Question: I am 73 years old, normal weight, eat a very healthy diet, and exercise. I have GERD and take a 20 mg omeprazole capsule each morning and Actenol once a week. My yearly physical showed all my totals were worse. My total cholesterol was 226 with LDL 144, HDL 55, and Triglyceride 120. This is the highest my cholesterol has ever been. How can I bring the LDL down and the HDL up without taking drugs?
Dr. Hibberd's Answer:
I agree with you in paying attention to trends in your lab parameters. Your values are not alarming, yet if you were diabetic or had a prior cardiac event, they would provoke aggressive treatment since the LDL target for patients with these conditions is actually 70 mg/dl.
As a female, your HDL (protective cholesterol) reading is actually quite low, and deserves to be improved. First of all, repeat your tests one morning after an overnight 12-hour fast to be sure of your values. Assuming they are duplicated, concentrate on improving your HDL.
Your cardiac risk factor assessment done by your doctor will help guide the degree of aggressive treatment that is advisable for you. Ask your doctor if you are a candidate for niacin treatment, and you may discuss other drug options with your doctor at this time.
Dietary changes may lower cholesterol and LDL (bad) cholesterol readings by 10-15%, but your HDL improvement without drugs has probably already been maximized by your healthy diet and frequent exercise. You may try adding 1200 mg daily omega-3 fatty acids (DHA and EPA) supplementation using fish oil capsules or liquids, or you may simply change your diet to include more fish rich in these agents. One glass of red wine daily has also been associated with an improvement in cardiac risk. If you smoke, stop now.
All things considered, if your cardiac risk assessment warrants treatment, you will probably need to choose one of various drug treatments available to increase your HDL while decreasing your LDL. We all would like to do this without drug use, but so far there is nothing that is effective and safe in the non-drug realm except for weight management, regular exercise, and a diet high in fiber and low in saturated fat.