DEAR DR. DONOHUE: My LDL cholesterol is 111 (2.9). My good cholesterol is very high, at 81 (2.1), and I am told this is excellent. My total cholesterol is 219 (5.7), 19 points over the 200 limit. The test says I have high cholesterol. What’s your opinion? Can you have too much good cholesterol? Is it better to have a lower total cholesterol reading than I have, or high good cholesterol like I have? I am a 46-year-old male who exercises on a stationary bike five times a week. – D.T.

ANSWER: Cholesterol professors tell us to focus mostly on LDL cholesterol – bad cholesterol, the kind that clings to artery walls. An LDL cholesterol reading of less than 100 mg/dL (2.59 mmol/L) is considered optimal, and one between 100 and 129 (2.59 to 3.34) is called near optimal. Values from 130 to 159 (3.36 to 4.11) are borderline, and anything above that is considered high. Your result of 111 is fine.

HDL cholesterol – good cholesterol, the kind that keeps arteries free of buildup — should be over 40 (1.04). Any value above 60 is super good. You are super good. I have never heard of having too-high HDL cholesterol.

Total cholesterol should be less than 200 (5.17). You are slightly above that reading. So what? Your LDL and HDL more than compensate.

We have a cholesterol obsession. It’s talked about all the time because there are medicines that can lower it and because it’s given as a number, something definite. People with low cholesterols can die of a heart attack. People with high cholesterols can live to be 100. I am not denigrating the cholesterol story; I am saying there are other important factors that should intrude into our consciousness. You are a relatively young, active man, and you are in good health.

The cholesterol booklet delves into this topic in depth. To obtain a copy, write: Dr. Donohue – No. 201, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: My doctor tells me I have a blood disorder called polycythemia vera. I take medicine for it. Is there a cure? Is this blood cancer? – M.B.

ANSWER: The name “polycythemia” (POL-ee-sigh-THEME-ee-uh) tells it all. “Poly” is for many; “cyt,” for cells; “emia,” for blood. People with it have too many blood cells – red, white and platelets. Platelets are the blood cells that form clots. Since the blood is loaded with cells, especially red blood cells, it becomes thick. As a result, people can come down with headaches, dizziness, ear ringing and a rise in blood pressure.

Cure? No. Containment? Yes. The usual treatment is simple: Remove blood from time to time. Once the blood count returns to normal, the interval between blood removals lengthens. If medicines are needed, they are available.

It is not cancer. A small percentage of patients develop leukemia. For most, polycythemia runs an indolent course measured in decades.

DEAR DR. DONOHUE: Eighty years ago I lost my sister to what my mom said was Bright’s disease. Can you tell me what this is? Is it called by another name? – R.K.

ANSWER: Bright’s disease is a term from the past. It was used for kidney diseases, mostly those diseases where much protein was lost in the urine.

Today, Bright’s disease is called glomerulonephritis (glow-MARE-you-low-nuh-FRIGHT-us).

Dr. Richard Bright was a British doctor who lived from 1789 to 1858.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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