Dr. Suzanne Steinbaum

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Cholesterol Levels: Stay Healthy By Staying Aware

Cholesterol levels may not be the first thing on your list of health concerns. High cholesterol is that problem your grandfather has, right? Or maybe your father? In any case, you don’t have to worry about that yet, do you? 

Well, yes, you do. High cholesterol might be your problem, too. The most common new health risk factor I see in my female patients is lipid abnormalities. Translation: problems with cholesterol. 

Test Your Cholesterol Often

It’s important you know your cholesterol number because more and more people are finding they have high cholesterol, primarily because of a poor diet and, in some cases, because of genetics. If you are a young woman without any apparent risk factors (because you can’t see high cholesterol), your doctor might not test your cholesterol unless you ask.  Make sure to ask to test because high cholesterol is a significant risk factor for heart disease.

I know because I used to have cholesterol, and I thought I was one of those people who just inherited naturally high cholesterol. But I had been living on candy and caffeine (ironically, during my medical training!). When I started eating better again, my cholesterol levels went back to where they should be. My lifestyle, not my genetics, was putting me at risk. So much for being the victim of my family history.

Gain Control Over Your Cholesterol Level

I had total control over my cholesterol level, and you do, too. Find out your total cholesterol and your HDL (“good”) and LDL (“bad”) cholesterol numbers. If your LDL is above 130, you are 2.2 times more likely to develop heart disease than someone with normal cholesterol. If it’s above 160, you are three times more likely to develop heart disease. HDL cholesterol is the protective stuff. I think of it like that 80’s computer game Pac man, eating the tiny dots of bad cholesterol and shuttling it out of the arteries. HDL is often high in younger women who have estrogen, which is one of the reasons young women aren’t assumed to be at risk for heart disease. However, HDL decreases with age and the decrease in estrogen that goes along with menopause. Also, when triglycerides are high (see the next paragraph), this can push HDL levels down. HDL levels should be at 40 and above for men and 50 and above for women. I consider anything above 60 is super protective, so that’s what I like seeing. 

Triglycerides are also part of the cholesterol profile, and high triglyceride levels are associated with eating too many carbohydrates and sugars. In women, high triglycerides are a more potent risk for heart disease than for men. You want to keep track of this number and keep it in the normal range, which is less than 150. The good news is that this one is easily correctable through lifestyle changes. 

Finally, you should also know your apolipoprotein B number. Apolipoprotein B is a protein that grabs onto cholesterol, and it has been shown to more accurately assess plaque risk, especially in women. An apolipoprotein B less than 80 mg/dl is the goal. Lifestyle interventions like diet and exercise can help. 

For a few people, medication to control cholesterol is necessary, so consult your doctor. Still, for most of us, all we have to do is improve what we eat and how much we move, and our cholesterol levels will normalize pretty quickly. You have the power to take the right steps in order to shift those numbers! Your heart will thank you.