Questions to ask your GP about cholesterol

I recently had my cholesterol checked as part of the occupation health programme run at work. It was 6.5 but I hadn’t fasted before the test.

I was advised to see my GP. I am a woman in my 40s and both my mother and older sister take medication for their high cholesterol. What questions should I ask my GP?

>>It is important that you have a fasting cholesterol test to confirm your result. Early morning is best as you will need to fast for at least 12 hours.

As there is a family history of high cholesterol it is important for your GP to be aware of this and also of any history of heart disease.

Cholesterol is a fatty substance that is made by a number of cells in your body with the liver making about a quarter of the total. It is carried around the body by proteins in your blood.

There are two main types of cholesterol:

*Low-density lipoprotein (LDL) — carries cholesterol from your liver to other cells and is known as ‘bad cholesterol’ because it sticks to the walls in your arteries making it narrow.

* High-density lipoprotein (HDL) — carries cholesterol from the cells back to the liver where it is broken down and is known as ‘good cholesterol’.

Cholesterol builds up in the artery and restricts the flow of blood.

There are a number of reasons for high cholesterol and making lifestyle changes can be beneficial. Some general suggestions to consider are:

* An unhealthy diet. Reduce the amount of saturated fat by eating lean meat and reduce the amount of meat products such as sausages and ready-made meat pies.

* Choose low-fat dairy products, low-fat spreads and use healthy ways of cooking, such as grilling or oven-baking instead of frying.

* Reduce the amount of salt in your diet.

* Keep weight under control.

* If you are a smoker, stop.

* Reduce alcohol.

* Take regular exercise.

Once your GP has the result from the fasting test, he will be able to advise on the most appropriate management.

* As a young girl I suffered every winter with chilblains on my toes. I am now 45 years old and over the last few weeks have suddenly developed chilblains again. Is there a way to avoid getting them?

>>I am sure you must have found this recurrence very uncomfortable. Chilblains are a reaction to cold temperatures and high humidity (damp cold) and usually affect the extremities especially the toes and fingers of thin women more than men. They tend to develop 12 to 24 hours after exposure and cause a burning and itching sensation and swelling lasting one to two weeks. This tends to get worse when you go into warmer temperatures.

Chilblains occur when the blood vessels near the surface of the skin narrow when the skin gets cold. If the skin then gets warm when you go indoors the vessels widen. Sometimes this happens too quickly and blood can leak into the surrounding tissue and it is thought that this is what causes the change in sensation.

Try to prevent chilblains by following the below suggestions:

* Avoid wearing tight-fitting boots and shoes.

* Wear several layers of loose clothes to avoid heat loss.

* Keep your hands and feet warm by wearing thermal socks, insulated gloves, hat and scarf when outdoors.

* If your shoes get wet dry them thoroughly before wearing them again.

* Keep active.

* If you smoke, stop.

* Take care of your feet, moisturise frequently and visit a chiropodist / podiatrist regularly.

If your skin does get cold warm up slowly don’t sit by the fire or use a hot water bottle. Warm your hands by placing them under warm running water and gently massage your toes and fingers. Chilblains will usually go away without any treatment. However, if you have them on a number of occasions make an appointment with your GP, who can advise how best to manage any recurrences.

Dr Bernadette Carr is Medical Director, Vhi Healthcare For more information visit www.vhi.ie or lo-call 1890 444 444

If you have a question about your health email it to [e-mail]][e-mail] or send a letter to: Feelgood, Irish Examiner, Linn Dubh, Assumption Road, Blackpool, Cork.