r/Cholesterol

I’ve recently had a CT HEART CORONARY ARTERY CALCIUM SCORE WITHOUT IV CONTRAST that showed mild coronary artery disease highly likely, and significant narrowing possible.

I’m Insulin resistant and have a high LDL.

Some context, 48, active male. Non smoker, non drinker (maybe once a month at most). Good weight, healthy diet, sleep well and metabolic age younger than my actual age. Now my cardiologist, after one test and one visit, wants me on a statin. So I started and 3 months later all my numbers are in range.

The reason for this post is I feel like chop liver, like it’s about money and not proper health care. Does anyone here see any MLH Cardiologist that they can recommend? To say the least, I’m not happy with mine.

Thanks in advance 🙏🏼

 

For context, I lost more than 100 pounds. Near the end of that weight loss period, my cholesterol levels became significantly elevated, with total cholesterol approaching 300. I suggested to my doctor that this might be related to the weight loss itself, but followed their recommendation to begin statin therapy. After about a year, I asked whether it would be reasonable to stop the statin for six weeks to reassess whether it was still necessary (I have a busy schedule, so I waited almost eight weeks to retest) . Although my doctor advised against this, they ultimately agreed to the trial.

My results….great!!!:

Cholesterol total: 150

HDL: 65

Triglycerides: 31

LDL: 70

It’s difficult to overstate how relieved I feel. My doctor has recommended repeating the test next month (just to be extra cautious), so I’m hopeful the results remain consistent.

I am still pro-statin, but I wish I had waited longer to make that decision.

How do i stop myself from eating meats, now its been 3 days where i go past 13g sat fat and i feel like thats really bad is it ok to go past it sometimes or will it affect my lipid levels results

Hi

What are your personal experiences(mainly LDL reduction, liver enzyme/kidney function/ A1C levels) between increasing rosuvastatin dose vs adding ezetimibe to your current statin?

Dr prefers upping the statin but from what I’ve read adding the ezetimibe would decrease LDL to a greater % without side effects. I’m on 10mg rosuvastatin but LDL is still 110.

Thanks!

Just got the last of the labs in and I'm really confused and concerned. Prior to trying a statin, (Sep 2025 to mid Jan 2026, 5mg of Rosuvastatin), then Ezemtimibe and Repatha, my Lp(a) this past yr had been 250 to 290 nmol/L.

I just did labs for my recent 3 mth treatment eval of Repartha/Ezem

(21 Jan to 14 Apr) and here are the results -

ApoB - 115 to 88 mg/dl, started at 154 prior to Zepbound in Apr 2025

Total Cholesterol - 197 to 165 mg/dl

LDL-C - 153 to 97 mg/dl, started at 205 prior to Zepbound in Apr 2025

HS-CRP - 4.3 to 4.5 mg/L, been steady at 4.3 until now

Lp(a) - 289 to 367 nmol/L, been 280s until now

CAC score - 21

Having read many, many articles, research papers, etc., I thought I'd see lower results on the LDL-C and hoped for a bit of a drop in the Lp(a) but was concerned to see the Lp(a) increase by 25%.

I'm 72F, a TIA at 42, no other heart issues, but fam history of heart attacks, strokes, etc., and until the last couple years had never heard of ApoB nor Lp(a). Never prescribed anything for cholesterol but did go on Rosuvastatin but couldn't tolerate the lowest dose. Memory issues and muscle cramping.

I've lost 50lbs this past year, eat very well, mostly cruciferous veggies, 4 oz of protein once or twice a day, no carbs much to speak of and the only fat comes from my baked Salmon and a bit of butter (9g).

I'm limited on exercise due to other health issues, but do try strength training.

Has anyone else on Repatha and Ezemtimibe noticed an increase in their Lp(a)? Am I an anomaly? I did try searching the sub, but didn't find any comments describing similar results.

I see my PCP on the 28th and was going to ask about adding Nexletol to the current treatment plan in hopes of reducing the LDL-C further. I really don't want to try a statin again. The memory piece was maddening for me. Since stopping the statin, I'm back to myself again.

Thoughts?

I’ve been injecting my thighs as I don’t seem to have as many side effects. I do usually get a localized reaction that comes a day or so after and then gets better with a little topical steroids. This time it sort of started getting smaller but now it keeps getting bigger and redder. I am kind of freaking out about it. I took a Claritin and a Zantac. Also some Motrin. Could a reaction like this turn into cellulitis? I’m watching too much of the Pitt.

I’m on 10mg Rosuvastatin and it’s really causing muscle pain and weakness especially in my legs.

Are there statins that are less likely to cause these side effects? Thanks!

41, male, 212lbs. Went in for a physical and Dr. did a lipid panel. Next day got a call that my triglycerides were 234 and wants to start me on zetia. Never had high cholesterol.

Just to give overall context. These were my numbers:

Total Ch: 221

HDL: 53

Triglycerides: 234

LDL: 130

CHOL/HDLC Ratio: 4.2

Non HDL: 168

This was non-fasting. Over the past couple of weeks I had been going heavy on the fast food. Not typical of myself.

Now, 8 months ago I had a lipid panel done and my triglycerides were 155 and LDL was 110. The other numbers were good. Also, I had been lifting weights religiously 5 days out of the week. However, since August I've not been back into the gym. So, my level of exercise took a nose dive to say the least.

