When Should You Contact Your Healthcare Provider About Your Cholesterol Levels
In truth, your healthcare provider will probably talk to you about your numbers first. As always, contact your provider if you have any new or worsening pain or other uncomfortable feelings. Make sure you know what medications you take and what they are expected to do. Call the provider if you have a reaction to the medicine.
Before you go to the office, and after you have had a cholesterol test, it helps to have a list of questions prepared about your test results and any proposed treatment.
A note from Cleveland Clinic
When considering cholesterol numbers, its important to remember that you really have the ability to make those numbers go in your favor. What you choose to eat, how much you are able to move and how you deal with lifes ups and downs are things that you can influence.
Last reviewed by a Cleveland Clinic medical professional on 07/31/2020.
The Healthy Eating Plate: What Is Cholesterol Made Of In The Body
Now, lets look at a Harvard Medical School version, of Medical Dietary Advice called the Healthy Eating Plate. But first, refresh your thinking and linking skills, re-read this quote from the US National Library of Medicine which says: Cholesterol is synthesized from Acetyl Coenzyme A in Three Stages. Acetyl CoA is the fuel for the citric acid cycle . This important molecule is formed from the breakdown of glycogen , fats and many amino acids.
LOOK at the Healthy Eating Plate. Can you identify food sources of glycogen, fats, and many amino acids?
Food in the Healthy Eating Plate Are Mixed Together to Make Cholesterol
What is cholesterol made of in the body
The Healthy Eating Plate foods stored asglycogen or fat by insulin are: fruits, juice, vegetables, potatoes & French fries, whole & refined grains, pasta, rice, bread, cakes, cookies, sweets, low-fat products, dairy, sugar & natural sweeteners. According to my Human Anatomy & Physiology copy by Professor Elaine N. Marieb, beans lack two essential amino acids which are tryptophan and methionine. Have you LOOKED at bean labels to see how much sugar & carbohydrate they contain?
The Healthy Eating Platefat food are: canola oil, olive oil, butter, margarine, fake butter
The Healthy Eating Plateamino acids belong to the protein food group. From the diagram above these foods are: fish, poultry, red meat, cheese, bacon, cold cuts & processed meat
Lets look at this quote one more time:
What Is Cholesterol And Where Does It Come From
The human body is an amazingly complex creation. If youve ever tried to really dig into the science behind how cholesterol works in your body, you may have been a bit overwhelmed, especially if you dont have much of a science background.
Much of the information on the design and function of cholesterol, your doctor probably does not even know1, unless he is one of the rare few who has independently been able to keep up with the latest research and has spent his own time studying the science of cholesterol.
In this post I will attempt to explain what cholesterol is and the relationship between the cholesterol in our body and the cholesterol that we eat . This is certainly not an exhaustive scientific study of cholesterol, but hopefully it will be a good lay-persons guide to the workings of cholesterol. If you would like to study cholesterol more in depth I highly recommend the cholesterol series on Dr. Peter Attias blog.
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Why Is Cholesterol Essential
Your body needs some cholesterol to work properly. For example, cholesterol is used to build cell walls and produce some hormones.
About three quarters of the cholesterol in your body is produced by your liver the rest comes from the food you eat.
Cholesterol is carried in the blood by lipoproteins. The main types of lipoproteins are high-density lipoprotein and low-density lipoprotein .
How Often To Have A Test
The American Heart Association recommends that people without a family history of heart disease or other risk factors check their cholesterol levels once when they are aged 911 years and again when they are aged 1721 years.
After the age of 20 years, the AHA suggests that people recheck their cholesterol levels and other risk factors every 46 years, as long as the risk remains low.
Those with a family history of heart disease should speak with a doctor about how often they need a cholesterol test.
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Medical Guidelines And Recommendations
In 2015, the United States Department of Agriculture Dietary Guidelines Advisory Committee recommended that Americans eat as little dietary cholesterol as possible, because most foods that are rich in cholesterol are also high in saturated fat and thereby may increase the risk of cardiovascular disease. For over 2 decades, the Dietary Guidelines for Americans recommended that dietary cholesterol be no more than 300 mg per day. In a 2014 draft, DGAC dropped this recommendation because evidence showed no appreciable relationship between dietary and serum cholesterol. This caught the eye of the Physicians Committee for Responsible Medicine , which sued DGAC due to concerns of conflicts of interest which prompted the final draft to recommend eating “as little dietary cholesterol as possible”. A 2013 report by the American Heart Association and the American College of Cardiology recommended to instead focus on healthy dietary patterns rather than cholesterol limits as they are hard for clinicians and consumers to implement. They recommend the DASH and Mediterranean diet, which are low in cholesterol. A 2017 review by the American Heart Association recommends switching saturated fats for polyunsaturated fats to reduce cardiovascular disease risk.
