DR ELLIE CANNON: Just what is a healthy level of cholesterol?

DR ELLIE CANNON: Just what is a healthy level of cholesterol these days?

I read in The Mail on Sunday that having very high HDL cholesterol is a worry, especially for middle-aged women like me.

My total cholesterol is 5.3 – and I have an HDL of 2.3. The ratio calculator online tells me this is healthy, but now I read that 2.3 is very high.

Also, could my high HDL be the reason for having a lipoma, and should I have it removed?

Our understanding about cholesterol has evolved over the past 20 years. Once, we were just concerned with total cholesterol, but now we are focused much more on sub-types of cholesterol, and how they contribute to increased risk of a heart attack.

Risk is a nuanced thing and many factors are at play – blood pressure, whether you’re overweight or smoke, your age and family history, as well as other illnesses you may suffer from, all contribute. Cholesterol isn’t the be-all-and-end-all but if you do have high overall cholesterol, and also raised levels of a sub-type called LDL cholesterol, sometimes called ‘bad’ cholesterol, you might be advised to take statins, which will lower it. HDL cholesterol was once thought to protect the heart, which is why it’s often called ‘good cholesterol’. And although it still does, it seems very high levels, above 1.4, are associated with a raised heart-attack risk.

Our understanding about cholesterol has evolved over the past 20 years. Once, we were just concerned with total cholesterol, but now we are focused much more on sub-types of cholesterol, and how they contribute to increased risk of a heart attack

This is based on new research and it’s not fully understood, but it is worth talking to your GP, showing them the article you mention. They might want to recalculate your risk, based on the new evidence.

Medication can’t lower HDL but there may be other steps worth taking, such as statins to lower LDL, tackling blood pressure, and lifestyle changes.

A lipoma is a benign, soft lump on the skin composed of fat – and this is unrelated to cholesterol. They are usually harmless, so doctors do not advise removing them unless they are unsightly or causing pain.

Life has left me utterly miserable. My GP suggested antidepressants but I don’t want to take them. Can you help?

It is not surprising that any of us would be feeling miserable right now. Not only has day-to-day life changed immeasurably, but the immense trauma, loss and uncertainty we have experienced nationally and individually since the start of the pandemic has, understandably, left huge emotional toll.

More from Dr Ellie Cannon for The Mail on Sunday…

Doctors are increasingly concerned about rising numbers of patients with symptoms of anxiety and depression – and those who actually make it as far as calling a doctor are probably just the tip of the iceberg.

It is vital that anyone feeling persistently low gets a proper assessment, so a diagnosis can be made. Depression is different to sadness or misery, and involves symptoms of mood or sadness but also changes in appetite, sleep, and thoughts. These things have an impact on daily life, work and relationships.

A GP can carry out initial consultation via video calls or phone.

Or you can cut out the middle man and refer yourself directly to a specialist in your area who offers psychological therapies.

If you search online for ‘IAPT services’ – IAPT stands for improving access to psychological therapies – the top hit should be the nhs.uk web page that allows you to refer.

Mental health treatment can involve medicine, but also psychotherapy and lifestyle changes. If medicine is not a choice for you, look at the two other options.

Free, NHS online therapy sessions for many areas of the country are available via iesohealth.com.

Doctors are increasingly concerned about rising numbers of patients with symptoms of anxiety and depression

There are some incredibly helpful mental health apps that I routinely recommend to patients. These are available to look at on the NHS apps library and are targeted to specific issues – for example Big White Wall for stress and anxiety, or Silvercloud which is an eight-week course for depression. Lifestyle measures sound simple but shouldn’t be underestimated. Walking daily, pushing yourself to exercise or finding a hobby, yoga or just conversations with a friend can have a tremendous impact on mood and feelings, even when the mental health problem is quite significant.

I am 76, and relatively fit, and until February was going to the gym up to three times a week. But then my hip starting hurting. A lot. An X-ray showed nothing wrong. What could it be?

Anyone aged over 76 will have some arthritis in the hips and knees, which may or may not show up on an X-ray. Other common hip pain comes from bursitis which is swelling from the fluid around the hip – known as trochanteric bursitis.

Your GP can arrange access to physiotherapy which is helpful for bursitis and can be sought at the moment remotely. Bursitis of the hip can be part of greater trochanteric pain syndrome, when the top of the thigh bone becomes irritated.

Avoid sitting cross-legged and do not sleep on the affected side, and it might improve matters.

I told Boris Johnson to be a mask model… now he is

I was on the news again last week talking about my favourite subject, masks – and the fact that leading politicians, despite telling us we should wear them, seem not to want to practise what they preach. 

Boris Johnson, Matt Hancock and Rishi Sunak had all been seen over the past fortnight out and about meeting the public, sometimes in close contact, not once wearing a mask. It wasn’t a good look, I argued. They need to be role models, as mask-wearing is a huge culture change for us Britons. Well, it seemed Boris was listening as on Friday he appeared, right, for the first time wearing a face covering. I hope the Cabinet follow his lead.

In other news, people have been asking where I get my cloth face coverings. They’re from the charity Binti, at bintiperiod.org. I might buy one for Boris.

Boris Johnson, Matt Hancock and Rishi Sunak had all been seen over the past fortnight out and about meeting the public, sometimes in close contact, not once wearing a mask. It wasn’t a good look, I argued, but now the PM has a been spotted with a mask

Has that mole changed? Get it checked now

I’ve been asked whether skin clinics are closed, by people worried about changes to a mole and have stressed that they should make a GP appointment without delay.

We are working differently, but are very much open, as are dermatology units. Most GP appointments will start on the phone and then, for a skin problem, we will either want to see photos or use a video consultation. If your GP is concerned, you can be referred. Many dermatology clinics are open for face- to-face appointments but it may be possible to have a more than adequate consultation remotely.

Signs of melanoma skin cancer include changes in shape, size or texture of a mole. One that looks very different to others around it can be a concern.

You are also more at risk over the age of 65, if you have fair skin and freckles, or if you have a member of your family with melanoma.

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