Cholesterol is generally viewed as a bad thing.  But, it is actually a necessary substance for bodily function.  Our bodies use it to make bile for digestion, cell walls, hormones, and vitamins.  We get cholesterol by eating cholesterol-containing foods and by manufacturing it in our livers from simple nutritional building blocks.  

Unfortunately, some people make too much cholesterol in their liver.  Others have a relative lack of cholesterol receptors to get the cholesterol out of the bloodstream and into the cells.  These situations can be inherited through your family.  Individuals with inherited or familial high cholesterol have readings that are usually very high.  And, the numbers don’t budge no matter how much they try to control it through lifestyle modification.  

Non-hereditary high cholesterol most commonly comes from consuming way too much cholesterol and fat through fatty foods.  High-fat foods, fast foods, processed foods, snack foods- these can elevate the blood cholesterol levels.  Add to this a general lack of regular exercise and it’s not surprising that most people have at least mildly elevated readings.  Regular exercise and dietary restraint can significantly lower the cholesterol levels in the general population.

The numbers by which we measure a person’s cholesterol refer to the cholesterol transport molecules in the bloodstream.  These are LDL (low-density lipoprotein), HDL (high-density lipoprotein), triglycerides, and non-LDL particles.  From study, we know that people with a high LDL, the “bad” cholesterol, and triglycerides will have a higher risk for heart attacks and strokes.  Also, people with a high HDL, “good” cholesterol, will have a lower risk.  Therefore, you want your LDL and triglycerides to be low and your HDL to be high.  

Bad cholesterol particles are what bring about hardening of the arteries (atherosclerosis).  These molecules get into the artery walls and cause plaques.  Thickening plaques create blockages in the blood flow and this can result in heart attacks, strokes, and arterial disease.  

We can improve our cholesterol levels by eating less cholesterol-containing foods.  Diminish your intake of saturated fats (whole milk, high-fat cheese, red meat, ice cream, etc), fried foods, and processed foods.  Increase your intake of healthy fats like fish oils and unsaturated fats.  Increasing dietary fiber helps to lower the blood cholesterol levels.  Additionally, regular exercise can improve your good and lower your bad cholesterol.  

Since the liver manufactures cholesterol, we can interrupt this process.  That’s how many of the prescription pills (e.g. statins) work to lower cholesterol.  They block cholesterol production in the liver.  In general, they lower your bad (LDL) and raise your good (HDL).  Other medicines can bind and remove cholesterol from your body’s digestive tract before it gets absorbed.  

Many of the medications used to treat high cholesterol have received negative press over the years.  Most recently, it was determined that the statins may increase the risk of developing diabetes in some individuals.  Unfortunately, like most medications, the statins can have undesirable effects that cloud their proven beneficial effects.  The bottom line is this- for folks at high risk for heart disease, the benefits of these medications likely outweigh the risk of side effects.   

A high blood cholesterol level usually won’t give you symptoms in and of itself.  That’s why it’s important to have your cholesterol checked.  Meet with your doctor to discuss individual treatments and additional risk factor reduction based on your lab results, medical history, and physical examination.

The content in this column is for informational purposes only.  Consult your physician for appropriate individual treatment.  Dr. Reynolds practices Family Medicine in Chesterfield.


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