High cholesterol

[Jennyhadenough]

I haven’t posted in awhile. I’m hoping that all of you are well.

My cholesterol has been elevating since diagnosis. It was usually my good cholesterol and triglycerides causing this elevation. Now it’s my LDL at 147. My dr prescribed fish oil to lower triglycerides. My triglycerides are normal now.

My total cholesterol is 247.

How high was your cholesterol when medication was needed?

I have always had great lipids

Except once when I was in my early 20s.

Thank you

[4pjx__]

Hi Jenny! I can't really answer your question but I too have a high cholesterol. My LDL is around 152 and my HDL is 97. My triglicerides were okay. Anyway, my doctor said she didn't want to give me the statins because they are tough on the liver but to try red rice yeast and check my lft's in a month. I haven't been back for the check yet.

Pam

[Jennyhadenough in reply to 4pjx__]

Thank you for responding. My HDL is 80. I know that the day will come when I need statins. I’m not sure if I can get my LDL back in normal range. I have an apt next week. I believe that my liver specialist wants me to take cholesterol meds. He’s leaving it to my primary.

I hope that your ok. I guess cholesterol deposits are in my future

[ninjagirlwebb]

If your total cholesterol is >200, ldl >130 (if you are normal risk for heart disease; if family history, then doctors want the ldl =<100), then doctor will prescribe meds if diet & exercise modifications do not help.

Hepatologist said statins are perfectly safe to take even with pbc. My understanding is a high hdl is actually good.

Per Mayo clinic, “HDL cholesterol, or "good" cholesterol, higher levels are better. High-density lipoprotein (HDL) cholesterol is known as the "good" cholesterol because it helps remove other forms of cholesterol from your bloodstream. Higher levels of HDL cholesterol are associated with a lower risk of heart disease.”

In addition to the regular cholesterol test, doctor may also perform an Lp(a) test to get more information about your health. A doctor can use an Lp(a) test to measure the levels of Lp(a) in your bloodstream, which are related to your risk of heart disease.

They may order the test if you have a family history of heart disease, heart attacks, or heart problems. They may also give you the test if your high cholesterol or LDL levels do not respond to treatment.

Increased amounts of Lp(a) in the body are associated with inflammation in the walls of the arteries. This can lead to changes in the blood vessels, including atherosclerosis. This is a hardening of the arteries.

[ninjagirlwebb]

Another test you can get to evaluate your risk & whether you should be on cholesterol meds is the heart scan. This is usually not covered by insurance & you pay out of pocket. It is ~$100.

A heart scan, also known as a coronary calcium scan, is a specialized X-ray test that provides pictures of your heart that can help your doctor detect and measure calcium-containing plaque in the arteries.

Plaque inside the arteries of your heart can grow and restrict blood flow to the muscles of the heart. Measuring calcified plaque with a heart scan may allow your doctor to identify possible coronary artery disease before you have signs and symptoms.

Your doctor will use your test results to determine if you may need medication or lifestyle changes to reduce the risk of heart attack or other heart problems.

Why it's done

Your doctor may order a heart scan to get a better understanding of your risk of heart disease or if your treatment plan is uncertain.

A heart scan uses a specialized X-ray technology called multidetector row or multislice computerized tomography (CT), which creates multiple images of plaque deposits in the blood vessels. The imaging test provides an early look at levels of plaque.

Plaque is made up of fats, cholesterol, calcium and other substances in the blood. It develops gradually over time, long before there are any signs or symptoms of disease. These deposits can restrict the flow of oxygen-rich blood to the muscles of the heart. Plaque also may burst, triggering a blood clot that can cause a heart attack.

When is a heart scan used?

A heart scan may help guide treatment if you have a low to moderate risk of heart disease or if your heart disease risk isn't clear. Your doctor can tell you if you might benefit from having a heart scan based on your risk factors.

A heart scan also may help motivate people at moderate risk to make important lifestyle changes and follow treatment plans.

When is a heart scan not used?

A heart scan requires exposure to radiation. While the exposure is generally considered safe, the scan isn't recommended if the risk of radiation exposure outweighs any potential benefit.

According to the American College of Cardiology and the American Heart Association guidelines, a heart scan may not be recommended for the following people:

Men under age 40 and women under age 50, because it's unlikely calcium can be detected at younger ages

People who have a very low risk, because detectable calcium is highly unlikely if you don't have a family history of heart attacks at an early age

People who already have a known high risk (especially heavy smokers or those with diabetes or very high cholesterol), because the heart scan will likely not provide any additional information to guide treatment

People with symptoms or a diagnosis of coronary artery disease, because the procedure won't help doctors better understand the disease progression or risk

People who already had an abnormal coronary calcium heart scan