Very high cholestoral at 37

[Limey8]

Hi, last week I found out my bad cholesotral is very high after going to A&E with heart palpitations. I had an ecg and chest xray which came back normal but the blood test results showed I have very high bad cholestoral levels. I saw my gp who is referring me to a lipids clinic but it's a 3 month wait for an appointment. My blood pressure was also quite high for a few days but has since come down and within normal range now, I think that was probably from anxiety. I'm taking morning and evening readings for 7 days.

It's really shaken me up as I'm 37 and thought I was fairly healthy. I do have a sweet tooth and I eat quite a lot of dairy but I eat fruit and veg and walk a lot and I'm slim. I only drink alcohol occasionally and have never smoked. They think it could be genetic but told me to cut down a lot of salt, sugar, dairy, red meat and caffeine. They said I might need to go on medication.

For over a year I haven't been feeling very well with fatigue, a bit dizzy and just not feeling not right. I've had multiple blood tests done at my gp which all came back normal. I assumed they would have checked my cholestoral as I thought a full blood test did, and it never even crossed my mind. But it seems they didn't check it before my hospital visit.

I'm struggling with my diet as looking at the foods I usually eat which I thought were healthy contain a lot of salt, which is quite shocking to me. I've been avoiding sugary treats and dairy, but I'm actually struggling with what to eat and I've lost some weight from under eating the past week since I found out about this.

My gp said I didn't need to be referred to a dietician but I feel I really would benefit from this as I'll probably make myself ill from not eating properly.

They didn't explain the cholestoral results to me either, only that the bad cholestoral is really high and I'm at risk of heart attack and stroke. They're also referring me for a 24 hour ecg. Not sure if they'll refer me to a cardiologist. I'm feeling really scared and anxious about this 😟

[Lowerfield_no_more]

First the good news, which is, you are still relatively young and you have been diagnosed early but there are treatments and strategies which will go a long way to reducing your heart health risk and will stand you in good stead for the rest of your life. Otherwise there are about 1 in every 250 people who are pre-disposed to very high cholesterol due to a genetic 'fault'. I was told had a total cholesterol count of > 9 over 25 years ago but have never been given any genetic testing (nothing like that existed back then), but close family members with similar cholesterol levels to me have been tested and they have a form of familial hypercholesterolaemia (FH), so it is likely I have too. Anyway I have been taking statins ever since, and recently added ezetimibe to my daily medications which further lowers the lipid count, currently under 4. As far as you are concerned I am surprised your GP has not started you on statins which is the usual first approach to getting a better lipid profile, especially since you have a long wait until your lipid clinic appointment. Perhaps you could ask your GP why they have not done this. But the other approach to getting a better lipid profile is 'lifestyle', which includes diet, exercise, body weight management, smoking and alcohol and which is covered within the BHF website. I suggest you look through this especially for ideas on what to eat, and to give you confidence that you are doing the right things. However for those with FH or very high cholesterol although it helps, lifestyle measures alone are not usually good enough, and that is why medication is usually needed as well. Especially since as soon as the lifestyle measures are relaxed the lipid profile moves back to where it started, as I found out all those years ago. Hope you get sorted

[TasteLessFood4Life]

When you say high, what do you mean? It is relative also, what is the split hdl vs ldl?

[mozart27]

When they said you might need to go on medication, it's probably a statin they were thinking about. I started taking statins when I was in my mid forties together with medicine for high blood pressure. I am now in my mid seventies and I have never had a heart attack or stroke. Some people experience side effects from statins but I never have. What I'm saying is try not to get too anxious and if it were me, I'd go back to the GP (with the home BP results as well) and talk about trying a low dose statin to see how you get on with one pending the appointment at the lipid clinic.

[Goonerboy6661]

Thank you for sharing what you’re going through — it’s completely understandable to feel shaken by this.

A few things you might find useful as you wait for your lipid clinic referral:

High LDL (“bad”) cholesterol can sometimes be genetic, particularly if other lifestyle risk factors are minimal. Familial hypercholesterolemia (FH) is one possibility, and it’s good that your GP is referring you for specialist input.

From my own research, I’ve learned that cholesterol risk is about more than just LDL levels. For example:

ApoB provides a count of all atherogenic particles and may correlate more closely with cardiovascular risk than LDL-C. This is supported by findings from the INTERHEART and AMORIS studies.

Lipoprotein(a) [Lp(a)] is a genetically determined cholesterol particle linked to increased cardiovascular risk, independent of other factors (see Emerging Risk Factors Collaboration, Lancet).

Triglycerides and HDL also play a major role. Elevated triglycerides and low HDL levels can signal insulin resistance and are increasingly recognized as important components of cardiometabolic risk, especially in younger people. The 2001 NCEP ATP III guidelines and more recently, European Society of Cardiology 2023 guidelines highlight this.

I’ve also read that some people with very high cholesterol never develop heart disease, while others with “normal” cholesterol do. This supports the idea that cholesterol levels alone don’t tell the whole story, and it’s the interplay of genetics, inflammation, particle number, metabolic health, and other lifestyle factors that matters most (see MESA Study and Framingham Heart Study data).