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How Can I Raise My Hdl Level
If your HDL level is too low, lifestyle changes may help. These changes may also help prevent other diseases, and make you feel better overall:
- Eat a healthy diet. To raise your HDL level, you need to eat good fats instead of bad fats. This means limiting saturated fats, which include full-fat milk and cheese, high-fat meats like sausage and bacon, and foods made with butter, lard, and shortening. You should also avoid trans fats, which may be in some margarines, fried foods, and processed foods like baked goods. Instead, eat unsaturated fats, which are found in avocado, vegetable oils like olive oil, and nuts. Limit carbohydrates, especially sugar. Also try to eat more foods naturally high in fiber, such as oatmeal and beans.
- Stay at a healthy weight. You can boost your HDL level by losing weight, especially if you have lots of fat around your waist.
- Exercise. Getting regular exercise can raise your HDL level, as well as lower your LDL. You should try to do 30 minutes of moderate to vigorous aerobic exercise on most, if not all, days.
- Avoid cigarettes.Smoking and exposure to secondhand smoke can lower your HDL level. If you are a smoker, ask your health care provider for help in finding the best way for you to quit. You should also try to avoid secondhand smoke.
- Limit alcohol. Moderate alcohol may lower your HDL level, although more studies are needed to confirm that. What we do know is that too much alcohol can make you gain weight, and that lowers your HDL level.
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What’s Cholesterol Doing In There
Although cholesterol tends to get a bad rap, it also performs several important functions in the body:
- It plays a role in forming and maintaining cell membranes and structures. Cholesterol can insert between fat molecules making up the cell, making the membrane more fluid. Cells also need cholesterol to help them adjust to changes in temperature.
- Cholesterol is essential for making a number of critical hormones, including the stress hormone cortisol. Cholesterol is also used to make the sex hormones testosterone, progesterone, and estrogen.
- The liver also uses cholesterol to make bile, a fluid that plays a vital role in the processing and digestion of fats.
- Cholesterol is used by nerve cells for insulation.
- Your body also needs cholesterol to make vitamin D. In the presence of sunlight, cholesterol is converted into vitamin D.
Introduction To Cholesterol Metabolism
Cholesterol is an extremely important biological molecule that has roles in membrane structure as well as being a precursor for the synthesis of the steroid hormones, the bile acids, and vitamin D. Both dietary cholesterol, and that synthesized de novo, are transported through the circulation in lipoprotein particles. The same is true of cholesteryl esters, the form in which cholesterol is stored in cells. Due to its important role in membrane function, all cells express the enzymes of cholesterol biosynthesis.
The synthesis and utilization of cholesterol must be tightly regulated in order to prevent over-accumulation and abnormal deposition within the body. Of particular clinical importance is the abnormal deposition of cholesterol and cholesterol-rich lipoproteins in the coronary arteries. Such deposition, eventually leading to atherosclerosis, is the leading contributory factor in diseases of the coronary arteries.
Structure of cholesterol
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Cholesterol Buster: Eat More Fiber
Diet changes offer a powerful way to fight high cholesterol. If you’ve ever wondered why some cereals claim to be heart-healthy, it’s the fiber. The soluble fiber found in many foods helps reduce LDL, the bad cholesterol. Good sources of soluble fiber include whole-grain breads and cereals, oatmeal, fruits, dried fruits, vegetables, and legumes such as kidney beans.
The 5 Main Forms Of Lipoproteins
Extremely large in size, Chylomicrons carry triglycerides . Given the fact that they are made in the digestive system, they are heavily influenced by your diet and eating habits.
Very Low Density Lipoprotein
While these particles carry triglycerides to tissues as well, they are produced by the liver instead of the digestive system.
The cells of your body extract fatty acids from these particles, which turn them first into Intermediate Density Lipoproteins, and after further extraction, into Low Density Lipoproteins.
Intermediate Density lipoprotein
After extraction of fatty acids from VLDLs, they turn into Intermediate Density Lipoproteins. While many of these are sent over by the liver for excretion, there are some from which more fatty acids are extracted, which later turn into low-density lipoproteins.
Low Density Lipoprotein
These particles are much richer in pure cholesterol, given the fact that the number of triglycerides present in them is next to none. Infamous for being the bad type of cholesterol, this is the variety whose excess contributes to artery-clogging plaque.
Composed almost entirely of fat, LDLs constitute about 70% of the cholesterol that circulates in the bloodstream.
They have a tendency to get deposited in the arteries, which leads to atherosclerosis a condition where the arteries become harder and narrower, which makes the heart vulnerable to diseases.
High Density Lipoprotein
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How Can I Lower My Cholesterol
If the lifestyle changes alone do not lower your cholesterol enough, you may also need to take medicines. There are several types of cholesterol-lowering drugs available, including statins. If you take medicines to lower your cholesterol, you still should continue with the lifestyle changes.
Some people with familial hypercholesterolemia may receive a treatment called lipoprotein apheresis. This treatment uses a filtering machine to remove LDL cholesterol from the blood. Then the machine returns the rest of the blood back to the person.
NIH: National Heart, Lung, and Blood Institute
What Is Cholesterol And What Does It Do To Your Body
Cholesterol plays a vital role in the body. It is our bodys waxy repair substance and it is found in all cells. It is responsible for repairing damaged tissue in the body and is produced in the liver, released into your bloodstream, and directed to the areas of the body that needs repair.
