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Julia Kizhner
Julia Kizhner, Physician Assistant
Category: Health
Satisfied Customers: 1126
Experience:  7 years experience working in Primary Care as well as Gastroenterology, Sleep Medicine & Weight Loss
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Hello, I just got back home from my doctor as I went there

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Hello, I just got back home from my doctor as I went there to check my blood test for cholesterol result. Remember, I am 32 and she said that it is a bit high - I think I was told 6.5. She recommends that I start taking simvastation medication for 4 months to see if it helps. I have not started taking them yet because I believe there is another way for me to get it better such as cutting down on beers, eating more fruits or what is the best course of action? The reason for me to see my doctor is because of my Dad's massive heart attack a month ago - 95% of artities being damaged and he got 4 stents - he is only 61 and does not smoke etc. So, that is why I am getting myself checked out. l look forward to your reply in due course and thank you.

Hello and thank you for your question,


The number 6.5 you are referring to is probably a ratio between the good and the bad cholesterol. It would be more important to know the exact numbers of your cholesterol profile - total cholesterol, LDL ("bad") cholesterol, HDL ("good") cholesterol, and triglycerides.

If you can get a copy of the blood test and let me know those values, it will be helpful. Or you can call the office and have a nurse read them out to you.

Could you also tell me if you are overweight? What is your diet like - meat? fast food? fried foods? Also, do you exercise and if so, how much?


Thanks for your time,


Customer: replied 6 years ago.
I will come back to you about that on Tuesday next week as it is a bank holiday in the United Kingdom which means everything closed on Monday and due to time differences.

Will contact you with the detials and answers to your questions.

Have a good weekend.

Many thanks.
No problem. I will wait for your reply. Have a good holiday (its a holiday in US as well this Monday).
Customer: replied 6 years ago.
Ah lovely, have a good one!

I think better not to start taking simvastation medication until I come back to you with the details. Mum thinks I should start taking them for my beneficial but I think it is because of my attitude to medication - I don't believe in them. I think I need to get rid of beer [lager] as these contains very fatty so I drink a lot e.g 10 pints in one night - sometimes 3 times a week - so that may be the problematic? I am a very fit person as I walk a lot to the park which takes me around 45 minutes to 1 hour every morning with my dog and I am slightly a bit overweight by 1 and half stone but not that bad. I eat healthy foods all the time such as salads, steak, pork, chicken, rice and I don't eat junk foods such as McDonalds or Subway etc etc. I do like subway but once now and again. I do go out for a swim - my dad is so fit but he got a problem with his heart so it makes no difference with excerise and intaking?
the other expert went off line. would you still like help?
Customer: replied 6 years ago.
Well, I prefer to wait until Julia comes back to me, don't you mind David Cameron - did not realise that you changed your job from being the Prime Minister of the UK to being a doctor just like his deceased father!
Ha ha. No worries.. :)

It will be totally fine to wait for a few days before starting Simvastatin. I will explain to you in detail why all statin drugs are beneficial in preventing heart disease (in addition to lowering cholesterol).

I would just like to get an idea where there is a problem with your cholesterol before I give you specific suggestions.

Its sounds that you are not very overweight. I believe 1.5 stone is 15 lbs? I will have to look it up. I wish we were on european scale :)

Will talk to you soon.


Customer: replied 6 years ago.
Hi Julia!

My doctor faxed me the results and here you go and I wish there is a feature to attach it but ...

Serum cholesterol/HDL ratio - 7 56 high
Serum lipids JBS Guidelinos [unclear] treatment targets HEART 2005.91 Sup v High CVD risk goal Minimum goal
Total cholesterol <4.0 <5.0
Non-HDL cholesterol <3.0 <4.0
LDL [calculated] <2.0 <3.0

Serum triglycerides = 5.41 mmo/L High
Non HDL cholesterol level = 5 64mmo/L High
Serum HDL cholesterol level = 0.86 mmo/L Low

Oh it is like a complex math language to me!

No idea but anyway, let me explain...

I do eat well but have stopped eating diary products and that I eat lot of salads with tuna and I go out for an hour walk in the park with my dog - fast walking while she is running around and following me etc. I think I got cholesterol problem because I drink beer? I don't know because I am a little bit lost here!

Thank you for getting back to me.


It is very interesting how cholesterol is counted in UK. In US, we have very different paramiters so I had to search for a conversion scale on the internet (which I found).


Were you fasting when you did your blood work? Did you have anything to eat prior to doing it?

Customer: replied 6 years ago.
I was fasting 12 hours before the blood test.

Ok, thank you.


So it seems that your overall cholesterol as well as triglycerides are very high.

Beer can raise your cholesterol, specifically it can raise triglycerides (which is a measure of fat in the blood), however, it will not raise your cholesterol to the level where you are currently at.


I don't think there any specific urgency to start taking Simvastatin right away. I understand that you are only 32 and that Simvastatin is a life-long drug so you can try to change your diet, however, I don't think you will be able to significantly lower your cholesterol with diet/exercise alone. Eventually I do think you will need to go on a cholesterol reducing agent. But to be fair, it would be no problem to try diet/exercise routine for 3 months prior to going on the medication.


