Extremely high cholesterol

[Agilic]

Coach,

I'm curious about the opinion of you and/or the board on my cholesterol levels, which have been well above the tolerated ranges for years. The 2 GP's I've seen in the last decade have both recommended immediate intervention with medication despite a family history of high cholesterol and no adverse health effects (both grandfather's lived to 90+ and father is 74 without a health incident as of yet). Here are my latest levels: LDL 255mg/dL, HDL 44mg/dL, Trig 95 mg/dL, NonHDL 274 mg/dL, Total 318 mg/dL.

I guess what my question boils down to is; are these levels high enough that if you were 33 you would go on medication for life per doctor's recommendations (I'm always skeptical of doctors and the medical industry in general), or try to get the levels down through dietary intervention, or not worry about it given the fact the high levels are genetic and have not caused health issues for family members of recent generations.

Thank you for the time and for being a no BS source of honest information!

[Mark Rippetoe]

This is not "extremely high cholesterol" unless you are the Lipitor salesman or his client. Let me recommend a very good book: Amazon.com

[FatButWeak]

Instead of reading the tea leaves of your blood to guess whether you are "at risk of" building atherosclerotic plaque, why don't you take a picture of your arteries instead to actually look to see if there's any plaque build up?

Using blood lipid tests to guess at heart disease is as stupid as using blood tests and checking for calcium levels, inflammation markers and trace proteins similar to what's in marrow to guess whether a bone is broken. Take a fucking x-ray, stupid.

The picture of your arteries they take is called a coronary calcium scan and its a type of CT scan where they actually measure the thickness of the build up - if any - of plaque in your arteries. Very diagnostic, very no nonsense, very no guessing. You then get a score, which is either "youre fucked and full of plaque" or "you have no plaque" or you have some plaque." You may have to pay like, I don't know, $100 bucks to get this done since the globo-homo-industrial-military-pharmacology-gubmint complex doesn't actually want you to know if you have plaque. That way they can keep selling you drugs to treat a "disease" that you may have because your "associated factors" place you at a "high risk" of getting the disease (heart disease, that is). This makes you fearful and easy to control.

Take the bull by the dick and go get a calcium scan and stop being afraid of fucking cholesterol.

[Bill Anders]

Very diagnostic, very no nonsense, very no guessing. You then get a score, which is either "youre fucked and full of plaque" or "you have no plaque" or you have some plaque."

If only.

While I agree with the diagnostic aspect, there are still plenty of charlatans peddling or misusing this test.

My GP pushed this test every year and while my actual measurements were well within the "discrete" (meaning visible, but not to a moderate or higher level, or, as FatButWeak said "you have some plaque"), I would get feedback like "you have the arteries of a 65 year old" when I'm in my low 50's. Mind you, there's no aspect of the scan that evaluates the relative age of the artery, yet that statement would be considered sufficient by the GP to pursue pharmaceutical intervention, even though they couldn't describe exactly how that statement was determined. That's one of many reasons why they are no longer my GP.

Having said that, it's a non-invasive evaluation for you to use to get an idea for yourself how things look, if you wish. And use that information to fight the pharmaceutical juggernaut.

But you're probably better off using that money to buy the book that Rip linked.

[BubbaMD]

I’m 44yo, 5’11, 240lbs and have what’s considered “borderline” hyperlipidemia. I’m not on statins and wouldn’t take them if my GP recommended, which he has not. My father had triple vessel CABG in his mid 50s. My grandfather did too. I had the opportunity to have a free coronary CTA done 2 years ago which showed a zero calcium score and no coronary stenosis in any vessels. My diet is shit on most days and I lift 3 days a week. I figure I will keep doing what I’m doing and will be fine from a cardiac standpoint for at least the next five years, then will reassess. I see no reason to have a coronary CTA done every year, unless you are experiencing angina on a regular basis. But then you’d probably just be referred for a cath.