HDL dropped (good cholesterol)

[Walkinginnature]

I have been trying to decrease my Statin dose and my lipid panel was good except my HDL dropped to 31. I do not have any of the risk factors ( not overweight, don’t smoke ,eat well exercise etc) so I asked google “ Can CLL cause your HDL to droop and the answer was YES. Does anyone have any information/experience with this.

[Spark_Plug]

A good follow up question may be, "How does CLL cause HDL to drop".

🙂

[Shedman in reply to Spark_Plug]

pmc.ncbi.nlm.nih.gov/articl... levels of HDL have been observed in the peripheral blood of CLL patients compared to aged matched healthy controls [33], which may be due to the overexpression of SR-B1 on CLL cells [34], leading to an increase in the sequestration of HDL into tumour cells."

..might increase apoptosis of CLL cells.. 👀

[Spark_Plug in reply to Shedman]

Very nice article Shedman, it explains Cholesterol action in cells very nicely ( I will have to deep read it again). I also like the consistent studies that have and are continuing in that area. It will be thought provoking as they learn more seeing that some results seem to be at odds, I feel hopeful that they'll gain a more definitive answer to some of the contradictions as they continue.

Thanks so much, 🙂

[Imua]

I've long wondered about the relationship between LDL/HDL and CLL. There is nothing more I can do to improve my levels other than statins but I have been reluctant to take them!

[Walkinginnature in reply to Imua]

I am trying to decrease/come off my statin. I have a call into my oncologist to ask his advice/oponion. I’ll post when I get any information.

[CoachVera55]

There is a documented relationship between Cholesterol & CLL but I can quote any sites lol.

I know for me, I was at my lowest weight 248 after losing 92lbs over 6yrs from 340 (all due to immobility issues). I did it all naturally & was so proud of myself. I was just about to celebrate my 100lb Weight Loss.

My CLL Leukemia was progressing since 2020 & I dropped 30lbs (from 310) that year but my Cholesterol Levels were rising. We were renovating my Condo from Head to Toe during that year as well. So I contribute Covid to activating my CLL but they also recommend no big construction projects due to the possibility of exposure to mold & worst particles.

By April 2023 I am 248lbs but my LDL & Non HDL has climbed up that my Cardiologist is saying that those 2 numbers cause Heart Attacks

[albie58]

Hi Walkinginnature!

Just recently, I pulled all my back lipid panels and noticed from just before I started treatment that my good cholesterol was dropping, and it eventually got into the 30's, and that was with a statin, a good diet, and exercise.

When I started treatment last year on acalabrutinib, I noticed that my good cholesterol was starting to climb. My last lipid panel was done in September and it had reached 57. Could it be that treatment was the cause? I don't know and I can never really get a good answer when I ask my doc, but I'll take it! I'll continue to watch it over the next year to see if it stays stable, rises, or drops. And this was without and with a statin.

[Walkinginnature in reply to albie58]

Thanks for the information

[ornstin]

Maybe you have (based on your tags above) Metabolic Syndrome As well as CLL, I have type 2 Diabetes, and before I took statins, low HDL, high LDL and high Triglycerides. There are articles online that show these conditions (leaving aside the CLL) can often occur together. Perhaps you are already aware of this

Whether or not you have the Syndrome, the drop in your HDL may well be linked to your reduction in the Statin dosage. I believe Statins should increase HDL Cholesterol. Best regards, Antony

[LeoPa]

Taking statins doesn't help with achieving high HDL and low triglycerides numbers (the rule of thumb indicator of good health) . A very low carbohydrate diet leads to high HDL and low triglycerides, but it makes LDL higher too. Which isn't a problem if carbs are kept very low. The only folks in danger are the ones with high fasting insulin levels who have high cholesterol levels too. Whis is almost everyone probably. But the fix isn't in taking statins. It's in eliminating carbs from the diet. Why this is so, is way more info than fits in a reply here. Let's just say I'd bet my life on it being true. Which I actually do, every day, with the way I eat.

