Cholesterol: What is it and how can I manage it?

Cholesterol: What is it and how can I manage it?

What is cholesterol?

Cholesterol is a lipid-like substance present in the body, synthesized internally and also obtained from dietary sources. While it plays a crucial role in maintaining health, excessive cholesterol levels can lead to arterial damage and elevate the risk of cardiovascular diseases.

Why is cholesterol vital?

Cholesterol is essential for various bodily functions, including the construction of cell membranes and the synthesis of certain hormones.


The types of cholesterol:

Cholesterol circulates in the bloodstream bound to lipoproteins. The primary types of lipoproteins are high-density lipoprotein (HDL) and low-density lipoprotein (LDL).

• HDL cholesterol, termed "good" cholesterol, aids in eliminating cholesterol from arterial walls by transporting it back to the liver for processing and disposal. • LDL cholesterol, known as "bad" cholesterol, tends to deposit cholesterol in the arteries, contributing to plaque formation. The total cholesterol test evaluates both HDL and LDL cholesterol levels. Physicians often conduct this test to assess the risk of heart disease or stroke, considering additional factors such as age, family history, ethnicity, hypertension, obesity, type 2 diabetes, sedentary lifestyle, and smoking.

Triglycerides, another form of blood lipid, also pose a risk of heart disease. Triglycerides are typically assessed alongside cholesterol during lipid profile testing, which encompasses measurements of total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides.

What are the symptoms of high cholesterol?

Elevated levels of low-density lipoprotein (LDL) cholesterol typically do not manifest noticeable symptoms. Many individuals remain unaware of their high blood cholesterol status until undergoing a routine doctor's visit and subsequent blood test.

However, in cases of exceptionally high LDL cholesterol levels, certain symptoms may become apparent, including:

Presence of fatty deposits (xanthomas) on the skin, commonly observed on the elbows, joints, knees, hands, feet, or buttocks. Grayish-white rings (corneal arcus) encircling the corneas in the eyes. These symptoms often arise in individuals with a familial predisposition to high cholesterol levels (familial hypercholesterolemia).

Undiagnosed or untreated high blood cholesterol poses significant health risks, such as heart attack and stroke. Therefore, timely diagnosis and management are crucial in preventing severe complications.

How is High Cholesterol Diagnosed?

Your doctor will diagnose high blood cholesterol by considering your medical and family history, conducting a physical examination, and performing a blood test to measure your cholesterol levels.

Medical History and Physical Examination:

During your consultation, your doctor will inquire about your dietary habits, level of physical activity, family medical history, current medications, and any risk factors associated with heart or cardiovascular diseases. Additionally, your doctor will conduct a physical examination to assess for signs of elevated cholesterol levels, such as xanthomas, and other health conditions linked to high cholesterol.

Screening for High Cholesterol:

Your doctor may order a lipid panel blood test to screen for abnormal cholesterol levels. This test, also known as a lipoprotein panel or lipid profile, measures the levels of LDL and HDL cholesterol, as well as triglycerides in your bloodstream. Deviations from normal cholesterol and triglyceride levels may indicate an increased risk of coronary heart disease.

Frequency of Lipid Panel Testing:

The frequency of lipid panel testing depends on factors such as age, risk factors, and family history of high cholesterol or cardiovascular diseases. Generally:

Age 19 or younger: Individuals aged 19 or younger should undergo screening every 5 years, starting between ages 9 to 11, with earlier screening for those with a family history of heart-related issues. Age 20 to 65: Younger adults (ages 20 to 65) should be screened every 5 years, while men aged 45 to 65 and women aged 55 to 65 should consider more frequent testing (every 1 to 2 years). Older than 65: Older adults (over 65) should undergo annual screening. Repeat Testing and Additional Considerations: If initial lipid panel results are outside the healthy range, your doctor may order a repeat test, especially if fasting was not observed before the first test. It's important to note that cholesterol levels are just one factor in assessing the risk of heart disease and stroke, with other factors like age, ethnicity, and lifestyle habits also playing significant roles.

Lipoprotein-a Testing:

In some cases, your doctor may recommend an Lp(a) test, which assesses levels of lipoprotein-a, a marker associated with increased risk of heart or vascular diseases, particularly if there's a family history of early heart disease. Statins, medications that help prevent heart disease, may be prescribed if Lp(a) levels are high, even if other cholesterol levels are within the healthy range.

Why is high cholesterol bad for health?

Excessive cholesterol poses health risks despite its essential role in bodily functions. When there's an abundance of LDL cholesterol, it accumulates in artery walls, forming plaques and triggering a condition known as atherosclerosis. These plaques can progressively narrow and eventually obstruct arteries, impeding blood flow.

How can I lower my cholesterol?

To decrease high levels of LDL cholesterol, there are several steps you can take:

Limit the intake of saturated fats in your diet and opt for a healthier eating plan. Foods rich in saturated fats include: • Cakes and biscuits • Fatty cuts of meat • Butter and full-fat dairy products • Foods containing coconut or palm oil

Foods and lifestyle changes to help lower cholesterol

Dietary and lifestyle adjustments to aid in lowering cholesterol levels include:

Incorporating a high-fiber diet abundant in vegetables, fruits, whole grains, and foods fortified with plant sterols can contribute to cholesterol reduction.

Boosting physical activity levels can also effectively lower cholesterol. Engaging in regular exercise, especially when coupled with a balanced diet, not only aids in cholesterol management but also facilitates weight loss for those who are overweight, promoting overall heart health.

If these lifestyle modifications fail to sufficiently decrease cholesterol levels, consulting with your doctor may lead to the consideration of cholesterol-lowering medications as part of your treatment regimen.