Cholesterol: How low should it go?
DEAR DR. DONOHUE: Please inform me if my cholesterol is too low at 106 mg/dL (2.7 mmol/L). Everything else is normal. I am taking cholesterol-lowering medicine, and I have lost weight and am exercising. Should I stay on the medication or what? — L.B.
ANSWER: For most of us, a total cholesterol reading of 200 mg/dL (5.2 mmol/L) is the goal. Your reading is very low. Digestive-tract illnesses that interfere with food absorption, an overactive thyroid gland and a familial trait are some of the things that lower cholesterol. Some cancers do it, too. You have no signs of those illnesses, and they are not likely explanations for your value. Your medicine, diet and exercise lowered it. Most likely, the low cholesterol reading isn’t a sign of trouble.
The next hurdle to jump over is the significance of very low LDL cholesterol, bad cholesterol. An LDL reading of less than 100 (2.6) is a suggested goal for most. For those with serious heart disease, a value of 70 (1.8) or slightly lower is desirable. Recent publications have suggested that a very low LDL might be associated with a higher risk for coming down with cancer. Out of 1,000 people with a very low LDL, there was one more unexpected case of cancer than in the control group. This isn’t proof of cause and effect. It requires further investigation. You didn’t say what your LDL cholesterol was but with your total cholesterol so low, the LDL cholesterol also must be quite low. You need to talk to your doctor. I am pretty sure the doctor will suggest a vacation from your cholesterol medicine.
Cholesterol is a national obsession. The booklet on it explains all its variations. To order a copy, write: Dr. Donohue — No. 201, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Allow four weeks for delivery.
DEAR DR. DONOHUE: Four years ago, I had extensive blood clots in the veins of both legs. They are still swollen, and the skin is dark looking. Doctors say there is nothing that they can do. They say the valves in my veins are harmed. I would appreciate anything you can tell me about this. — C.W.
ANSWER: You have postphlebetic (post-flea-BET-ik) syndrome, a common aftermath of leg vein clots. The vein clots stretched your veins out of shape. Their valves have become ineffective. Let me explain. It’s a major engineering feat to return blood from the legs to the heart. It’s effectively done because of vein valves. As blood trickles upward in the veins, valves close to prevent it from flowing back down. Without working valves, blood does flow back down. The legs swell because the fluid part of blood oozes into the leg tissues. The swelling disrupts circulation to the legs’ skin. It becomes mottled and can develop sores. Nothing can restore the valves. You can help matters by elevating your legs as often as you can during the day. To be effective, elevation means lying on your back with pillows propping your legs up. Compression stockings help. The best are the kind whose greatest compression is in the feet and ankles, with less compression at their tops.
DEAR DR. DONOHUE: How could you? With all the inflammatory diseases, cancers, cardiac disease, arteriosclerosis, high blood pressure and diabetes killing off the oversized American public, and with all the impurities, bacteria, viruses, carcinogens, antibiotics and hormones in farmed meats and all the hydrogenated oils and high-fructose corn syrup in packaged food, how could you advise people that they get enough protein in meat and dairy products? Your misinformation is a disservice to the public. Beans are the best protein sources. Go vegan. — D.S.
ANSWER: It is a delight and a rare privilege to hear from an expert in nutrition and the American diet. If you choose to eschew meat, that’s your right. Meat and dairy are the best sources of protein. One chicken breast has 25 to 30 grams; 3 ounces of tuna has about 20 grams; one glass of milk, 7.5 grams. You can get all your protein from plants if you wish. One cup of baked beans has 14 grams; half a cup of kidney beans, 6 grams; a cup of lima beans, 14.7 grams. You do your thing. Let others do theirs. Dietary zealotry is annoying.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.