You mentioned having a sweet tooth — from what I understand, high carbohydrate intake, especially refined sugars and processed foods, can elevate triglycerides and reduce HDL. This pattern has been associated with increased cardiovascular risk (see PURE Study, Lancet) In some cases, high sugar intake can also indirectly drive up LDL-C by increasing hepatic fat and altering lipid metabolism.

Re: diet — if you’re now cutting many foods and finding yourself under-eating, that’s definitely something to keep an eye on. It’s easy to over-restrict out of fear, especially when guidance is vague. A registered dietitian — ideally one familiar with lipid disorders — could help you build a heart-healthy plan that’s still satisfying and balanced. If your GP won’t refer, private or virtual options may be worth exploring, even for one session.

Regarding medication — if your lipid clinic recommends statin therapy or another lipid-lowering treatment, it may be worth knowing that early intervention in high-risk individuals has been shown to significantly reduce long-term cardiovascular risk (see WOSCOPS, JUPITER, and HOPE-3 trials). If treatment is needed, there are now multiple options beyond just statins, including ezetimibe and newer therapies like PCSK9 inhibitors.

[Barty2]

sorry to hear you are struggling, like others I am surprised that statins have not been mentioned by your go. Can I recommend you listen to the Zoe podcasts (all free). While they are specialists in the micro biome they have so much advice on what to eat and what not to eat … so many people suffer from tiredness and not feeling right as a consequence of their own reaction to food stuffs - it will hopefully inspire you on your food journey and bring joy back to your mealtimes

[Ham1846]

Hi there I was told I had inherited bad cholesterol as mine was high in my 40’s and I’ve been on a statin for a few years now and had it upped in doseage last Dec. As for diet if you look on the BHF website they have stuff on what you should eat on there with recipes. Exercise and keeping your weight a healthy level also help.

[nilmonisikdar40]

Hi Limey8. I hope I can help you in this matter. I know you have a bad cholesterol which is LDL cholesterol wich is high but remember you akso have good cholesterol which is HDL cholesterol. What matters is the ratio of the two types of cholesterol . Next time when he go to your GP ask the ratio - it may not be bad as you thought. With regard to diet, it is important to know what you can eat and not only what you can't eat. Oily fish like Herring, mackerol are posiively good for you. Certain sea food like prawn, lobster, I think should be avoided. With regard to dairy products like hard cheese for example cheddar not good but I think soft cheese and cottage cheese are okay in moderation is good. Weight loss through exercise is positively good. You are 37 only and have a long and fulfilling life. Regards.

[SuddenShock]

There are so many comments about what you should / can / must not eat, I doubt that you will get a single answer. For example, intuitively leafy green veg must be good for you but it turns out that it is high in potassium which can be very bad, LoSalt is definately very bad but it is used to reduce your salt intake which should be good.

Not wanting to start any arguments but personally I go for variety in foods, natural where possible and skip the stuff that you know is bad (high salt such as bacon, ultra processed such as sausages and ready meals, sugar such as anything that is nice to snack on even though your mum told you that it would rot your teeth but she didn't know about cholesterol). Don't suddenly become vegan or start eating stuff that you do not like just because of this not quite diagnosis (I cannot stand fish but I do eat prawns and white crab meat), just avoid the obviously bad. To me this seemed a sensible approach especially since my CAD diagnosis.

Try not to worry too much, you are no different today to how you were before going to a&e and your GP would almost certainly have gone for statins if there was a significant concern (it's in the beginners guide to being a GP handbook somewhere that statins should be prescribed if your cholesterol level is above some nominal level (or it is wednesday and the wind is blowing from the east or a black cat crossed the path of a ladder))

[Jaybbb]

” I assume they would check my cholesterol “. That is what you said, and that is key to your future health. YOU are responsible for your wellbeing and YOUR health. You are still early in your career- but an approach to your welfare needs to be made BY YOU. My take on you assuming they would check for cholesterol is total negligence on your part. Why don’t you know definitively that this was done— a lipid panel. Did you not get a copy of the blood work and see it was not done. Take control of your own health. And in regard to high cholesterol— you do not need to have someone tell you what you have to do. Do your reading on healthy eating and healthy foods. Cut out your junk food. Cut out HIGH cholesterol food. No fat or low fat dairy products. Learn to read labels on all foods to determine what is garbage food that will lead you to cardiac disease. At 37 you can start this on your own, today. Do not need to wait for a dietitian to tell you on what information is available in so many places. Good luck.

[Asmokes1]

hey, I am 36 and suffered an NSTEMI randomly playing football. I had years of untreated blood pressure and borderline choloteral even though I was physically active my high BP and poor diet was eroding my fitness and took a toll on my body. Thankful I had a ballon procedure so they have managed to open up my artery and so far so good.

Feel free to DM so I can share my diet plan

[Pundit999]

Don't worry. It is easy to treat high cholesterol with medication. (one small dose of a statin and cholesterol goes down 50% in a few days/weeks)

For now, start eating mostly whole plants to reduce the risk.

And you are doing the right thing trying to get control of your health by, for example, coming to this great forum. I am sure you are reading about cholesterol online and in books. You will know about it all in a short time

You are young and have been lucky in a sense to have discovered this very danderous lurking issue in time. Rest assured this will be taken care of. But you will require constant monitoring from yourself and your doctors all your life.

But it is not difficult. Most everybody here has been doing the same.