Hi Cholesterol

[Daisy246]

Hello everyone,

I’ve just had some blood tests after a bout of Gallstones and it’s revealed I have high cholesterol and high blood platelets.

Is this normal and is it more to do with Pred?

[PMRpro Ambassador]

Pred can increase the cholesterol level, yes. And can also increase the number of platelets - in fact, corticosteroids are used in some diseases to increase the platelet count.

[Daisy246 in reply to PMRpro]

Thank you, it’s something I’ve not had before and my doctor has given me 3 months to reduce it by diet, I’m hoping I can because I really don’t want to go on medication.

Thank you

[PMRpro Ambassador in reply to Daisy246]

It is pretty difficult to reduce cholesterol levels by diet because most of the cholesterol in the body is produced by the liver. It CAN be done if you have a really poor diet with a lot of fat in it though. The keto diet sometimes increases the cholesterol level - which is why we talk about low carb rather than no carb - but cutting carbs in the form of simple carbs and sugar does often help the cholesterol level too. Losing weight and exercising are also important factors.

Out of interest, how high is it? And how high is your HDL cholesterol?

[Daisy246 in reply to PMRpro]

It’s 3.6 and the serum is 7.

I have been cutting carbs, mostly supporting my partner as he was pre diabetic (now reversed)

One thing is I thought cholesterol test was a fasting one, which I hadn’t done

[PMRpro Ambassador in reply to Daisy246]

It is disputed whether that makes a significant difference - but you could hope!!!!

[Daisy246 in reply to PMRpro]

I know, clutching at straws! 😃

[SheffieldJane in reply to Daisy246]

I have read literature that suggests that Statins do not do much for women. I refused them anyway. I try to keep my prescription simple during this period of flux with blood sugar, cholesterol and blood pressure all raised. Succumbed to Metformin and feel rotten. Borderline, steroid induced diabetes. I have machines to test it all.

[Daisy246 in reply to SheffieldJane]

Thank you, can you get Cholesterol testers too?

We’ve one for blood sugar

[SheffieldJane in reply to Daisy246]

Yes, from all good chemists eg Boots, Superdrug, Lloyds Chemist. I have a good blood pressure kit too. My husband is giving me cause for concern with his numbers. Lockdown wine habit is my guess.

[Daisy246 in reply to SheffieldJane]

Thank you, I’ll check them out

[PMRpro Ambassador in reply to SheffieldJane]

How was your carb intake? Is there wriggle room there? Metformin isn't the only option and if you are only borderline you do have some time for dietary approaches.

[SheffieldJane in reply to PMRpro]

It was Sarah, my GP thought diet & exercise. I am moving towards giving up on Metformin. Or asking to. Having had a good ride with PMR why is my body beating me up now? Very low carbs now.

Pity party. 😟

[PMRpro Ambassador in reply to SheffieldJane]

Sods law - a lot of us have had similar problems recently. I think Covid has a lot to answer for ...

[SheffieldJane in reply to PMRpro]

That’s true!

[SheffieldJane]

I am getting significant stomach pain, nausea, dizziness that seems to coincide with Slow release Metformin. Have you noticed this? The diabetes depresses me most of all.

[SheffieldJane]

This all takes such a lot of monitoring. My Pred is down to 12.5 from a GCA start dose of 40 mgs. I feel rough all the time but nothing like a PMR flare. Metformin has stomach pain in the side effects too and in me pre-dates the Tocilizumab injections but it might be a double whammy. 3rd injection yesterday. Developed a sticky eye, I hope this doesn’t mean I should stop Toc. I keep getting the ER-4 error message on my blood sugar machine ( high viscosity) then eventually a horrible high reading. It is usually 7 or 8. Ho hum!

Your walks are impressive.

[Daffodilia]

I do low fat diet for gallstones which cuts out some carbs too

[herdysheep]

Hi, I'm grappling with high cholesterol count, too, although platelets seem to be okay. 7 mths ago cholesterol reading was 7.4, now 8.1. The ratio is 4.5 - I presume that is ratio between good and bad? Been on pred since 2912 and still can't get below 7 mg.

[Daisy246 in reply to herdysheep]

I’m struggling too to reduce and getting a lot of pressure from GP to get off them!

[PMRpro Ambassador]

INR can vary a lot anyway with warfarin - my husband eats the same thing day after day and NEVER eat leafy greens and his INR can swing quite a bit. I eventually had to stop a warfarin clone - the INR would go from 1.7 to 3.2 within 2 or 3 days. That was nothing to do with diet or changing dose.

[nuigini]

Thanks for asking the question Daisy. I recently had a high cholesterol reading and have learned a lot from the responses you received.

I'm fortunate at having to deal with PMR and high BP meds only and have total aversion to the thought of taking any statin medication.

Based on what I've read here I'll do my best to drop some weight and do more exercise, as permitted by PMR.

