question about HDL

Hello! I have a question about my lab results. I am a 35 year old female. No medical problems, not overweight, do not drink, smoke ect. Try to live a "clean" lifestyle. Although I do suffer alot of stress and have anxiety issues. I had my cholesterol tested and the results were......

total 145
Trigs 99
VLDL 19.8
LDL 94.93
HDL 30.27

Okay good, excpet for the HDL which scares me to no ends........

I have great blood pressure...........usually 110/60 resting and no diabetes. Pulse is around 55 resting.
My father who is 56 has had 2 heart attacks. BUT........he is also a heavy smoker(since 15) and heavt drinker and eats horrible.and has high blood pressure. Even after multiple events he continues to do so. I do not know how he is still alive. Also has PAD. Anyway...........how can i raise the HDL? I have started taking Fish oil(combo fish, borage, flaxseed) and i need to get in teh exercise routine. I dont drink but if drinking 1 glass of red wine will help i will. (Ill hold my nose ;) Am i in danger of an immediate heart attack? This has stressed  me out to no end and i can stop looking online about it and everything i read is so upsetting. How much fish oil can I safely take? I can read about Niacin........how much can I safely take of that without having to get liver test done by my doctor so often. Any suggestion are greatly appreciated. I bought your book, and i have enjoyed it. Thankyou!

[Lee Kirksey, MD]

Hello
Sorry for the delayed answer. My notification feature didnt work. Your question is very interesting. It sounds like your personal risk factors are limited to your father's bad lifestyle (and that may be a neglible genetic contribution since you have attributed his health to his behaviors). Most aggressive treatment for the prevention of cardiovascular risk factors is based upon a person's risk profile. This is important because as you know, all medications have potential side affects and if the benefit of the medication is neglible- the sideaffects may outweigh the benefits

Having said that, other lab indicators of your cardiovascular health include CRP level, a measure of chronic inflammation and fractionated measurement of your cholesterol. (learn more at www.optimalhealthtoday.com-click cardiovascular testing  link). If your risk profile is low, at your age I would recommend a sound exercise program and a low fat diet (by low fat I mean <30 gms total fat and <15 gms sat fat).

In my opinion, we may be a little bit too quick to recommend pharmacologic therapies before maxing out behavior modification. If people are really interested in lowering their cholesterol without medication-a plant based diet would be the first place to begin

Failing that, niaspan, crestor or trilipix are considerations for HDL directed therapy. If you elect to use fish oils, they must by pharmaceutical grade to provide benefit or else your just throwing money away. We use douglas labs in our practice.



Good luck

[shubunkin2974]

I would REALLY appreciate it if my question would get an answer.

[osiag]

Am i in danger of an immediate heart attack? It is highly unlikely that a 35 yr old female who doesn't smoke, is not diabetic, has normal BP, and LDL of 95 is in immediate danger of a heart attack.  

Technically, your only risk factor is HDL.  I would recommend getting a test that shows the subfraction of HDL.  There are different forms of HDL.  HDL 2 is more powerful than HDL 3.  So, if you HDL 2 is in range, you may be worrying for no reason.  HDL can only be readily raised by losing weight, controling diabetes or prediabetes, or by taking niacin.  Avoiding execessive carbohydrates even in people with normal glucose control may be helpful as well.  

How much fish oil can I safely take?

Look at the AHA website.  They give recommendations as to intake of fish oil.  The amount is gaged by adding the mgs of EPA + DHA.

Niacin........how much can I safely take of that without having to get liver test done by my doctor so often.

The amount of niacin that increases HDL requiers monitoring by your doctor.  Dont do this on your own.  Niacin can negatively affect the liver.  

I hope that this helps.  

I suffer from anxiety myself and have a very bad family history of CAD.  I say that to emphasis that I am not being glib when I say that you most danagerous risk factor is your stress level.  You are a great candiate for regular aerobic exercise and mediation.

[shubunkin2974]

thankyou very much!