Why report HDL as high on blood test report?

[Jerry_NJ]

I just got a copy of my blood tests from my annual physical and again (I've noticed before) how silly the "flags" can be.

For my Cholesterol reading I got a great 160, and can say thanks to Simvastatin,

So off to a good start, but reading on down my eye naturally catches the bold 1 HIGH and 3 LOW lines under the Flag Column,  i.e., something that needs to be noticed - and assumed to be a problem, I'd expect, but not so.

My HDL is 69 and marked "HIGH" , why?  Because it isn't in the range 35-65,  why isn't the range over 35, there is no too high, is there,

To continue with the silliness,

LDL 72 is marked a "LOW", why? Because the reference range is 100-130, why isn't the range under 100, there is no too low, is there?

The same screw ball way of reporting also give me a "LOW" on LDL/HDL ratio and CHOL/HDL ratio, of course here there is no too low.

Just venting, Happy Easter.

[itdood]

Hi Jerry, I think they put upper limits on "good cholesterol" because it *might* indicate the existence of a secondary condition like a thyroid problem.  It's one of those hey-look-at-me indicators for further evaluation.  If everything checks out it's fine.  HDL is protective so no action required.

Same with LDL but in reverse.  Too low might indicate a secondary condition.  We do need LDL for other reasons. Eliminating it completely will cause other problems.  

I'm on simvastatin too and I have very similar numbers.  My most recent said LDL TOO LOW, it made me laugh.  I thought that's what they wanted!!  My doc said it was cool, no secondary issues so carry on.

[Red_Star]

Yes well your risk of preterm birth and low birth weight is zilch LOL. My info is on various articles/studies. All i can say is you need cholesterol for good health so don't go to low eh?

[Jerry_NJ]

Most of the problems apply to me except for those associated with bearing children.

I of course didn't want an LDL of 0, but to call (statistically or not) 70 "low" is unnecessary I think.  An LDL "range" would be better sat at 50 or similar for a lower level, that is below that level needs attention.  A 70 doesn't need attention or my Primary Care and Cardiologist need some Update on their Training.  

I have never considered there was such a thing at HDL too high, I will not argue but suspect an HDL over 85 is almost impossible and if present has noticeable symptoms.  My point again, and taking your numbers as the best, set the HDL range as 35 to 80.  

As for 160 total, when I was still able to run for exercise I saw a total as low as 135, and that was with a high HDL.  My cardiologist and primary were not concerned and wanted me to be below 200, for those diagnosed with heart disease, me even back then.

I will soon be 74 and I have never had any blockage, well none detected yet and I get a through set of tests - just did a Nuclear Stress and Echo Cardiogram, the second in one year.

I am not trying to start an argument, my reason for posting was to "laugh" at what I still consider a report format that could alarm a patient.  But, except for patients like me who ask for a copy of all tests, most never see the report... they just go on their happy way when someone  from the doctor's office calls and says:  "you blood test is normal".

[Red_Star]

LDL is important to transport vitamin A and vitamin E as well as cholesterol to tissues.  According to the Mayo Clinic, low levels of LDL cholesterol may increase your risk of cancer, depression, anxiety, and preterm birth and low birth weight.

Ansell et al showed that patients with heart disease and HDL-C greater than 85 mg/dL carry dysfunctional HDL. High concentrations of dysfunctional HDL may be more dangerous for cardiovascular health than low levels of functional HDL. A dysfunctional HDL may be a cause or cofactor in the development of diabetes.  

Total cholesterol below 180 mg/dL increases the risk for hemorrhagic stroke.  Total cholesterol levels below 160 mg/dL is classified as hypocholesterolemia.  Low cholesterol levels increase the risk of cancer, hemorrhagic stroke, respiratory and infectious diseases, depression, anxiety, impulsivity, aggression, and suicide.

[is_something_wrong]

The answer is that blood test "normal" areas are statistically determined by what X % (usually 95%) of healthy subjects have. Also, "normal" values are not the same as "desired" values. If you are outside the "normal" values, it is noted by "high" or "low". To be outside the normal area isn't necessarily bad, in your case it's the opposite.

Just a note; LDL isn't ALWAYS (though usually) the lower the better, a low LDL is good but a far too low LDL (like below 50) can be too low. LDL also have a purpose.

But your cholesterol is great and I agree - it's confusing. I wish my cholesterol was that good. Happy easter :-)

[DeltaDawn23]

You are right -- this is ridiculous.  Looks like your numbers are great! HDL = the higher the better, and the same with LDL = the lower the better.  My pcp calls this kind of stuff "scaring my patients."  Congratulations on the great results -- you are clearly doing something right!