My GP told me my cholesterol was fine. Every year, the same letter, the same reassurance. What nobody was telling me, because nobody was looking at it, was that my good cholesterol, HDL, had been quietly falling for eleven years while I sat on the same statin dose.
I only found this out by going back through thirteen years of my own NHS blood tests, one number at a time. Total cholesterol was the headline everyone watched. HDL sat underneath it the whole time, sliding, and not one appointment ever mentioned it.
Turns out the thing that eventually turned it around wasn’t the tablet at all.
The Cholesterol Number Everyone Watches, and the One Nobody Does
If you’re on a statin, you’ve probably had the same conversation I had, more or less every year. The letter arrives. Total cholesterol’s the number your GP reads out. If it’s come down, or holding steady, that’s the appointment done. Next test in twelve months.
And on the surface, that makes complete sense. Total cholesterol is what the statin’s designed to lower. It’s the number in the guidelines. Watching it isn’t wrong.
What I didn’t know, and what nobody had ever explained, is that HDL, your so-called “good” cholesterol, can be doing something completely different underneath a total cholesterol number that looks under control. They’re not the same measurement telling you the same story twice. They can move in opposite directions on the same set of tablets.
Eleven Years of Sliding, Underneath a “Fine” Result
Here’s what the actual numbers looked like, pulled straight from my NHS records.
2012, HDL 1.6. Reasonable. This was before I’d even started the statin.
2016, HDL 1.51. A few years into medication by this point. Still looked fine. The kind of small dip nobody would flag on its own.
2023, HDL 1.3. Eleven years on the same tablet, same dose. My cholesterol/HDL ratio was sitting at 6.15, well outside the under-5 target most GPs work to. Nobody had mentioned it, not because anyone was hiding anything, but because total cholesterol was “under control” and that was the number the conversation stopped at.
I’m not a cardiologist. I didn’t know HDL and total cholesterol could drift apart while you’re medicated for the same thing. Turns out they can. For eleven years, mine did, and I never once asked to see the HDL line on its own.
What Actually Turned It Around Wasn’t the Tablet
In March 2024, one month off the statin, which I’d stopped myself, on my own initiative, I sat across from my GP with a fresh set of bloods to show him. Total cholesterol had dropped from 8.0 to 7.0. LDL was down. Triglycerides were down. He looked up and said, more or less word for word: “Your lipids are better now than when you were medicated. Whatever you’re doing, keep doing it.”
Even that visit was still about total cholesterol, though. HDL didn’t get its own moment until later, going back through the whole run of numbers side by side rather than one printout at a time.
By April 2025, fourteen months off the statin, HDL was back up to 1.5. The ratio had dropped to 4.7, inside target for the first time in years. And here’s the part that actually mattered: I hadn’t started anything new. Resistance training four times a week, kettlebells, bodyweight work, progressive overload, I’d been doing that the entire way through. It wasn’t a new intervention. I just hadn’t connected it to that specific number.
Think of it like the bin lorries on your street rather than how full any one bin looks. Total cholesterol is the bin: how much rubbish is sitting there. HDL is the collection service: how much is actually getting taken away. You can have a tidy looking bin and still have hardly any collections running. That’s what eleven years on a statin looked like for me. The bin looked fine. The lorries had basically stopped turning up.
Why This Isn’t Standard GP Conversation Yet
There’s a couple of exercise physiologists, Neil McCartney and Stuart Phillips, whose work stuck with me once I’d seen my own numbers. They point out that resistance training is now standard cardiac rehab, not something avoided after a heart event but actively prescribed, and that it improves strength, endurance and quality of life often about as effectively as drug treatment does.
If it’s doing that much work in a rehab setting, it’s not a stretch that it was quietly doing something to my HDL for the whole eleven years, underneath a number nobody was watching.
My own GP hadn’t been trained to flag HDL trajectory the way he’d flag total cholesterol. That’s not a criticism of him. It’s just how the system’s built. The number that gets watched is the number that gets discussed, and the guidelines haven’t caught up with tracking HDL trend the way they track the headline figure.
What I’d Ask Differently Now
If I could go back, I’d have asked for the HDL trend specifically, every single test, rather than only hearing the total cholesterol figure. Eleven years is a long time for a line to sit quietly in a file nobody’s cross-referencing.
If you’ve already got years of blood tests sitting in an NHS app or a folder somewhere, it might be worth asking your GP to pull the HDL line out on its own, across the whole run, not just this year’s snapshot. Not a diagnosis. Just a different question at the appointment you’re already having.
And if you’re not on anything yet, but you’ve started lifting or doing some kind of resistance work and you’re curious what it’s actually doing underneath the surface, that might be worth tracking from day one rather than working it out backwards eleven years later, like I did.
I’ll leave that with you.
🎯 Key Takeaways
- Total cholesterol and HDL can move in opposite directions: even while you’re medicated for the same thing, on the same dose, for years
- HDL fell for 11 years on statins alone: from 1.6 to 1.3, with the ratio drifting to 6.15, before anyone flagged it
- Resistance training, not the tablet, moved the number: four sessions a week, already happening, just never connected to this specific reading
- Resistance training is standard cardiac rehab: evidence suggests it works about as effectively as drug treatment for some outcomes
- The GP conversation IS the disclaimer here: Neil stopped his own medication first and brought the data back to his GP afterwards. That is not the approach being recommended
Ready to Start Tracking Your Own Patterns?
If eleven years of an unwatched number sounds familiar, this is exactly what the 14-Day Rhythm Reset Guide is for: a starting structure for paying attention to your own data properly, not just collecting results in a drawer.
👉 Get the 14-Day Rhythm Reset Guide (free)
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⚠️ 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.
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