Well, I don't know what I should be doing about this, or even if

[oursin]

My dr rdrz will recollect that two weeks ago I went for my free routine NHS checkup, and was praised for the very lovely state of my blood pressure, my BMI was also found in fine order (though I know this is a metric about which doubts have been expressed...)

And last week I went to have my blood samples taken in connection with this.

And this week I had a letter saying that they had found from this that my cholesterol level was somewhat high, not inordinately so, but I might think about dietary changes or more exercise and I am welcome to make an appointment with the practice nurse to discuss lifestyle changes.

Well, my dearios, I have looked up the dietary recommendations and frankly they do not differ greatly from what I am already eating WOT. The oats, the nuts and seeds, the fruit and veg, the pulses, the healthy oils, etc.

Okay, I have cream in my coffee, but on reflection, I am not consuming vast amounts of dairy products or other saturated fats in the course of the week.

I'd really like to do more exercise, but it's quite hard to find something that doesn't have an adverse impact on the arthritis, because a lot of things that one wouldn't think had a direct effect nonetheless do have some. And I am already doing some exercise, possibly statistically a bit more than the norm for my age-group?

So really, maybe I shouldn't be doing anything, more than what I am already doing?

Comments

[rydra_wong]

Did you happen to get a breakdown of HDL vs LDL?

I ask just because the one thing that reliably shows up every time I get a blood test is really high cholesterol, and then the doctor gets alarmed and then they look at the HDL vs. LDL numbers and get un-alarmed again, because the stuff that's high for me is the "good" cholesterol.

So really, maybe I shouldn't be doing anything, more than what I am already doing?

Yeah, it does sound like you've basically got it covered already -- maybe there are things that can be tweaked, but not obvious big changes.

[alithea]

Yeah this. Some GPs seem to be obsessed with total cholesterol whereas actually the research shows it doesn't matter if the total is high as long as it's the good cholesterol that's highest (and possibly a certain proportion, I forget the exact details).

Doesn't sound like you need to change your diet and yes, more exercise is good but I suspect your practice nurse is unlikely to be the best person to advise you on the best exercise to do which doesn't aggravate your arthritis.

[jenett]

My cholesterol runs highish (at the "This would be a good time to do something about it" level, not "you might want to do that urgently" level), and my doctor an I have been poking at some different options that are not more meds.

What we ended up with in consultation with my nutritionist (same practice) was more fish. I eat fish 2-3 times a week (or at least aim to, and I mostly manage) and I also take a fish oil pill daily.

just before my next appointment (4 months later), I did another round of blood tests, and then the research came out that for most people the fish oil doesn't make a lot of difference. The next day, I got the results back (I do testing the week before I see my doctor for the stuff we know we want to test routinely, so I can talk it over with her at the appointment).

And my cholesterol was noticeably improved. She walked into the exam room, and I said "So, I saw that study that just came out about fish oil not working, and clearly it works for me, so we'll keep doing that then?"

All of which is to say, this stuff is weird and individualistic, but I found more fish was handy on my end, both as food and supplement.

[rydra_wong]

What we ended up with in consultation with my nutritionist (same practice) was more fish. I eat fish 2-3 times a week (or at least aim to, and I mostly manage) and I also take a fish oil pill daily.

Ooh, good call. Yeah, that might be a thing to try (as long as you're not on blood-thinning meds or anything else that doesn't play well with fish oil, IANAD, etc. etc.). Also, it's a decent anti-inflammatory, so you might (or might not!) find it some use with the arthritis.

Another thought:

the nuts and seeds

Tried flaxseed? Soluble fibre, lignans, seems to do good things to cholesterol. Boring stuff but you can find mixtures of pre-ground flax with nuts which you can sprinkle on yoghurt or whatever.

[brewsternorth]

Ooh, good one. FWIW, when I'm having oatmeal I put a couple of tablespoons of flaxmeal in there before cooking. It may be good diet-wise; I certainly like the effect it has on the texture. YMMV.

