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Dr. David
Dr. David, Board Certified Physician
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My total cholesterol is 240. Triglycerides 59, HDL 97, LDL

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My total cholesterol is 240. Triglycerides 59, HDL 97, LDL 131, VLDL 12. I am a healthy and lean 47 year old (5'7, 155 lbs) male and exercise daily as I am a competitive runner. Due to recent onset of heart palpitations, my cardiologist ordered a stress echo and 24 Hr. Holter monitor. Holter results were negative save a few PACs and PVCs. I scored in the top 2% on the treadmill stress echo. I neither drink nor smoke. No heart disease in family except one grandmother who was a heavy smoker - my father had type II DM but was 40 lbs overweight for 40 years. I have differing opinions from my PCP vs. my cardiologist with regard to whether I should be on cholesterol-lowering drug therapy. I'd appreciate an additional option - thanks!
Hello, this is Dr. David. I have read your question and I'm ready to help.

it doesn't sound like you are in the super high risks category like diabetes, smoker, recent heart attack.

you might not have maximized your dietary improvements yet to try to lower your cholesterol.

have you tried to increase your fiber intake?

eating fish 2-3 times a week? eating more whole grain oats and fiber. good fats like olive oil and fiber?

if you haven't maximized these dietary changes, then I would do this along with continue to exercise to try to brin your cholesterol levels down naturally.

what does your PCP and your cardiologist say about this situation?
Customer: replied 3 years ago.

PCP feels cholesterol lowering drugs are necessary as my total cholesterol has been elevated > 6 months. However, my cardiologist states I have little to no risk factors, and an high HDL of 97 offers strong protection against CHD, especially considering the LDL is only slightly elevated at 131. In response to your question, no, I have not maximized/optimized my dietary changes, and have decided I will do that first - I believe the additional fiber, plant sterols, and elimination of saturated animal fats (red meat) will definitely pull down the LDL. Thanks for your advice.

I agree with your cardiologist.

you don't have high risks factors.

you are welcome

definitely maximize your diet changes first. avoid animal fats, no transfats, more good olive oil, avacados, oats, whole grains, fish,

and I bet your LDL will get better and your HDL might get better too

best of luck to you.

keep exercising

let me know if you have other questions.

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