r/Cholesterol

27M, wondering if I should ask for Ezetimibe

Have had high cholesterol and blood pressure since my pre teen age. I weigh 150 lb. Only recently did I get my lpa checked, and it came out to 145 nmol. It’s been a year since i’ve been on crestor 5mg because of it. I’ve had a CTA done and the results are normal with score of 0.

My LDL dropped to 41 with medication and an intense diet. I’ve slowly been easing off my diet to live a normal life with friends and family. LDL creeped up to mid 60’s over the past 6 months. Mind you, my diet is still decently ok. I have one, very rarely two, meals a week that people here would consider an “unhealthy meal”. Other days my daily intake of sat. fat is around 5g, mostly from chicken. I also take psyllium husk 4 times a week.

My cardiologist says he wants my LDL below 75, so he dismissed me and recommends the annual checkup. Lots of discussions here say that LDL should be below 55 with an Lpa as high as mine. I’m wondering if i should find a new cardiologist and ask for ezetimibe? Or should i live miserably and go on an intense diet again lol.

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u/accyoast — 8 hours ago

My LDL came back at 60 and I finally understand why the new guideline draws the line at 55

Got my lipid panel back a couple weeks ago. LDL 60 mg/dL, calculated with Martin-Hopkins. That sits right on the threshold the new 2026 ACC/AHA dyslipidemia guideline drew for very-high-risk patients: <55 mg/dL. The guideline goes no lower than that.

I had to look into why. The trial evidence keeps going lower. In FOURIER-OLE, the long-term extension of the evolocumab outcomes trial, achieved LDL kept reducing cardiovascular events all the way down past 20 mg/dL. Lower kept being better. So if 30 is biologically better than 55, why didn’t the guideline say so?

The answer, in the editorial accompanying the guideline (Schwartz in JACC), is a cost ladder. From the PROVE-IT data: about 35% of high-risk patients reach LDL <55 on atorvastatin 80mg alone. Add ezetimibe and 55% reach goal. Two generic pills, combined cost of $20-40 a month at most US pharmacies.

To push below 55, about 45% of patients would need a third drug, typically a PCSK9 inhibitor. To push below 30, more than 90% would. Repatha’s cash price via GoodRx is around $2,900 a year right now (list price still around $6,000) — meaningfully cheaper than it was a few years ago but still a real step up from two generics.

The marginal benefit, per FOURIER-OLE, is about 1 percentage point of absolute reduction in cardiovascular death, MI, or stroke over 5 years when you go from LDL 55 down to 40. That’s the math the guideline writers balanced.

For me sitting at 60, this means I’m done. The third drug isn’t worth it for the marginal benefit. For someone with high Lp(a), bad family history, or established CVD with multiple events, the calculus tilts the other way and pushing lower is reasonable.

One thing worth noting: LDL on a routine panel includes the cholesterol carried inside Lp(a) particles. Statins and ezetimibe barely lower Lp(a). So if you’re comparing two people at LDL 80, the one with high Lp(a) has “less modifiable” LDL and a worse forecast. In FOURIER-OLE, patients who achieved LDL <20 had a median Lp(a) of 8 nmol/L; those who landed at 40-55 had a median of 41. Some of the apparent benefit of very-low achieved LDL may actually be the low-Lp(a) phenotype rather than the LDL number itself.

Has anyone here with established CVD or genetically high Lp(a) been pushed below 55 on PCSK9 inhibitor + statin + ezetimibe? Curious what your achieved LDL ended up being and whether the cost felt worth the additional reduction.

u/DadStrengthDaily — 10 hours ago

Huge drop in Triglycerides

I was not expecting this. I did eat clean.
No sugar, processed foods, honey, dates, oil, rice, milk, no fruits except berries.
I was eating greens and lentils and fish and taking 200mg lipidil.
I am actually surprised as to how they came down so fast.
It is because of the medicine?
I also did 30 minutes incline treadmill almost daily and walked outdoors to.

u/ApprehensivePea4161 — 8 hours ago

How screwed am I? (Lipid blood test results) 30M

ApoA 169 mg/dl

ApoB 114 mg/dl

Total 253

HDL 68

LDL direct 171

Trig 82

HSCRP 0.27 mg/l

So I just got my results from my blood test, and the numbers look pretty awful. I'm quite lanky and don't overeat, and I exercise as well. Time to start on statins? I am currently on a non strict low carb diet as well where try to avoid carbs during dinner and skip breakfast.

