Dear Dr. Roach: I recently had my yearly blood work done. I always check last year’s results against my current results, so I was surprised to see that my total cholesterol levels had dropped from 222 mg/dL to 181 mg/dL, and my triglyceride level dropped from 174 mg/dL to 146 mg/dL. I do not take statins. There have been no remarkable dietary, medication or lifestyle changes. I’ve recently lost eight pounds of weight.
I was concerned and checked with my doctor. She didn’t seem to care or even want to discuss the changes; she only said that she liked the new numbers. Can you offer any reasons for such drastic changes? I guess I’m worried that something isn’t working right.
E.S.
Weight loss often leads to improvement in cholesterol, but I am also surprised to see a 20% decrease with eight pounds of weight loss. Cholesterol numbers do go up and down over hours and days, and you might have just happened to hit your low point. If you were to get it rechecked, I wouldn’t be surprised if the numbers went up a little bit (a statistical concept called “regression toward the mean”). It’s also possible that last year’s numbers were taken after a meal, or you just happened to catch yourself at a high point.
I do wonder, though, with no remarkable dietary or lifestyle changes, why did you lose eight pounds? Unintentional weight loss always gets me concerned that there might be something else going on. Thyroid disease, diabetes, malabsorption and, of course, cancer are on the list, but so are depression and anxiety.
Still, regression to the mean and weight loss are a better explanation for the lowered cholesterol levels than a worrisome metabolic problem. If you continue to lose weight without trying, that deserves further evaluation.
Dear Dr. Roach: I’m a 63-year-old nonsmoking man, and I’ve been developing skin tags on my arms, neck and abdomen. I even have one in my underarm. What causes them? Is there any way to get rid of them?
R.S.
Acrochordons (skin tags) are outgrowths of normal skin, and they’re not considered to be any kind of tumour. They most commonly occur in places where skin can rub up against itself. I see many in the underarm area, in neck folds, in the groin or under breasts. They seem to be more common in people with insulin resistance, such as those with Type 2 diabetes or prediabetes. If you are at risk for diabetes because of family history, being overweight or high blood pressure, you should consider getting tested.
Skin tags don’t need to be treated, but if they are bothersome, or a person wants them removed for cosmetic reasons, they can be treated surgically in the office. I’ve been cautious ever since I removed one in a patient who came back an hour later still bleeding, requiring a stitch. Although there are over-the-counter preparations I have seen, most of my patients and readers have told me that they are ineffective. Still, others have written to me that the treatment was completely effective for them.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Email ToYourGoodHealth @med.cornell.edu
