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Dear Dr. Roach, A 74-year-old woman has a total cholesterol level of 123 and is told that such a low cholesterol level greatly increases the risk of diabetes, stroke and cancer. It seems that she has low cholesterol for many years. What do you think is the optimal level of health? What would you recommend to increase its total cholesterol?
R.I.
When cholesterol issues come up, most people worry about a level too high. Coronary heart disease remains the leading cause of death in industrialized societies, and high levels of LDL and total cholesterol are risk factors for the development of cardiac artery obstructions that characterize this disease. High cholesterol is not the only risk factor: people can develop coronary heart disease with normal cholesterol and some people with high cholesterol never develop this type of heart disease. However, lowering cholesterol through diet and exercise, statins and, to a lesser extent, certain other medications reduces the risk of coronary heart disease in people at higher than average risk. It seems that the lower the cholesterol level, the lower the risk.
Most types of stroke have the same risk factors as coronary artery disease. Therefore, these treatments also reduce the risk of stroke.
However, there is a less common type of stroke, hemorrhagic stroke, which is somewhat increased in a person with low cholesterol. Nevertheless, the overall risk of attack is reduced by lowering cholesterol.
With the possible exception of liver cancer, there is no indication that high or low blood cholesterol is a major risk for cancer. There are conflicting studies and no consensus. What is clear is that people with cancer can develop low cholesterol levels because of cancer or nutritional problems badociated with cancer treatment. This can lead people to mistakenly attribute low cholesterol levels to cancer as a cause of cancer.
It is also clear that the increase in cholesterol should not be a goal. For a person who has had low cholesterol for a long time, there is probably nothing to do besides age-appropriate cancer screening, such as a mammogram, possibly a colonoscopy and a colonoscopy. taking lung cancer screening into account if she had smoked a lot.
Separating the causes and effects is very difficult in this case. I would always recommend a diet consisting mainly of plants, whole grains, nuts and oily fish if she likes it. If she is underweight, high quality nutrition becomes even more important, she should consult a dietician nutritionist.
Dear Dr. Roach, I am a 59 year old man. In the past four months, my erection has become abnormal. My penis, when erected, has a distinct curvature. What do you think it could happen? Am I facing permanent problems?
Anon
This is most likely Peyronie's disease, an abnormality of penile healing leading to curvature. It is more common than you think (three to nine percent of men are affected) and more common as men grow older.
Peyronie's disease can sometimes improve itself, but I would recommend that you see an urologist right away because medical treatment may be more effective if it is started quickly. Pentoxifylline, an oral medication, is the first usual treatment. If men are not doing better, many urologists use an injection of collagenase to treat this condition, often in combination with a traction device. Surgery can be used in men who do not respond to this treatment and who have significant problems with badual function.
Dr. Roach regretted that he could not reply to individual letters, but would incorporate them in the column whenever possible. Readers can send questions via email to [email protected].
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