High Cholesterol, high HDL, low triglycerides

Cardiac Health Admin Ask Doctor T, Cardiac Risks 0 Comments

I’d like to ask a question about my recent cholesterol test results.  I had it tested for the first time ever recently.  I am a 38-yr-old female, 5’3″ and 115 lbs, no known health issues.  I do cardio exercise 4 -6 days a week for a half hour.  My diet is fairly healthy, as I actively avoid high fat/high sodium foods (though I do not specifically eat ‘diet’ foods, I just limit my intake of the bad stuff, such as saturated/trans fats and sodium).  I consider myself health conscious and fairly healthy.  There is no heart disease or high cholesterol in my very large family that anyone is aware of.So I was very surprised to receive my cholesterol results in the mail and see that it is considered very high.  Total Cholesterol: 250LDL: 162 (normal <130)HDL: 79 (normal >45)Triglycerides: 42 (Normal <150)As you can see, my HDL and triglyceride numbers appear to be very good, but I’m perplexed about the high LDL.  As I said, high cholesterol and heart disease do not run in my family, and I do attempt to exercise and eat a healthy diet, and am far from overweight.  What might account for this high LDL?  Could I be eating too much of something else that I’m not paying enough attention to, such as sugar?  Are there any nutritional deficiencies or other issues that could contribute?  (I do have to keep getting tested for my vitamin D levels, which are continuously very low despite taking prescription doses.) Thyroid disease does run heavily in my family – is this in any way connected to cholesterol levels?

There are 2 kinds of LDL cholesterol, A and B, of which B is associated with heart disease.
Most labs calculate LDL as follows:

LDL = Total Cholesterol – HDL – triglycerides/5.

This doesn’t explain the difference between LDL A (no risk)  or B (at risk for heart disease).

Studies have shown that there is a strong correlation between a low triglyceride/high HDL level and LDL pattern A (good kind).

On the other hand, a high triglyceride/low HDL level is strongly associated with LDL pattern B (heart disease risk). Thus high triglycerides are an independent risk factor for heart disease.

From this you can calculate that in your situation a high LDL is mostly Type A (good), confirmed by a high HDL and low triglyrerides and that therefore there a very low risk of heart disease.

Having high cholesterol may still be healthy if good cholesterol levels, triglycerides, and other markers of cardiovascular health are good. You can calculate this here. People with high good cholesterol levels (60 mg/dL or more) and low levels of triglycerides (less than 100 mg/dL) may actually be at a lower risk for heart disease than people with normal cholesterol levels who have lower levels of good cholesterol and higher levels of bad cholesterol.

Hope this helps,

Dr T

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