[Daisy246 in reply to nuigini]

Exactly how I feel, really don’t want to take statin and am going to try to exercise and lose some weight, GP given me 3 months 😬

Good luck!

[nuigini]

Best of luck to you too!

[Kendrew]

Hi Daisy246. Just read through all replies so far and would agree with a lot of statin related comments. I have been on and off statins for a good few years now. Began with a reading of over 6mmol/L and was given 3months to try and bring it down myself which I managed very successfully (just under 4mmol/L) but it took a lot of self discipline with diet and exercise and in the end it was not possible to live my life and sustain that level of discipline. I ate only healthy fats, wholegrain, and fresh fruit and vegetables and also regularly exercised. If any one of these was taken out of the mix, my cholesterol level would increase again. I was still maintaining this regime up to developing PMR, but at a more manageable level. As I've become older, my body hasn't been able to metabolise the bad fats as effectively (according to my cardiologist) and I've needed a little help......statins. I had a break off them for about 2years and then I was tested again after PMR diagnosis ....it was over 12mmol/L....and was now classified as hypercholesterolaemia. I know that some people have had unsatisfactory experiences taking statins with steroids, but I'm an example of someone who thankfully has been fine. I've been made very aware though that prednisolone can cause cholesterol levels to increase and you definitely need to keep an eye on it. Mine has remained below 5mmol/L during the 15mths I've been on steroids.

[Daisy246 in reply to Kendrew]

Hi Kendrew,

Thank you so much for all that information, I shall give the 3 months ago but reading your reply has reassured me a bit more.

Thank you

[PMRpro Ambassador]

Because it was swinging so wildly - and then here they start the same way they initiate management, testing almost daily for a week or two. That was how we knew how much and how quickly it was fluctuating. The halflife for warfarin is quite long - if it is high the levels need to be checked to assess how it is falling. And after a reading of 4.2 when my target range is 2-3 and had been stable for months it rang alarm bells.

[herdysheep]

That was the classification I was given but did not want to try to spell it!

[Kendrew]

Just be aware that you have a set level of body cholesterol that when its reached, won't change but most people can have varying degrees of success initially with diet and exercise. Losing weight won't diminish high cholesterol though, it's WHAT you eat that makes the difference, and more importantly....what you cut out! I cut out bad, saturated fats like butter, cheese, cakes, pastries, chips, chocolate, cream, etc, but increased the good fats, like nuts, seeds, avocado etc. Also certain foods help 'mop up' the bad LDL cholesterol, such as whole grains.... oats (porridge) There's lots to help you on British Heart Foundation web site.

Diet can be well managed with PMR but the fatigue can upset the exercise regimes. I can't go to the gym at the moment as it's closed of course, but I walk every day and do some hand weights and stretches at home, within my capabilities. I have osteoporosis and take Alendronic acid but for me, it's important to do some exercise every day....however gentle. Until you try something you won't know if it'll effect you or not. We're all different but it's about weighing up the risks against each other. If statins are definitely required and cause you problems you can discuss it with your gp or specialist with a view to coming off them or trying a different one. Just my thoughts. Only you know what will be best for you. Hope that helps a bit.

[Daisy246 in reply to Kendrew]

Thank you, that’s been so helpful

[SheffieldJane]

We have formed a small support group. It is still an event in my house.

[Rimmy]

The whole thing about diet cholesterol and gallbladder issues can be a real conundrum - in my experience anyway. Years ago in an effort to lose weight (in my pre- PMR/GCA years) I went on a low fat diet. In the end I found myself eating lots more carbs - feeling washed out and awful although I lost weight BUT I also developed gallstones and realised this was unsustainable. I also recall my son saying to me at the time "Mum our brains NEED a certain amount of fats/oils" (LOL!!). Conversely, I have recently found myself eating too many fats (in my efforts to reduce carbs for Pred 'weight' tendencies) and my gallbladder has become inflamed - but I am yet to have it checked for any stones and won't take statins regardless. Anyway its clearly about 'too much and/or not enough' - unbalancing our diets in an effort to counter various drug side effects etc etc. I am now coming to the conclusion a 'balanced' diet is the most sensible - yeah I know all this should be obvious - but all of us are trying to juggle other elements of our body 'chemistry' to get the best possible results - and this can be quite hard - even almost impossible at times.

[Daisy246 in reply to Rimmy]

It’s all such a balancing act, I had been doing low carb when last month I had Gallstones and inflamed gallbladder, waiting for a scan.

I did hear that it’s not always what you can’t eat and what you should be eating, oats are one that mop up the bad stuff.

Who knows!

[Rimmy in reply to Daisy246]

Yes and lucky I like oats - with a few sultanas though (LOL) !!

[Kendrew in reply to Rimmy]

You're so right in what you say. For me, low fat didn't mean 'no' fat. We must have fat in our diets but it must be healthy fats. We also need some carbs because that's a main source of our energy. Like you said....it's all about 'balance'.