The ins and outs of cholesterol, and 7 rules I’ve followed to improve my numbers this year, without statins.
Let’s talk cholesterol, shall we?
Summertime is my rest and recovery time. I spend more time doing my Geriatric Gymnastics shenanigans. It is also my time to visit my doctors and check in on my health data. I see my endocrinologist every year since my thyroid was removed in my 20s to manage my medication.
Part of that is checking my thyroid levels with a blood test. Since they’re drawing blood anyway, I take advantage of the moment. I ask the doc to check off every single box that can reasonably be checked. I really want to know the details of how my daily habits are affecting me on the inside.
For the most part, my numbers are usually good: glucose, minerals, vitamins, even iron is in the low normal range. I have been turned away from donating blood due to low hemoglobin levels, so when I see that number on the low end of normal, I tend to do a little happy dance. I’m weird, I know.
The result I am most concerned about is the lipid panel: what is happening with my cholesterol?
Perimenopause is not our friend when it comes to how we metabolize the foods we eat. My nutritionist has taught me to eat in a way that helps lower cholesterol in this challenging time in life. The threat of weight gain and insulin resistance are also big factors in this massive, mid-life puzzle.
I have written about some of the docs that are bringing more awareness and advocacy for women in their transition. Read Empowering GenX Women: Navigating Perimenopause with Expert Guidance for more on that.
Of course, knowing the basics about cholesterol helps us to understand why we need to manage it.
What is cholesterol?
The American Heart Association gives a great breakdown of the good, bad and the ugly of cholesterol and it’s components. I thought I’d summarize some important facts we all need to know:
- Cholesterol is a waxy substance that circulates in the blood and helps to make new cells, vitamins, and hormones.
- The liver makes all the cholesterol we need, but we also get it from animal foods. Saturated fats introduce more cholesterol into the body, which can cause an increase in our body’s natural levels.
- Too much cholesterol leads to cardiovascular diseases. It builds up and creates hard deposits on the inside of the blood vessels, making them less flexible. This makes it harder for the blood to circulate properly, leading to high blood pressure, heart attacks and strokes.
There are two types of cholesterol:
- HDL (High Density Lipoprotein): This is the good stuff that you actually want to be higher. It helps to carry the bad stuff away from your arteries and send it back to the liver for processing.
- LDL (Low Density Lipoprotein): This is the bad stuff that sticks to the walls of your arteries. It creates big problems so you want this number as low as possible.
Triglycerides aren’t technically cholesterol, but they are important to manage. These are the fats responsible for storing excess energy in your diet. High triglycerides, high LDL and low HDL levels are linked to fatty deposits building up in your arteries. We know the devastation that can bring in our lives.
Your total cholesterol is comprised of your HDL, LDL and 20% of your triglyceride level.
Being a health-conscious person, I get a little stressed when it’s time to look at the numbers. But, the numbers don’t lie. So here goes…
Comparing my cholesterol numbers
In 2023, my total cholesterol was 216. That’s high by the standard range given on the lab results (see the chart below). Seeing the number that high freaks me out, since I work to do everything “right”. I am very active and I try to prioritize foods that support the best health outcomes. With waning estrogen, I am now very concerned that the cholesterol and weight gain situation is a very slippery slope.
To be fair, my HDL (the good stuff) was actually nice and high. Unfortunately, my LDL (the bad stuff) was way too high. I was not happy about that result, and was determined to make improvements over the course of the year.
A change for the better
The table below shows my numbers from last year and this year. There was a significant improvement, which my nutritionist was ecstatic to see: People would pay for such good numbers! My endocrinologist was also pretty impressed; his eyes opened wide when he saw the results on the screen. He asked if I’m on cholesterol meds. I proudly said no. He’s used to treating really sick people; apparently he looks forward to our yearly “healthy” visits.
| Test (mg/dL) | August 2023 | August 2024 |
| Total Cholesterol (0-200) | 216 (high) | 188 |
| Triglycerides (0-199) | 111 | 142 |
| HDL (35-100) | 63 | 62 |
| LDL (40-130) | 130.8 (high) | 97.6 |
| VLDL (0-38) | 22 | 28 |
| Chol/HDL (0-4.5) | 3.4 | 3.0 |
Yes, the triglycerides increased but still well within the normal range. More notably, the LDL decreased by 25%! That’s good reason for a happy dance 💃🏻.
