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High Cholesterol Message Board


High Cholesterol Board Index


I am a 36 year old male, weighing in at a little less than 285 (6ft 2in tall). About a month ago, I went to the doctor to talk about my anxiety and high blood pressure which seemed to be related to high stress levels.

To rule out several other potential causes of my anxiety symptoms, he did several blood tests and, long story short, it all came back good with the exception of my cholesterol (I had fasted for 12-15 hours before the visit just in case he did blood work).

At that time, my readings came back as Total=215, HDL=25, LDL=139, Trig="over 300". Due to my then sedentery lifestyle, high stress, high blood pressure and bad cholesterol readings, he immediately put me on a BP medication (Benicar HCT 20/12.5) and Simvastatin (20mg).

Now, a full 30 days later, my BP is down to a daily average of 116/77 (was 140/90) and the blood work came back as Total=140, HDL=23, LDL=75, Trig=209. With the doctor's ok, I started mild to moderate exercise 30 minutes as I began the medications and have been performing aerobic exercise at 60-70% max HR for 30 minutes EVERY DAY for the past 2-3 weeks. I've also slowly begun changing my diet to one of less red meat, more poultry, plants and fish, but have not cut out the nightly 1-2 scoops of ice cream with fresh fruit.

The nurse just called and said the good doctor is still concerned about the elevated Trig's and very low HDL, so would like to to add Trilipix to the mix, as well.

My concern is, am I at that great of a risk of heart disease that these numbers need immediate pharmaceutical intervention or would it be more prudent to continue exercising every day (I will continue that anyway...I really like it!) and improving my diet, or do I go along with yet another drug to add to my system?

Any input from those of you that have gone through all this before? I've thought about adding in approximately 3g of fish oil (1.8g EPA & 1.2G DHA) with aged garlic and CoQ10/L-Carnatine (to help prevent statin side effects - doctor suggested this), but I'm a bit overwhelmed.

Thanks in advance for any thoughts or experience any of you can share.
Adding Triliptix or what use to be called Tricor, seens like overkill to me. If your Triglycerides are 209, that dont seem high enough to add another drug. Triliptix is a fibrate that works on lowering Tri's. 150 or lower is normal.
I take Simvastatin and Tricor. My tri's are about 210 with Tricor, and me and my doctor are happy about it.
Fish oil is gross.
Have you had a cholesterol test since starting exercising? Your HDL of 23 to 25 is considered a risk factor (because it is less than 40, and your total / HDL ratio is high as well), but exercise tends to increase HDL.

Your triglycerides are considered high; try reducing intake of sugars, simple carbohydrates, and alcohol.

Losing excess body fat should also help with reducing the LDL and triglycerides numbers.

Frequent ice cream intake is not good for your cholesterol levels. The dairy fat has a lot of LDL-raising saturated fat, and the sugar content is not good for your triglyceride levels. Plus, the calories may make it hard to lose excess body fat. Whole fruit, on the other hand, is generally good to eat.
I agree with everything the previous poster just mentioned.

Cut out the daily ice cream, sweets and any junk food you may be eating. Reduce or eliminate wheat, high carb foods, and fruits that don't contain fiber (white grapes, fruit juices, etc).

Ask your doctor for a VAP test, homocysteine, vitamin D levels, and c-reactive protein. A regular cholesterol test is close to useless.

You can ask your doctor about taking Lovaza (or OTC fish oil) instead of a fibrate. And fish oil isn't gross... if it is, you are buying the wrong brand (or a rancid bottle). Good fish oil basically has little to no taste, or contains lemon flavoring.

High dose niacin or prescription Niaspan may be a better option than a statin or a fibrate, as it will help raise HDL much better than any other drug. But only take niacin under a doctor's care.

