Family history a significant sign

Dear Dr. Gott: I like my primary care doctor, so I’m hoping to get some guidance from you on whether I should be asking for a second opinion. I am 46, female, with two cholesterol tests in a period of several months last year reading 254 and 282. My doctor seems to be reluctant to begin cholesterol-lowering medication until I hit 50. He says my risk factors remain low despite the high cholesterol, since I never smoked and am not significantly overweight. He also tells me it’s unlikely I can do much in terms of diet to lower my cholesterol more than a few points (I did not eat a high-fat diet to begin with).

My concern is that my father’s side of the family has a strong history of heart disease and high cholesterol. My grandfather and all of my father’s siblings died young of heart attacks. My father survived his because, as the youngest, he benefited from improved medical technology.

Do you think I should be treating the cholesterol problem now, or waiting?

Dear Reader: I believe you need cholesterol-lowering medications, coupled with a low-cholesterol diet and a program of regular physical activity.

First of all, your family history is significant. You may well have inherited the “wrong” genes.

Second, excess cholesterol is believed to be a factor in accelerating the build up of substances that cause coronary artery blockage; thus, by holding off treatment, you are placing yourself in a risky position.

I have middle-aged patients – with elevated cholesterol levels – who are not eager to take medication but are willing to try substitute therapy, such as niacin and/or omega-3 fish oil. Ask your doctor about this option.

To give you related information, I am sending you copies my Health Reports “Understanding Cholesterol” and “Coronary Artery Disease.” Other readers who would like copies should send a long, self-addressed, stamped envelope and $2 per report to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

Dear Dr. Gott: What part of an egg contains cholesterol? I eat eight whole hardboiled eggs a day because I’m a weightlifter and need the protein. Would I do better eating one whole egg a day, along with seven egg whites?

Dear Reader: Egg yolks are rich in cholesterol. Egg whites are a good source of protein. I believe that eating eight eggs a day is probably not appropriate; hence, I endorse your compromise of one whole egg and seven whites. Also, you could safely add more protein to your diet by consuming a daily protein drink such as Ensure or other similar products.