High LDL cholesterol

Medical Q&A [Moderated]
1

I’m 25 male 5ft10, 160lbs with a 30inch waist and 22% body fat(kind of skinny fat I guess…?)

I have done my first blood test in October last year and the result was

Total cholesterol: 307
Triglyceride:77
HDL:70
LDL-C:221

After a month(November) I did the test again (I haven’t done anything to lower the LDL level)

Result
Triglyceride:59
HDL:75
LDL:141
(Total cholesterol was not noted)

I did the test again in January this year because I thought it’s weird that LDL level was dropped 80 in a month without doing anything.

Result
Triglyceride:130
HDL:76
LDL:154

Question

  1. How can the LDL level drop so much in a month? Is there any chance the first test was wrong?
  2. Do I have to do something to lower LDL? (Losing weight, dietary fat intake restriction etc.)

Notes
The second and third tests were done in the same hospital, and the first ones were done elsewhere.
I have a family history of high LDL.
I have no other condition and I think I’m generally healthy.

2

That is a bit larger variation than I’d expect, but it’s been shown that these tests can have up to 15% or so inter-test variation.

The more useful metric we use for estimating risk is the non-HDL cholesterol (i.e., total cholesterol minus HDL-C). With that said, your LDL-C on its own sitting around 140-150 is not dangerously high right now, but would be correlated with slightly elevated long-term risk over the course of your life.

With respect to nutritional intake, we generally recommend reducing body fat & maintaining a normal waist circumference, increasing dietary fiber to 30-35+ g / day, and aiming to replace saturated fat intake with more poly- or monounsaturated fats.