January, 2011 – Cholesterol: What Do The Numbers Mean?

Ask the Docs

Cholesterol: What Do The Numbers Mean?

By Heather Loguidice, ARNP

Let’s all let out a collective sigh of relief now that the holidays are over.  Hopefully, your stress level has decreased as you packed away the last holiday decoration.  I am sure we have all over indulged in gooey sweets, succulent meats with gravy, loads of mashed potatoes, and loaves of bread with butter. I can feel my cholesterol going higher just thinking about all of the rich holiday foods that I have consumed over the past two months.

Cholesterol is a fat-like substance found in the bloodstream and in all your body’s cells. Your body produces all of the cholesterol that it needs via the liver.  Your diet also contributes to your cholesterol level.  Having too much cholesterol increases your risk for heart disease and stroke.

Cholesterol is broken down into low-density lipoprotein (LDL), the “bad kind” and high-density lipoprotein, the “good kind”.  Too much LDL can clog the arteries causing reduced blood flow. If this clogged area ruptures, a blood clot may form or a piece may break off and travel in the bloodstream. If it travels to the heart, it causes a heart attack.  If it travels to the brain, it causes a stroke.  HDL carries bad cholesterol away from the arteries and helps protect you from heart attack and stroke.  Thus, high levels of HDL help to reduce your risk for heart disease and stroke.

Blood cholesterol for adults is classified by levels. Your healthcare provider must interpret your cholesterol numbers based on other risk factors such as age, gender, family history, race, smoking, high blood pressure, physical inactivity, obesity, and diabetes. The American Heart Association recommends following the National Cholesterol Education Program ( NCEP) guidelines for evaluation of high cholesterol. Total cholesterol levels should be less than 200mg/dl.  Levels between 200 and 239 mg/dl are borderline high. Levels above 240 mg/dl are considered to be very high and doubles your risk for heart disease. Optimal HDL levels should be greater than 50 for women and greater than 40 for men.  Levels above 60mg/dl are considered protective against heart disease.

Your LDL goal depends on how many other risk factors you have. If you don’t have heart disease or diabetes and have one or no risk factors, your LDL goal is less than 160 mg/dl. If you have two or more risk factors without having heart disease or diabetes, your LDL goal is less than 130 mg/dl. If you have heart disease or diabetes, your LDL goal is less than 100mg/dl.

Triglyceride is the most common type of fat in the body. It contributes to your total cholesterol level. Ideally, your triglyceride level should be less than 150 mg/dl.

Therapeutic lifestyle changes to lower LDL cholesterol involves losing excess weight, exercising regularly, and following a diet that is low in saturated fat and cholesterol. Increasing your intake of fiber, fruits, vegetables, chicken and fish can help lower your bad cholesterol. Avoid fried foods, limit red meat to once a week, avoid saturated fats found in butter and palm oil, and avoid processed foods such as cookies and doughnuts.

Red yeast rice is available over the counter as a product to help lower cholesterol. Red yeast rice is rice that has been fermented by the red yeast. It has been used in China for over 1000 years for medicinal purposes. Limited studies have been done in the United States looking at the effects of red yeast rice. It is believed to be safe in the long-term since it has been a food staple for thousands of years in Asian countries without reports of toxicity.  The products available in the United States do not contain high enough levels of red yeast rice to cause harmful effects. Patients with moderate to severe LDL levels (> 160mg/dl), and those who are at a high risk of developing heart attack or stroke are not candidates for red yeast rice.

Omega 3 fish oil is another natural way to lower cholesterol particularly when one has elevated triglycerides. The recommended dose varies from 1 to 4 grams per day depending on triglyceride level and risk factors. Fish oil can be obtained by eating fish such as tuna, salmon, anchovy, sardines, mackerel, and trout. Over the counter supplements are available, but make sure the product is purified to reduce contaminants such as mercury and dioxins. There is a purified form of omega 3 fish oil available by prescription called Lovaza.

Statins are prescription medication used to lower cholesterol and reduce the risk of heart disease and stroke. Statins stimulate the body to process and remove cholesterol from the body. Their major effect is to lower LDL levels. Other prescription medications include bile acid binders, niacin, and fibric acids that can all be used to reduce LDL and, in some cases, raise HDL levels.  Always follow your healthcare provider’s orders carefully, and inform him/her of any side effects. You will have to have regular blood tests to evaluate your liver function and cholesterol levels when taking any of these medications.

If you would like further information or would like to have your cholesterol evaluated, please call us at Family Medical and Wellness Center (561) 721-1953.