There are two types of cholesterol, low-density lipoprotein or LDL, and high-density lipoprotein.
Low-density lipoprotein or LDL is considered bad cholesterol because it can get stuck and pile up on damaged arterial walls, and later become calcified, narrowing blood passages. Although this cholesterol is dubbed bad, this type of cholesterol is not entirely bad. Read more about that here.
High-density lipoprotein is considered good cholesterol because it carries the bad cholesterol out of the arteries, back to the liver and enhances heart health.
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Cholesterol is not always bad. It becomes harmful when inflammation in your arteries occurs. These inflammations can cause holes in the artery walls. Cholesterol in your bloodstream reacts to the affected area and immediately tries to repair the damage. As it works to heal the artery bad cholesterol, pile up, and thicken arterial walls causing calcification. This build-up narrows blood passages causing pressure to the damaged arterial walls, which can then lead to ruptures.
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Regulation Of Cellular Sterol Content
The continual alteration of the intracellular sterol content occurs through the regulation of key sterol synthetic enzymes as well as by altering the levels of cell-surface LDL receptors. As cells need more sterol they will induce their synthesis and uptake, conversely when the need declines synthesis and uptake are decreased. Regulation of these events is brought about primarily by sterol-regulated transcription of key rate limiting enzymes and by the regulated degradation of HMGR. Activation of transcriptional control occurs through the regulated cleavage of the membrane-bound transcription factor sterol regulated element binding protein, SREBP. As discussed above, degradation of HMGR is controlled by the ubiquitin-mediated pathway for proteolysis.
SREBP-1a regulates all SREBP-responsive genes in both the cholesterol and fatty acid biosynthetic pathways. SREBP-1c controls the expression of genes involved in fatty acid synthesis and is involved in the differentiation of adipocytes. SREBP-1c is also an essential transcription factor downstream of the actions of insulin at the level of carbohydrate and lipid metabolism. SREBP-2 is the predominant form of this transcription factor in the liver and it exhibits preference at controlling the expression of genes involved in cholesterol homeostasis, including all of the genes encoding the sterol biosynthetic enzymes. In addition SREBP-2 controls expression of the LDL receptor gene.
Protease-mediated regulation of SREBP activation.
Why Cholesterol Matters
Cholesterol circulates in the blood. As the amount of cholesterol in your blood increases, so does the risk to your health. High cholesterol contributes to a higher risk of cardiovascular diseases, such as heart disease and stroke. Thats why its important to have your cholesterol tested, so you can know your levels.
The two types of cholesterol are: LDL cholesterol, which is bad, and HDL, which is good. Too much of the bad kind, or not enough of the good kind, increases the risk cholesterol will slowly build up in the inner walls of the arteries that feed the heart and brain.
Cholesterol can join with other substances to form a thick, hard deposit on the inside of the arteries. This can narrow the arteries and make them less flexible a condition known as atherosclerosis. If a blood clot forms and blocks one of these narrowed arteries, a heart attack or stroke can result.
When it comes to cholesterol, remember: check, change and control. That is:
- Check your cholesterol levels. Its key to know your numbers and assess your risk.
- Change your diet and lifestyle to help improve your levels.
- Control your cholesterol, with help from your doctor if needed
High cholesterol is one of the major controllable risk factors for coronary heart disease, heart attack and stroke. If you have other risk factors such as smoking, high blood pressure or diabetes, your risk increases even more.
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What Are Hdl And Ldl
HDL and LDL are two types of lipoproteins.They are a combination of fat and protein. The lipids need to be attached to the proteins so they can move through the blood. HDL and LDL have different purposes:
- HDL stands for high-density lipoproteins. It is sometimes called the “good” cholesterol because it carries cholesterol from other parts of your body back to your liver. Your liver then removes the cholesterol from your body.
- LDL stands for low-density lipoproteins. It is sometimes called the “bad” cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries.
Estimation Of Ldl Particles Via Cholesterol Content
Chemical measures of lipid concentration have long been the most-used clinical measurement, not because they have the best correlation with individual outcome, but because these lab methods are less expensive and more widely available.
The lipid profile does not measure LDL particles. It only estimates them using the Friedewald equationby subtracting the amount of cholesterol associated with other particles, such as HDL and VLDL, assuming a prolonged fasting state, etc.:
- L T
- where H is HDL cholesterol, L is LDL cholesterol, C is total cholesterol, T are triglycerides, and k is 0.20 if the quantities are measured in mg/dl and 0.45 if in mmol/l.
There are limitations to this method, most notably that samples must be obtained after a 12 to 14 h fast and that LDL-C cannot be calculated if plasma triglyceride is > 4.52 mmol/L . Even at triglyceride levels 2.5 to 4.5 mmol/L, this formula is considered inaccurate. If both total cholesterol and triglyceride levels are elevated then a modified formula, with quantities in mg/dl, may be used
- L T
This formula provides an approximation with fair accuracy for most people, assuming the blood was drawn after fasting for about 14 hours or longer, but does not reveal the actual LDL particle concentration because the percentage of fat molecules within the LDL particles which are cholesterol varies, as much as 8:1 variation.
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