I was honestly shocked to see such a massive improvement. Cholesterol is something that is so hard to change without medication in mid-life. But, I have been really diligent and mindful about tweaking my everyday choices, one thing at a time. Practicing healthy habits really does work.
Okay, so I improved her numbers. How did that happen?
How I improved my cholesterol numbers
Let me start by saying that improving your health is never about just one thing. It is about mindfully managing every choice and behavior every moment of every day. That sounds like a lot, I know. But, once a good habit is established, you don’t have to think as hard to follow it. You just do it.
My happy place is in living an active lifestyle and eating to support that. I don’t smoke and my alcohol consumption is limited (most of the time). I like eating the foods that are “good for you,” and minimize exposure to the “bad for you” foods. I value rest and sleep as much as my body will allow (remember, perimenopause is tricky). Some think of my life choices as boring, but I beg to disagree.
I am also not a robot. I love delicious food and dessert, a generous libation, and a cup or two of coffee. When I decide to enjoy a “vice” it is a mindful choice. Otherwise, in my every day habits, I pick foods that support my body’s needs. Sometimes, being a couch potato is more desirable than moving around. But, at 52, I can do a roundoff back handspring. I can run up the stairs. I can lift heavy things on my own. I am also working on getting a pull-up.
I’ll break it down a little more specifically.
Everyday “rules” I have chosen to follow
These are seven rules that I follow that have contributed to improving my health, inside and out.
RULE 1: Prioritize protein and fiber
I try to get these in as often as possible. My protein goal is 1 gram/lb of ideal body weight. For fiber, I try for 25-30 grams per day. I don’t always attain those goals, but I have increased my daily intake since I’ve been making them a priority.
RULE 2: Aim for 4 fat grams per serving
I follow this as a general rule when I’m looking for every day foods. That way, I can afford to enjoy something a little more indulgent once in a while. It tastes better when you partake an occasional decadent treat, like my husband’s chocolate cake or chocolate chip cookies. I don’t think twice about it when it’s there for Sunday family dinner.
RULE 3: Drink a ton of water
Hydration is really crucial to keep all the body systems working properly. My bladder is the size of a hummingbird’s, so I just take extra bathroom trips. When your pee is clear, you know you are hydrated.
RULE 4: Supplement
I do take some vitamin and minerals to cover what I am not getting enough of from food. My go-to list: a multivitamin, vitamin D (no one gets enough of that), magnesium, fish oil, and B complex. I also started using creatine monohydrate in my morning protein shake to help with energy availability and muscle building.
RULE 5: Sleep
This is the toughest one to get enough of at my age. I go up to bed around 10:30 p.m. just to keep my circadian rhythm in proper form. Seven hours is my goal, but it doesn’t always happen when I’m working.
RULE 6: Move and lift heavy things
Many studies show that aerobic and resistance training have a great effect on improving cholesterol numbers. They raise HDL and lower both LDL and triglycerides. I train at the gym to flip three times a week. I hike or walk fast for a couple of miles at least once a week. I am not afraid of lifting the heavy dog food bag or overfull laundry basket. I’m working on improving my muscular strength whenever I can. Wherever I can add movement to my day, I do.
RULE 7: A bit of HRT
I consider Dr. Mary Claire Haver’s book The New Menopause the gold standard of menopausal health. I read it cover to cover and I decided to advocate for myself. Since I have been feeling the creep of some perimenopausal symptoms, I started on a little estrogen replacement in June. So far, I’m noticing small improvements (like my cholesterol numbers). Since I’m feeling pretty good, I’ll stay the course.
The bottom line
Taking care of our health, especially in mid-life, is not simple. It can certainly be frustrating as we adjust to a fluctuating “new normal.” The rules I follow are a reflection of the habits I’ve developed based on the research. People much smarter than me have spent their lives studying what works and what doesn’t. Spend my time and effort doing what works enables me to live the life I want. Hopefully, for a very long time.
Here’s the thing we have to remember:
- We empower ourselves every single day by upgrading the choices we make.
- Sometimes, we have to give ourselves some grace when we fall to a vice. We are all doing our best.
Combining those two thoughts, we can develop sustainable habits that can absolutely lead to improved health.
SOURCES
Cholesterol. American Heart Association, 2024
HDL cholesterol: How to boost your ‘good’ cholesterol. May Clinic, 2024
The New Menopause. Dr. Mary Claire Haver, 2024
Stacey's Headspace 
Very informative.
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