I suggest anyone on a fibrate research the mortality rates on those drugs -- you may not like what you see.
Thanks for the replies, everyone. I've completely cut out alcohol, I am down to 2 slices of whole-wheat bread daily and the fruits I consume consist of mainly banana's and apples with the occasional mixture of blackberries, raspberries and blueberries every night in place of ice cream (yes, I gave that up a couple of evenings ago and I don't realy miss it with the fruit in its place).

My typical day's food intake is as follows (maybe this holds some clues?):

Morning
8oz fat free fruit yogurt
banana
1 slice toast with sugar-free orange marmalade or honey

Lunch
Salad with 2oz chicken, tomatoes, shredded cheese, ranch dressing (drizzled not drenched) shredded carrots...your typical side salad with chicken added, I guess.
Otherwise, 1 turkey-ham sandwich with a slice of fat free cheese, pickle slices and mustard plus a single serving bag of baked chips.

Dinner
2 to 4oz of meat (chicken, lean beef, lean pork, fish)
1 to 2 cups veggies (peas, green beans, broccoli, corn are most frequent)
1-1/2 cups rice or mashed potatoes with either lo-salt soy sauce or olive oil spread

Snacks
fat free yogurt with mixed berries in evening
granola bar(s) during day
very occasionally a small piece of candy/chocolate during afternoon, usually once per week

Drinks
water, water, water...I probably drink upwards of a gallon of water per day. I prefer it to anything else and have even cut off coffee other than 1/2 cup 1-2 days per week when my wife makes a pot of the stuff.

So...that diet along with 30 minutes daily of aerobic exercise plus a statin plus Trilipix (not a typical fibrate from what I'm reading) plus 2g fish oil with at least 2 meals a day. Shouldn't that be a little bit of an overkill for where I started?

However, the HDL has not improved despite 30 days of daily exercise. LDL cut in half and total Cholesterol is way down, but the low HDL/high Tri problem remains. One nice benefit of all this is that due to the diet changes and the daily exercise, I've lost nearly 25lbs in the past 6 weeks, which I'm sure can only help, as well! I'm guessing the journey to ideal blood lipids takes time if done right/naturally...
Note that preflavored yogurts are high in added sugar. Plain yogurt to which you add your own whole fresh or frozen fruit is a better choice.

Your breakfast seems to be high in fast digesting carbohydrates (toast, banana is a relatively fast digesting fruit; if the yogurt is preflavored, it is high in added sugar), which may not be good for your triglyceride levels. You may want to substitute a slower digesting whole fruit like a citrus fruit or berries, and substitute oatmeal or other whole grain hot cereal for the toast. Or try putting a nut butter on whole wheat toast (good unsaturated fats in the nut butter will slow down the sugar spikes).

Granola bars are probably fast digesting carbohydrates.
Yeah, go with oat bran for breakfast instead of yogurt + toast. Or try oat bran muffins (homemade), in moderation, but don't load them with sugar or bad things like that.

If you do eat yogurt, always go with plain, like the poster below just recommended.

I'd recommend dropping the toast, bananas, granola bars, corn, rice and potatoes. If you do go with rice, make sure it's brown rice. Mashed potatoes is pretty much a useless food, little nutritional value and lots of carbs.

Overall, your diet isn't that bad though. You may want to consider more leafy vegetables (garden salad, spinach). Wheat bread in moderation like you are doing is probably okay, but even better if you go with a low carb wheat bread -- Arnold's makes a decent one.

I'm not sure if you really need Trilipix on top of a statin plus fish oil. You may wish to ask your doctor about trying statin + fish oil along with diet/exercise changes, and see how it goes first. Fish oil at 2-3 grams/daily usually works quite well for trigs, better than most other medications.

HDL is tricky to raise sometimes. One little known fact is, as a person loses weight, their HDL can sometimes decrease. But after a while, once a person's weight levels out, HDL will rise again. Normalizing vitamin D levels into the 45-50 range can often raise HDL too.