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u/throwawayaway539 — 10 hours ago

I’m Struggling

I (27F) just got hit with a 170 LDL result. My doctor referred my to a dietician who told me all the things I was pretty aware of already. I’m a runner and don’t eat red meat, but my vice is baking. I have a major sweet tooth and love to bake, it brings me so much joy. I truly do not think cutting out baked goods is feasible for me, and yes I know there are “healthy” baked goods, but I’m just not the kinda girl who wants to make a zucchini brownie. At this point I truly think I’d rather be on a statin for the rest of my life than give up a passion. Is it worth it? How do you balance your physical health with your mental health?

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u/rj8264829173 — 23 hours ago

Lowered my LDL from 196 to 144 with one change to diet

A few months ago after a horrible reading of 196 LDL I couldn't believe it was that high, after doing research on it and realizing saturated fat was the enemy, I decided to completely cut out melted butter which was a big part of my diet and it's amazing to see my LDL drop so much naturally

Keep in mind I'm still eating a lot of fast food which I should also cut out and see how low I can actually get it because this is still high and my diet still sucks but it's definitely better than being in the danger zone, I'm a male in my late 20's btw.

Triglycerides also went from 168 to 84.

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u/Loud_Bowler2938 — 16 hours ago

Is it weird to say this cheese saved my life?

The most cheesiest cheese witch is also saturated fat free

u/g2gtpgtpwtw — 1 day ago

Super high triglycerides

Husbands bloodwork

Male, 40, average weight, doesnt know family history, they all died (alcohol and drug related). Hes very anti any drug because of this.

He doesnt eat badly, but doesnt eat great. His calcium score was zero. His doctor wants him to start a statin and he doesnt want to take it.

To me, these numbers look really bad and they are kind of freaking me out. It looks like his tryglycerides were so high they couldnt even calculate an LDL? I feel like this is something that even good eating and exercise wont do enough for.

How did you all decide to do something about it? Were you resistant? Did results scare you enough to do something? I cant force him to so anything but I cant just sit by and not try to help.

u/PearlChains48 — 21 hours ago

Stuck on what to do, not sure I trust dr’s opinion

30 F, history of heart attack on dad’s side of the family (his father and brother both in late 50s / early 60s). My dad is 71 and on cholesterol medication, no heart attacks.

Numbers from last year to this year:

Total cholesterol:
210 → 224
HDL (good cholesterol):
73 → 72
Triglycerides:
140 → 103
LDL (bad cholesterol):
112 → 131
Non-HDL:
137 → 152

I don’t think my diet is worse than a majority of people’s. No alcohol, recreational drug use, no smoking, no soda, no caffeine. Used to frequently eat sweets / dessert but cut that out years ago when my cholesterol was first reported to be high. It jumped up from 2022 to 2023 despite no lifestyle changes and the numbers have never gone back down. My weight and numbers have continued to go up. BMI is currently 24.74.

Doctor today suggested a list of supplements that I’ve then googled and have found no information on: MegaRed, CoQ10, and Red Yeast Rice. She said diet would not be enough to get me in a safe range with combined genetic history.

She is having me go back in 6 months for one final repeat panel before putting me on a statin. I’m really worried. I don’t want to be on a medication for the rest of my life at 30.. my dad even told me he didn’t start his cholesterol medication this young, and my doctor said this was unusual for a female at my age. I’m a very anxious person / hypochondriac so I want to get this taken care of, but I make minimum wage (retail) so I’m definitely stressed out.

I’m on my feet all day at my job for 7 - 8 hour shifts but no other exercise at this time.

Diet:
Breakfast — Cinnamon Cheerios with Oats & Activia Fiber Yogurt
Lunch - PB&J on white with red apple slices and grapes (was cheese it’s and pudding but I am removing those from my daily diet)
Dinner — probably where a majority of the issues lie — hot dogs, pizza, steak, fried cod, Chinese food. I am trying to have chicken more often and grilled cod to combat this.

