Question about cholesterol and triglycerides: confusing

Posted by tlhuckins @tlhuckins, Nov 22, 2022

Hello.

On 10/25/22 i had a cholesterol panel done. My total cholesterol was 315, LDL 215. LabCorp suggested Familial Hypercholesterolemia and my primary care provider put me on a 10mg dose of Atorvastatin. I am 40, don’t smoke, eat healthy, walk 2 miles 6x / week. Slightly overweight but not by a lot. 3 weeks later, my total cholesterol has dropped from 315 to 191, LDL from 215 to 104. However, in that time my triglycerides went up 81 points from 127 to 208. My question is - does my initial lab report seem like a lab error? I’ve been told by another internal med doc that 10mg is not enough to do significant change and that 40mg is the therapeutic dose. And I feel like 3 weeks time is too fast to lower it that drastically. I asked my PCP why my triglycerides jumped up 81 points in 3 weeks and she said “processed food, and the statin will lower that.” So I said “I have not eaten any processed food. And so on the statin it went up 81 points but if I stay on the statin it will go down?” And she said yes. Which, to me, is confusing and doesn’t make sense. I dont want to be on a statin if I don’t have to be, and I am confused by what to do next. I can’t get into an Endocrinologist for 5 months. Can anyone offer advice?

Interested in more discussions like this? Go to the Heart & Blood Health Support Group.

@tlhuckins, I moved your question to appear in both the Heart & Blood Health and the Endocrine System groups so that you can connect easily with other members talking about cholesterol and triglycerides like @harolddr @tsc @lioness @macto @sue225 @1chuchie.

While we wait for others to chime in, you might be interested in the helpful posts in this related discussion:
- High Cholesterol: how do you control it?: https://connect.mayoclinic.org/discussion/high-cholesterol-1/

And this article by Mayo Clinic
- Triglycerides: Why do they matter? https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/triglycerides/art-20048186

It sounds like further monitoring and testing are in order. Seems like you have lifestyle options that can help delay or prevent the need for medication and you're making great strides in that direction.

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I can’t speak to the triglyceride issue, but I can say that three weeks is enough time for a statin to make a difference in the lipid panel. Mine dropped in half almost immediately, in probably 2-3 weeks as well.

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@sjy70

I can’t speak to the triglyceride issue, but I can say that three weeks is enough time for a statin to make a difference in the lipid panel. Mine dropped in half almost immediately, in probably 2-3 weeks as well.

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I did recently watch a video that explains the cholesterol panel stuff in an easy to understand way. Might explain why some doctors don't know a lot about it 🙂

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I would urge you to seek out another doctor - a cardiologist - and consult with her/him. Get clear on all your questions ahead of time and write them down. Let the doctor know in advance that you are coming to get a second opinion. Medicare allows second opinions. We did this for my husband’s recent prescription to go on statins and got some helpful guidance.

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@johnbishop

I did recently watch a video that explains the cholesterol panel stuff in an easy to understand way. Might explain why some doctors don't know a lot about it 🙂

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This is a very basic summary - and doesn't actually discuss deviations from a normal lipid panel, how they interact, or which should be treated.

There are hundreds of summaries to improve understanding available from reputable health care systems, hospitals, etc - and hundreds of studies that provide the next levels.

Anyone with heart disease should do their own research for basic knowledge - and, IMO should not listen to one person or one video, especially if it is as general as this video.

Most commenting on this site should obtain an advanced lipid panel, a CAC scoring, and should prepare their material in a clear manner to speak with their PCP, and, if warranted a cardiologist.

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@mayoconnectuser1

This is a very basic summary - and doesn't actually discuss deviations from a normal lipid panel, how they interact, or which should be treated.

There are hundreds of summaries to improve understanding available from reputable health care systems, hospitals, etc - and hundreds of studies that provide the next levels.

Anyone with heart disease should do their own research for basic knowledge - and, IMO should not listen to one person or one video, especially if it is as general as this video.

Most commenting on this site should obtain an advanced lipid panel, a CAC scoring, and should prepare their material in a clear manner to speak with their PCP, and, if warranted a cardiologist.

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I agree. It's essential to do your own research even when talking to your doctor as it's not possible for the doctor to know everything and most are not specialists. The video is a basic summary but my previous PCP didn't even have that grasp and I had to order my own lipid panel. That and a lot of the studies are difficult for the average person to understand so the research can help you ask better questions of your doctor.

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John,

I am shocked that any PCP would not fully understand the need and interpretation, at least annually, of a basic lipid panel - it is the most basic of the basics. I have never had a conversation with a physician - of any kind - who did not understand this basic information.

I'll note, again, the absolute need for anyone with any sort of heart disease to ensure they obtain an advanced lipid panel - sometimes called a Cardio IQ panel by one of the labs. It is essential for understanding the basics of anyone's situation.

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@mayoconnectuser1

John,

I am shocked that any PCP would not fully understand the need and interpretation, at least annually, of a basic lipid panel - it is the most basic of the basics. I have never had a conversation with a physician - of any kind - who did not understand this basic information.

I'll note, again, the absolute need for anyone with any sort of heart disease to ensure they obtain an advanced lipid panel - sometimes called a Cardio IQ panel by one of the labs. It is essential for understanding the basics of anyone's situation.

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In defense of my PCP, I do get a new resident every 2 years due to being a patient at a local Mayo Family Health Clinic. I've always been labeled pre-diabetic and the focus was on the good, the bad and the ugly numbers with HDL, LDL and A1C without much explanation other than it's OK, not OK, too high until I started asking questions and not wanting to take statins to lower my cholesterol due to already having neuropathy. That's why I joined the Patient Revolution - https://patientrevolution.org/visit-tools 🙃

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John,

That links goes to an incomplete site - nothing really there ...

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@mayoconnectuser1

John,

That links goes to an incomplete site - nothing really there ...

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Weird? Always works for me?

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