Take a fresh look at your lifestyle.

DR ELLIE CANNON: What is healthy cholesterol today?

I read in The Mail on Sunday that having very high HDL cholesterol is a concern, especially for middle-aged women like me.

My total cholesterol is 5.3 – and I have an HDL of 2.3. The ratio calculator online tells me this is healthy, but now I read that 2.3 is very high.

Can my high HDL also be the reason for a lipoma and should I have it removed?

Our understanding of cholesterol has evolved over the past 20 years. Once we were only concerned with total cholesterol, but now we are much more focused on cholesterol subtypes and how they contribute to an increased risk of heart attack.

Risks are nuanced and many factors come into play – blood pressure, whether you are overweight or smoking, your age and family history, as well as other illnesses you may be suffering from, all contribute. Cholesterol is not the most important thing, but if you have high general cholesterol and also elevated levels of a subtype called LDL cholesterol, also known as ‘bad’ cholesterol, you may be advised to take statins, which will lower it. HDL cholesterol was once thought to protect the heart, which is why it is often referred to as ‘good cholesterol’. And while that’s still the case, very high levels, above 1.4, seem associated with an increased risk of heart attacks.

Our understanding of cholesterol has evolved over the past 20 years. We were once only concerned with total cholesterol, but now we are much more focused on cholesterol subtypes and how they contribute to an increased risk of heart attack

Our understanding of cholesterol has evolved over the past 20 years. We were once only concerned with total cholesterol, but now we are much more focused on cholesterol subtypes and how they contribute to an increased risk of heart attack

This is based on new research and it is not fully understood, but it is worth talking to your doctor and showing him the article you mention. They may want to recalculate your risk based on the new evidence.

Medication can’t lower HDL, but there may be other worthwhile steps, such as statins to lower LDL, fight blood pressure, and make lifestyle changes.

A lipoma is a benign, soft bump on the skin that is made up of fat – and this has nothing to do with cholesterol. They are usually harmless, so doctors do not recommend removing them unless they are unsightly or cause pain.

Life has left me utterly miserable. My doctor suggested antidepressants, but I don’t want to take them. Can you help?

Unsurprisingly, one of us is miserable right now. Not only has everyday life changed immeasurably, but the immense trauma, loss and uncertainty that we have experienced nationally and individually since the onset of the pandemic has understandably taken a tremendous emotional toll.

More by Dr. Ellie Cannon for The Mail on Sunday …

Doctors are increasingly concerned about the rising number of patients with symptoms of anxiety and depression – and those who actually call a doctor are probably just the tip of the iceberg.

It is essential that anyone who is feeling low all the time is properly assessed so that a diagnosis can be made. Depression is different from sadness or misery and includes symptoms of mood or sadness, as well as changes in appetite, sleep, and thoughts. These things have an impact on daily life, work and relationships.

A general practitioner can perform the first consultation via video calls or telephone.

Or you can take out the middleman and refer yourself directly to a specialist in your area who offers psychological therapies.

If you search online for ‘IAPT services’ – IAPT stands for improving access to psychological therapies – the top hit should be the nhs.uk web page you can refer to.

Mental health care can include medicines, as well as psychotherapy and lifestyle changes. If medications are not a choice for you, check out the other two options.

Free, NHS online therapy sessions for many parts of the country are available at iesohealth.com.

Doctors are increasingly concerned about the increasing number of patients with symptoms of anxiety and depression

Doctors are increasingly concerned about the increasing number of patients with symptoms of anxiety and depression

Doctors are increasingly concerned about the increasing number of patients with symptoms of anxiety and depression

There are some incredibly useful mental health apps that I routinely recommend to patients. These are available to view in the library of NHS apps and focus on specific issues – for example, Big White Wall for stress and anxiety, or Silvercloud, an eight-week course for depression. Lifestyle measures sound simple, but should not be underestimated. Walking daily, pushing yourself to exercise or finding a hobby, yoga or just conversations with a friend can have a huge impact on your mood and feelings, even if the psychological problem is quite significant.

I’m 76 and relatively fit and went to the gym up to three times a week until February. But then my hip started to hurt. A lot of. An X-ray showed nothing. What can it be?

Everyone over 76 has arthritis in the hips and knees, which may or may not show up on an X-ray. Another common hip pain comes from bursitis that swells from the fluid around the hip – known as trochanteric bursitis.

Your primary care physician can arrange access to physical therapy that is useful for bursitis and can currently be searched remotely. Hip bursitis can be part of the greater trochanteric pain syndrome, when the top of the thigh becomes irritated.

Do not sit cross-legged or sleep on the affected side, as this can improve things.

I told Boris Johnson to be a mask model … now he is

I was back in the news last week on my favorite topic, masks – and the fact that lead politicians, while telling us to wear them, don’t want to practice what they preach.

Boris Johnson, Matt Hancock, and Rishi Sunak had all been seen in the past two weeks and met the audience, sometimes in close contact, not once with a mask on. It didn’t look good, I argued. They have to be role models, because wearing a mask is a huge cultural shift for us British. Well, it seemed that Boris was listening because on Friday he first appeared with a face cover. I hope the cabinet follows his example.

In other news, people have asked where I get my fabric covers for my clothes. They are from the charity Binti, at bintiperiod.org. Maybe I’ll buy one for Boris.

Boris Johnson, Matt Hancock, and Rishi Sunak had all been seen in the past two weeks and met the audience, sometimes in close contact, not once with a mask on. It didn't look good, I argued, but now the prime minister has been spotted wearing a mask

Boris Johnson, Matt Hancock and Rishi Sunak had all been seen in the past two weeks, and met the audience, sometimes in close contact, not once with a mask on. It didn't look good, I argued, but now the prime minister has been spotted wearing a mask

Boris Johnson, Matt Hancock, and Rishi Sunak had all been seen in the past two weeks and met the audience, sometimes in close contact, not once with a mask on. It didn’t look good, I argued, but now the prime minister has been spotted wearing a mask

Has that mole changed? Have it checked now

I have been asked if skin clinics are closed, by people who are concerned about changes to a mole and have emphasized that they should make a GP appointment without delay.

We work differently, but are very open, just like dermatological departments. Most GP appointments start on the phone, and for a skin problem, we either want to see photos or use a video meeting. You can be referred if your doctor is concerned. Many dermatological clinics are open to face-to-face appointments, but it may be possible to have a more than adequate consultation remotely.

Signs of melanoma skin cancer include changes in the shape, size or texture of a birthmark. One that looks very different from others around it can be a concern.

You are also more at risk if you are 65, if you have fair skin and freckles, or if you have a family member with melanoma.

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