Drinks — orange juice in the morning and apple juice with dinner, water throughout the day

I’m just at a loss and am looking for more advice. I don’t like how there was no information online on those supplements my doctor mentioned and making minimum wage I can only afford to do so much. I really don’t want to be on a medication for the rest of my life.

Any insight is appreciated. Thank you!

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u/TahliaLynn — 1 day ago

31F, how bad is it? If you have had similar numbers, what approach helped you?

So, I'm a 31F. I'm 5'4 and 163 lbs, single parent if that matters. I feel so lost right now. I went in for a regular check-up and to talk about family history with my new doctor. I was primarily concerned about my thyroid because I'm losing hair, my skin is dry, and some days I'm exhausted and fighting to stay awake. I mentioned how I've noticed my heart rate being slow, honestly believing it was a simple thyroid case. After mentioning heart disease in the family though, she started asking more questions about my heart. She became more concerned as I answered... EKG showed abnormal results.

I definitely have some weight to lose. I've lost about 17 pounds in the last 6 months. I think from August 2025 until April 2026 (232 days total), I worked out every single day, most days being 1 hour HIIT. I know I probably should have been able to lose more over this time for the amount of work I put in, but I didn't.

Most days I'd eat well, others I wouldn't. Salmon, rice, quinoa, sweet potatoes, 2 eggs for breakfast (daily), cooking with butter, spaghetti, sandwiches, sometimes I'd pick up a premade pretzel sandwich from the store and some chips for a "fun" dinner, etc. Either way, I'd be losing weight just to visit my parents and they'd order food in and I'd end up gaining the weight back. Usually, we call Friday our pizza night, so we'd order pizza in, or Banchan (japchae, fried chicken, etc).

My numbers are-

Cholesterol: 247

Triglyceride: 221

HDL Cholesterol: 38.7

LDL Cholesterol Calculation: 164

Non-HDL Cholesterol: 208.3

Total Cholesterol: HDL Ratio: 6.4

Hemoglobin A1c: 4.8 [the only normal one out of this bunch]

My doctor told me that my risk for a cardio event is high... I guess I want to hear from others who have similar numbers and what they've done. Doctor prescribed Lipitor (statins?).

Am I like... near death? lol. Like how bad is this??

I've been taking psyllium husk and switched to a Mediterranean diet (which low key has felt like the cure to depression because even though I LOVE food, I've been bored with it for awhile and this goodness makes me want to cry with joy lol)

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u/Dream-Bean95 — 20 hours ago

lipoprotein (a)

I got some blood work back, and I’m trying to understand my number and I’m concerned. From looking it up it says lipoprotein (a), my number is 34.3, is intermediate risk is that true? If so what are lifestyle changes that could fix this

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u/jitsukawaa — 22 hours ago

Low HDL and high triglycerides - what the hell can I eat at this point?

Might be more of a question for the nutrition sub but I've been feeling horrible lately (arm pain, cannot get a good night's sleep at all, headaches, occasional shortness of breath) - I've already gone to see a cardio that is gonna do a stress test on Friday and an echo at the end of the month. (Also have to pay for all this out of pocket because my insurance deductible is high, but that's a different story)

And I took a blood test and it showed:

HDL: 28

Triglycerides: 297

Total cholesterol: 136

LDL: 48

I weigh 130lbs at 5'7 so losing weight isn't really an option. High cholesterol and heart issues run in my family.

At this point, I've cut out:

Breakfast in general (I fast until lunch, but sometimes I'll have a mix of Greek yogurt, blueberry, and walnuts)

Red meat (except chicken and ground turkey)

I rarely eat pasta or bread anymore.

Generally try to stay under 70-80% of my total daily allowed sugar (working more on getting this under 60% and cutting out soda)

But at this point. ... Idk what to eat. I feel hungry all the time because it doesn't seem like I can have anything that doesn't have cholesterol, carbs, sugar, fat.

