Bonkers GP appointment

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My GP told me that changing my diet wouldn’t really affect mt cholesterol levels.

Reported

This week we’re having salad before every meal except breakfast.
I’m not convinced that eating leaves before meals is any more beneficial than eating meals like those in my pictures, which is what we usually eat in summer, but if it means avoiding statins, which I think are harming DH, we’ll give it a go.
For some reason pictures won’t post.

Yes- that's what my GP said. Thanks for your input.

Good for you! I can see that there's isn't too much to worry about - and I expect your GP saw that too. Your readings are borderline high, but only just. I'm glad you now know your actual readings and how to find them.

The NHS changed the guidelines about prescribing statins from a QRISK score of 20% to 10% and I know some GPs don't agree with that, but they're still duty-bound to tell their patients what the official advice is. Age is a risk factor - and you can't do anything about that - so I expect your GP will tell you about statins every time you visit from now on because your risk is bound to increase. Just decline them, if everything else is fine and you don't want to take them.

PS. Personally, I eat loads of salad and veggies anyway, but I wouldn't get hung-up about having a salad before every meal because the evidence shows it doesn't have much of an effect.

PPS. It's been interesting to have this discussion.

19th June 2024 HbA1- 44.0
1st April 2025 HbA1-43.0
10th April Qrisk= 11.9%
7th May serum cholesterol 5.3
7th May serum HD cholesterol 1.6
7th May serum cholesterol/HDL ratio 3.3
8th May Qrisk- 11.2%

It has been very interesting reading through my history and now my test results are here for all to see!

I sahll return to my GP when I'm ill, or when they ask me to attend for some reason.
Otherwise I'll just carry on making those small changes.
GPs are very busy and if I don't need to go, I don't.
Meanwhile, I'll carry on with the salads!

keepingquiet You seem to be missing something quite important. You stated in your op that you are pre-diabetic. I have no idea why the GP thinks that, but he/she won't have made it up. You must have had a blood test which included an HbA1c test at some stage.

Pre-diabetes and diabetes are a continuum. I don't know what your blood glucose readings are, but you could be just below mine - and I am classified as a diabetic. I'm one side of the line; you're on the other side - our risks probably aren't very different. I have played with the QRISK3 calculator and diabetes adds 6.5% risk to your score - you could be heading towards that. You need to know your scores, if you're going to be in control of your health, which is why you need to request an HbA1c test. Diabetes can cause cholesterol problems.

I think you stated that you are slightly overweight. That will be a risk factor, so if you're at the top end of "normal" for blood pressure, cholesterol or diabetes, it would be a good idea to try and lose it.

The advice and information your GP seems to be giving you seems barmy to me. Look on the app - all your test results will be on there. You can Google what they mean, if you're not sure. Nobody is trying to hide that information from you.

I looked up the science about eating salad before meals. What you claim to have been told is nonsense. Of course, salad will help with your weight, cholesterol, blood pressure and pre-diabetes if you substitute it for something less healthy (ie more carbs or saturated fat), but not if carrying on eating as normal and just add a salad like you would a supplement. There is some evidence that eating vegetables and protein before starchy carbs can lower post-prandial (after eating) blood glucose levels in T2 diabetics, but not in non-diabetics because the pancreas is working as it should anyway and releasing insulin. That means swapping round the order you eat a normal meal, not adding something else to it. That's what peer-reviewed scientific research says.

I don't really understand why you don't want to return your GP. I'd want to know what my blood tests say about the state of my health and do something about it, if I could. It's up to you what action you take, but it's the GP's job to tell you what your risk of heart disease is. Incidentally, it's rubbish that any pharmacist can just give you statins without a prescription.

Thankyou for all this info Growstuff- I do have the app and will refer back to your comments later.
Qrisk may not be a new system, but I hadn't heard of it before a few weeks ago.
Maybe there are more I don't know about?
I don't see my GP very often- only twice in over two years and those only recently.
I don't plan on returning any time soon...

I sometimes have breakfasts like that, but it's not the same as a green salad before breakfast. OP wasn't told to adjust what she eats, apart from eating a green salad before every meal.

www.womenshealthmag.com/food/g28483648/breakfast-salad/?utm_source=google&utm_medium=cpc&utm_campaign=mgu_ga_whm_md_pmx_ca_hybd_mix_20188187880&gad_source=1&gad_campaignid=20192831021&gbraid=0AAAAACrQpny3wLsG51PemVnDAAdr9kSfX&gclid=CjwKCAjwz_bABhAGEiwAm-P8YRmYZndhnF0iRgPIhmrmBs9p_kFriovRGrravnclgTl2fnEVnyhBCRoClsYQAvD_BwE

I found this article for breakfast salads. I wouldn't fancy one myself, since I love my oatmeal, but hey, if it can help, then good luck to you!

I know very well how the algorithm works. However, it seems to me that there's a breakdown in communication between you and your GP. QRISK is not a new system.

All my results are also on my online Patient Record. If you're not signed up for it, just ask the receptionist.

If you really want to make informed choices, you need your results and it's honestly not at all difficult to get them.

keepingquiet Do you have the NHS app? Your cholesterol breakdown will be there.

If you don't, you can ask your GP's receptionist for a written copy of any blood tests. The GP is obliged to provide them.

You can calculate your own QRISK score here:

www.qrisk.org/

However, you do need your cholesterol/HDL ratio, which was part of your cholesterol result. It would also be useful to have your HbA1c result.

You can play around when entering your risk factors to work out what's causing your risk.

