DEAR DR. GOTT: I am so confused! I am a 47-year-old female, 5’5” tall, 128 pounds, pre-menopausal. My hypothyroidism is managed by Synthroid 25 mcg per day. Also, I have a vitamin D deficiency managed by 50000 units per week. I do not eat any red meat, exercise at least 30 minutes per day (breaking a light sweat through using a stationary bike at 15-16 mph).
I eat a balanced diet consisting of beans and legumes for protein and I cook with olive oil and other “good” fats. I consume two to three ounces of red wine with dinner nightly. Despite all this, my cholesterol is 221 and my triglycerides are 195. My HDL is 59 (I worked hard to raise it from 50) and my LDL is 123. I am dumbfounded! How can I lower my cholesterol and triglycerides further? Also, the lab collected blood after a 5 hour fast only and they did not instruct me to abstain from alcohol for 24 hours. Did this alter my results? Any advice would be much appreciated.
DEAR READER: For the record, target goals for HDL (the good cholesterol) are between 40 and 60mg/dL with higher numbers better than lower ones. LDL (the bad cholesterol) should be between 70 and 130 mg/dL with the lower numbers preferred. Triglycerides have a broad range of between 10 and 150 mg/dL, with the lower numbers better, and total cholesterol should, under most circumstances, be less than 200 mg/dL. There are specific medical disorders such as cardiac disease in which a physician might prefer a patient remain substantially lower than the norm for this category.
Your five-hour fast before the testing isn’t generally sufficient. In most instances, physicians urge patients to fast for nine to 12 hours prior to testing, so this may play a role in your abnormal results. I suggest you request a repeat test in which you have fasted for 12 hours prior to testing to determine if this played a role.
Beyond that, it appears you are doing all you can to address your hypercholesterolemia; however, I may be able to offer some reasons why your levels are not lower that you haven’t considered. You suffer from hypothyroidism, for which you take Synthroid. An underactive thyroid gland (and diabetes) can lead to high cholesterol levels. Beyond that, is there a possibility you may be taking birth control pills, a diuretic, estrogen, or one of several medications for depression — all of which can increase cholesterol levels? Have you had polycystic ovary syndrome, or kidney disease? Do you smoke? While the habit will not elevate your total cholesterol count, it can lower your HDL (good cholesterol) figure. Then, perhaps last but not least, do you have a family history of high levels? This can be rather frustrating because, as you may have discovered, no matter what you do your family history of disease can be tough to overcome. If this is the case, you may need to be placed on a cholesterol-lowering drug – either an over-the-counter or prescription.
I know a number of individuals who will not take a statin drug because of the bad publicity for medications in this class. Instead, they prefer taking over-the-counter plant stanols and sterols such as Cholest-Off; others sprinkle flax seed on their cereal and other foods throughout the day; some take flaxseed oil capsules for convenience every day. Have you considered vitamin B3 (niacin), or tried adding a teaspoon of cinnamon to your daily diet? These simpler options may not work but they also might help you reach your goal. Become educated by reading labels. Eliminate saturated fats and trans fats from your diet. Replace them with whole grains, fresh fruits and vegetables.
Readers who would like additional information can order my Health Reports “Understanding Cholesterol” and “Compelling Home Remedies” by sending a self-addressed, stamped number 10 envelope and $2 (for each report) US or money order to my attention at PO Box 433, Lakeville, CT 06039. Be sure to mention the title(s) when writing or print out an order form from my website www.AskDrGottMD.com.
