Medical Questions » Pathology Questions » Question No. 776
| Question: | I am a 50 year old male. My total cholesterol is 4.2, my HDL is 0.7 and my LDL is 3.0. I have encountered a difference of opinion between doctors as to whether this is a good level or a bad level, and one doctor has said that I cannot get Medicare benefits for a blood test at these levels. What do you think? |
| Answer: | There is considerable debate between doctors over just what the ideal level of cholesterol should be, and this debate is now even more controversial because the government has delineated a set of criteria that must be met before Medicare payments for cholesterol blood tests will be funded. There is also a very complex formula for deciding who is allowed subsidised treatment for high cholesterol levels under the Pharmaceutical Benefits Scheme.
The following criteria are mine personally, and do not necessarily reflect any official line.
A total cholesterol of under 5.5 is of no concern. A cholesterol between 5.5 and 7.0 is a grey area, and treatment would depend on the ratio of the two main types of cholesterol (high—HDL, and low—LDL), family history of heart disease and stroke, smoking, blood pressure and obesity. Over a level of 7.0, most patients should be treated.
The HDL (high density lipoproteins) are generally good for you, while the LDL (low density lipoproteins) are bad. HDL should be above 0.9 and LDL below 3.0.
On the total cholesterol criteria you do not require treatment, but your ratios are slightly unfavourable. Your doctors are right in saying that under present government criteria you cannot have a blood test for the ratios under Medicare, and the government will not subsidise any treatment.
I do not know your family history etc., but unless other factors are extremely bad, I do not believe that you require treatment at this time.
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