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# Cholesterol

I don't understand my cholesterol levels. My LDL looks within the normal range. But beside Cholesterol there's a number higher than the normal range. H mean abnormal high apparently. What's the difference between LDL and cholesterol? Do I have anything to worry about?  My blood test results show this:

Test Name                  Result           Reference Range

LDL, Calculated           2.36              1.70-3.00                    mmol/L

Cholesterol                  4.70      H      3.20-4.60                    mmol/L

Triglycerides                1.10              0.60-2.30                   mmol/L

HDL cholesterol           1.84               >=0.91                      mmol/L
Total: HDL
Cholesterol                  2.6
Ratio

H- Abnormal High
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Welcome and thanks for the question. The reason that your total cholesterol is slightly high is because your HDL or good cholesterol is well above average, that's a good thing, especially when your LDL or bad cholesterol is in line.

LDL cholesterol are the small dense particles that like to stick to artery walls and cause blockages. HDL cholesterol seeks out LDL and binds with it to remove it from you blood back to your liver to recycled or eliminated. The more HDL, the more LDL that can be eliminated. Your numbers look good, I don't see anything to worry about, but I'm not a doctor.

What did your doctor have to say?

I hope this helps,

Jon
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Having very low cholesterol levels (below 4.2 mmol/L or 160 mg/dL) is called hypocholesterolemia - the presence of abnormally low levels of cholesterol in the blood.  Below 4.2mmol/L cannot be considered normal in other words. 4.7mmol/L is abnormally high?..i don't think so. :)
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Actually, there is no set threshold for hypocholesterolemia. According to  the NIH it is the bottom 5th percentile adjusted for age, gender and race. In discussing this with the cardiologist on call tonight, in my case the low threshold would be around a TC of 120 so it is different for every person.

http://www.ncbi.nlm.nih.gov/pubmed/20626336
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Far too many studies show the dangers of low cholesterol regardless of the disagreement of the hypocholesterolemia threshold.  One particular study found that men with cholesterol levels below 150 mg/dl or 3.8mmol/L had four times the risk of cerebral haemorrhage compared with men with cholesterol levels above 190 mg/dl or 4.9mmol/L.
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Agreed, many conflicting studies. Too many showing poor outcomes with low cholesterol, more that show poor outcomes with high cholesterol. The trick for the future researchers is going to be how to find out what is too low and what is normal and how to normalize a number that can be adjusted to all age, race and gender groups with and without risk factors.

I don't know much about you, but I'm guessing what is an appropriate number for me is different for you. I cycle 15 miles a day, EVERY day, have lost 80 pounds, have an excellent exercise tolerance and an LDL of 68(just last visit) so apparently 68 is not too low for me. My HDL also tends to run low at 37 but with an LDL of 68 it just doesn't really matter. Would these numbers be ideal for everyone? I doubt it. I have seen no ill effects from a TC or LDL as low as mine yet the reports say I should be experiencing brain bleeds, loss of memory, low testosterone levels ect, ect. None of which is the case.

We are all individuals and that is why it takes a trained medical professional to sort out our individual medical histories and weigh the risks verses the benefits. We as patients have the responsibility to be proactive and make sure we understand the treatment prescribed and their potential threats and benefits to us.

FYI, when I go off statins my LDL shoots back up over 130, it makes you wonder what role that tendency plays in ones overall health.

Jon
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I've never seen a cholesterol of 4,7 been referred to as "abnormally high". In my country the range is:

Below 30 years old: Reference range: 2,9 - 6,1 mmol/l
31-59 years old: Reference range 3,4 - 7,8 mmol/l
Above 60 years: Reference range 3,8 - 8,4 mmol/l

However, there is a difference between reference range (which means what 95% of healthy subjects have) and desireable values: Desireable values in my country are:

Total cholesterol: <5,0 mmol/l

Also, there are some rules:

Acceptable in the absence of other risk factors: <5,8 mmol/l
Acceptable with one risk factor: <5,5 mmol/l
Treatment target with major risk factors (diabetes, hypertension) 4,5 mmol/l
Treatment target with manifest cardiovascular disease: 4,0 mmol/l

Also, there are rules for LDL and HDL cholesterol but that doesn't seem like a problem to you. In my humble opinion your cholesterol is excellent!
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