Medical Questions & Answers » Cholesterol

Blood Cholesterol Level

medicalquestions — Thu, 05 Mar 2009 06:00:00 +0000

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.

Dealing with Cholesterol

medicalquestions — Wed, 31 Dec 2008 05:11:17 +0000

My cholesterol levels including Lipid Profile are borderline, and being maintained with lifestyle changes. Since last 3/4 years I’ve developed white spots of about 1 cm in diameter on both my eyelids. What are these growths and is there any permanent way of getting rid of them?
The skin condition on your eyes is known as Xanthelasma. Half the people with this condition have a normal serum lipid profile, as in your case. These growths can be destroyed by repeated application of 35% Trichlorotcetic acid solution. They may also be destroyed by electro cauterization or removed by surgery. Lasers too, have been used with some risk of scarring and pigmentation.

Concern about Cholesterol

medicalquestions — Thu, 27 Nov 2008 05:48:32 +0000

My 50 year-old sister who attained menopause at 45, was recently asked to undergo a Lipid profile. All the figures were normal — Blood sugar, serum cholesterol, Triglycerides, VLDL. Her HDL cholesterol level was a healthy 62. Only the LDL cholesterol was borderline high at 146 mg/dl. For a fit, healthy person of normal weight, is borderline high LDL cholesterol, in isolation, a cause for concern?

From your letter I presume that she is non hypertensive and non diabetic. In the absence of the above, and any other risk factors (including family history), her LDL cholesterol level should not be a major concern. However to maintain artery health, it is always a good idea to keep the LDL cholesterol level below 130 mg% with dietary modifications and exercise.

Heart Beats Per Minute

medicalquestions — Sat, 12 Jul 2008 08:55:50 +0000

Question: Can you tell me please how many beats a normal heart does in one minute. I am over 70 and my heart when I wake in the morning, and am still in bed, beats only 52 times a minute. Is that too low?
The normal heartbeat rate, according to textbooks, is 72 beats per minute, but there are wide variations on this depending upon what you are doing, how you are doing ir, your age, and how fit you are. If exercising vigorously, a young person’s heart rate may increase to 250, while an Olympic athlete’s may not go above 150.
Younger people tend to have a higher heart rate than the elderly. At rest, a baby may have a heart rate of 85, a child 80, a young person 70, and an elderly person 60. If you are anxious or frightened, your heart rate will also increase. Illness, fevers and many disorders of the body (eg. overactive thyroid, heart disease) will also increase the pulse rate.
If you are totally relaxed and comfortable, as you should be in a warm bed on waking from a good night’s sleep, your pulse rate will be at its minimum, and a rate of 52 under these circumstances is nothing to be concerned about. An extremely fit athlete in the same circumstances could have a heart rate of 40.

Question: How the heart works for a school project.
The heart is a hollow ball of muscle about the same size as your fist, and it acts as a very efficient pump. It is situated high in the chest behind the breast bone, and one corner extends out towards the left nipple.
The hollow heart is divided into four chambers by relatively thin walls made of muscle and fibrous tissue. The upper right chamber (right atrium) of the heart receives the blood returning through the veins from all parts of the body. With a gentle squeeze, it pushes the blood through a valve into the lower right chamber. A split second later, the lower right chamber (right ventricle) contracts quite forcibly to push the blood into the lungs. There it loses the carbon dioxide it has picked up in the body, and exchanges it for oxygen.
From the lungs, the blood flows into the upper left: chamber of the heart (left atrium). This acts in the same way, and simultaneously with, the right atrium, and pushes the blood into the final chamber, the left lower one (left ventricle). This is the most powerful and important chamber of the four as it is responsible for pumping the blood out of the heart and around the body. The flow of blood to the head, all organs and down to the toes is caused by the contraction of the left ventricle.
After passing through microscopic capillaries, the blood moves back through the veins to the heart’s right atrium, completing the cycle.

