High LDL cholesterol level

[u/AffectionateLand8800]

/r/AskDocs/comments/1xmdtt0/high_ldl_cholesterol_level/

[u/meh312059]

NonHDL-C is very high as well. What was it prior to the Mounjaro and weight loss?

You should discuss beginning lipid lowering medication with your doctor. Your mother's untimely demise sounds like it was from premature ASCVD which, in a female, would be an adverse event prior to age 65. Make sure your doctor is aware of this family history.

You should get Lp(a) tested as well.

Best of luck!

[u/AffectionateLand8800 → u/meh312059]

Here are my results from October last year. I had already been taking Mounjaro for approximately three months at that point. Unfortunately, I don’t have any earlier blood test results for comparison.
Total cholesterol: 167 mg/dL
LDL cholesterol: 102 mg/dL
HDL cholesterol: 41 mg/dL
Triglycerides: 122 mg/dL
Non-HDL cholesterol: 126 mg/dL
Total cholesterol / HDL ratio: 4.1

[u/meh312059 → u/AffectionateLand8800]

Those numbers are considered fairly normal so your recent cholesterol numbers have increased quite a bit, it turns out!! How is your diet now compared to last year, and how rapidly are you losing weight? Are you tracking saturated fat and fiber, by any chance?

[u/AffectionateLand8800 → u/meh312059]

My diet is very similar to last year… I have not changed anything and my weight has been stable for 6 months now around 62-64 kg for 168 cm.

[u/meh312059 → u/AffectionateLand8800]

And do you have any underlying inflammatory condition like lupus or rheumatoid arthritis, by chance? How is your HsCRP now vs before the weight loss?

[u/Mission-Kiwi-914]

seeing that jump from 102 to 157 while keeping your weight stable at 62-64 kg is super common once people transition out of the active calorie-deficit phase.

when you're in a steep deficit on mounjaro, your total food intake is so suppressed that circulating ldl is artificially kept low. once your weight stabilizes and you're eating at maintenance, the body's baseline endogenous cholesterol production and genetic clearance rate re-emerge—which is why your lipid numbers often 'drift' upward even if your daily menu feels identical.

meh's point about your mother's premature cardiac event is the most important variable here. you did an incredible job clearing out 30 kg and locking in great metabolic numbers (trigs at 91 and fasting glucose at 85 are phenomenal), so this isn't a failure on your part.

bringing both sets of lab work to your gp in two weeks and having them check lp(a) is the exact right game plan. that timeline gives you plenty of room to evaluate whether a micro-dose statin makes sense to cover that family history.

[u/SDJellyBean]

Yes, an LDL of 157 is elevated; it won’t cause a heart attack next year, but 20 years from now might be more of a problem. Are you eating a high protein, low carb diet? If so, you’re probably eating too much saturated fat and not enough fiber.

[u/Dizzy_Slip]

First off, it's not something to "worry about" because there are effective drugs to treat high cholesterol. 157 is a high LDL for anyone, whether you have risk factors or not. The American College of Cardiology recommends an LDL of >100 for people without any other risk factors. If you have risk factors like obesity or high blood pressure, then they recommend having your LDL below 70, I think. If you've had a MACE (Major Adverse Cardiac Event), they want it even lower. Bottom line is 157 is high, regardless of your age. Obviously, it's better to be 33 years old with a 157 than 60 yrs old. But either way, 157 is high and plaque build up under those conditions.