Edited to addNovember results to these as my HDL has gone up an therefore my total but ldl has come down a smidge!
Three months ago at my annual Diabetic Review - in May 2018 - the majority of it was spent on what I was made to feel was my major failure -
my total cholesterol score of 13.7! Okay I’d aced on my other test results and measurements - my HBACa1 had gone down to 30 (at diagnosis 97) even though I’d come off the metformin 7 months before, my Blood Pressure was now low and I was off all my meds for BP too. In addition my BMI was down to 20 (down from 30 on diagnosis) but this was kicked into the long grass as I was, of course, in imminent danger of a heart attack and it may be that I was suffering from Familial Hypercholesterolemia! It was crucial she felt that I start statin therapy and may even need referral to a lipids clinic.
However thanks to the forum I knew that there may be a few explanations and I had tried statins a year before for a few weeks and really made me quite ill so it wasn't a path I wanted to go down unless I had to!
I asked for time - three months to see what happened and also requested a full lipid panel - as all my cholesterol tests to date had been non fasting and did not include Triglycerides and I knew I wanted to have more information before agreeing to statin therapy, lipids referral etc. I also used the time to find out everything I could to help thanks to
@bulkbiker and all those helpful member out there giving me reassurance, information and links to ratio calculators etc
I got my NHS results today and had a discussion with the DN and it was fascinating:
Here are my results and comparisons:
Total Cholesterol May 13.7 August 7.4. November 8.33
Non HDL cholesterol May 11.4 August 4.8 November 4.8
HDL May 2.3 August 2.6 November 3.53
Cholesterol/HDL Ratio May 6 August 2.8. November 2.3
Triglycerides May N/K August 0.9 November 0.9
LDL May N/K August 4.4 November 4.36
Edit Trigs to HDL ratio november 0.27 was 0.45 in May so this has improved
What made the difference?
I think it was probably what would have happened to me anyway to some extent - I’d lost weight quite rapidly but had settled into a fairly regular weight for the last couple of months and was now maintaining my new weight
In addition I did make some changes to my way of eating - I eat Keto ie less than 20g of carbs per day and high fat so I did make changes to the fat I ate with more ‘mediterranean’ fats but I stuck to high fats and reduced but did not cut out cream or butter for example - just added in full fat yoghurt alongside cream. I also switched french press coffee to filter as I’d heard this can help LDL reduction plus added in regular green tea, plant sterols and a small glass of red wine. Who knows???
The important thing I do know is that it's my ratios that matter and not my total cholesterol so here they are:
Total Cholesterol/HDL ratio down from 6 to 2.8 (ideals should be less than 3.5)
HDL/LDL Ratio - not Known in May but now 0.543 (ideal should be over 0.4)
Trigs/HDL Ratio not known in May but now 0.457 ( ideal should be under 0.87)
Edit I used the following cholesterol calculator
https://www.omnicalculator.com/health/cholesterol-ratio
And my DN discussion this morning?
She reminded me, understandably, that she has to follow NICE guidelines and my total cholesterol and the fact that I was diabetic meant that statins were advised. I reminded her of my weight loss, my low HBACa1, my general fitness, and my low BP as well as the fact that I've never smoked and she accepted that it was my choice and agreed to carry on as we were with another full lipid panel in 6 months.
Thank you to all you cholesterol experts out there on the forum using the recommended ratios I can see that I am actually in the ideal range even though my cholesterol total is still relatively high. Interestingly I looked back on all my cholesterol tests over the years and they have all averaged a total of 6.7 even ten years ago - but interesting at that younger age and with no diabetic diagnosis my GP said I was at low risk despite total because of my high HDL and he wouldn't recommend statins. Ive since read studies that conclude that for older women in particular high cholesterol may be a good indicator of good health and I tell you what I feel really healthy and currently have no plans to lower my cholesterol by using statins.
I’ve put a lot of detail on here but thought it may help people who are concerned about their cholesterol - it's a personal decision but whatever you do get a full lipid panel so you can look at your ratios to see what's happening ‘under the bonnet’ and look at your own risks and get lots of information.