r/Cholesterol

Anyone else not see much LDL lowering when adding Ezetimibe to Rosuvastatin?

After 6 months of ONLY 5 mg Rosuvastatin, my LDL dropped from 140 to 76.

I have FH, high LP(a), and familial history of early cardiac events/death, so doctor said my LDL needs to be below 55. Added 10 mg of Ezetimibe 3 months ago.

LDL 76 -> 69

I’m bummed. Diet is very clean (less than 10 g of sat fat, etc.). I am lean, exercise a lot, don’t drink or eat junk, etc., etc., etc.

Is this tepid response typical with FH? Should I increase dose of Rosuvastatin (despite studies showing most lowering comes with 5 mg dose)? Is it time for Repatha? Just frustrated because there are not many other levers I can pull.

I’m a 44 year old, fairly healthy male who’s LDL has been on the higher side my last couple physicals. This past week I tested at 141

- I eat fairly healthy
- I exercise a few times a week, plus walk a lot
- I’m not overweight
- I don’t smoke

I feel like I’m definitely on the healthier side of things. I have the occasional junk food but maybe once a week. I also have a few drinks a week but never in excess.

I would prefer not to alter my diet a crazy amount, but my LDL has been on the higher side there last few years, going up a little each time (so this week was the highest)

Any suggestions??

So I suffer from chronic health anxiety and last year I got my lipid panel done and it showed an LDL of 154. This was not a fasting blood test so my doctor says let’s try again in a year and fast this time. After a year of really cutting my saturated fats, sugars mom, etc it dropped to 134. I’m very thin and lost too much weight doing this and now I’m worried that Iv only dropped it 20 points in a year’s time. My doctor isn’t worried and says my calculated risk for cardiac events is 1%. I’m 39 years old and I haven’t been as active as I should be… Is my doctor under reacting?

So I just got my yearly physically and my HDL is surprisingly high. I know HDL is considered “good” cholesterol but I just don’t know why mine is so high and if I should be worried. I don’t drink alcohol so the number just isn’t making sense to me. Also my blood pressure is phenomenal and I don’t have any discernible symptoms.

Cholesterol: 231 mg/dL
Triglycerides: 56 mg/dL
HDL: 122 mg/dL
LDL: 98 mg/dL
VLDL: 11.2 mg/dL

Total: 269 mg/dL, HDL 79 mg/dL, LDL 174 mg/dL, triglycerides 84 mg/dL.

Last year: total 226, HDL 67, LDL 144, triglycerides 84.

33F, 5'2" 110 lbs, no other issues (good bp, good sugars, etc). Family history of high cholesterol, and I personally have always had high cholesterol since childhood.

I eat the exact same diet as last year (no red meat, lots of beans, dairy intolerant so no cheese etc, mainly vegetarian but occasional chicken, occasional baked goods but like a few times a month).

I'm not super active but I do a lot of walking. From last year to this year I've lost ~5 lbs unintentionally but not rapidly and not due to any major life changes. I just don't eat much fat since I can't have dairy and hate most dairy alternate options.

The ONLY major difference I can think of from last year to this year is last year I was super intentional about cramming fiber into everything. This year I did not really monitor fiber or try especially hard. I still eat a good amount of fiber and my main protein staple is beans.

I'm just frustrated at my own body and blood. My numbers look like I'm enjoying butter and eggs every day and living my best culinary life but I'm here eating rice and beans and being sad about not having baked goods.

I know it's almost definitely familial/genetic (Father has high cholesterol, family history on both sides of heart disease ... ). I literally cannot eat leaner proteins. I know the doctor is probably going to recommend statins esp since my numbers did jump from last year.

But here's the issue. I am planning on TTC in the next year (depending on clinic availability, testing, etc since I will have to need ART). I've read it's not recommended to be on statins during that process and to go off them several months before ttc or as soon as you find out you are pregnant.

Is it unreasonable to ask to put off statins and just go REALLY hard on fiber? I've never tried psyllium and am thinking of trying that to supplement.

Would appreciate thoughts. Just frustrated with how my numbers never seem to reflect my effort ...

