• mizzemm mizzemm
    August 28, 2009
    Can high HDL account for high total cholesterol?
    mizzemm mizzemm
    August 28, 2009

    I am a 33 year old vegetarian who has always had low cholesterol. I do not eat red meat or high saturated fat foods, fast food, junk food, etc. I am relatively active and in shape - I live in NYC and walk a lot. My weight is about 125 at 5'7". However, my last cholesterol reading was 208. The doctor said they could do it over because I had eaten that day and she was sure it was probably a false result. She did not give me the break down of HDL to LDL, but in the past I have always had high HDL and low LDL. Is there any possibility that my HDL might be so high that it is causing my overall cholesterol to be high? And if so, should my overall cholesterol still be under 200? I do eat a lot of cheese, avocado and hummus and I use sugar in my coffee and occassionally butter  - those are the only foods I can think of that might be responsible for raising my cholesterol.  Any help would be appreciated. Thanks.

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FROM OUR EXPERTS

  • Lisa Nelson, RD, LN
    Health Pro
    August 28, 2009
    Lisa Nelson, RD, LN
    Health Pro
    August 28, 2009

    Hi Mizzemm,

     

    The formula to calculate total cholesterol is:

     

    Total cholesterol = HDL + LDL + Triglycerides

     

    So, yes, a high HDL can cause your total cholesterol to be elevated.  It's best to base treatment decisions on cholesterol components (HDL, LDL, and triglycerides) versus total cholesterol.  Also, it's even better to go a step further and have a comprehensive lipid profile.  This provides information on particle size, which is even more beneficial to determine if you are at risk or not.

     

    All the best,

    Lisa Nelson RD

    How to Lower Cholesterol in 8 Simple Steps

    • mizzemm
      August 28, 2009
      mizzemm
      August 28, 2009

      Thanks Lisa - I know, I do need to get the breakdown, but I've heard that no matter what, cholesterol should generally be under 200. There don't seem to be many instances of people with cholesterol over 200 where it's due to HDL as far as I can find. So I was curious as to whether it's common or possible that 208 can be a healthy number. Thanks again.   

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    • mizzemm
      September 03, 2009
      mizzemm
      September 03, 2009

      Hi Lisa - I just had a physical today and got the breakdown of my cholesterol results: 209 total - HDL 93, LDL 101, which I guess means triglycerides were 15? He didn't point those out and I forgot to ask. I also got my bloodwork done again, since last time I had eaten and I was told that could produce false results. I'm still confused though. Assuming these are accurate results, should I be changing my diet in any way? I'm a vegetarian and eat a lot of cheese because I tend to use it as my only protein/ fat...I would be very sad if I had to cut back, as I am in love with cheese. But I don't want my levels to keep rising as I get older! My father is on medication for HBP and my mother's levels are high. However, I have a very different diet and lifestyle than they do. The doctor suggested cutting back on cheese, but also said that the slightly high LDL is essentially canceled out by the very high HDL...so do I have to beware of cheese or not?! Thanks for your help....

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    • RachMD
      January 02, 2011
      RachMD
      January 02, 2011

      Hi I just saw this, this is a little late, but quick correction: Total cholesterol = HDL + LDL + TG/5   ; so her cholesterol is actually 75 not 15.

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    • HH
      HH
      April 09, 2012
      HH
      HH
      April 09, 2012

      Lisa--I'm curious about the same thing but I have more information about my cholesterol than it appears Mizzemm does. My Total Cholesterol is 224, putting me in the "borderline high" category." But here's the kicker; my HDL is 96, so my TC/HDL Ratio is beyond good--it's VERY low. Triglycerides are below 45.  So, should I be worried?  I can't get a straight answer; my primary care doc doesn't seem worried but every other physician I've ever mentioned this to goes through the roof and tells me that at my age (62) I should consider going on medication to lower my cholesterol.  I'm normal weight (5'9"/155 lbs.), very physically active and have low RHR (52), BP of 118/68 and so on.  The idea of medication is simply abhorrent to me--but if it really is called for, I'd do it.

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    • Lisa Nelson, RD, LN
      April 09, 2012
      Lisa Nelson, RD, LN
      Health Pro
      April 09, 2012

      Hi HH,

       

      The following post addresses this issue:

       

      Can My HDL Be Too High?

       

      There are "good" and "bad" forms of HDL cholesterol, even though it's mostly considered to be good if HDL levels are high. However, if your HDL particle size is the unhealthy version then it may still be cause for concern. I recommend discussing a comprehensive lipid panel with your to look at your particle sizes and ensure the HDL particles are healthy.  This will also allow you to access the LDL particles as well. As long as all particles are healthy, then a total cholesterol of 224 would not be of great concern.

       

      All the best,

      Lisa Nelson RD

      How to Lower Cholesterol in 8 Simple Steps

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    • HH
      HH
      April 09, 2012
      HH
      HH
      April 09, 2012

      Thanks so much for the prompt reply.  I will go ahead and get the comprehensive panel, as you suggest. (Because I have a high deductible insurance policy, it's not going to matter whether my primary care physician recommends it or not, but I certainly will ask him!) I've been thinking about it for some time, and this is the push I needed. 

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    • Karenf
      July 16, 2013
      Karenf
      July 16, 2013

      I also found that the formula to calculate total cholesterol is:  

      Total cholesterol = HDL + LDL + Triglycerides/5

       

      my Cholesterol results this week correlate to this total cholesterol formula:

       

      TOTAL 274, HDL 132, LDL 122, TRIG 101

      132 + 122 + (101/5) = 274


      emphasis - formula includes 20% of your triglyceride count (mg/dL); not the full amount given with lab results.

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    • Karenf
      July 16, 2013
      Karenf
      July 16, 2013

      I also found that the formula to calculate total cholesterol is:  

      Total cholesterol = HDL + LDL + Triglycerides/5

       

      my Cholesterol results this week correlate to this total cholesterol formula:

       

      TOTAL 274, HDL 132, LDL 122, TRIG 101

      132 + 122 + (101/5) = 274


      emphasis - formula includes 20% of your triglyceride count (mg/dL); not the full amount given with lab results.

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FROM OUR COMMUNITY

  • veggiemak September 30, 2009
    veggiemak
    August 28, 2009

    I am a 32 yo vegetarian who also maintains a relatively healthy diet, exercise routine and weight. My cholesteral just came in at 202. I don't know the exact breakdown, but my Dr. said my bad cholesterol is "low" and my good cholesterol is "very high", so my total number is actually a good thing, although 202 sounds high overall.  I eat quite a lot of soy products, so I wonder if that is why my HDL levels are where they are.

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    • Karenf
      July 16, 2013
      Karenf
      July 16, 2013

      you may want to review this article from the MAYO clinic.  I found it helpful.

       

      http://www.mayoclinic.com/health/cholesterol-levels/CL00001

       

       

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  • Kaseydc April 23, 2012
    Kaseydc
    August 28, 2009

    A reading of a total cholesterol only gives you a small picture of what is going on.  You really need to know what your HDL and LDL are.  Triglycerides are NOT part of total cholesterol. That is incorrect.  Yes, a very high HDL can contribute to a high total cholesterol.  

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    • Pitcher23
      August 07, 2012
      Pitcher23
      August 07, 2012

      Triglycerides are most certainly part of total cholesterol. Your total cholesterol is HDL + LDL + 1/5 of total Tryglicerides.

       

      You can find a calculator here: http://www.hughchou.org/calc/chol.php

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