It sounds that you eat rather healthy. What happens is that our bodies make cholesterol on top of what we digest and some people over-produce their own cholesterol which is why exercise and diet is not always beneficial. All statin drugs, including Simvastatin, not only lower cholesterol but also stabilize plaques which form in the arteries secondary to high cholesterol. A heart attack happens when a plaque which has been building in the artery ruptures and a blood clot travels down a narrow artery and eventually gets stuck. One of the roles of the statin drugs is to actually stabilize that plaque and reduce a chance of it rupturing.

Not everyone who has heart attacks has high cholesterol such as the case with your dad.


In terms of dietary modifications - definitely try to reduce, if not eliminate, your beer intake. Try to avoid red meats and eat more chicken and fish. Avoid dairy products high in fats (sour cream, mayo, whipped cream, butter, etc). You can take Fish oil supplement (which helps with lowering triglycerides and is more natural). Use olive oil or grape seed oil for cooking. And, of course, eat lots of fruits and vegetables.


After implementing these changes, you can repeat your cholesterol in 3 months to see if there has been any change. If there has been a change, you can probably continue with diet/exercise to see if the levels improve even further, if not, you should take Simvastatin.


I hope you find this information helpful. Sorry for such a lengthy reply. Let me know if you have any other questions.

If you are satisfied with the answer, please do click 'Accept' button so that I may get credit for my work.


Best wishes and good luck,


Julia Kizhner, Physician Assistant
Category: Health
Satisfied Customers: 1126
Experience: 7 years experience working in Primary Care as well as Gastroenterology, Sleep Medicine & Weight Loss
Julia Kizhner and 4 other Health Specialists are ready to help you
Customer: replied 6 years ago.
Thank you for a good reply and I will read it again to make sure I understand it clearly so can you tell me as to why I got a high level - where is it coming from? Is it from many years of abuse to my health such as eating kebab in my youth etc and drinking all night and smoking but I only smoke when I drink alochol so I don't smoke or drink every day though.

Today, I experience a lot of heart burn and feeling tired as well - I think after having a soup with too much black pepper? Gosh, I have to seek a centre where I get some help to tell me exactly what not to eat and what to eat and what suits me as I am having a hard time! It is like as if my life is going to end!!!!

You are welcome. Sure, read my answer over and let me know if you have any questions.


Your cholesterol is high (at least at the levels that you are at) most likely due to genetic factors - someone in your family also has high cholesterol. Besides the cholesterol which you eat, your liver also produces cholesterol. So, in your case, it is likely that you are over-producing your own cholesterol - this is due to a genetic predisposition. It is not due to you smoking or drinking socially and it is not due to eating kebabs. I know people who are vegetarians and who have high cholesterol and, the other way around, I know people who eat a lot of fatty/greasy foods and still have good cholesterol (actually everyone in my family is like that, luckily).


For your heartburn, take some Alka-Seltzer - in US it is available over-the-counter. It will help you get rid of heartburn in a few minutes.



Customer: replied 6 years ago.
Thank you for your reply so you are saying that simvastation is the best course of action to reduce it regardless what I do? My friend started it and he is feeling great and doing normal things that he like and it does not affect him at all anymore?

My doctor says 'Stop smoking' but the website says that it is not linked at all.

What do you think of this website?

Google for this - The Cholesterol Truth

I have to leave work right now but I will reply to you as soon as I get a chance to come home. I am sorry for the inconvenience (have a nanny at home who has to go home on time).

Customer: replied 6 years ago.
Ok no problem and can you ask Doctor Cameron to read your answer for 2nd opinion and it don't mean I don't trust you but would like a 2nd opinion and thanks.

Smoking does not affect your cholesterol in one way or another but smoking in addition to having high cholesterol increases your risk of heart disease and since you already have family history of it, not smoking will be only beneficial for your future health.


In the long run Simvastatin will probably be your best bet and will give you the most reduction in cholesterol. But to be fair, it is reasonable to give you a chance to watch your diet to see if in 3 months it improves on its own, if it doesn't, then you can start Simvastatin then. Starting it 3 months from now will not cause any harm. Simvastatin is usually very well tolerated and 98% of people who take it have no side effects at all.


In terms of Dr. Cameron...unfortunately this website doesn't work like this. You will need to post a new question specifically addressing him if you want his opinion.



Customer: replied 6 years ago.
Thanks and what did you think of the website I asked you to google?

I quickly looked at the site - it mostly talks about Zetia (Ezitimibe) on the first page. The information on the website about Ezitimibe is false.

The next article which talks about alternative to statins is also false - there are no alternatives to statins. If one has high cholesterol which cannot be brought down with exercise and diet, there will be nothing like a statin to bring it down.


I didn't read any other articles but judging by what I read so far, there is not much truth to that.

Julia Kizhner, Physician Assistant
Category: Health
Satisfied Customers: 1126
Experience: 7 years experience working in Primary Care as well as Gastroenterology, Sleep Medicine & Weight Loss
Julia Kizhner and 4 other Health Specialists are ready to help you