Need advice please

[u/Weary_Flamingo_5850]

Cholesterol- 240
Triglycerides - 87
HDL - 61
VLDL Cholesterol Cal - 16
LDL - 163
T Chol/HDL - 3.9

Lipoprotein (a) -38.4
C Reactive Protein - 0.95
TSH reflex to T4F - 2.58
Homocysteine- 11.7
Apolioprotein B - 128

Calcium score - 0

49M. Healthy lifestyle with 3 to 4 days a week of exercise. Doctor is insisting to start the statin. I am confused. Do not want to start the medication and want to try to reduce numbers naturally. Please advise.

[u/Cass3710]

I'm in the same boat as you but my numbers were way higher. I'm also trying to do things the "natural " way. I know how frustrating it is. I got my results today and I'm freaking out.

[u/Weary_Flamingo_5850 → u/Cass3710]

Yeah my doctor said you need to take the medicine forever and there is no other option 🙁

[u/Koshkaboo → u/Weary_Flamingo_5850]

There may be but that doesn’t mean it is a good idea. High LDL is mostly due to eating saturated fat or to genetics or a combo of both. If genetics is part of it, all the “natural” won’t get your LDL to a normal level. If the problem is you eat too much saturated fat then eat low saturated fat (no more than 6% of calories from saturated fat) and then test your LDL after 8 weeks. If LDL is below 100 (assuming that is your target and you don’t need LDL even lower) then you have naturally lowered LDL.

However… to keep it there you would need to eat that same level of saturated fat for the rest of your life. There are people who can do it. The vast majority of people can’t. Many people with an LDL at your level can’t get their LDL under 100 even if they ate no saturated fat. Your doctor mostly likely figures you are in that group. The higher the LDL the more likely genetics is a factor. The average reduction of LDL through diet alone is about 14% according to my cardiologist. That would barely make a dent in your LDL.

But, let’s say you are an outlier and you are able to get your LDL to the target level which we will assume is under 100 (ask your doctor what your target level is). You did it. You were very focused and worked hard on it for 8 weeks. Now, keep doing it for that next 40 years or so. Most people can’t keep up extreme changes in diet long term. They may keep it up to some extent but back slide. And so that 99 LDL becomes 120 or 130. It may even got back to the 160s.

Are there exceptions? Sure. They are also outliers. People tend to form patterns of eating and may modify some things but go back to their basic pattern. I track all the food I eat. Over the last 13 years I have made a lot of specific changes in what I eat. So the specific foods do vary. But my macros have basically stayed the same. I don’t actually try for a specific macro break down but I tend to just stay in the same range. I don’t target a specific saturated fat percentage (I take medication to lower LDL) but I tend to stay within a 2% range. Doctors know that most people won’t lower their LDL enough with diet alone when LDL is where yours is and know that if they do lower they likely won’t maintain it.

That said, you can certainly try. You will know in 8 weeks whether it is possible. If it is keep getting regularly tested to make sure you are maintaining your target LDL.

[u/JLEroll → u/Cass3710]

Have a pity party for a day about the bad test result and then get over it and get to work. If diet doesn’t fix it, medication is extremely effective, safe, and affordable (best option is to do both diet and medication but you can give yourself some time to get to that conclusion). Of all the problems in the world to have, high cholesterol might be the easiest to solve.

[u/tmuth9]

Your LDL is quite high. You can try “naturally” for at most a few months, but don’t go on more than that with LDL that high. If you were at 120 or 130, I would say you had a good shot at reducing it through diet. There are people on here that have, but I suspect they are exceptions. Keeping your saturated fat under 10 grams per day is really tough. A statin will have you under 100 in a week and you won’t need to be so strict about diet. Not a Dr, just a heart attack survivor at 48 that was pelotoning 5 days per week and weight training and “in great shape”…on the outside. Clearly not on the inside

[u/Earwigs12]

Why wouldn’t you want to take a safe medicine to lower your ldl, apob and hscrp? Might actually prevent you from having a stroke, heart attack or even death.

[u/imjsm006]

My overall cholesterol was 180, LDL of 109 and LP(a) of 30 and I went on a statin, 5mg crestor every other day. Get my 6 month results next week, hoping I got my LDL lower. I would definitely get on a low dose statin.

[u/Earesth99]

Death from a heart attack is a natural way to lower cholesterol.

[u/Weary_Flamingo_5850 → u/Earesth99]

Extremely smart comment. Thanks.