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What do we mean by the term cholesterol?

Cholesterol is a white waxy material that is transported in the blood attached to special proteins. Cholesterol is important for several important functions like forming cell membranes, as a source of energy and to form hormones.

How is cholesterol formed?

The initial step in cholesterol formation is absorption of lipids from the gastrointestinal tract. The lipids are transported through the blood stream to the liver attached to special proteins. In the liver this mixture is transformed to a special substance called low density lipoprotein (LDL). The higher levels of this lipoprotein are associated with an increased incidence of vascular disease. The body transforms the LDL to another substance called high density lipoprotein (HDL). This substance returns the cholesterol to the liver again. The higher the HDL level, the less the chance of having vascular disease.

Why do we care about cholesterol?

Because abnormal cholesterol levels can lead to vascular disease. By abnormal level we mean high level of bad cholesterol (Low density lipoprotein (LDL)) or low levels of the good cholesterol (high density lipoprotein (HDL)).

What causes abnormal cholesterol levels?

There are many reasons. Sometimes it is due to genetical reasons, but this only in a minority of cases. The most common causes of abnormal levels are bad life style habits such as eating unhealthy food (type and amount), sedentary life style, not doing enough exercise and smoking.

Can I try diet before taking medications?

Certainly! However, when the cholesterol level is very high one can predict that diet by itself will not be enough. You can try diet for a few months and then check the level again, and then your doctor can decide if there is a need to take a medication. Medications are not a substitute for healthy food, exercise, and not smoking.

Can cholesterol medication be stopped once it is started?

Once cholesterol treatment is started it is for the long term or for life. Once medication is stopped then the level returns to pre-treatment level. If you decide to stop cholesterol medications there is no immediate danger, but then you lose the protection offered by the medication against vascular disease.

Can a pregnant woman take cholesterol medication?

No. There are many types of medications and it may be that some can be taken. But some other types can affect growth of the baby. Therefore it is better not to take a medication except in exceptional cases.

Are there side effects to lipid lowering medications?

Any medication can potentially lead to side effects. The most common side effects of the standard medications are muscle pain and abnormal liver function. These side effects are rare and usually occur in the first few months of taking the medication or if the dose is increased. If you feel pain in the muscles or any unusual symptom then inform you physician and read the leaflet that lists potential side effects. Liver tests abnormality can be detected early and it is therefore recommended to do a blood test of the liver function a few times when starting to take the medication.

What is the required cholesterol level?

The required level varies from one person to another. In general, the higher the risk of coronary artery disease, for example in people who have diabetes mellitus, the lower the target. This is for bad cholesterol (LDL), while the opposite (high level) is needed for the good cholesterol (HDL)

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