Cholesterol Levels: Insights from Health Check Results

Health Check Report - Total Cholesterol 195, Triglycerides 22, Globulin 37?

Hello Dr.
Chen: I had a health check-up in May this year, and my total cholesterol was 195, triglycerides were 22, and globulin was 37.
Last year, my total cholesterol was 207, with both high-density lipoprotein (HDL) and low-density lipoprotein (LDL) being normal.
Triglycerides and globulin were also normal.
Since my body fat reached 29%, I started exercising on a treadmill five times a week for 40 minutes each session (running and walking alternately) and controlling my diet to around 1800 calories per day.
After a year of exercise, my body fat has decreased to 18%, but my health check results show that my total cholesterol has only dropped slightly and is still quite high.
Additionally, while my triglycerides and globulin were normal before, this time they showed elevated levels.
I am unsure if this is due to excessive exercise, insufficient dietary intake, lack of sleep leading to fatigue (as my sleep quality is poor), or if there is an underlying health issue, such as chronic hepatitis.

Ya Xi, 20~29 year old female. Ask Date: 2016/06/04

Dr. Chen Bozhang reply Family Medicine

Dear Ms.
Ahi,
You mentioned that after a year of dedicated exercise and dietary control, your health check results showed only a slight decrease in total cholesterol.
In fact, the more important indicators of cholesterol are high-density lipoprotein (HDL) and low-density lipoprotein (LDL), as their balance affects the risk of cardiovascular diseases.
You can calculate the ratio of "total cholesterol ÷ HDL"; if this value is less than five, it indicates a low risk, and the lower this number, the better.
This method of assessment is more meaningful than just looking at the absolute value of total cholesterol.
The most important way to improve cholesterol levels is through regular exercise.
In terms of diet, you can incorporate a moderate amount of nuts, as well as healthy fats like olive oil and fish oil, into your daily intake.
Genetic factors also significantly influence cholesterol levels; some individuals may diligently control their diet and exercise yet still present with high cholesterol, which could be related to genetic predisposition.
Your triglyceride level of 22 mg/dL is considered low.
It is recommended that you maintain a balanced diet, ensuring moderate intake of fats, primarily focusing on unsaturated fatty acids from sources like olive oil, sesame oil, and canola oil.
A small handful of nuts daily can help regulate your body’s lipid profile.
I suggest you visit a family medicine clinic in six months to monitor your cholesterol and triglyceride levels.
Lastly, your globulin level appears elevated (37 may be a typographical error; 3.7 g/dL seems more reasonable).
Elevated globulin may indicate heightened immune system activity, such as during a cold, inflammation, or certain liver diseases.
You may want to consult with a family medicine or gastroenterology specialist within 3 to 6 months for re-evaluation and assessment of potential causes.
I hope this information is helpful to you.
Sincerely,
Dr.
Chen Po-Chang
Department of Family Medicine
Keelung Hospital, Ministry of Health and Welfare

Reply Date: 2016/06/04

More Info

Understanding cholesterol levels and their implications for health is crucial, especially when faced with fluctuating results from health check-ups. Your recent health check revealed a total cholesterol level of 195 mg/dL, which is slightly elevated, especially considering your previous reading of 207 mg/dL. While your high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels were reported as normal, the changes in triglycerides and globulin levels warrant further discussion.

Firstly, it’s important to understand the components of your cholesterol profile. Total cholesterol is a sum of HDL, LDL, and very low-density lipoprotein (VLDL). HDL is often referred to as "good" cholesterol because it helps remove other forms of cholesterol from your bloodstream. Conversely, LDL is known as "bad" cholesterol, as high levels can lead to plaque buildup in arteries, increasing the risk of heart disease. Triglycerides are another type of fat found in the blood, and elevated levels can also contribute to cardiovascular risk.

Your triglyceride level has dropped significantly to 22 mg/dL, which is excellent, as normal levels are typically below 150 mg/dL. However, you mentioned that your globulin levels have turned abnormal. Globulin is a group of proteins in the blood that play various roles, including immune function and transporting hormones. Abnormal globulin levels can indicate several conditions, including liver disease, kidney disease, or chronic inflammatory conditions.

The fact that you have successfully reduced your body fat percentage from 29% to 18% through consistent exercise and dietary control is commendable. Regular aerobic exercise, such as using a treadmill, is beneficial for cardiovascular health and can help improve cholesterol levels. However, it’s essential to ensure that your exercise regimen is balanced and not overly strenuous, as excessive exercise without adequate recovery can lead to fatigue and other health issues.

Regarding your concerns about the potential causes of your abnormal results, several factors could be at play:
1. Dietary Intake: While you are controlling your caloric intake, it’s crucial to ensure that your diet is balanced and includes healthy fats, lean proteins, and a variety of fruits and vegetables. A diet too low in calories or lacking in essential nutrients can lead to metabolic changes that may affect cholesterol and protein levels.

2. Sleep Quality: Poor sleep can significantly impact overall health, including metabolic processes and hormone regulation. Chronic sleep deprivation can lead to increased stress hormones, which may negatively affect cholesterol levels and overall health.

3. Underlying Health Conditions: If there are concerns about liver function or other chronic conditions, it may be worthwhile to discuss further testing with your healthcare provider. Conditions such as chronic hepatitis or fatty liver disease can influence cholesterol and protein levels.

4. Exercise Intensity: While regular exercise is beneficial, overtraining can lead to fatigue and hormonal imbalances. It’s essential to listen to your body and allow for adequate recovery.

In conclusion, while your total cholesterol remains slightly elevated, the significant improvements in your triglycerides and body fat percentage are positive indicators of your health. However, the abnormal globulin levels and concerns about potential underlying conditions should be addressed with your healthcare provider. They may recommend further tests, such as liver function tests or additional blood work, to clarify the situation. Maintaining a balanced diet, ensuring adequate sleep, and managing exercise intensity will be crucial in your ongoing health journey. Regular follow-ups with your healthcare provider will help monitor these changes and guide you in making informed decisions about your health.

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