I am a 50 year old male. My total cholesterol is 4.2, my HDL is 0.7 and my LDL is 3.0. I have encountered a difference of opinion between doctors as to whether this is a good level or a bad level, and one doctor has said that I cannot get Medicare benefits for a blood test at these levels. What do you think?
There is considerable debate between doctors over jusr what the ideal level of cholesterol should be, and this debate is now even more controversial because the government has delineated a set of criteria that must be met before Medicare payments for cholesterol blood tests will be funded. There is also a very complex formula for deciding who is allowed subsidised treatment for high cholesterol levels under the Pharmaceutical Benefits Scheme.
The following criteria are mine personally, and do not necessarily reflect any official line.
A total cholesterol of under 5.5 is of no concern. A cholesterol between 5.5 and 7.0 is a grey area, and treatment would depend on the ratio of the two main types of cholesterol (high—HDL, and low—LDL), family history of heart disease and stroke, smoking, blood pressure and obesity. Over a level of 7.0, most patients should be treated.
The HDL (high density lipoproteins) are generally good for you, while the LDL (low density lipoproteins) are bad. HDL should be above 0.9 and LDL below 3.0. On the total cholesterol criteria you do not require treatment, but your ratios are slightly unfavourable. Your doctors are right in saying that under present government criteria you cannot have a blood test for the ratios under Medicare, and the government will not subsidise any treatment.
I do not know your family history etc., but unless other factors are extremely bad, I do not believe that you require treatment at this time.
On a routine blood test, my ESR was high, and now my GP keeps ordering new tests to find out why. What could this mean?
The erythrocyte sedimentation rate (ESR) is a frequently performed blood test that gives an indication of inflammation, infection or cancer in the body, but gives no indication of where the disease is located, or the nature of the disease. It is a measure of the rate at which erythrocytes (red blood cells) settle in a thin tube. The higher the rate, the more significant the result.
It is a warning sign to doctors to watch out for some significant disease, but may be raised in anything from a simple viral infection or pregnancy to a heart attack or most types of cancer.
It is sensible to find out whether the cause for your raised ESR is serious or inconsequential. If the level rapidly returns to normal, there is usually nothing to be concerned about, but if it continues to rise test after test, the cause must be found.