junk food! Along with many others here I would guess! I don’t think it’s that unusual to like it? More unusual to like it but have the self control to not have it!
in reply to Sillyfroggy
Mmm, don't know what to say really, as I really don't want to cause any offence! I would have thought anyone who has had a HA would have seen junk food, cakes, biccies and so on as poison. I personally do find it unusual as I have never really liked that kind of crap, but I do admit to being a bit too keen on dairy produce along with the usual meat based diet. Since having had 2 stents fitted after diagnosed with 96% LAD blockage I have become vegetarian, and apart from loving it have come to view things like lamb stew and butter with almost revulsion. There is no way I want whipping into the DRI at top speed courtesy of a yellow bus again! I think the food industry has a lot to answer for and the promotion of this fast, junk food is becoming a national disgrace to be honest. As you say it is not unusual unfortunately but things have to change.
Ader42 in reply to
I’d agree with you on the cakes and biscuits being poison. Sugar and flour are a disaster for heart and artery health. I don’t have a problem with natural unprocessed real food like meat, eggs and butter though, but each to their own.
The only sugar I intake is a satsuma a day and maybe some berries. VitC is good for arteries in it’s natural state and the good of the fibre offsets the bad of the fructose.
I can’t say I’m a fan of veggies unless I make veg stew, chilli or curry in the slow cooker! Especially including heart healthy choices such as asparagus, garlic, turmeric, olive oil, broccoli etc.
in reply to Ader42
White flour is not good, but maybe not a "disaster" Certainly refined sugar in it's various forms (yep, biscuits, cakes, chocolate bars etc) is an increasing problem in society, you only have to look around at the increasing levels of obesity. As you say each to their own, personally I believe we are consuming far too much dairy and red meat, beef in particular. I am unsure about eggs, but I think the saturated fat content of butter should make it a big no no for anyone who has CAD, especially in respect of the plant Sterol rich alternatives. I think people are probably fairly ignorant of the amazing veggie based meals that can be made to be honest! As regards Beef, we absolutely have to reduce our desire and consumption of it anyway, it is a very significant contributor to greenhouse gases.
Ader42 in reply to
I’m sure you’re right about ignorance of good veggie options, and I say this with my other half being a veggie for 30 odd years!
Thanks for the advice all ... first day of rehab done today and feeling really good , plus all the help on here 👌
Brazil Nuts can help to lower cholesterol: healthunlocked.com/bhf/post...
Following a recent health check I discovered that I have high cholesterol. The nurse advised me to go on to statins but I refused. She then said I could try changing my diet for 6 months and retake the blood test. I had highish cholesterol 5 years ago 6.7 and managed to get it down to 4.5. However I did not stick to the low fat diet. Family gave me chocolate for my birthday about 2 kg and I consumed the lot in about 3 weeks, shortly afterwards I had the blood test, which may be some of the cause of the high results. Nothing better than a few chunks of chocolate for breakfast.
When I reduced it before I cut out fried food, no full English Breakfasts, cut out red meat no deserts, fruit instead, no cheese. Only buying food that has low saturated fat, low sugar, low salt, green or or orange labeling, no reds. Pleanty of fish, vegetables,salads, chicken instead of beef, pork and lamb.Nuts and pulses.
Venison or pheasant are ok. No ice cream, cream or butter. Benecol instead
and Benecol yoghurt that contains plant stanols. Aparently the French eat butter, cream etc and have a lower level of heart disease than the UK but there is a reason for that.
Hope this helps it did work for me the first time, just hope it works again and I will have to stick to it this time.
The thing is, we are not all the same but the medical community thinks we are all the same and wants to give us all the same advice.
2 years ago my Total Cholesterol was 9. I dropped this to 7 within a week by eating a lot more fat. Turns out I am a hyper responder so eating more good fat (avocado, salmon, nuts etc) and avoiding carbs works for me.
We all have differing genes and differing biochemistry so what fits one person may not fit the next. The best ball-park is likely the mediterranean diet, but adjust from there to suit.
Hi mine was 8.9 in July after my heart attack .I'm 36 not overweight ate relativity well but I did smoke (idiot).
I'm on atrovastatin and my last check in Nov my is now 3.1. I'm eating mostly a vegetarian diet 6 days a week will a treat at month end. Gym 3 the 5 days a week and feel great. You can do it but you Must change your lifestyle it's not easy but it's worth it
Boosting an old post ... so had my annual check up which is about 5- 6 months post HA and the results are promising the statins and healthier lifestyle seem to be working ... feeling happy and encouraged
Total cholesterol down to 4.5 from 8.4 triglycerides down to 2.7 from 9.24
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