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Cholesterol Levels: My Numbers, My Worries, and What I’m Actually Doing About It

Valerie Teal
Apr 21
3 min read

My cholesterol levels aren’t “ideal.” At least, according to the “standards,” they aren’t. Even when I was younger, my numbers were always a touch high for my age. In my 60s, my total hovered around 200. I did get it down to about 180 after switching to oatmeal for breakfast, but then it crept back up to 201 last year… and recently spiked to 240.


My PCP wasn’t concerned about the 201 and didn’t even hint at statins, but 240 might be a different story. I’m getting retested in a couple of months, and if it’s not lower, we might be talking medication.


This seems to be a family thing — my mother had high cholesterol since they started measuring it, and my way‑more‑fit‑than‑me brother is already on a statin.


Statins can be incredibly useful drugs, but they also come with side effects, and I’d really like to stay off them as long as possible. So the question becomes: Should I consider them if my PCP suggests them? What cholesterol levels are actually concerning? Should I be worried?


Let’s dive in.


What the Guidelines Actually Say


According to the American Heart Association (AHA), decisions about statins aren’t supposed to be based on a single cholesterol measurement. Instead, they use a calculated 10‑year cardiovascular disease (CVD) risk score (found online here)  that includes:


  • age

  • sex

  • BMI

  • kidney function (eGFR)

  • diabetes status

  • blood pressure

  • cholesterol levels


They only recommend medication based on cholesterol levels alone when LDL is over 190. Lucky for me, I don’t fit that category. My 10‑year CVD risk is 4.4%, well below the 7.5% threshold where they start raising eyebrows.


So… good for me.


But this did get me wondering: Is there an ideal cholesterol level? Can it be too low? Does it matter as much as we think?


I couldn’t find any hard‑and‑fast answers. Most research focuses on LDL specifically. There’s general agreement that:


  • HDL (“good” cholesterol) should be >50, and higher is better

  • LDL (“bad” cholesterol) should be <100


My HDL is 68 (great), but my LDL is 143 (not great). This paper I looked at suggested that both very low and very high LDL levels are associated with higher CVD mortality. My level of ~140 was linked with higher CVD mortality but not higher cancer mortality.


So yes — my LDL is higher than I’d like.

 

📌 Science Note: LDL vs HDL  

  • HDL (“good”) ideally >50 — higher is better.

  • LDL (“bad”) ideally <100.

  • AHA uses a 10‑year CVD risk score, not a single number, to guide statin decisions.

  • LDL >190 is the only level where medication is recommended based on LDL alone.



What I’m Changing (and Why)


My PCP told me to wait a couple of months after the holidays and retest. I’m writing this on Ash Wednesday, at the beginning of Lent, when I’ve already committed to giving up cakes and cookies.


Exercise seems to have a modest if any effect on LDL, so I’m focusing on diet changes. I wanted specifics, not just the usual “eat fruits and vegetables” advice. I found a Swedish review paper by Schoeneck and Iggman that summarized which foods have actual evidence for lowering or raising LDL.



rom Schoeneck & Iggman: foods with demonstrated LDL‑raising or LDL‑lowering effects.
From Schoeneck & Iggman: foods with demonstrated LDL‑raising or LDL‑lowering effects.

How to Use This Chart

Foods at the top (red) tend to raise LDL. Foods in the middle are mostly neutral. Foods at the bottom (green) have evidence for lowering LDL. Bubble size represents the strength of the evidence. Distance up or down represents the magnitude of the effect.


Based on that, here’s what I’m doing.


What I Already Do

  • Old‑fashioned oatmeal for breakfast most days (trying to do more steel‑cut oats)

  • Green tea in the afternoon


Changes I’ve Made Recently

  • Switched from full‑fat dairy to low‑fat or fat‑free

  • Using Smart Balance instead of butter

  • Changed to filtered coffee (little filters for my reusable K‑cups)

  • No cookies/cakes/etc. during Lent (and hopefully beyond)

    • Post-Easter update – couldn’t keep this up did cut back though!


Things I’m Trying to Add

  • Olive oil instead of butter where possible

  • More beans and pulses (already‑cooked lentils added to salads = genius)

  • Making my bean salad again

  • Snacking on nuts more often

  • Figuring out Metamucil — tried it, didn’t like it, but the evidence is good so I’m working on it


What Happens Next

I’ll retest in a couple of months and see what happens. If my LDL comes down, great. If not, I’ll have a conversation with my PCP about next steps — including whether statins make sense for me. For now, I’m making thoughtful changes and giving my body the time it needs to respond.

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