Cholesterol levels and next steps

[AngelRain]

Fasting cholesterol test done 4 November, but I had to wait until 6 December for a routine appointment to discuss with the GP. Here are my results with the results from the previous test in 2021 in square brackets:

Total cholesterol 6.5 [5.4]

HDL 1.6 (>1.2) [1.1]

Triglycerides 2.0 (<1.7) [1.9]

Ratio 4.1 (no range) [4.9]

Calculated LDL 4.0 (no range) [3.4]

Non HDL 4.9 (no range)

I am now being told I need to be on statins, which I am very unsure about. I know that as a thyroid patient, I am more likely to have higher cholesterol levels anyway and stand a better chance than most of experiencing side effects if I do take statins. As a starting point, I have been given three months to get my levels down and have been told that I need to see the dietitian attached to the surgery to help with this. Is this a standard approach? I've not heard of it before.

If anyone has done this for similar reasons, I would be interested to hear what advice you received and whether following it made any difference in the end to your cholesterol levels.

I am gluten and dairy free because of gut issues since 2020, also caffeine free for 25 years, but eat well. I am active and I have a BMI currently of 25.6, so only just into the overweight range. I'd love to get that 3lbs off, but the underactive thyroid makes it well nigh impossible.

All thoughts gratefully received.

Thank you

[Happyrosie]

your doctor has presumably followed NICE (National Institute for Clinical Excellence ) guidelines, which you can look up yourself in the NICE website. You can see your statistical risk of cardiovascular problems using QRISK3 tool ( just google this if you want to do it yourself )

Unless you are high risk, dietary and lifestyle advice should be the initial therapy. The fact that you have been referred to a dietician is great news - I didn’t have this option.

Other posters might have different experience.

[AngelRain in reply to Happyrosie]

I've just looked at QRisk3, which says,the following:

"Welcome to the QRISK®3-2018 risk calculator qrisk.org

This calculator is only valid if you do not already have a diagnosis of coronary heart disease (including angina or heart attack) or stroke/transient ischaemic attack."

As I have a diagnosis of vasospastic angina, presumably QRisk3 is not valid in my case, although my GP did not seem to know this as she had used this assessment tool prior to my appointment last week. Interestingly, the result she had come up with was far higher than the one I came up with when I tried it later!

[Happyrosie in reply to AngelRain]

I’m sorry, I had not read from your post that you already have a cardiovascular issue and you are absolutely right, this is inappropriate for you.

[Lowerfield_no_more]

The side effects from statins affect less than 10% of users, but sadly as far as I can see it's the 10% of naysayers that get the headlines. Anyway you won't know whether they are going to affect you until you try them, so if you do go ahead you have about a 1 in 10 chance of being affected. And if one statin affects you there are others to try. You could try 'lifestyle measures' to better manage your lipid profile but if you already have a 'healthy' lifestyle including a good diet and exercise regularly it won't make a great deal of difference and as soon as you relax it, if there has been any improvement, it goes back again . And my guess, and that is all it is, is you will be offered a low dose statin like 20mg Atorvastatin to trial (just like my wife who has recently started as a result of a cholesterol total of about 5.8). To put that in context I and many others take 80mg of atorvastatin and suffer no side effects. And if I were you I would not be worried about losing any weight if your BMI is around 25, it's more likely to be more trouble to you than it's worth. Finally you might find the information below useful , which is a link to a pdf 'Should I take a statin?'

nice.org.uk/guidance/ng238/...

[Murderfan58]

A friend of mine had cholesterol of 7.5 but got it done to 5.8 by exercise and cutting high fat foods out of her diet. She recently had it done again and it's 5.1. So her GP said to keep doing what she is.

Mine was 5 last time now 4.4 . I found cutting out high fat foods out of my diet and exercise even though limited due to my neurological condition. I do sit fit class and do exercises at home daily has helped with my cholesterol.

My brother is on statins but the first one they tried have him muscle pain in his legs so was changed and had one he is ok on . Because of him swimming for a hour every morning doing lengths and walking minimum 10,000 steps a day ,his allotment and doing weights at home has reduced his dosage .

Some people have naturally high cholesterol even though right weight for their height and very fit .

If statins was offered to me I wouldn't have them as they would interfere with my medication for my neurological condition and do more exercise and lose more weight .

Hopefully with the help of the dietician you can avoid statins.

[flower365]

Unfortunately having a thyroid problem, being over 60, being female and being active all raise your chance of having problems with statins. Having said that, if you assess your chances of having a problem with CVD is high enough to risk the downside then take the statin route.Do you see a cardiologist for your angina? If so that is the person I would talk to. Read widely and look at percentage gains for your position it is a personal choice.

[AngelRain in reply to flower365]

I have a post up about the failure of anyone to monitor or support me with my vasospastic angina. I have asked for a referral back to Cardiology, but if the pre-emptive ECG, without which they cannot refer, is clear which I expect it will be, then the request for a referral maybe refused. That is yet another nightmare

[flower365 in reply to AngelRain]

Yes medical care is a bit of a nightmare at the moment in the uk. I live in Galicia now and it is better as not under so much pressure. Regret I know nothing about vasospastic angina but if I were you I would research if there is a connection with it and high cholesterol, I would assess how high a risk my cholesterol is for future Cvd, why my triglycerides are outside the range and will statins help with that and then assess why the gp is recommending statins for me. Hope you find answers to make you feel more confident when you discuss it with your gp.

[Craftycrafty]

Hi

There are other drugs other than statins you can take to lower your cholesterol. If you need drugs ask your doctor for one that isn’t a statin.

[Partner20]

High cholesterol can be associated with untreated or undermedicated hypothyroidism. This is why when cholesterol is discovered to be high the recommendation is to then check for a thyroid abnormality before addressing the cholesterol problem.

If your thyroid condition was the reason for your high cholesterol then optimising your thyroid levels should improve your cholesterol levels too.

[FestivalVibes]

Hi, I get your apprehension about statins as I too have had various conversations with health care professionals on the subject of me not taking them! Initially six years ago my cholesterol was 4.46 total, 2.35 HDL with a 1.9 ratio. After four months on a strict diet my sats were, 3.41 total, 1.84 HDL and 1.9 ratio. That said, since then my motivation with my diet has lapsed and it's now creeping up again.

We are all unique and one size does not fit all, but diet and lifestyle can only achieve so much if your body has a predisposition to high cholesterol. My cholesterol is still low enough for my cardiologist to reluctantly accept my preferring to control it with diet and lifestyle, but I would have no hesitation in taking medication if it continues to go up. Life is for living and it's all a case of balance and what suits you personally ... and accepting things may change along the way. Take care of you, you know you better than anyone else x