Cholesterol Tests Keep Multiplying

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DEAR DR. DONOHUE: My husband had blood work for a cholesterol study. It included something called lipoprotein (a), something we never heard of. It was over the normal value. I called my doctor, but he was on vacation, so I left word for the covering doctor. A phone call came from his secretary, who said: “He didn’t say anything, so I guess it’s OK.” I want answers. Will you explain this to me? — F.

ANSWER: Lipoprotein (a), spoken as “lipoprotein little a,” is another cholesterol fraction that is an independent risk for artery clogging and heart attacks. It’s different from LDL cholesterol (bad cholesterol) and HDL cholesterol (good cholesterol).

Frankly, at the present, doctors find it hard to counsel patients about lipoprotein (a), so most don’t order it.

Now emphasis is placed on lowering LDL cholesterol (your husband’s value is very good) and raising HDL cholesterol (again your husband’s was very good). I will trade places with him if he wishes, and I’ll take his lipoprotein (a) reading to boot.

I can tell you what lowers lipoprotein (a). Niacin does. There is no proof, however, that lowering it lowers the risk of a heart attack. Daily exercise of 30 minutes also brings it down, if the doctor approves of exercise for a person. As does losing weight if that applies. A low-fat diet high in vegetables, fruits and grains is another way of reducing lipoprotein (a). From his other cholesterol values, I’d say he must be doing some of this anyway. All of this, except for niacin, is the much-preached recipe for heart health regardless of lipoprotein (a).

Until told otherwise, put lipoprotein (a) on a back burner.

The booklet on cholesterol explains this topic that is talked about to excess. Readers can obtain a copy by writing: Dr. Donohue — No. 201W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: None of my 21 grandchildren has had their tonsils out. All of my seven children did. Is this no longer done? I wish doctors would make up their minds about these things. — B.B.

ANSWER: When your children were young, it was almost standard practice to remove tonsils as a way to protect against strep throat. We now know this isn’t necessary, and we now have antibiotics to treat strep throat.

Children who have repeated strep throat infections still have their tonsils removed, but the operation is no longer done for prevention.

DEAR DR. DONOHUE: I work out at home on an exercise bike and a treadmill. On days my knees are bothering me, I don’t do either. One doctor suggests that I cease the exercise bike but use the treadmill. The other says just the opposite. They both can’t be right. Who is? — R.G.

ANSWER: You can answer this one for yourself. Which hurts your knees? I find that bike pedaling is harder on my knees. Others find running a bigger source of pain.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

© 2009 North America Synd., Inc.

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