EDIT: I will be talking to my doctor just want to hear people's thoughts before that

I recently learned I have reasonably high Lp(a). I've also learned that no matter what I ate, didn't eat, drank, didn't drink, how many miles I ran, how many weights I lifted or what my BMI was, this marker alone increases my risk for heart disease. I also had a CAC performed weeks after the Lp(a) test results and more bad news - high score for my age. 95th percentile. I've had moderately high LDL for what I can look back on is 15+ years. It was not yet in the statin recommended area, but it was over 100. Additionally, ALL my other lab numbers are not only within range but well within optimal range. Was there not a red flag there that my LDL was the rogue biomarker? My doctor finally ran the Lp(a) after I tried desperately to change my diet over the past year, improving my LDL by a miniscule 5 points. I feel like if I had known, and my doctor had known, a decade or more ago about my Lp(a) I could have been recommended a statin much earlier and avoided all the atherosclerosis buildup that is in my heart and vascular system now. I'm angry beyond belief. I feel like an innocent person just condemned to solitary confinement..A medical death sentence. If 20% of the population has elevated Lp(a), and heart disease is the leading cause of death, and the test is a very simple blood test, WHY ON EARTH ISN'T IT A BASIC TEST RUN ON EVERY PATIENT???

60yo F here, generally healthy and active, BMI 25. My cholesterol's run borderline high since my 20s, with LDLs of about 120, and I have a family history (mother had a heart attack at age 54 and three strokes since then). So I eat mostly plant-based, have a big bowl of steel-cut oats with apple, berries, chai spice, and walnuts every morning, eat beans daily, almost never eat red meat or chicken, have fish or eggs maybe once every month. I do enjoy ice cream about 1-2x a month. In 2024 my calcium score was tested at 0 and Lp(a) of 7, so that was reassuring. Didn't get cholesterol checked last year, but as of my annual checkup last week it's up to
LDL 137
HDL 66
triglycerides 138
total cholesterol 231.

My PCP hasn't reached out to me about these numbers, but a family friend who's a primary care doc suggested adding psyllium husk for a month or two and if that doesn't budge the numbers enough, either keep on with it or ask my PCP about a low-dose statin as an "insurance policy."

So I started in with the psyllium husk but I'm struggling with it. I can only force myself to drink about 1/2 teaspoon per cup of water. It's a mental hangup, I guess. Is it supposed to dissolve? Do you get used to it? Any tips?

Also, does this seem like a reasonable strategy overall?

Hello r/Cholesterol

I am looking for some help with lowering my cholesterol and to help me understand it all a bit better.

in 2025 my LDL cholesterol was very high, around 210. I am a physical active/fit person so I just kind of didn't care about it for most of my 20s and just assumed, "I'm active, I'm healthy"

After my doctor said I really need to try and bring it down without meds, I did my best to lock in and stop eating junk as frequently as I did in the past, mostly stopped buying candy and avoided high fat fast foods as much as possible, I still ate out but maybe once a week.

Cue my next bloodwork and doctors visit 4-5 months later I am pleasantly surprised to see my LDL cholesterol had dropped to around 160.

And I just recently did some more bloodwork again just last week and was hoping to see a similar trend but I am actually trending back up, it was 170.

I remember what I did to drop my cholesterol down by 50 points and I basically avoided eating as much fat as possible. I thought I was doing that still for the most part but clearly I am not.

When really trying to lower cholesterol, what should I be looking to avoid on nutrition labels? Is it the fat and saturated fat or the literal 'cholesterol' on the nutrition label? Or both?

thanks

Usually, capsules contain very tiny amounts of psyllium and it's hard to take 20 tabs a day.

In the past year I (36F) have been diagnosed with high cholesterol (total 207, HDL 101, LDL 96, trig 62). My doctor told me I’m “not ready” for medication (too young) and just needed to change my lifestyle. This all seemed reasonable until the specifics started to be discussed.

I’m already a pretty active person with a decent diet. At the time of the test I’d been eating pescatarian, getting most of my fat from olive oil and avocado (maxing out at 10-12g of saturated fat daily), walking 10k steps daily, and working out 5-6 days per week (including 10-15 miles of running each week). I’m certainly not a pro athlete, but on average I didn’t think I was doing too horribly.

The diet and lifestyle the doc outlined included going low fat, low carb, and low sodium, and significantly increasing my activity level. Calculated out this means a less than 1400 calorie per day low carb, high fiber, high protein diet while increasing my cardio significantly. In order to set some goal I decided to start training for a half marathon to motivate myself to make the increases in my training schedule. The trouble is that I only seem able to maintain this lifestyle for a week or two before becoming extremely fatigued and getting light headed while running.

