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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Should I Take Medicine For Borderline Cholesterol?

Have there been any studies to clarify the effects of cholesterol on the body. If I exercise regularly, but my cholesterol is borderline, should I be concerned? I believe that LDL is used to repair tissue, and that slightly elevated LDL should be acceptable for people who aren't on the couch all day. Statistics show 10% chance for people with high cholesterol from 35-45 of having Heart Attack. I would like to know what differentiates that 90%. Of course, without detailed medical history one can never know for certain, but some doctors seem to focus on the number so intently, and I don't see any answers on the web with any precision.

Tue, 17 Nov 2015
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Dietitian & Nutritionist 's  Response
Hello. There have been many studies in this area. Refer to the AACE 2013 guidelines for cholesterol and intervention algorithms. The endocrinology association came out with revised guidelines in spring of 2015. There is no such thing as "borderline" cholesterol since ATP III became outdated. The treatment of elevated lipids is detemined now by an algorithm of risk factors and current health history. I suggest if you would like to know more about the studies you google this document and review the information and the associated studies.

LDL is used as a protein carrier for cholesterol that dumps the cholesterol onto the arterial wall for plaque formation. The 10% differentiation? First I would have to ask where you got that information, is it evidence-based and as in all things - a bell curve leaves the biggest part of the curve representing the majority and then there are the smaller 10% "outliers" that don't fit the bell curve. I don't quite understand what you are looking for here.

Should you take medicine? I would have to review your lipid profile, how high the lipids were, look at your current health, your genetics and other risk factors, plug them into an algorithm to determine a course to take. That is your physicians job.

In the meantime you can follow a heart healthy diet (google Mediterrean diet), kill off trans fat, limit cholesterol to 200 mg/day, increase soluble fibers, add omega 3 fatty acids to the diet, limit saturated fat to 7% of your calories and increase plant sterols. These are general, public health guidelines for a heart healthy diet, oh, and 240 minutes of exercise per week.

I do hope I have answered your question. If not, please come back after reading the recommended literature with questions. I also tried to give you non-drug options. I truly hope this has helped. Kathryn Shattler, MS,RDN
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Should I Take Medicine For Borderline Cholesterol?

Hello. There have been many studies in this area. Refer to the AACE 2013 guidelines for cholesterol and intervention algorithms. The endocrinology association came out with revised guidelines in spring of 2015. There is no such thing as borderline cholesterol since ATP III became outdated. The treatment of elevated lipids is detemined now by an algorithm of risk factors and current health history. I suggest if you would like to know more about the studies you google this document and review the information and the associated studies. LDL is used as a protein carrier for cholesterol that dumps the cholesterol onto the arterial wall for plaque formation. The 10% differentiation? First I would have to ask where you got that information, is it evidence-based and as in all things - a bell curve leaves the biggest part of the curve representing the majority and then there are the smaller 10% outliers that don t fit the bell curve. I don t quite understand what you are looking for here. Should you take medicine? I would have to review your lipid profile, how high the lipids were, look at your current health, your genetics and other risk factors, plug them into an algorithm to determine a course to take. That is your physicians job. In the meantime you can follow a heart healthy diet (google Mediterrean diet), kill off trans fat, limit cholesterol to 200 mg/day, increase soluble fibers, add omega 3 fatty acids to the diet, limit saturated fat to 7% of your calories and increase plant sterols. These are general, public health guidelines for a heart healthy diet, oh, and 240 minutes of exercise per week. I do hope I have answered your question. If not, please come back after reading the recommended literature with questions. I also tried to give you non-drug options. I truly hope this has helped. Kathryn Shattler, MS,RDN