I did what the doctor said. Took the statins every morning for eleven years. And at the end of those eleven years, my cholesterol was higher than when I started.
Not slightly higher. Higher than the very first blood test I ever had, before I’d taken a single pill.
My GP never mentioned it. Because technically, I was within range.
I’ve got NHS blood tests going back to 2012 in a folder on my phone. What I found when I finally laid them all out side by side in December 2023 was a pattern nobody had ever shown me. A number that had been moving in the wrong direction for over a decade, quietly, while a different number was being managed on the surface. In this post I’ll walk you through exactly what that pattern looked like, why I think the ratio matters more than the total cholesterol most GPs flag, and what happened in the fourteen months after I stopped medication, using the NHS blood tests I took to my GP afterwards.
[Note to Neil: Add YouTube embed once video is published]
You’ve Done What You Were Told. That Deserves Acknowledging.
If you’ve been on cholesterol medication for years, you have almost certainly been a good patient. You filled the prescription. You took it every morning. You trusted that the number being managed meant the problem was being managed. That is a completely reasonable thing to believe. It is what the information available to you suggested.
The idea that managing the cholesterol figure is the same as managing cardiovascular risk is everywhere. It’s in NHS guidance. It’s what most GPs are working from. It’s the logic that has shaped cholesterol treatment for decades. On the surface, it makes complete sense: high cholesterol is linked to heart disease, so lower the cholesterol and you lower the risk.
That logic is not wrong exactly. But it may be incomplete. And in my case, the gap in that logic turned out to matter quite a lot.
What blood tests going back to 2012 Actually Showed
April 2012. My first relevant blood test, before any medication. Total cholesterol: 7.5 mmol/L. Triglycerides: 3.4, outside reference range. My GP recommended statins. I was in my forties, the number was elevated, the recommendation made sense. I started Atorvastatin 40mg daily without question. (WMTWL-EVID-142)
December 2016. Four years into treatment. Total cholesterol had dropped to 5.3 mmol/L. That is a meaningful reduction. On paper, the medication was working.
But here is where I want you to look at a different number. Not total cholesterol. The ratio: cholesterol divided by HDL, the so-called good cholesterol. Some clinicians consider this a better indicator of cardiovascular risk than the headline figure alone. In 2012, before any medication, my ratio was 4.7 — below five, within target. By 2016, when total cholesterol had dropped to 5.3, the ratio was 4.2. Improving. The picture the GP was seeing looked like progress. Total number down, ratio improving, medication doing its job.
Then something started shifting.
By 2021 to 2022, total cholesterol had climbed back up to 7.3 to 7.4 mmol/L. I was still on the medication. Still taking it every morning. The number had returned to near where it was before I started. (WMTWL-EVID-147)
October 2022. My HbA1c came back at 47 — pre-diabetic range. A blood sugar marker. I didn’t connect it to the cholesterol at the time. But it becomes important for understanding the mechanism, and I’ll come back to it.
December 2023. Total cholesterol: 8.0 mmol/L, the highest it had ever been. LDL, the so-called bad cholesterol: 5.6. My cholesterol/HDL ratio: 6.2. (WMTWL-EVID-143)
That 6.2 is the number I need to sit with for a moment.
In 2012, pre-medication, that ratio was 4.7. Eleven years later, on dual medication (Atorvastatin plus Ezetimibe added part way through), the ratio had reached 6.2. That is a 32% increase in the cardiovascular risk indicator across the entire period I was supposedly being treated for cardiovascular risk. (WMTWL-EVID-142)
And the reason nobody flagged it is that GPs are generally tracking total cholesterol and LDL. The ratio sits in the results. It’s calculated, it’s there. Mine was never the number that prompted a conversation.
I only found it because in December 2023 I went back to the 2012 baseline and compared, properly, for the first time. I’m not sure I grasped the weight of what I was looking at in that moment. It felt more like an odd observation than a revelation. The meaning arrived later, on reflection. Patterns rarely announce themselves.
What Happened When I Stopped
In February 2024, I stopped the statins. I want to be honest about how that happened, because it wasn’t a carefully planned GP-supervised protocol. The prescriptions had run out at the end of October 2023. By February 2024 the remaining stock was gone. The decision was mine. My GP has been monitoring what happened after. But the sequence was mine, not hers, and I would not necessarily recommend doing it the way I did it. What I would recommend is what I eventually had: regular blood tests, GP awareness, and a clear picture of what your markers are doing.
March 2024. First test off medication. Total cholesterol: 7.0 mmol/L. Still elevated. But the ratio: 4.7. Back to exactly where it was in 2012, in a single month. (WMTWL-EVID-101)
April 2025. Fourteen months off medication. LDL down from 5.6 to levels I had not seen in years. Cholesterol/HDL ratio: 4.7 to 4.8. Sitting inside target. (WMTWL-EVID-110, WMTWL-EVID-105)
November 2025. Twenty months off medication. Total cholesterol: 6.77 mmol/L, lower than at any point during eleven years of treatment. Ratio: 4.8.
My GP looked at the November results and asked, roughly, whether I had been put on something new. She had not seen the number move like that. I said no, same approach, no medication. She noted it. That was the extent of it. But it was the first time she had expressed anything like surprise at the direction of travel.