A small piece of dark chocolate daily (one square) might help HDL a little.. Niaspan would help too. And don't forget to take CoQ10 with that statin.
Well I stand by my post. Tri's at 209 may be high but they are not bad for most people who have high trigycerides. Yes you can cut out white food ( sugar, wheat, whatever. Good advice I guess. But for most Doctors I have ever talked to say realistically its not possible to do all that. CHew 2x4's if you want but you wont live longer. Do what your doctor tells you. FISH OIL IS GROSS. Not everyone agrees but I would rather take a fibrate over fish oil anyday. Exercise is the best medicine. You and I are similar boats. Good Luck.
[QUOTE=MT10149;3933423]FISH OIL IS GROSS.[/QUOTE]

Why not eat fish if you want to get the effects of fish oil without eating the fish oil by itself?
[QUOTE=MT10149;3933423]Well I stand by my post. Tri's at 209 may be high but they are not bad for most people who have high trigycerides. Yes you can cut out white food ( sugar, wheat, whatever. Good advice I guess. But for most Doctors I have ever talked to say realistically its not possible to do all that. CHew 2x4's if you want but you wont live longer. Do what your doctor tells you. FISH OIL IS GROSS. Not everyone agrees but I would rather take a fibrate over fish oil anyday. Exercise is the best medicine. You and I are similar boats. Good Luck.[/QUOTE]

Triglycerides probably don't cause heart disease directly. But what happens is, triglycerides tend to have bad friends: small particle LDL, for instance.

To say a level of 209 is not bad for most people is false. If your doctor didn't give you a VAP or lipoprotein test, he honestly has no idea if your 209 is okay or not. Ideally, triglycerides should be below 100 for most people.

And if your doctors are saying it's not possible to reduce or eliminate excess sugar, they are bad doctors. You should listen to good doctors, but don't assume every doctor is a good one. Fish oil happens to be in a prescription form too, Lovaza, so plenty of doctors are prescribing it. Fish oil is actually healthier than eating fish, as to get the same amounts of Omega 3s in your diet, you'd have to eat a large serving of fish daily -- and then mercury becomes an issue.

And I don't want to sound alarmist, but as for most doctors knowing how to treat heart disease, my family doctor recently changed to a better office. The former occupant of this office (a doctor) died of a heart attack in his 40s.
Ok, so good input from everyone. I don't eat as much fish as I should, so I am supplementing with fish oil (though probably not of high quality?) in the form of [B]Kyolic EPA Aged Garlic Extract[/B], which contains 10IU Vitamin E, 2000mg Omega-3's including 600mg EPA & 400mg DHA, and 240mg aged garlic extract powder.

I take one dose of this with each of my 3 daily meals for a total of 6g of Omega-3, including 1.8g EPA and 1.2g DHA.

I'm also on my 2nd month of Simvastatin 20mg daily and 2nd week of Trilipix 135mg daily. I've cut back to one banana per day, only an occasional piece of toast for breakfast and generally low glycemic foods (no more mashed potatoes and the rice is now brown, if I have it at all). Lots of beans in my diet which have wonderful side effects at the moment (beans, beans the musical fruit, the more you eat...well you know how it goes, LOL).

I've also continued the 30 minutes of daily aerobic exercise and will be bumping it up by 3 minutes each month until I'm somewhere between 45-60 minutes daily. Maybe then I can substitute some strength training for 2-3 of those aerobic days. :)

As a result of the first 6 weeks of exercise and eating habit alterations, I've lost 25lbs, which is a pretty exciting side effect. Wonder if that will have an effect on my blood results in mid-April?
Got my last round of bloodwork back after 4 weeks on Trilipix and a second month of Simvastatin. I've continued to exercise for at least 30 minutes EVERY day and am really watching my diet (1 serving red meat weekly, 1-2 servings frozen fat free yogurt with fruit weekly, mostly chicken or beans for protein, lots of veggies and 1-2 servings of fruit per day, limiting the amount of potatoes, rice, etc.)