PamelaJ1

growstuff the salad would be an add on for me. I don’t eat too many chips but a few lettuce leaves probably wouldn’t hurt if it really worked.
My QRisk is ‘only’ 10% and at my age, 72, that is probably normal.
So if the point at which statins are recommended is over10 I wonder why they have been recommended for me.
Another question for my next encounter with a health professional at the surgery.

Yes, I would question it too- the risk is incremental. So if you are less than 10 on the Qrisk this requires no intervention (unless it goes up with age) between 10 and 20 means you could benefit from intervention and over 20 means you're on your way out unless you agree to intervention.
My Qrisk has gone from 11.9% to 11:5% but I don't know the timescale that is based on. It may have nothing at all to do with eating salad.
In addition althought the Qrisk is made up of lots of components it seems to me that they only use it to initiate the taking of statins and statins are only used for treatment and prevention of high cholesterol. I still don't have a breakdown of all the other components of my Qrisk. Neither do I know my blood cholesterol level. I am always told if I don't hear from the surgery I should assume everything's ok.
I am not completely resistant to taking statins, but I feel if it is my choice I should have the info I need in order to make that choice.
Being told by the GP receptionist that I didn't need to see my GP to go on statins and I could just go and get them from the pharmacist, was not acceptable for me.
You really do have to have your wits about you when it comes to navigating the NHS!

growstuff

keepingquiet I'm still baffled. How has your QRisk score reduced, if the GP didn't have a baseline because you hadn't had your cholesterol tested for a year?

I have no idea- I thought the Qrisk was done on some bloods I had a few months ago, but the Doctor I saw said no, it was done on some algorhythm and so this flagged up I should be on statins. She also said she was dealing with the coded cases and didn't even know I had a recent blood test (when my cholesterol wasn't even done) so it was me really who requested the blood cholesterol.
As I said before it is also to do with the government and the IT system they now use across the NHS to assess your risk of heart attack/stroke in the next ten years. (Qrisk) I asked what my risk of cancer was (I have had cancer and there's lots of it in my family) but she said they don't test for cancer risk.
Crackers really.

growstuff the salad would be an add on for me. I don’t eat too many chips but a few lettuce leaves probably wouldn’t hurt if it really worked.
My QRisk is ‘only’ 10% and at my age, 72, that is probably normal.
So if the point at which statins are recommended is over10 I wonder why they have been recommended for me.
Another question for my next encounter with a health professional at the surgery.

I understand that RedRidingHood. My QRisk score is over 10 (which is the threshold when statins are considered) because I'm diabetic and have had a heart attack. Like you, I can't change my medical history. I'm not overweight, don't smoke, have satisfactory blood pressure and cholesterol. I don't have any side effects from statins, so I take them.

You can cheyour own qrisk. It can be high even if your cholestrol is low. Mine is high because I have rheumatoid arthritis which increases risk, also arrhythmia. My cholesterol is low.
I have to take a ton of drugs already and so did resist statins but was persuaded by my cardiologist to try.
I take a low dose statin and have zero side effects because there more likelihood of benefit than not.
Yes I also eat salad, am not remotely overweight and I exercise.

keepingquiet I'm still baffled. How has your QRisk score reduced, if the GP didn't have a baseline because you hadn't had your cholesterol tested for a year?

PamelaJ1 I'm sure eating salad instead of eating chips, pasties or puddings would benefit you, but if you're thinking of eating salad as an "add on"/supplement, I think I wouldn't give up on the statins just yet.

I take a low dose statin and have been eating salad (about half my plate for lunch and dinner is salad) for decades - I still need the statin (and the diabetic medications).

I have found this thread interesting.
It did seem to be bonkers initially but comparing it to my experience I think your GP had a very refreshing outlook.
I had a bit of a heart scare and was encouraged to take statins.
I am not overweight, eat healthily, very little added sugar, UPF, lots of veg.
I was told that I may be able to get my cholesterol level down by diet. My cholesterol isn’t very high, just over the target level and as I eat a well balanced diet I didn’t feel that I could change much.
So I’m taking the statins- they have worked but I would rather eat salad.
I will bring it up next time I am in contact with a Health Professional. I haven’t spoken to or seen a GP for years even though I ended up in A&E after collapsing on a tennis court.

Sorry to confuse. It was my Qrisk, which the Dr didn't break down. I did say it was a bit bonkers. In fact, it is too confusing to explain here... the test I had a month ago said I was still pre-diabetic but they wanted me to start statins, which is a cholesterol thing, due to my Qrisk.

The Dr admitted I hadn't had my cholesterol checked for more than a year, so requested one.

Then she told me to eat salad before every meal, which I have and now my Qrisk has fallen.

I told you it was bonkers- but now I have a reprieve from the statins and no one said to have blood sugars tested again.

It's all to do with the algorhythms you see- the data on the screen.

I'm just glad I'm heading the right direction anyway...

I'm confused. I thought the problem was that you are pre-diabetic. Blood cholesterol doesn't assess diabetes. You need an HbA1c test for that - and there's no point doing an HbA1c test more frequently than every three months. You could still be pre-diabetic, but your GP doesn't seem to be addressing that. You need a proper breakdown of what has actually been tested and what the results were.

Update today- the bloods came back and just had message from the GP I saw last week.

My Qrisk is down by 0.5%! There was no breakdown but my blood cholsterol was taken yesterday so I am assuming it is that recent test that has brought it down.

Maybe it is the salad, maybe not but she gave me the choice of starting statins now or waiting three months- so I am going to carry on with the salads for three months if I can.

Either way it is good news for me so thankyou all for your info- and I think this thread can now be closed, although I may be back here in August!