Requesting Opinions on what to discuss with my Doctor on Monday: High LDL's.

Factual Questions
1

My blood work came back and I am in good shape except my Cholesterol. It is around 240 which isn’t too bad, the LDL is 170 which I understand is bad and the Doctor is recommending medication before I speak to him. My appointment in Monday afternoon. I have an extremely bad diet and poor exercise. I am hoping to alter my cholesterol counts through Diet and increased exercise.
I am soliciting any advice on what questions to ask my Doctor so I do not go in completely ignorant.
On a similar subject, I need to resolve and ongoing problem where I come down with Strep throat at least once a year kicked off by or with a Sinus infection.
I am curious if there is anything known to help prevent these episode that I can ask my Doctor about.

Thank you in advance,
Jim

Mods: I know I am bordering into a gray area here, but I am soliciting advice and information to be a more informed patient, not to self medicate myself. I am hoping you can let this thread live with the way I have phrased and explained it.

2

Well, it’s always a good idea to know what your HDL level is. A very high HDL offsets the deleterious effect of a high LDL to some degree.

When deciding whether and how to treat a high LDL level, it’s also important to be aware if you have other risk factors for atherosclerosis. In isolation, a high LDL is not nearly as significant as a high LDL in association with diabetes (or “glucose intolerance”), hypertension, smoking, family history, kidney problems, etc.

You may also want to get an idea just how “bad” your current diet is. That way, you may get some sense of whether dietary changes are likely to do much.

Finally, look here.

3

Thank you for the link, looks like some sound advice.
My diet is very bad. My average weekday breakfast is either a danish or a Granola bar and my lunches are usually fast food.
I’m switching to Instant Oatmeal for Breakfast and I will try out Wendy’s Salads and whatever else I can come up with to reduce Cholesterol and Saturated fats for Lunch. Ice Cream will be replaced with No Sugar Ice Pops. I picked up some low fat Caramel Popcorn cakes for snacks at work. No Cholesterol, low fat and only 50 calories. I spend half my lunch playing Quoits and I will try to Bike Ride at least 3 times a week.
I’ll see what the Doctor says on Monday.

Jim

4

Ask your doctor whether you should be taking Omega-3 fish oil capsules, if he doesn’t recommend them first.

5

Your total cholesterol and LDL levels fall into the “high” range. Not at all the same as “isn’t too bad.” You also don’t mention your triglyceride levels which are just as important.

The changes you mention are good, but you don’t mention dinner at all, which is probably your biggest meal of the day. Nor do you mention snacks. A few donuts, just for example, have a huge amount of fat in them.

If you’re serious about attacking your levels through diet, then you have to rethink you’re whole way of eating. Every food you put in your mouth has to be examined for its fat, saturated fat, and trans fat amounts. You also need to balance the rest of your diet with the whole grains, lean meats, and lots of fruits and vegetables that everyone recommends.

What’s important is that you understand that this is a lifetime change. Eating oatmeal every morning will grow boring very soon. Salads at Wendy’s, same thing. Besides, salad dressing is pure fat and those salads are topped with cheese, bacon, almond slivers and other high fat items. You need to find an enjoyable and satisfying low-fat lifestyle that you will be able to stick forever, without constant cheating.

Increasing your knowledge about nutrition and calorie, fat, carb, sugar and protein counts in foods will be enormously helpful.

If you can cook for yourself, do so as much as possible. Make your own lunches. Fast food restaurants are traps. You can, if you know enough, find low-fat items there, but there are few of them, they are the worst tasting foods on their menus, and they load them up with high-fat traps to make them edible. I know how convenient it is to have others do all the cooking, but it’s very tough to go low-fat on restaurant cooking.

And there is a genetic component to all this. Even a low-fat diet may not be enough. Some of the statin drugs may be necessary to get your numbers down.

It’s not easy and I had to learn the hard way how necessary it all is. When you haven’t followed a regimen of proper nutrition, exercise, and avoidance of other risk factors, the change is major. You don’t say how old you are, but being older not only increases your risk but makes any change more difficult.

It can be done, though. I’m proof. And my reward was that my doctor just increased my dosage of Lipitor because it wasn’t enough. Genetics. I told him I’d dig up my parents and complain, but except for the exercise it wouldn’t do me much good. :smiley:

I’m still not going back to my old diet and hope that the drugs will work anyway. Besides, it’s wonderfully motivating to reject a much longed-for pizza by thinking, if I eat this it will kill me.

Doesn’t matter if it’s literally true or not. Whatever works for you, is good.

6

**Exapno Mapcase **
I’ll be 40 soon. I’m pretty good about not eating cakes and donuts. But Danish in the morning is common.
I have to wait for the rest of my numbers, I don’t have them yet. I was told by the Nurse that the 240 number is not too bad but the 170 LDL is definitely bad. She said my Cholesterol should be around 200. That is all I know so far.
My Cholesterol has never been this high before but it has been slowly climbing over the years along with my weight.
I have done the Oatmeal for Breakfast every workday before. I can actually live with this one. I did a salad today as a stopgap while I start educating myself of what I can make or have for lunch. I already make a lunch for my daughter every night, making one for myself will probably have to become a regular event.
My dinners vary widely. A lot of Broil chicken and pasta. We eat out or order probably twice a week. That is almost always bad. I generally don’t use salad dressing, so that source of fat won’t be a problem.
Increasing my fruit consumption is going to be tough. I find citrus fruits hard on my stomach and Apples, Bananas and Melons irritating for some reason to my mouth. I’ll have to keep lots of Grapes, Carrots, Celery and String Beans in the house.

Thank you,
Jim

7

SInce this is GQ (despite the IMHO-like tone of the OP), I feel compelled to note/ask:

  1. Total cholesterol is an irrelevant measure when we know the LDL and HDL. Recommendations based on “total cholesterol” are never as accurate as those based on the more specific levels of the LDL and HDL subfractions. Phrased differently, “total cholesterol” is blind to the relative contribution of the epidemiologically dissimilar LDL and HDL.

  2. For people with an LDL of < 4.2 (160), without known atherosclerosis and without other risk factors, current guidelines would recommend against treatment.

Treatment is recommended only for those with LDL > 3.2 (120) and other risk factors OR those with LDL > 2.5 (100) and established atherosclerosis.

  1. Your assertion that “triglyceride levels are just as important” as cholesterol levels is interesting. Although it is the case that some studies have demonstrated a relationship between increasing triglyceride levels and increasing coronary risk (but not to the extent of “just as important”), there is no convincing data to demonstrate that reducing triglyceride levels leads to a reduction in coronary risk (one way to interpret this is that high levels of triglyceride are, themselves, just a risk marker for another, unmeasured, or unaccounted for, risk [e.g. mild diabetes, hyperinsulinemia, “small, dense, LDL”, etc.])
8

Karl, thank you again. I know my question barely qualifies for GQ, but I needed good solid GQ answers to help me along and not see the Doctor today with no knowledge at my disposal. I can at least ask some questions now that might help in my understanding and getting the most appropriate medical treatment.
On the IMHO side, you and others have raised my hopes that diet and exercise might have very positive affects.
Your advice and links were significantly better then my fumbling through a Google search and asking my co-workers.
If anyone else has anymore information for me in the next hour or three I would still appreciate it. I have some notes put together to ask questions of my doctor.

Jim