Bloodwork back, total cholesterol is high, I am freaking out a little bit page

[14emom]

So I recently got some bloodwork done, I have been tired. (I struggle with insomnia, partly because I have a daughter with a seizure disorder, but that story is for another time.)

I was curious to see what my cholesterol level was going to be. It was high.

Total cholesterol: 251
Triglycerides: 70
HDL cholesterol: 109
VLDL: 14
LDL: 128

My ratios seem good, but that total cholesterol number sticks out like a sore thumb, it's freaking me out a bit. I have been eating primal since Thanksgiving time, I exercise 5x/week, my carbs are under 75 grams/day. I fluctuate between 80/20 and 90/10. I love the way I feel, so happy I don't have to feel hungry to be "healthy" and "fit". The primal way of eating seems like a good fit for me, until I got these results. Can anyone relate to this and what should I do? The doctor didn't mention anything, but he can be flakey sometimes, lol. Any input would be appreciated, thank you.

[Kata]

I've read that in the 70's, the healthy level was 280 (I can't verify that, I just remember reading it somewhere) and there was a lot less heart disease then than there is now. My mom recently had bloodwork done and her total was around 200, and her doc told her that that was too high, and that it should be under 170. It seems like they just keep lowering the standards, but heart disease rates continue to rise. So, I wouldn't put too much faith in those standards. As long as your ratios are good, you're probably perfectly fine.

[Neckhammer]

Those numbers are fairly excellent. Keep up the good work!

To set your mind at ease:

5 reasons not to worry about your cholesterol numbers


The Straight Dope on Cholesterol: 10 Things You Need to Know – Part 1 | Mark's Daily Apple

Your total cholesterol number may very well be the most useless piece of information ever gained from a blood test. It baffles me that any doc would rely on it. This info has been out for many years now. Even traditional docs can't be that far behind. Ahhhhh statins, how we love thee.

[14emom]

Neckhammer, thank you for that article!!!!!!!

[Neckhammer]

No Problem

[ChocoTaco369]

My ratios seem good, but that total cholesterol number sticks out like a sore thumb, it's freaking me out a bit.

Why?

I believe lowest risk of all-cause mortality is a total cholesterol in the 200-240 range. Below 180 starts becoming a health risk.

Your total cholesterol number isn't correct, anyway. Your trigs are too low, so your LDL cholesterol isn't calculated correctly. It's not a direct LDL measurement, it's almost certainly an estimate based on the Friedewald formula for LDL calculation. As you can see, when trigs are low, the number is wildly inaccurate. This guy's calculation (posted above) was off by over 45 points!

In short, you do not know your total cholesterol. Your LDL is a calculation, likely off by about 20-30%, which will skew your totals horribly. It's all wrong.

Get a direct LDL measurement, an LDL particle test and a C-reactive protein test. Add this info to your HDL and trig numbers and you'll have a better feel for your health.

[ChocoTaco369]

I want to add:

Total cholesterol = (trigs/5) + HDL + LDL. In your case: (70/5)+109+128=251

Realistically, your LDL is probably 20% high due to calculation error (as detailed above). If that is the case and your LDL is around 102 (probably more reasonable), redo the calculation.

TC = (70/5) + 109 + 102 = 225

That puts you smack dab in the middle of lowest risk of all cause mortality.

Happier?

[sakura_girl]

Why?
Your total cholesterol number isn't correct, anyway. Your trigs are too low, so your LDL cholesterol isn't calculated correctly.

In short, you do not know your total cholesterol. Your LDL is a calculation, likely off by about 20-30%, which will skew your totals horribly. It's all wrong.

Get a direct LDL measurement, an LDL particle test and a C-reactive protein test. Add this info to your HDL and trig numbers and you'll have a better feel for your health.

I am so confused by what you said....

So....your total cholesterol wrong is because your LDL was wrong, because your LDL was based off a calculation from total cholesterol? Circular thinking much?

I'm pretty sure total cholesterol was measured correctly, whereas LDL was just wrong due to the calculation error.

[Neckhammer]

LDL is frequently calculated rather than measured. But the equation for that calculation does not work when you trigs are quite low. It just throws the whole equation off.

Here is the equation

LDL = TC - HDL - (TG/5)

So you measured the TC, Trigs and the HDL but you depend on a quotient of the trigs. If the trigs are low this imbalances the equation.

This one works better when trigs are bellow 100

LDL = TC/1.19 + TG/1.9 - HDL/1.1 - 38

A little algebra gets you from the LDL= equation to the TC= Equation that choco posted, but that kinda messed you up cause its actually the LDL that is calculated and his equation makes it look like the TC is what was calculated. No big deal, the point is the is still valid that LDL was incorrectly calculated. But, having a VLDL listed in her numbers seems to indicate hers were done by direct measurement I believe....

Either way OP your LDL (even at 128) is bellow the level to worry about even in traditional sense (even the biggest statin pushers put it at 130).

I think we've fairly well mucked this up. I stand by my first response

[sakura_girl]

Choco, as an afterthought:

Or are you saying that the methods for them to measure total cholesterol are wrong, so you are better off getting your LDL measured and calculating total cholesterol from that?