Is it possible the most recent lipid panel numbers were not my technically true? It was non-fasting and I'd ate granola, Greek yogurt, and grapes about 4 hours prior to the labs being drawn.

Just wondering if zetia will help? Dr. Didn't want to use a statin out the gate.

Any advice or thoughts from your experiences, whether similar or not. Just looking for reassurance is all because my dad passed away at 48 from HA. He also smoke and drank daily. However, I do not. Feel like I'm heading down the end road here, lol. Thanks guys.

Hey folks,

I've been struggling with high cholesterol for several years now. A big part of it is hereditary, but I could certainly be doing better with my diet. I live with chronic depression and anxiety, and ADHD, so meal planning or even making sure I've eaten enough in a day is really challenging for me. I know I need to work on making my diet healthier, but it's difficult to know where to start. I see so many great recipe ideas on this subreddit and I'm going to give them a try. I just feel so defeated before I've even begun, and I was wondering if anyone going through something similar has any advice, encouragement, or kind words that could help me and others feeling similarly defeated. What words of encouragement or perspectives helped you when you were tackling health concerns?

Disclaimer: I am not a doctor. This post reflects my personal experience and medical data tracking. I am working closely with my cardiologist to manage my health. Do not change your medication, diet, or medical treatment based on this post. Always consult with a healthcare professional.

Context: I am a 37-year-old male, athletic, and a former smoker. My initial labs while following a strict Keto/high-fat diet showed a significant spike in LDL, which is a known phenomenon in the Lean Mass Hyper-Responder (LMHR) community. Despite excellent metabolic markers (Fasting Insulin: 3.2), my LDL-C reached levels that required further investigation.

This post is also an update for:

1. https://www.reddit.com/r/askCardiology/comments/1s00fdm/37m_moderate_aortic_regurgitation_ldl_340_worried/
2. https://www.reddit.com/r/Cholesterol/comments/1s1pg69/ldl_340_vs_insulin_32_the_ultimate_genetic/

The "Before" Labs (Strict Keto / High Fat):

• Total Cholesterol: ~420 mg/dL
• LDL-C: 340.1 mg/dL
• HDL-C: 72.7 mg/dL
• Triglycerides: 76 mg/dL
• ApoB: Not measured initially.

The Investigation: Due to family history and a small 1.7mm carotid plaque (identified as a potential "relic" from my smoking years), my cardiologist ordered a Coronary CT Angiography (CCTA) to assess actual heart disease risk.

• Result: CAD-RADS: 0 (No detected plaque in the coronary arteries).
• This provided a "sanity check," showing that despite the high LDL, my heart arteries currently remain clear.

The Metabolic Pivot (4-Week Experiment): Under clinical observation, I decided to test the "Lipid Energy Model" hypothesis. I shifted my diet to increase fiber and complex carbohydrates (whole wheat spaghetti, legumes, apples) while significantly reducing added fats (swapping 6 whole eggs for 4 egg whites, reducing nuts, and avoiding beef and chicken skin).

The "After" Labs (4 Weeks Later):

• Total Cholesterol: 253 mg/dL (-40%)
• LDL-C: 173.4 mg/dL (-49%)
• HDL-C: 61.3 mg/dL
• Triglycerides: 93 mg/dL
• ApoB: 122 mg/dL (Now within the laboratory reference range)

What I observed in my case:

• LDL Dynamics: In my specific metabolism, LDL seems to act as a dynamic fuel-transport signal. Dropping LDL-C by nearly 170 points through dietary macros alone suggests that my baseline Keto levels were largely driven by energy demand.
• The Role of Imaging: The CAD-RADS 0 result was crucial. It suggested that my metabolic health (Insulin: 3.2) might be providing a protective context, though it doesn't mean high LDL is inherently "safe" for everyone.
• Collaborative Care: Based on these results—the clean heart scan and the significant dietary response—my cardiologist has decided to shift our strategy toward a more conservative management plan rather than the immediate high-dose statin therapy originally considered.

Ps. No statins or other LDL lowering medication were used during this process or ever. This was a 100% dietary intervention.

So the lipidologist doesn’t recommend a statin because of my elevated Lp(a) (165), especially since my ApoB has stayed below 80. My general cardiologist, however, wants me to start rosuvastatin now. I pointed out the conflicting advice, and both essentially said the decision is mine. The lipidologist favors continuing ezetimibe and/or adding Repatha (if i can afford it even), at least until Lp(a) reducign medications become available.

I’m feeling conflicted and frustrated. Is this a known conflict of thought? Has anyone else been in a similar situation? Both of these doctors are well esteemed and part of major health care systems in NYC-- no chiropractor wackery.

Hello, I received a high cholesterol test. 180 ldl 28 hdl and 95 triglycerides. I would like to remain from stations. Is there a way to reduce this? I have already came down alot as my first test was almost 300 total.

I have had calcium score test and scored 0.​

I had the cac test this past Friday and received the results today and I have a 0% however there is calcification on my aortic valve. Mild but still Present. I am 46 male and have been on statins since 30. Anyone else have similar test? I am currently on 20mg of lipitor and fenofibrate. I may ask my doctor to switch to 20mg crestor.

Just curious if this is possible, if you ask a dr they'd say it's not possible because they think we are not capable of holding a diet and a regime. But was there anyone capable of doing this from diet and activity, is it theoretically possible?