EATING BEFORE CHOLESTEROL TESTS
Question: I had my cholesterol tested recently at a health fair. We previous day, I ate two meals with lots of fat and cholesterol. Did that throw off my cholesterol reading?
Answer: No. Levels of total cholesterol don’t change much from day to day. So you don’t have to fast or worry about what you eat the day before a test. But if you were having blood drawn for a complete lipid analysis, including HDL cholesterol and triglycerides, then a 12- to 14-hour fast would be required.
THE GALLBLADDER AND CHOLESTEROL
Question: My blood-cholesterol levels are high despite a low-fat diet. Could that have anything to do with the removal of my gallbladder 20 years ago?
Answer: No. The gallbladder stores, concentrates, and regulates the flow of bile, which helps digest fats. But removing it has no noticeable effect on digestion and no effect at all on blood-cholesterol levels.
HDL FROM FOOD
Question: We’re constantly hearing about the opposing effects ofhigh-density and low-density lipoprotein cholesterol in our blood, but when food is discussed, the distinction is dropped. Does the amount of HDL or LDL cholesterol in food affect the levels in our blood?
Answer: No. Those lipoprotein-cholesterol combinations are broken down during digestion and reassembled within your liver from their separate components—amino acids, cholesterol, and fats.
HIGH CHOLESTEROL, HIGH HDL
Question: I’m a 64-year-old man with a total cholesterol level of 225, despite a very-low-fat diet. My HDL and triglyceride levels are both 67. Since my HDL level is high, my doctor says I don’t need to take cholesterol-lowering drugs. Do you agree?
Answer: Yes. Based on the numbers you provide, your level of LDL cholesterol (the “bad” kind) would be about 145, which is only mildly elevated and not in need of reduction by medication unless you already have coronary disease. And since your level of HDL cholesterol (the “good” kind) is so high (normal for men is 35 to 45), your risk of coronary heart disease is relatively low.
HIGH CHOLESTEROL, LOW RISK
Question: Last year, a lipoprotein analysis showed I had a total cholesterol level of 276 mg/dl, an LDL of 188 mg/dl, and an HDL of 77 mg/dl. My doctor says these results indicate a low risk of coronary heart disease. I eat a low-fat diet, I’m active, and my weight is good. Yet you have suggested that drug therapy may be necessary for such a high LDL level. Is it neces-sary for me?
Answer: Expert opinion is mixed on this question. Some would treat the high LDL cholesterol. However, before putting you on medication your physician should consider a number of variables, including your personal and family medical histories and any other risk factors for coronary disease. Based on your high level of HDL (“good”) cholesterol and your health habits, it sounds as if your risk factors are indeed well under control.
Question: According to a finger-prick test, my blood-cholesterol was 197. Two months later, it was 272 on a fasting blood workup. My diet didn’t change during that time. Is such a jump possible in only two months?
Answer: No. Cholesterol readings cannot vary that much, that soon. The finger-prick test was probably wrong. Squeezing the fingertip to draw blood produces secretions that dilute the blood and can lead to a falsely low reading.
Question: I recently read that the sustained-release form of niacin, which I’ve been taking to control my blood cholesterol, can cause liver damage. Why is this form of niacin dangerous, but the regular crystalline form, which causes me to flush, is not?
Answer: It’s long been known that both crystalline (shortacting) and sustained-release niacin can damage the liver at high doses. It now seems that the sustained-release form can cause liver injury even at low therapeutic doses. In several case reports, people who had recovered from such damage were then given crystalline niacin, with no ill effects. The reason for the difference is unclear; it may be that taking short-acting crystalline niacin allows the liver to recover between doses while slow-release niacin affects liver enzyme systems for longer durations and with fewer recovery periods.
Another report suggests that high doses of niacin can aggravate diabetes and may induce the disease in borderline diabetics. Although niacin is available without a prescription, it should nevertheless be taken under a doctor’s supervision and only in crystalline form. Increasing the dosage very slowly to the target level will minimize any uncomfortable facial flushing.
Health handbook introducing you to read the article: Beta-Blockers And Cholesterol
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