Here's what my readings have been now in February-March-April; before meds-with statin-with statin plus Trilipix:

Total Cholesterol - 215-140-136
Triglycerides - 350-209-190
HDL - 25-23-20
LDL - 139-75-78
Glucose - 93 (didn't ask about previous readings)
Liver Function - 34 (remained constant)

I've dropped from 314lbs to 276lbs over the past 2-3 months and continue to lose with the lifestyle changes. Doctor says to continue with meds and my diet/exercise changes for 6 months and come back for another round of blood tests.

In the meantime, I'm heading over to the Heart Clinic to have some tests done to verify that nothing's wrong with "the plumbing" on Monday (more of a peace of mind thing for the Doc and I than because he thinks anything's wrong). I've had acid reflux for several years and before we attribute some of my physical symptoms to GERD, I'd love to rule out heart as the source of any of the ills...especially with the "out of whack" cholesterol readings (if they really mean anything).

Here's hoping weight loss and exercise is what turns this around for me, but any other ideas?

Should I ask the doctor for a fish oil prescription so I can be sure I'm getting good quality stuff, or is there a brand I should try to find that will supplement the statin and Trilipix?
Ok, so the cardiologist is preaching patience when it comes to the cholesterol numbers. Mentioned that if the Trilipix/Simvastatin combo along with exercise and weight loss haven't budged my numbers enough in 3-6 months, that we'll start looking at alternatives, such as Niaspan (probably Simcor to combine the Simvastatin I'm on with Niaspan).

I still get to go in for an echocardiogram and a treadmill test in 10 days, so here's hoping nothing negative shows up there!

I'll post back in a few months with any updates to my numbers or change in regimen.
Hi Starling,

The KYOLIC is very good to take. KYOLIC (garlic extract) has a blood thinning effect and helps a little with the cholesterol numbers. The Added Omega-3 in the Kyolic is also a big plus. If you have prescription Insurance I would definitely ask your doctor to prescribe LOVAZA. The price of LOVAZA is approx. 125.00 for only 100 (1000 mg soft-gels). The EPA/DHA is the highest currently available. One to Two pills a day is more than enough to lower your trigs. As far as the HDL is concerned the weight loss and diet will help some.
Red Wine and Walnuts are excellent to further raise HDL levels. The best way to make a big dent in your HDL numbers is to add NIACIN (at least 500 mg) a day. This will help to balance all your cholesterol numbers and improve other blood markers. Simvastatin and Niacin taken together have a dramatic effect in cleaning plaque from your arteries. The immediate release niacin is the safest to take. Keep away from Sustained or Extended release. These are the most toxic to the liver. The main side effect of NIACIN is a hot face and upper body flush. This means NIACIN is working to release impurities and improve blood circulation. It can feel a little scary but it's harmless. With Niacin you start very low than work your way up. For ex. I started Niacin at 50 mg a day. I purchased a small CVS Niacin bottle (100mg tab)and broke the tablet in half. I did this for a few days then I took 100mg for 3 more days than 150 for 2 days etc.. With these small amounts my HDL increased by almost 10 points. I take a prescription Niacin called NIACOR. It is immediate release and not too expensive. The other prescription form is NIASPAN (an Extended Release formula) which is very expensive. Another excellent OMEGA -3 fish oil is sold by CARLSON. This is the Cadillac of the fish oils.
If you have prescription coverage LOVAZA may be much cheaper.

The vitamin E in the KYOLIC is too low. You can benefit by taking an additional 400 iu of Vitamin E (Natural only) a day. For an extra cholesterol one-two punch add 1000 - 2000 mg a day of Vitamin C. These antioxidants scavenge free radicals and target oxidized LDL and Trig. particles.

Starling - The above information is only my opinion (of course). I do not mean to be pushing meds, supplements or wine etc. The information I provided helped improve my cholesterol and also helped my blood pressure...

