Cholesterol Issues

Medical Q&A [Moderated]
1

My friend recently got her lipid screening done and her results are as follows:

Total Cholesterol: 286 mg/dL
Triglycerides: 75 mg/dL
HDL: 55 mg/dL
LDL: 216 mg/dL

She is 5’3, 100lbs, and is 22.

She got a blood test done and her doctor said that everything else looked good except her cholesterol. She was very concerned and wanted to prescribe her atorvastatin 40mg. She did not want to go on medication and asked if there were alternative options. Her doctor stated that t was too late and she had to be on this medication to avoid heart disease in the future. She then got told from another doctor in the same hospital saying that she cannot o on this medication due to being young and a female. She recommended a lipid specialist. She is in the process of scheduling an appointment.

She has been trying to avoid saturated and trans fats entirely. Her main concern is knowing if she can lower her cholesterol to normal levels without going on search hard medication. She read that she can only lower it 20% and that still does not get her levels to where they need to be. Can exercise and proper diet get her levels to where they need to be? She would greatly appreciate andy guidelines or recommendations from you.

Thank you.

2

I agree that this lipid panel shows significant elevations that make me wonder whether there’s a genetic component at play, so I agree with the referral to a lipidologist for further evaluation. Atorvastatin is not a “hard” medication, but I agree with a reluctance to use in a young female of childbearing age, since these medications can cause issues in case of pregnancy. Regardless, these blood levels will increase risk over the course of a lifetime and should be addressed.

The main things from a diet/ilfestyle standpoint that we can do to reduce blood lipid levels include:
-Maintaining a healthy body composition & waist circumference
-Increasing dietary fiber from food as high as possible, and can also consider supplemental psyllium as well
-Replacing animal-based saturated fats with unsaturated fats from fish, mixed nuts, and plant sources
-Meeting/exceeding physical activity guidelines

From a medical standpoint,
-Ensure normal thyroid function
-Ensure she is not on any medications that can cause increased blood lipid levels
-Lipid specialist evaluation for potential genetic conditions, as this would make lifestyle measures alone insufficient to address this.

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