[oursin]

For years now I have been starting the day with something that evolved out of a home-made muesli recipe, now involving oats, linseeds, bran, a sprinkle of chopped nuts, dried fruit and Vit D fortified milk. Maybe I should now add a few anchovies as well....

[rydra_wong]

Heston Blumenthal would probably approve.

[oursin]

It has to be particular kinds of fish, though, I think? i.e. I don't think whatever's on offer at the fish and chip shop would necessarily fit the bill, agreeable as it would be to say that I was having a regular fish and chip supper for the good of my health. I do eat a fair amount of fish: but whether it counts when it's in the form of a fish pate I don't know. Clearly this is something that needs more investigation.

[rydra_wong]

It has to be particular kinds of fish, though, I think?

Yup, specifically oily fish: salmon, tuna, sardine, anchovies, herring mackerel, trout. Not white fish (cod, haddock, etc.), so chip shop supper will probably not fit the bill, alas.

[kore]

I personally don't think moderately high cholesterol is that much of a problem, as long as there's not some other health problem that goes along with it (high blood pressure, cardiac disease, kidney disease, that kind of thing). I think what health professionals usually try to treat re high cholesterol is stuff like an unhealthy diet (typically saturated fats) combined with other risk factors like smoking, &c &c. I do personally think statins tend to be overprescribed. (There was a recent controversial study which got translated in media pop scientese as "Throw away your statins," which I think goes too far in the other direction!) ITA that while you might try to tweak some things, it doesn't sound like big changes are called for, as long as there aren't other comorbid (I think that's the word) conditions and overall health is good. You might want to keep an eye on it to see if it keeps going up over the next six months/couple of years, maybe.

[ironymaiden]

I don't know if you have access to such things, but I do an indoor deep water aerobics class and it is very easy on the joints.

[ethelmay]

Complete anecdote warning here: my husband found his slightly elevated cholesterol went down when he started drinking drip coffee rather than French press (he had read some study suggesting a connection). I don't even recall if you drink coffee (oh wait, you did say so in the post NEVER MIND), but fwiw and all that.

[ethelmay]

Oh, and thyroid problems can cause elevated cholesterol levels, but presumably that's on their radar to check once in a while, being so common.

[commodorified]

I was going to mention that the first clinical sign of my thyroid getting out of whack is a cholesterol spike. So if and only if that wasn't checked already, might be worthwhile.

[oursin]

The way it was phrased just said slightly high, rather than a spike, and not really major cause for concern, but that I might address diet & exercise issues.

[rydra_wong]

(he had read some study suggesting a connection)

Yeah, it's absolutely a thing. There are some cholesterol-raising compounds that vary hugely depending on brewing method (IIRC they're mostly removed by paper filters).

So potentially worth looking up. It's into the "tweaks" category, but could be a good one.

[kore]

I forgot about cafestol! which is dumb of me because T really benefited from cutting out espresso. But drip coffee with paper filters seems to be OK.

[kore]

Yeah, there's something called cafestol, and once my husband quit drinking quadruple Americanos years ago his cholesterol level DROPPED dramatically. Now we just drink drip coffee with paper filters. It's mainly a French press/espresso problem though.

[ethelmay]

I have been trying to limit the French press stuff myself (partly by drinking tea some mornings) and today made myself do drip. Also found myself buying salmon for supper last night. I think it is rather amusing how this kind of discussion affects one (or doesn't).

[alatefeline]

Quite likely. Sounds like standardized advice given without regard for your actual behavior.

We cannot forget about the margarine thing, after all.

[shadowkat]

Had more or less the same response to my own doctor's appointment. ;-)

[themis1]

I would take complaints about chloresterol levels more seriously if they didn't keep changing the gateposts. What was perfectly acceptable two years ago is now *OMG TOO HIGH!* so frankly I just ignore them!