Fish oil for Cholesterol

medicalquestions — Sun, 27 Apr 2008 06:00:20 +0000

Question: Does fish oil help cholesterol?
This is still a controversial subject amongst doctors. There is some evidence that the taking of large amounts of fish oil alters the balance between high-density and low-density cholesterol. It is better to have more of the high-density form.
There is no evidence that using fish oil will lower an abnormally high blood level of cholesterol without a change to the rest of the diet. Foods high in cholesterol include milk and dairy products, fatty meats, sausages, game birds, shellfish, caviar, and egg yolk. It is far simpler to reduce the amount of these foods in your diet to lower your cholesterol level, rather than add oils that may or may not be beneficial.

Cholesterol and Dairy Products

medicalquestions — Sat, 26 Apr 2008 06:00:54 +0000

Question: Are dairy products and sugar safe to eat? I keep hearing how cholesterol and sweets are bad for you.
Dairy products are a staple food in the diet of nearly every civilization around the world. The intake varies from one place to another. The Japanese have virtually none, Europeans quite a lot, and some Arab tribes live almost entirely on dairy products. They are an excellent source of carbohydrates, protein and fat and the sugar lactose.
People can live virtually on milk alone if necessary. Some specialized dairy products, such as yogurt and junket, are excellent aids to digestion and bowel function. Cheeses are compressed energy, and are included in survival rations.
As with all foods, too much can be harmful. Those who have a high cholesterol level in their bloodstream and the more obese members of the community should not eat whole milk products, but skim milk and fat-reduced dairy products can still be consumed. Milk with added calcium (’Shape’) is now available to help prevent osteoporosis in middle-aged women.
Sugar is also an essential part of your diet, and it is found to some extent in nearly all fruit and vegetables. It acts as a natural preservative for a wide range of foods, and glucose (a form of sugar) is essential for the normal functioning of the brain. Once again, moderation is appropriate, and sugar intake should be minimized in the overweight and care should be taken not to take excess sugar in a concentrated form (sweets, soft-drinks etc.) that will cause dental caries.

Cholesterol level

medicalquestions — Sat, 26 Apr 2008 06:00:43 +0000

Question: What should your cholesterol level be?
This is a very controversial area. Cholesterol is a type of fat which is essential for the functioning of the body, but it can cause severe diseases if present in excess amounts. I have heard figures between 4.5 and 7.0 quoted as being the upper limit of normal for cholesterol, but most laboratories use a value of 5.5.
Your sex and age is important too. A higher value is accepted in older people and females than in younger males.
Doctors are more likely to treat the problem if you are overweight, have high blood pressure or diabetes, or have a family history of heart disease or stroke. Cholesterol is divided into high-density and low-density fats. If the amount of high-density fats is high, there is less to be concerned about, as it is the lo density fats that are a factor in heart disease and hardening of the arteries. I recommend a diet to anyone who has a level of 5.5 or more. Treatment with drugs as well as diet would certainly be given at a level of 7.0.

Cholesterol

medicalquestions — Sat, 26 Apr 2008 06:00:11 +0000

Question: What is Cholesterol and why should I avoid it?
Cholesterol is essential for the normal functioning of the human body. It is responsible for cementing cells together, is a major constituent of bile, and is the basic building block for sex hormones. Only in excess is it harmful. If too much cholesterol is carried around in our blood stream, it may be deposited in gradually increasing amounts inside the arteries. Slowly the affected artery narrows, until the flow of blood is sufficiently obstructed to cause the area supplied by that artery to suffer. If that area is the heart, a heart attack will result; if it is the brain, a stroke will occur.
This deposition of fat is known as arteriosclerosis, or hardening of th arteries. If you are in the high-risk group, there are several measures you can take to bring you back to normal. The first step is to stop smoking, limit your alcohol intake, take more exercise and lose weight if you are obese. If these measures are insufficient, doctors will recommend a diet that is low in cholesterol which involves avoiding most dairy products, fatty meats sausages, offal, fried foods, and egg yolk. Despite a strict diet, there are still some people who cannot keep their cholesterol levels under control. They will require further life-long medical management by the regular use of tablets that are designed to lower the level of fat in the blood.