So why did this happen? Because stopping medication is not a mechanism. A sequence of events is not an explanation.
The Root That Was Never Treated
There is a cardiologist called Sanjay Gupta — he works out of York Cardiology, not the television one — and he put something in a way that changed how I understood my own data. He said that blood pressure is a scream. The body screaming that something is wrong. And if you treat the scream as if it is the disease, you end up managing the blood pressure without addressing whatever is causing the body to scream.
That framing maps directly onto cholesterol.
The elevated number is not the disease. It is the scream. And in my case, with HbA1c climbing toward pre-diabetic range across the same period the cholesterol was worsening, what the evidence now suggests to me is that insulin resistance was the underlying process running the whole time. Elevated insulin keeps fat locked in storage, drives the liver to produce more cholesterol, and shifts the lipid profile in exactly the direction mine was going. The statin was suppressing the number while the metabolic process that was generating it kept running. (EXP 1017)
When I addressed that directly — time-restricted eating, removing ultra-processed food, giving insulin a sustained chance to come down — the lipid profile started moving differently. Not because I stopped medication. Because the thing the medication was never treating started improving.
Here is where the ratio matters more than the headline number, and why I want you to hold onto this.
LDL cholesterol is essentially a delivery driver dropping parcels at the wrong address — specifically inside your arterial walls, where they build up and cause problems. HDL is the returns driver, picking up the misdelivered parcels and taking them back to the liver to be processed properly. Total cholesterol alone does not tell you how busy the returns service is. The ratio does. A high total with an excellent returns service tells a different cardiovascular story to a high total with almost no returns at all. Mine, at 6.2, meant the returns service had been deteriorating for years while the headline number was being kept in view. (ANA-181)
That is the pattern I missed for eleven years. I only saw it when I put all the results side by side for the first time.
This is N=1. One person, one set of blood tests, one set of circumstances. Cholesterol is complex. Individual responses vary considerably. I cannot tell you this would happen for you, and I would not want to. What I can tell you is that the ratio tells a different story to the total, and it is worth asking your GP to walk through both.
What I Would Do Differently
The cholesterol/HDL ratio was in every result I ever received. It was calculated, it was there, it was never the number that prompted a conversation. If I were starting again, I would track it from the very first test. Not just whether the total is in range. What the ratio is doing, year on year, across time. Direction of travel matters. A number that is technically in range and getting worse is a different situation to a number that is technically out of range and improving. I would not make the assumption again that being managed means being fixed.
If you have access to your historical blood test results — through the NHS app or by asking your GP practice — it is worth looking at the ratio across the years, not just the most recent reading. If the total has been managed but the ratio has been drifting upward, that is a question worth bringing to your GP. Not an alarm. A conversation. “Can we look at what the ratio has been doing over time?” is a completely reasonable thing to ask.
Here is the thing about the pattern I am describing. The metabolic process that appears to have been driving my cholesterol in the wrong direction — insulin resistance, developing quietly across years — tends to build long before anyone measures it or names it. HbA1c drifting toward pre-diabetic range. Energy not quite right. Weight that does not shift the way it used to. These are the signals that show up in the data before a specific clinical conversation happens about cardiovascular risk. The mechanism runs ahead of the diagnosis. Cholesterol being managed on the surface while something deeper is developing underneath — that pattern does not announce itself. It accumulates. The earlier you notice the direction of travel, the more options you have about what to do about it.
I will leave that with you.
Key Takeaways
- The ratio matters more than the total: Cholesterol/HDL ratio is a better cardiovascular risk indicator than total cholesterol alone. It is in your NHS results. Ask about it.
- Managed does not mean fixed: My total cholesterol appeared controlled for years while the underlying risk marker was moving in the wrong direction.
- The 32% figure: My cholesterol/HDL ratio increased from 4.7 to 6.2 across eleven years on dual statin therapy — a 32% increase in the period I was supposedly being treated.
- The ratio corrected quickly: Within one month of stopping medication and beginning to address the metabolic root, the ratio returned to 4.7. Within twenty months it was at its best point in over a decade.
- Insulin resistance as the likely mechanism: HbA1c tracking into pre-diabetic range across the same period points to an underlying process the medication was not addressing. That is what changed when the inputs changed.
Want to Track Your Own Numbers Over Time?
What this post is really about is pattern recognition, not just single readings. If you want to start seeing the direction of travel in your own biomarkers — cholesterol ratio, blood sugar, and the markers that tend to move before anything gets flagged clinically — the 14-Day Rhythm Reset Guide gives you a grounded starting point for building the habits that show up in your blood work over time.
👉 Get the 14-Day Rhythm Reset Guide (free)
💪 Want ongoing support? Join Rhythm Club for £30/month (includes FREE app access, community, and weekly accountability calls)
⚠️ Important: This is educational content based on evidence and personal experience. It is not medical advice. Speak to your GP before making changes to your fasting pattern, diet, or medication.
Questions? Email hello@waymorethanweightloss.com
© 2025 Way More Than Weight Loss. All Rights Reserved.