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u/CRLA3210 — 1 day ago

Lipid panel got worse

I’m 28 F. I’ve been dieting and eating very healthy since February. I’ve lost 18 pounds. I eat very low fat, low sodium, sugar free. somehow my cholesterol got worse. cholest went from 192 to 212, my HDL stayed the same. 37. My non HDL went from 155 to 175 and my LDLC went from 89 to 118.
I do not understand how this happened. I have completely changedmy diet. The only thing that improved was my triglycerides going from 330 to 289. and my glucose going from 99 to 88. what am I doing wrong

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u/creemypii — 1 day ago

Can someone help me

Can someone help me with these numbers and what they mean and what I need to do to bring them down any Information will help and any tips on what you changed as far as eating maybe if you can spill your eating plan I will be doing grocery tommorow so any tips will help for that so I can start to eat right and I need to excersice well start to.

u/OldSubstance8103 — 1 day ago

Relaxing sat fats a little

Background. 58M. Ultra runner. Disovered I have heart disease (CAC 38, mild soft plaque) after a succession of slightly raised LDL results (130,143,126) and ApoB 93. As soon as I received the CAC I changed my diet immediately and 2 weeks later started 20g Atorvastatin. 2 weeks after LDL down to 39. I’ve been sticking the both diet and statins. I have not retested ApoB as it’s not available on the NHS.

I‘m starting to think about relaxing my diet just to give me a bit more flexibility. I responded very well to statins and I think I have some wiggle room. it was reading about stearic acid that triggered this post.

As I understand it stearic acid is at worst neutral and possible a little beneficial and the following foods have more stearic acid than the other sat fat acids: -

  • Extra virgin olive oil
  • Avocado
  • Dark chocolate
  • Cocoa
  • Almonds
  • Walnuts
  • Pistachios
  • Peanuts/peanut butter
  • Oily fish
  • Olives

I already eat most things on this list but not liberally. I no longer count sat fats as I know having done so previously that my average per day is no more than 10g.

It‘s mainly these that I plan to relax. EVOO is probably the main one as it’s the basis of most of the cooking I do. I know it’s about 14% sat fats. But generally my plan is just to eat the above to desire.

Finally, I plan to add parmesan back into my diet but only as an addition to certain pasta dishes as an accouterment. I’d use no more that 1-2 heaped teaspoons (~10g and 1.7g sat fats).

This seems like such common sense that it must surely be being doing by others so I thought I’d ask for feedback.

Ultimately I know this is about LDL and ApoB and I will retest both in a couple of months.

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Suddenly High Cholesterol at 27 (M). Everyone says I'm fine. Please help

Hello,
I just got my blood test back and have 117 mg/dl LDL. Everything else like triglycerides, HDL A1C, blood sugar is in the optimal range. the Triglyceride to HDL Ratio is perfect. I had plenty of ECGs, Stress ECG an Echo and a Doppler Ultrasound, everything is fine. I don't drink, I don't smoke and an exercises regularly and get my steps in daily, my stress level is mostly low (I sometimes suffer from mild anxiety). I supplement Omega 3 from Algae, Vitamin D3/K2 and magnesium bisglycinate. My diet is mainly mediterranean with Olive Oil, Oats, Yoghurt, plenty of Fruit & veggies, Kefir, Sweet Potatoes, rarely Bread and no meat (I dont like it personally). No sign for genetically high Cholesterol. I feel fine. My LDL score has always been around 60-70 until this year, but therefore the tri's, HDL and A1C and blood sugar was in the higher end of the range. Also scared to check Lipo A because for now I can't change it anyways.

What can I do to lower my Cholesterol or do I stress out too much and the level is fine? I appreciate any help, thanks a lot...

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u/Sweet_Past_5877 — 1 day ago

Cholesterol Update!

I am proud to announce I did what I thought would be the impossible and made that cholesterol my bitch! I got the scare of a life time in October 2025 and since then, I've been locked in. I changed up my diet and started eating only what was recommended on this sub and started working out. And the most important thing is, I did it without any prescription. Thank you to everyone in this sub for your help.

u/spinz89 — 1 day ago

28 years old

Went to the doctor today… never took my health seriously until I couldn’t really get it hard with a girl I love and is hot… my LDL Cholesterol is 175 he said which is very bad…. I’ve had bad cholesterol for years but never cared seems like it’s catching up he put me on statins but I never took them what should I do? Should I start taking statins? I’m scared and need help thank you.

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u/warrior358 — 2 days ago