Brief Answer:
I would recommend as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would explain that your cholesterol levels and LDL are high. I don't understand the values of your Total cholesterol/ HDL ratio and your triglyceride level.

Total cholestero/HDL ratio is a better indicator of your cardio vascular risk, than total cholesterol level or LDL levels. A ratio below 4.0 for women would be safe for any cardio-vascular risk.

You should know that fenofribrate acts mainly by lowering your triglycerides levels and has fewer effects of cholesterol levels.

I would recommend to switch from fenofibrate to a statin (simvastatin, atorvastatin, etc.), which act mainly in your cholesterol levels (by lowering LDL and increasing HDL).

Meanwhile I would recommend making some diet modifications,besides your daily physical activity. Here are some food which can help you reduce your cholesterol levels:

-Oatmeal, oat XXXXXXX and high-fiber foods: soluble fiber can reduce the absorption of cholesterol into your bloodstream. Five to 10 grams or more of soluble fiber a day decreases your total and LDL cholesterol.
-Fish and omega-3 fatty acids (it is recommendable eating at least two servings of fish a week)
-Walnuts, almonds and other nuts : eating about a handful (1.5 ounces, or 42.5 grams) a day of most nuts, such as almonds, hazelnuts, peanuts, pecans, some pine nuts, pistachio nuts and walnuts, may reduce your risk of heart disease. Make sure the nuts you eat aren't salted or coated with sugar.
-Avocados are a potent source of nutrients as well as monounsaturated fatty acids (MUFAs)
-Olive oil (2 table spoons per day). This is another good source of MUFAs.
-Foods with added plant sterols or stanols: Some margarines, orange juice and yogurt drinks come with added plant sterols and can help reduce LDL cholesterol by 5 to 15 percent. The amount of daily plant sterols needed for results is at least 2 grams.

Regarding your bun levels, I would say that it is above the normal limits (20mg/dl), but it can be influenced by different factors (including a high protein diet, dehydration or low fluids intake, urinary tract obstruction or kidney dysfunction).
I would advise repeating this test after a good hydration and perform other kidney function tests (creatinine blood levesl, creatinine urine levels, creatinine clearance), to exclude any possible organ dysfunction related to this values.

To conclude, what about your thyroid test: it refers to TSH, T3 or T4 levels?

I recommend consulting with an endocrinologist to exclude a possible thyroid dysfunction. You should know that a thyroid dysfunction can lead to high cholesterol levels, which decrease if the thyroid disorder is treated properly.

Hope to have been helpful!

Feel free to ask any other questions, whenever you need!

Best wishes,

Dr. Iliri

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