[SFF95]

My HDL and LDL dropped while on O&V, (month 9 of treatment). Both dropped 25-30 mg/dl. This was a good thing as my total was well over 200. My diet was the same, except I dropped alcohol to zero from one glass of wine per night. Exercise was about the same.

[Luv2Craft]

My HDL was very low and my LDL was slightly higher than the normal range. After eliminating high cholesterol foods from my diet (meat, dairy and highly processed foods), all of my cholesterol levels went into the normal range.

My husband who has been on Statins and high blood pressure medicine for 30 years decided to try the a similar diet where he eliminated meat, dairy and his high sugary snacks.

Within a week his blood pressure which had been high for the past 30+ years dropped into the normal range. We never found out what effect the diet change had on his abnormal cholesterol and prediabetes because he resumed the high cholesterol foods before his next doctor visit and labs.

He thinks I am an exceptional person being able to stay with a Plant-based food lifestyle (beans, tofu, veggies and green smoothies etc), but when you have two blood cancers like I do, you are more willing to do as many healthy things in your life as possible to improve your health.

If I had never discovered the relationship between my diet and my abnormal cholesterol levels, I probably would have thought my CLL was the cause of my low HDL. It may have contributed to my low HDL, but diet played the biggest contributing factor. to my improvements. I have labs to prove it.

[New-bee-cell]

Yep. Mine had been dropping and resulted in a not-good LDL:HDL ratio, so I started a statin despite no other risk factors other than family history. In the meantime, I have started treatment for my SLL (Obinutuzumab + venetaclax). I am curious to see if my HDL rises after I finish treatment next fall.

[FredNerk]

Comments:

- There is only one form of the molecule cholesterol, i.e. there is no such thing as 'good' and 'bad' cholesterol. LDL and HDL are lipoproteins that are transport vehicles for various lipids (such as triglycerides, phospholipids, and cholesterol) in blood plasma.

- Cause and effect studies that any level of cholesterol, lipoproteins or any lipid subfraction results in hard health outcomes do not exist. The only exception is that a cholesterol level of zero results in death. As such, there is no proof that any level of these substances cause or are protective against any disease process. This remains an opinion based ideology and lipid panel blood tests are not predictive of anything.

- Lipid lowering medication, including statins, is a very profitable industry.

- Average cholesterol levels in the Western population have reduced over the last few decades, unfortunately incidence of cardiac vascular disease has not. Limited studies appear to indicate that CVD fits to a normal distribution (bell curve) when looking at cholesterol.

- The level of cholesterol in your body is determined by your genetics and the environment you place those genes in. Billions of years of evolution ensures that your body produces the correct amount of cholesterol at any given time. This can fluctuate greatly during the same day.

- If higher than the current recommended 'healthy' cholesterol ranges caused any sort of pathology it is likely that the ancestors of our current speciation would have died out millions of years ago. Evolution would not allow our bodies to produce an essential substance that is harmful.

Does any of this answer the question does CLL cause HDL to drop? Probably not. Cause and effect studies of this nature don't and can't exist. Whatever the HDL level, it is where it needs to be. Eat a species appropriate diet and let your body decide what is the optimal level of cholesterol. If you have metabolic issues, focus on those instead.

[AussieNeil Partner Administrator in reply to FredNerk]

With respect to "unfortunately incidence of cardiac vascular disease has not"

How about some references to back that up please? In the period covered by the below report of cardiovascular disease and death burden from Australia, life expectancy improved from ~69 to ~83 years!

From Trends in cardiovascular deaths (Australia)

aihw.gov.au/getmedia/2ba74f...

- Since 1968, the cardiovascular disease death rate has fallen by 82%.

From the introduction

Cardiovascular disease is largely preventable, and many of its risk factors can be modified, including tobacco smoking, high blood pressure and cholesterol, physical inactivity, poor nutrition, and obesity (AIHW 2015).

Controlling risk factors for cardiovascular disease can result in large health gains in the population. It reduces the risk of onset of disease, the progression of disease, and the development of complications in those people with established disease.

