Cholesterol ( How do Spanish doctors read results?)
 

Went to get my blood test yesterday and my Total Cholesterol was 215mg/DL ( 5.56 in UK). My doctor said everything was fine and he wasn't worried about it as it was less than it was 5 years ago ( 226). And that was it!. But when I got home I noticed that he hadn't said anything about my LDL which was 134 and that seems to be the number you are meant to look at ( according to various articles online over 100 is bad) ). However when I looked back at my previous results I see that 3 different doctors have all done the same and simply underline the TC result and appear to ignore everything else. Is this a Spanish thing? Should I go back to my doctor and come across as hypochondriac/ internet health slueth? Or just trust he and his colleagues are doing what is common in Spain?

Re: Cholesterol ( How do Spanish doctors read results?)
 

I've been taking a statin since 2015. I had never had high cholesterol in my life, was never overweight and did a lot of exercise. Before that, since I came to Spain in 2006 I had had regular checkups with a gynaecologist via my private health insurance, and she ordered blood tests for me every year. Post menopause I noticed that my cholesterol levels had started to climb steadily, for no apparent reason. She never mentioned it at my checkups but after a couple of years I asked her if I should be concerned about it and she said no. But in 2015 I went to see a cardiologist for a routine checkup (or so I thought, only went because the health insurance offered one and I thought I might as well get something for the money). The cardiologist discovered that much to my shock I had a faulty mitral valve, already at the moderate/severe stage so obviously something I had had for a long time but been totally unaware of. He looked at my blood test results (can't remember the numbers, it is too long ago) and did prescribe a statin for me. I expressed some reluctance to take it as I'd read so much stuff about side effects from statins especially debilitating joint and muscle pain, and that they raised the risk of Type 2 diabetes of which I have some family history. He put me on pitavastatin which he said had a lower risk of these side effects than the most common types, although it was quite a bit more expensive when I was paying for private prescriptions, around €28 per month when the most common ones were very cheap. But it did the job, within 6 months my cholesterol levels had dropped by over 30% and I have never had any side effects from it, nor have I developed Type 2 diabetes. So I would take from that that cardiologists may have a different approach from GPs.

However, at some time during the second year after I eventually had surgery to repair my mitral valve (they just monitored it for 3.5 years after diagnosis) I had a "silent" heart attack, nobody knows exactly when as I had no symptoms and it was only discovered at a routine cardiology check. The funny thing was that I had cardiac catheterisation the day before my surgery (they check to see if any stents are required so that if necessary they can be done at the same time) and they said my coronary arteries were in very good shape. I had a MRI and a nuclear medicine scan of my heart after the heart attack and consequent damage to the heart muscle had been detected and they didn't find anything wrong with my coronary arteries either. So taking the statin didn't prevent that, because it appears high cholesterol wasn't the cause!

Re: Cholesterol ( How do Spanish doctors read results?)
 

Thanks for that. I know there is a growing level of scepticism about the connection between high cholesterol and heart disease and some people are pointing out it has been a long time since any large scale studies have been conducted. Anyway clearly the Statins haven't caused you any illness so I guess there was no harm in taking them - although if you say that tests showed your arteries showed no sign of damage ( as is meant to happen with high cholesterol) them it seems they were not necessary and did little to prevent you suffering a small heart attack. Glad you are ok now

Re: Cholesterol ( How do Spanish doctors read results?)
 

There is now a new anti-cholesterol drug available which specifically lowers LDL by 50% or more. Its called Inclisiran and is an injection. I am now on it as Statins were not effective enough.

Re: Cholesterol ( How do Spanish doctors read results?)
 

That sounds good but I need to get my doctor to recognize I might need meds first.

Re: Cholesterol ( How do Spanish doctors read results?)
 

Lets get real, GP are just generic jack-of-all-trade medical personel. They know a bit of everything but nothing in detail.
If you are not happy with GP, change it, you are not married to it.

If you have specific concerns about your health, not just some generic unspecified feeling, go and see specialist.
You get what you pay for.

Re: Cholesterol ( How do Spanish doctors read results?)
 

Yes, Fred, my neighbour was talking about those the other day as the local doctor had been explaining the new drugs which will replace statins to her - could be a game changer?

Re: Cholesterol ( How do Spanish doctors read results?)
 

It might be, but at the moment they are too expensive for general use.

Re: Cholesterol ( How do Spanish doctors read results?)
 

Okay. I have just looked at my previous tests and can see that on my recent one there appears to be an error as it says the normal LDL level should be 45 mg/dl- 55mg/dl. On the previous ones it says 45- 155g/dl. So my 134 is acceptable. I also notice that Spain has a different range of tolerances compared to UK so that is why my doctor said all is basically ok. Clearly there is a lot of differing views on cholesterol and heart disease especially between countries.

Re: Cholesterol ( How do Spanish doctors read results?)
 

So it's not like a one-off or a 'once every x months' solution?

I know my mom uses Crestor which is available in Spain so when she visits she tends to pick up several boxes as it's cheaper here.

Re: Cholesterol ( How do Spanish doctors read results?)
 

Inclisiran dosage is 1 jab on day 1, 1 jab after 3 month and the another at 6 months and every 6 months thereafter. Current price approx €4000 a shot.

Re: Cholesterol ( How do Spanish doctors read results?)
 

I looked up my old reports out of curiosity (there are reams of them!). When I first had a blood test here, in 2009, my total cholesterol was 192 (ref. level up to 200), HDL was 68 (ref. level >68) and LDL 107 (ref. level <150). By 2015, when the cardiologist first prescribed the statin, they had gone up to total cholesterol 250 (ref. level 150-220), HDL 70 (ref. level up to 150) and LDL 158 (ref. level 150). All for no apparent reason and the cardiologist agreed that there were no lifestyle measures I could take to reduce it, apart from what I was already doing and it was still rising. Now, after taking the statin my levels are total cholesterol 164 (ref. level up to 200), HDL 69 (ref. level 45-90) and LDL 78 (ref. level 60-160). There is also a measurement called colesterol no HDL which is shown as 95 and the SCORE according to European guidelines gives anything below 145 as low risk.

Re: Cholesterol ( How do Spanish doctors read results?)
 

That's good to see. Mine is a bit lower than yours was when you were prescribed. TC 216 HDL 66 LDL 134. However according to the new guidelines in Spain ( on my forms ) my TC should be 200 ( that has changed from last time when in 2020 it was 220. So I guess I am just on the border and you were just over it- hence why they put you on statins but I imagine as you had already be diagnosed with a slight heart issue they probably thought statins were a good idea. And it certainly suggests that if your arteries were fine when they did a more detailed check the connection between cholesterol and cardio issues aren't always connected. Anyway appreciate you going to the effort to look up everything and post it. Big thanks
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