P.S. I hope this information is helpful.......
I would follow your doctors advice for sure, but don't be afraid to ask questions. The Trilipix can lower your trig. vastly. He just wants you to get out of the dangerous range. Just think, you may be able to get off all of those meds eventually if you stick with the exercise. I hate to say it, but you have to cut out the ice cream, it has tons of fat. Every time you eat ice cream it pours fat into your bloodstream and pumps up those lipid levels.
Thanks, guys. I'm headed off to have a precautionary echo and treadmill test just to rule out (or confirm, I guess?) heart issues. Cardiologist wants me to continue with Trilipix for a couple of months and then revisit. Exercise is helping with overall feeling good, if anything, and the weight continues to come off. I dropped the ice cream, so that's surely helping by now, too. :)
Quick update. I've been on Simvastatin 20mg now for 5+ months and recently stopped taking Trilipix due to being diagnosed with gallstones and prepping for gallbladder removal (hmmm...high cholesterol can cause stones to be created, I hear). I'll go back on the Trilipix awhile after surgery, I think...

Anyway, as part of all this recent activity, I was able to get updated blood work done with the following results:

(I've now lost more weight, too. Down to 257 from 314)
TC = 126
LDL = 50
HDL = 19
Tri = 298

I continue to exercise daily for 40 minutes at a time and I eat less food overall, though recently it's been more from the grill and thus a lot more red meat has snuck its way into my diet. Tri's are higher now due to not taking Trilipix (had them down under 190).

With LDL as low as it is (50), does HDL matter as much? Should my focus be on the high Triglycerides, the low HDL or are they both equally important? I have a few more dietary adjustments to make to get the Tri's down (I'm down to one regular Coke per day...I think I'm ready to eliminate it completely - also could reduce carbs a little more with less bread, rice and sweetcorn), but I am at a total loss on raising HDL unless it just takes that much time for weight loss and exercise to kick in?
Why is your HDL dropping?That's the one number you want to be higher.
No clue why HDL keeps dropping. Doctor says I may have to try Niaspan as his normal course of meds isn't helping the HDL number at all, despite weight loss and daily exercise. First things first, though...have to get that ol' gallbladder removed in a couple days. My GP says he wonders if that will help the chronically high triglycerides, too (not why it's coming out...I have gall stones and chronic symptoms of GB crappiness).

We'll see how the numbers look a month or two after my surgery, I guess.
Weight loss can temporarily decrease HDL. Once weight is stabilized, it should go up again.
Not that anyone's tracking this thread but me at this point, but here's an update.

Since my last post in July 2009, I had my gallbladder removed and my doctor has also switched me from Simvastatin and Trillipix to Simcor 1000/20 (20mg Simvastatin and 1g Niaspan). After approximately a year on the Simcor and nearly 2 years now of daily exercise, I've dropped more than 100lbs from my original weight of 314 (at 212.5 as of last Sunday) and am running 3-4 miles 5 or 6 days per week. I eat a diet that's pretty balanced with few processed foods and lots of fruits (oranges, clementines, apples, berries) and veggies (raw carrots, broccoli, cauliflower, beans, etc) with some fish, lots of chicken and red meat once per week. Oh, and my starchy indulgence is a sweet potato (yam) 2-3 times per week with fat free cottage cheese and chipotle pepper. =)

Here's my numbers...there's still some work to do on the HDL, but I'm still hoping that once my weight loss stops (25 more pounds!), it's going to be at least into the 40's (fingers crossed):

TC = 126 (126 in 2009)
LDL = 74 (50)
HDL = 31 (19)
Tri = 107 (298)

As you can see, my total cholesterol has remained constant now, LDL has trended up but is well below 100, HDL is up quite a bit but still below 40 (ugh!), and the Trigs have dropped dramatically!

Hoping the last 25lbs will make a little more difference, but may also add back the fish oil to supplement the small amount of fish I actually eat.

Anyway...progress! And I LOVE running again after 15 years away from it! =)





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