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What Causes Elevated LDL Levels?

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Posted on Mon, 11 Aug 2014
Question: Dear Sir,
I run a small software firm in XXXXXXX My work timings are usually night time (USA hours). I recently checked and found my LDL to be 274, HDL to be 38 and Triglycerides to be 129. I realize that this is extremely high. I do not eat any other meat apart from chicken or fish (once or twice a week maximum). However I do have very unhealthy eating habits and do not eat on time and skip breakfast most of the time. Dinner is the most heavy meal for me. I plan to make all the lifestyle changes including walking regularly and also consuming the healthy diet. However do you see any immediate risk for me? I do not have any family history for heart related ailments and also i personally have normal blood Sugar and Blood pressure. Do you think i should get checked how much harm the LDL has already done? if yes, what is the right way to go about it? Also if i correct my diet and do regular exercising, can i expect drastic changes in my cholesterol level, because as you will see that i have to bring it down by 50%
doctor
Answered by Dr. Indu Kumar (27 minutes later)
Brief Answer:
Your LDL is raised.

Detailed Answer:
Hello XXXXXXX
Thanks for writing to HCM

I have gone through your findings in detail.
Your LDL is raised.HDL and triglyceride level are within normal limit.Cholesterol level is not mentioned in the query.

You need few other investigations like Liver function test(LFT),Ultrasound of abdomen.

Your condition can be manged by diet, lifestyle changes and medicines.
You should try to lose your weight if you are overweight.
You should be active in your daily life and avoid red meat and high fat milk products.
Cook food in olive or canola oil.
You should take limited salt in your diet.You should also avoid fried and junk food.
Take lot of fruits and vegetables.You should also increase your physical activity in the form of walking and exercise.
Avoid alcohol and smoking if you take these things.
You can also do meditation and yoga.It will help you a lot.
Don't take stress in life.You will be fine.

Please get at least ultrasound of abdomen done.Ultrasound of abdomen is important to know the condition of liver.

I suggest my patient to take single tablet atorvastatin 10 mg at night after dinner.It corrects lipid profile.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indu Kumar (22 hours later)
Dear Sir,

Thank you for your detailed response yesterday. Couple of points that you asked for are as below -

1) Cholesterol Level - Actually i did a mistake. My total cholesterol is 274 (and not LDL). It also has HDL - 38 and Triglycerides to be 129. There is no separate reading for LDL

2) I did ultrasound of Abdomen . Gall Bladder, Pancreas, Spleen, Kidneys are all normal. For Just the Liver it says - "Normal in Size and Contour. Parenchymal echotexture is Mildly increased. No IHBD. CBD is Normal. Portal vein is Normal. However in the Conclusion it says - Ultrasound findings are - ---Gr-I Fatty infiltration of Liver. No Focal Lesion.

3) Apart from this I see Fasting Blood Glucose, Post Lunch Blood Glucose, SGPT (ALT), Serum Creatinine, Total Bilirubin, Direct Bilirubin, Indirect Bilirubin, SGOT and Blood Urea all in the normal range.

4) I DO NOT smoke, and Alcohol will be about 3 pints (330 ML) of beer once a week or so. Usually on Saturdays. I have not had any alcohol for almost 3 weeks now and have not had any alcohol almost 10 days prior to getting my tests done.

5) I am attaching my diet that i am having in Pdf, can you tell me if this is fine? or if i am overeating or need to include anything that is not there?

I have a few questions -

1) Do i still need the Liver function test. If yes then how soon?
2) Is there a test to find out the plaque already deposited in my Arteries? If yes, what is it and if you know where can i get it done in XXXXXXX XXXXXXX
3) Is it possible that i am having this high cholesterol for a very long time and i have not even known and a lot of damage is already done. In other words, do i have to be worried of any thing happening immediately as i need to travel to US and i want to be sure that i am fit to travel. I am already on a very strict diet plan and also started exercising everyday
4) Beer - can i have 1-2 pints (once a week) like i normally do or you think even that is a lot. Sometimes it gets difficult to avoid when you meet clients, but i certainly can if i MUST.
5) I am attaching my diet plan that i am having for last 4 days. Do you think that is fine. or it need change?
6) Unfortunately i do not have a 9-5 job. I have two businesses and have to get working at around 1PM in the afternoon till about 1-2 in the night. I usually sleep 2AM - 10:00 AM. Is that a big issue?
7) Is there any medication that can remove already deposited plaque from arteries and also get my fatty liver back to normal?
8) Can i eat out occasionally like once a week? Or do i have to follow a very strict diet.
doctor
Answered by Dr. Indu Kumar (19 hours later)
Brief Answer:
Please find detail answer below.

Detailed Answer:
Hello XXXXXXX
Thanks for writing back

I suggest my patients to take tablet atorvastatin with elevated cholesterol level as we discussed earlier.

You also have mild fatty liver.It is a reversible condition.It is due to deposition of fat within the liver cells.You can follow advise discussed earlier.

Yes,you need Liver function test as increase cholesterol level may cause damage to liver.
You should try to avoid alcohol completely.It is not good for you at all.

Don't worry about deposition of plaques within the vessels.It take long years for deposition.

Your diet chart is fine.Try to adhere to it.It is good that you are avoiding fried and fatty food.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Indu Kumar (4 hours later)
Dear Sir,

Thank you for your response and it was very helpful. It does give some respite. Now that I am on strict diet control as well as exercising, I hope I will be able to revise it quickly. I will also get the LFT done and will get in touch with you again if there are more questions. I think I am good for now but just 2-3 more questions on diet.
1) Is white rice bad for cholesterol?
2) Is Banana bad for me?
3) Are dates bad for me?

I could not get good information on these 3 on the internet and hence the question to you directly.

Thank you for all your help.

Thanks XXXXXXX
doctor
Answered by Dr. Indu Kumar (1 hour later)
Brief Answer:
Please find detail answer below.

Detailed Answer:
Hello XXXXXXX
Thanks for writing back

You can eat these things but excess white rice should be avoided because it is rich in carbohydrate.

Get well soon.
Hope I have answered your question.
Further queries are most welcome.

Take Care
Dr.Indu XXXXXXX
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6729 Questions

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What Causes Elevated LDL Levels?

Brief Answer: Your LDL is raised. Detailed Answer: Hello XXXXXXX Thanks for writing to HCM I have gone through your findings in detail. Your LDL is raised.HDL and triglyceride level are within normal limit.Cholesterol level is not mentioned in the query. You need few other investigations like Liver function test(LFT),Ultrasound of abdomen. Your condition can be manged by diet, lifestyle changes and medicines. You should try to lose your weight if you are overweight. You should be active in your daily life and avoid red meat and high fat milk products. Cook food in olive or canola oil. You should take limited salt in your diet.You should also avoid fried and junk food. Take lot of fruits and vegetables.You should also increase your physical activity in the form of walking and exercise. Avoid alcohol and smoking if you take these things. You can also do meditation and yoga.It will help you a lot. Don't take stress in life.You will be fine. Please get at least ultrasound of abdomen done.Ultrasound of abdomen is important to know the condition of liver. I suggest my patient to take single tablet atorvastatin 10 mg at night after dinner.It corrects lipid profile. Get well soon. Hope I have answered your question. Further queries are most welcome. Take Care Dr.Indu XXXXXXX