LDL Cholesterol: 145mg/dL

What does an LDL level of 145 mean? Are there any symptoms associated with this level?

An LDL level of 145 mg/dL is considered elevated. An optimal LDL level is <100 mg/dL. Although cholesterol is involved in several important functions in the body, elevated LDL cholesterol may put you at greater risk for heart disease. 

Elevated LDL cholesterol doesn’t have symptoms, which is why it’s important to know your levels. Lowering your cholesterol will reduce your risk of developing heart disease and other health issues. If you already have heart disease, lowering your LDL can reduce your odds of serious complications, like a heart attack or stroke. 

Factors that could contribute to a level of 145: 

• Weight. Being overweight tends to increase cholesterol levels, including LDL cholesterol. 

• Diet: Diets that are high in saturated fats, trans fats, added sugar, and low in fiber can also cause LDL cholesterol to rise.

• Physical inactivity. A sedentary lifestyle can increase LDL (bad) cholesterol and lower HDL (good) cholesterol levels. 

• Smoking. Smoking lowers your HDL (good) cholesterol which can contribute to a higher level of LDL (bad) cholesterol.

• Medications: Some medications can increase cholesterol levels. These include corticosteroids, beta-blockers, thiazide diuretics, antivirals, retinoids, and growth hormones.

• Diseases: Certain diseases like chronic kidney disease, diabetes, and HIV/AIDS can elevate LDL and total cholesterol.

• Age and Sex: Before menopause, women tend to have lower LDL cholesterol levels than men of the same age. However, cholesterol levels tend to increase with age, in both sexes. After the age of menopause, women's LDL cholesterol levels tend to rise.

• Genetics (heredity): Your genes partly determine how much cholesterol your body makes, which is why high blood cholesterol can run in families.

• Race. Certain races may have an increased risk of high blood cholesterol. For example, Blacks/African Americans typically have higher HDL and LDL cholesterol levels than Caucasians.

What to do if your level is 145?

Making some basic diet and lifestyle changes can help reduce your LDL cholesterol level. Here are some things you can do to help lower your LDL:

• Eat plenty of fiber-rich foods including veggies, fruit, whole grains, and legumes, gradually increasing your fiber intake to 30-40 g/ day. 

• Reduce the refined carbs and added sugars in your diet. Avoid sugar-sweetened beverages and trade whole grains for white bread, pasta, and rice.  

• Eat small, fatty fish like salmon, sardines, and trout at least twice a week.

• Avoid trans fats (partially hydrogenated oils) and reduce your saturated fat intake to < 10% total calories. 

• Move your body every day. Aim to get 30-60 minutes of physical activity 5x/week. 

• Get 2 grams of plant sterols and stanols daily, from foods and a supplement. 

• Lose excess weight.

• Quit smoking.

• If you have diabetes, achieve and maintain good blood sugar control (HbA1c).

Medications and supplements used to improve results

Medications and supplements can help reduce your LDL if diet and lifestyle changes are not enough on their own.

Medications

Medications can be prescribed to help lower your LDL levels. Some common cholesterol medications include:

• Statins: Statins (including atorvastatin, simvastatin, and rosuvastatin) reduce cholesterol production in your liver. Because they typically need to be taken for life, statins are only prescribed if diet and lifestyle changes aren’t enough [3].

• Ezetimibe can be helpful for those with familial hypercholesterolemia and/or who have side effects with statins. 

• Bile acid sequestrants: These medications block cholesterol-rich bile acid from being absorbed into the bloodstream and can be prescribed in place of or in addition to a statin. 

• PCSK9 inhibitors: This medicine is injected under your skin every 2 or 4 weeks. If you are at high risk of heart attack or stroke or have familial hypercholesterolemia, it may be prescribed along with a statin 

• Lomitapide: Typically prescribed if you have familial hypercholesterolemia. Lomitapide requires liver enzyme monitoring as it can cause liver damage and is commonly taken with vitamin E.

Supplements

• Plant sterols and stanols: Plant sterols and stanols (also called phytosterols) block dietary cholesterol from being absorbed since they are similar in structure. Found in plant cell membranes, Phytosterols can be consumed in small quantities from vegetable oils, nuts, legumes, whole grains, fruits, and vegetables, however, the average daily intake (500 mg)  is typically not enough to lower cholesterol. Studies show consuming 2000 mg (2 g) of plant sterol and stanols daily from diet and/or supplements to be most effective [4]. Plant sterol and stanol supplements are taken before or with meals can help lower total cholesterol in parallel with other recommended diet and lifestyle changes [4]. 

• Beta-glucan: Beta-glucan is a form of soluble fiber that has been shown to help lower cholesterol levels. It’s found naturally in whole grains like barley, oats, rye, and wheat, mushrooms, and seaweed, and is also available as a nutritional supplement. For cholesterol-lowering benefits, consume 3-7 g/day from your diet and/or a supplement.

• Psyllium: Another type of soluble fiber made from the husk of psyllium seeds, psyllium is good for digestive health and regularity, and can also be helpful in lowering cholesterol. Psyllium supplements are sold in powder form and can help reduce lipid levels when taken daily at a dose of 8-12g/day. 

• Alpha-lipoic acid: A potent antioxidant made in the body, alpha lipoic acid is also found in foods including carrots, beets, spinach, broccoli, potatoes, and red meat. Research indicates that 600 mg/day of alpha-lipoic acid from your diet and/or a supplement may help lower total cholesterol and LDL (bad) cholesterol [8]. 

• Bergamot extract: Bergamot is a citrus fruit that has long been used for medicinal purposes. Taking bergamot extract (made from the juice of the fruit) seems to lower cholesterol and triglyceride levels in adults with high cholesterol [9,10]. One study suggests taking bergamot extract daily for a month may be as effective as taking a low dose of the cholesterol-lowering drug called rosuvastatin (Crestor) [10]. A recent research review indicates that 1000 mg/day may be most effective for lowering cholesterol. 

• Green tea extract: Green tea extract is made from the leaves of the Camellia Sinensis plant and has been shown to help lower LDL (bad) and total cholesterol [11]. Taking 400 mg daily may help lower your cholesterol. Since it can interact with certain medications, including beta-blockers and blood thinners, it's best to check with your doctor before taking green tea extract In addition, green tea extract may also have a stimulant effect.

• Berberine: A compound extracted from certain medicinal herbs, some studies suggest berberine can reduce LDL (bad) cholesterol and triglycerides in type 2 diabetics, as well as slightly increase HDL (good) cholesterol [12]. A standard dose of berberine is 900-2000 mg/day (divided into 3-4 doses), taken with or just after a meal.