As a casual athlete and someone who has always cared about nutrition, the advice I received seemed extreme and unreasonable. However, I recognize that I’ve always been focused on advice for a reasonably healthy person. Is this normal for cholesterol patients? Do I just need to get used to feeling awful while training hard if I want to preserve cardiovascular health? How do you convince yourself that hopefully living a few years longer is worth feeling horrible for the rest of your life?

M35

LDL -154

HDL-43

APO B - 93

LP A - 18

Smoking history. Hba1c -5.2 and no hypertension.

I'm 25M, otherwise pretty healthy, lean, and exercise regularly. For months, I had been eating 2 eggs every day. Aside from those eggs, I was already essentially plant based.

While eating the eggs, my labs were:

LDL-C: ~119 mg/dL

ApoB: 0.95 g/L

About 3 months ago I stopped eating the eggs completely. I replaced them with legumes and otherwise kept my diet pretty similar.

My latest results:

LDL-C: 69 mg/dL

ApoB: 0.65 g/L

So LDL dropped by about 50 mg/dL (~42%), while ApoB dropped by about 0.30 g/L (~32%).

What makes this interesting to me is that I was already eating a fairly high-fiber, mostly whole-food vegan diet before removing the eggs. I was getting plenty of soluble fiber from legumes, oats, etc., so I don't think the change can simply be explained by suddenly switching from a typical Western diet to a high-fiber diet.

The main difference was removing the eggs, which meant a substantial reduction in dietary cholesterol, and probably some reduction in saturated fat as well.

That said, my saturated fat intake wasn't particularly low even before. I was eating things like olive oil, cocoa powder, nuts and seeds, and was averaging around 10 g of saturated fat per day.

So I'm wondering whether I might simply be quite responsive to dietary cholesterol from eggs.

I know this isn't a controlled experiment and there could obviously be other changes I haven't accounted for. I'm not claiming that eggs are inherently bad or that everyone would see this response.

I'm just surprised by the magnitude of the change, especially the ApoB change.

Has anyone else seen a similar drop in LDL/ApoB after removing eggs while otherwise already eating a predominantly whole-food plant-based diet?

And does a ~30% reduction in ApoB from a dietary change seem plausible?

I've had high LDL around 170, HDL 36, triglycerides around 50, non HDL around 190.

These numbers have been almost static since 2023, the first time I got tested for these. I'm a 30-year-old male.

I am a vegetarian and the only sources of saturated fat and cholesterol in my diet are peanut butter and nuts, which I consume on a daily basis around one serving. I don't have egg yolk, just egg whites regularly. I take zero-fat milk and yogurt. I do eat a lot of fibers, avocado, etc. I run a lot regularly (15-20 miles a week) and I work out as well. My cardio health is pretty good.

I want to get your help with understanding why it's not changing even though my diet and execute are ideal. It can't be genetic because my parents, who have a much worse diet and eat fried food and whole fat dairy regularly, don't have high cholesterol.

Having been through the sub I know psyllium husk, garlic, omega 3 pills (I don't eat fish) and finally, statins can help. The reason I'm even thinking of statins is because I've seen psyllium husk garlic studies mention that it lowers LDL by 5 to 10%, which would still be too high for me.

I essentially want all of your opinions on understanding the possible reasons why, without taking any supplements and drugs, I am failing to control my LDL.

Is this just a Canadian thing or do you have this in the US too? It drives me nuts when I see lab sheets here mark 3.5mmol or under as the boundary for "normal". And yes, this is marked like that even if the same lab sheet will show "hba1c : 6.7", becoming comically contradictory in nature. How is letting a borderline number sit unchecked a good thing or "normal"? I mean, will 3.5 mmol or 135mg/dl of LDL cause no issues over decades? What do cardiologists or lipid researchers think of this?

I have family history of heart disease and congestive heart failure. My LDL today is 139, HDL 38, Cholesterol 197. My doctor brought up possibly putting me on a statin given the elevated LDL and family history.

I’m not sure if I should, I know that I am not doing good with my diet and exercise though. Any advice would be great!

Choline is an essential nutrient that supports brain function, memory, nerve signaling, liver health, and muscle function.

Adequate Intakes (AIs) for Choline (19+ years) are 425 mg/day for women and 550 mg/day for men.

The highest sources of choline are beef liver and eggs (mainly egg yolks). So, what do you eat to meet these requirements that’s not high in saturated fat?

“My previous post got removed because of downvotes” 🫤