Despite the magnitude of the current cardiovascular disease burden, deaths from both coronary heart disease and stroke have declined substantially in Australia over the past 50 years.

Levels peaked in the late 1960s and early 1970s, with cardiovascular disease responsible for 55% of all deaths each year (about 60,000 deaths). In 2015, cardiovascular disease was responsible for 29% of all deaths.

These falls are the result of a combination of improvements in preventing and detecting the disease, as well as clinical management of people who have it

:

Treatment and medical care

Advances in diagnosis and treatment of cardiovascular disease include the development of effective medications for treatment and control of high blood pressure, widespread use of statins to lower cholesterol levels, greater numbers of specialists and other health-care providers focusing on cardiovascular disease, better emergency medical services for heart attack and stroke, and an increase in specialised coronary care and stroke units. Each have contributed to lower case fatality rates and lengthened survival times (Briffa 2009, Ford & Capewell 2011).

:

The slowing of the rate of decline in cardiovascular disease deaths among young adults in recent decades have occurred not only in Australia, but in other countries including the United States and the United Kingdom.

(My emphasis)

More can be found here, on what is still, unfortunately in Australia, the second leading cause of death behind cancer.

Heart, stroke and vascular disease: Australian facts

From the Australian Centre for Monitoring Population Health

aihw.gov.au/reports/heart-s...

Neil

CV disease deaths/100,000 in Au peaked ~1970 and are now lower than they were in 1950

[CocoMolly in reply to AussieNeil]

Spot on Neil, and if you're unlucky enough to have CLL then Australia is the best place to be,

[FredNerk in reply to AussieNeil]

Thanks Neil. I agree that CVD death rates are likely to have fallen over this period. However, my comment related to CVD events, not necessarily deaths. Treatments and response times have certainly improved to prevent deaths, but there appears to be an absence of evidence to suggest occurrences have reduced. Any way you look at it, it's all associative; not causative.

[CLLerinOz Administrator in reply to FredNerk]

The Australian Institute of Health and Welfare presents data about various health matters, including the incidence of CVD deaths and events in Australia.

Its latest report, updated in December 2024, states:

"Trends

The age-standardised rate of acute coronary events fell by more than half (59%) between 2001 and 2021 (675 to 274 per 100,000 population). The decline was slightly higher for women (63%) than men (58%) (Figure 4).

The decline in rates of acute coronary events has been attributed to a number of factors, including improvements in medical and surgical treatment, and the increased use of antithrombotic drugs as well as drugs to lower blood pressure and cholesterol. Reductions in risk factor levels – including tobacco smoking, high blood cholesterol and high blood pressure – have also contributed to these declines (Taylor et al. 2006)."

aihw.gov.au/reports/heart-s...

CLLerinOz

Fig 4: Heart, stroke and vascular disease: Australian facts

[FredNerk in reply to CLLerinOz]

Yes, multifactorial. Associative data cannot be used to draw cause and effect conclusions.

[CLLerinOz Administrator in reply to FredNerk]

I was responding to your statement that "there appears to be an absence of evidence to suggest occurrences have reduced."

The data provided shows a drop in coronary events in Australia in a 20 year period. "more than half (59%) between 2001 and 2021 (675 to 274 per 100,000 population). The decline was slightly higher for women (63%) than men (58%)".

CLLerinOz

[AussieNeil Partner Administrator in reply to FredNerk]

With respect to your opening sentence in your first reply "There is only one form of the molecule cholesterol, i.e. there is no such thing as 'good' and 'bad' cholesterol." Cleveland Clinic has this to say (from my.clevelandclinic.org/heal... )

"LDLs are important to your body. But they become bad when you have too many of them circulating in your blood. They can combine with other substances and build up on the walls of your arteries. These fatty deposits form plaque that gets bigger over time. This plaque growth is called atherosclerosis, and it raises your risk of a heart attack, stroke and other diseases."

and

"HDL cholesterol refers to high-density lipoproteins. These lipoproteins are made mostly of protein. HDL is the “good” cholesterol because it takes extra cholesterol out of your bloodstream and transports it to your liver. Your liver then breaks down the cholesterol and gets rid of it. This process is called reverse cholesterol transport."

