cholesterol increase and HCT

[dawn7276]

Hello,

Over the past five months my total cholesterol rose 45 points (19%) and my LDL rose 48 points (32%).  HDL also rose by 11 points (24%)- the only good news. I went from one of the lowest results I had ever had (although still too high) to the highest (by at least 25 points) I had ever had.

During this period of time I increased my intake of fish and fish oil and started taking Red Yeast Rice (w/ co-q-10) twice a day.  Also during this time my BP med was doubled and HCT was added. I know that HCT can raise cholesterol levels, but usually only at higher doses than I take (12.5 mg per day), and then only on average by 11%.

My diet and weight did not change during the five months between blood work.  I may have gained about 4 pounds in that period of time and my intake of sweets increased a bit (as it often does during the winter months), but no significant change.  I generally eat quite healthy-- lots of fresh vegetables, very little saturated fat, etc.  I have no immediate family members with high cholesterol, yet my cholesterol has been high for 20 years (I am 60).

I must have a lot of inflammation in my body.  Last time my C-reactive protein was checked it was 2.7.  I currently requested the new blood test to check for plaque (PLAC-test) and it was 230- the high end of "moderate risk" ("high risk" is over 235).  

I convinced my doctor to prescribe my BP med without the HCT and I have stopped the Red Yeast Rice.

My doctor and I are baffled by this huge increase in my cholesterol, especially in light of having taken Red Yeast Rice and fish oil over this period of time.

Any ideas?

[Circa49]

Well,  I must say, the proposed changes you've listed are unlikely to make enough of a difference to  get  your TC under 200,  which is the minimal goal for most folks.   More troubling is having LDL between 150 and 198.

If you concentrate too much on not wanting your HDL to fall,  then you may be missing the point of the ratios.   Naturally if your TC falls down to 180,  by the very nature of the process your HDL will also fall.
That is not bad if the ratios improve in the process.  LDL vs HDL and TC vs HDL.  
It is difficult for a person who can't do a good deal of exercise.  Exercise is one of the best ways to raise one's HDL.

I would say,  not to get oversold on the "good fats".   Lately I seem to be seeing people use that to load up on "good fats".

Not sure what kind of "low fat" diet the dietician had you on.
That term is kind of  a catch-all for a broad range of eating.
For sure,  the one that Bill Clinton is on is at the very lower end of fat elimination.   Then again he has been scared into it,  having already undergone a quadrupal bypass.

I'm surprised your doctor hasn't already suggested or put you on a statin especially given your recent test results.
I'd prefer to do it naturally, but short of  that working,  I guess I'd take a statin.

Oats and oatmeal are good,  but they only take most folks down about 5 or 10 points.   Perhaps they'll do more for you.   I buy and eat plain old fashion Oatmeal.   You don't even have to cook it.  In fact most Swiss museli is just plane oats with some fruit mixed in....without sugar.
Simple.    You mentioned low fat dairy.   Some time ago I switched to soy milk and never noticed the loss or difference.   Most easy health switch I'ved ever made.

I also know some of what you say about some ultra-low fat vegans not looking too healthy.   However that has a lot to do with modern American perceptions of what is normal...in a nation where 2 out of three adults are either overweight or obese.   The new normal is not healthy.
Take a look at the before and after pics of Bill Clinton.  
Some might say he is too thin,  but after all said and done,  he has said he just wants to keep living and so he got serious about his diet.

I'd say given where you were before this last test,  in the 250 range of TC,  that you could probably get it under 200 without needing meds,  but you'd have to make some significant changes.   More than most folks are willing to do.

Anyway,  if you get a chance, check out those doctors I mentioned.
One of them,  Esselstyn works for the Cleveland Clinic,  the same  place that runs this board.

Oh, one other thought,  the Framingham Heart Study is without a doubt the largest and longest running study in the world.   Look at the wiki page on it some time.
Anyway, the guy who was the head of it for a long time is well known and gives some interviews.  
Here is a link to one that you  might find excellent reading

http://www.prescription2000.com/Interview-Transcripts/2011-02-18-william-castelli-heart-disease-lipids-transcript.html

Agree with it or not,  but there is no  denying that that man has about as much information on this important topic as anyone in the world.
That entire ongoing study is one of the most valuable sources of information in the world.

They have been following over 5,000 people for over 60 years.
Given your condition,  you owe it to yourself to understand the data they have collected and continue to collect.

http://www.framinghamheartstudy.org/about/index.html

[dawn7276]

Thanks for all the advice. I take two fish oil/omega 3 a day -about 2400 mg and eat fish once or twice per week- broiled or baked. I eat red meat only a couple of times a year!  I limit saturated fat and whole dairy fat and eat good fats- avocados, olive oil, nuts. I eat tons of fresh vegetables. I have no family history of high cholesterol. My weight is in a healthy range, although I would do well to lose 10-15 lbs. Because of a disability, I am unable to exercise, except for some yoga and stretching.  

I am not sold on the idea of "low fat." I tried that once under a dietician's direction, and because I eat primarily good fats, once I lowered my intake of them, my HDL fell by half! I also generally don't think low fat diets are healthy. Most people who lose weight on low fat diets do not look good to me- pale and aged (obviously just my opinion).

I think that I need to get the sweets out of my diet. Sugar is a major inflammatory factor, and I need to get the inflammation down. I have also started to add ground flaxseed to my food, eat more oatmeal (steel cut), and plan to get more sterols/stanols in my diet through consuming  even more vegetables and a couple of commercial products that have added stanols.

Wish there was a magic formula. I just hope that what I'm doing now will work!

[Circa49]

Did the math given the data you supplied and indeed your TC is getting up there.  Also, the LDL would be about 198 given the numbers and percentage increase you supplied.

You say you increased the fish and fish oil.   Not sure what that means in amounts,  but could you now be getting too much?
Fish may be better than beef and pork,  but it does contain a fair amount of fat and cholesterol.    Also wondering how you cook your fish.

Different people respond differently to things that are helpful for others.
I also add in fish and fish oil but not in large amounts.   But my cholesterol is always well under 200 on any test.   I'm lucky in that regard, but I eat a very low fat diet to keep it down.

I'm not a super ultra low fat eater and am not a total  vegetarian or vegan, but I have seen some people with problem cholesterol go on a complete lifestyle change and get signficant,  even dramatic results.

Wondering if you've ever tried that even for a few months.

If you are uncertain about what that means,  there are several good,  non-crazy,  doctors who seem to have a large following.

In fact,  former President Bill Clinton now follows one of them and credits the help of one other also.

Those two are Dr.  Esselstyn and Dr.  Dean Ornish.   Both very well known in dealing with situations such as yours.   Both have one or more books on the subject.
One more doctor along the same lines of thinking is John McDougall.
He also has books and a active web community.

Now,  those changes aren't for everyone.   Many people don't think they could do it or don't think it is worth it.
Bill Clinton delayed for some time,  then he had a bypass operation and even afterwards found the problems returning.   Only then did he do the full compliance,  wanting to be able to see his grandchildren if they come in the future.  He got scared.

Given your current data,   high cholesterol,  high blood pressure,  possible weight,  and age,   you might want to look into it.

I do a  partial version of their plans,  but then again I don't have any of your issues.    

Just a thought.   I'm sure there is some way and some lifestyle that can give you good numbers and help with your BP.

Wish you well in finding that direction.  
I do think you should persue some course,  as your numbers are too high for your long term health.

(oh yes,  I am NOT a medical doctor, nor do I have any medical training)