With respect to events and deaths, we need to be very wary of bias - such statements about events increasing per 100,000 population not taking into account changes in life expectancy. If the percentage of events has increased per 100,000 by 10%, while life expectancy has concurrently increased by 20%, then there likely has been a reduction in CV disease. As the Australian Centre for Monitoring Population Health report I quoted stated, "These falls are the result of a combination of improvements in preventing and detecting the disease, as well as clinical management of people who have it." Obviously, higher detection rates will also affect reporting and need to be taken into account.

Neil

[FredNerk in reply to AussieNeil]

The Cleveland Clinic reference highlights the problem with a great deal of mainstream advice. If false information is repeated often enough, for long enough, people start believing it and start repeating it themselves.

- Lipoproteins are still not cholesterol.

- 'Good' and 'bad' cholesterol still do not exist as there is only one type of cholesterol.

- Who decides what the threshold for 'too many' is and under what basis? How does this apply to any one individual with their unique genes and unique environment?

- The science of atherosclerosis is far from settled. What are the other substances and in what proportions are they present in arterial plaquing? Why doesn't the plaquing occur evenly throughout the arterial system as it's all subject to the same cholesterol? Why do people with long-term 'low' levels of cholesterol still get plaquing? What roles to high blood pressure, systemic inflammation, poorly controlled diabetes etc play? We already know that 'elevated' cholesterol is not sufficient on its own as the venous system is not subject to plaquing. Like any health outcome it's likely multifactorial and cause and effect evidence is unlikely to ever exist. We simply aren't smart enough to figure it out.

The concept of LDL bad, HDL good is far too simplistic and needs to stop. All of the lipoproteins have essential roles to play in the body and the levels are under the control of your genes. These genes have evolved over billions of years. A few decades of associative correlation studies cannot trump this.

Your last paragraph demonstrates how difficult (impossible) it is to draw any meaningful cause and effect conclusions for human health outcomes from a given data set. There are far too many degrees of freedom to categorically state that X causes Y.

It's unlikely that anything I have said will change people's ideology regarding this subject, but it never hurts to have an open discussion.

[AussieNeil Partner Administrator in reply to FredNerk]

Certainly open discussions are desirable, so rather than opininating that "It's unlikely that anything I have said will change people's ideology regarding this subject", why not give those interested the opportunity to do more research by providing references?

As you say, "All of the lipoproteins have essential roles to play", and I quoted from the Cleveland Clinic about the different roles LDL and HDL typically play. Try servicing your automobile on the basis of "there is only one type of cholesterol" (oil) and see how long before you aren't going anywhere!

Neil

[FredNerk in reply to AussieNeil]

The commonly held opinion is that there are 5 main lipoproteins. Are IDL, VLDL and chylomicrons also 'cholesterol'? Which of these are bad, which are good?

The chemical formula for cholesterol is C27H46O. This can be easily looked up. There is no other formulation. For those that prefer a graphical format there is also the structural formula.

I do not provide references as essentially all studies regarding human health outcomes are incapable of informing on causation. They are subject to biases among other weaknesses. Relying on these has lead humanity down the path of worsening overall health.

Not sure the relevance of cars and oil is. This appears to be a straw man argument?

[AussieNeil Partner Administrator in reply to FredNerk]

I could have used a better car and oil comparison and used the analogy of saying there's only one carbon used in oils. Like cholesterol and lipoproteins it's a building block. It's what's added that determines properties and use. Saying that there is only one cholesterol is a distraction from the fact that there are different lipoproteins of which cholesterol is the building block.

As to your reason why you "do not provide references", despite the difficulties you mention, scientists still try to find ways to remove confounding factors and share references, so they can research different experimental approaches to determine effective approaches to improving health.

Neil