High Cholesterol: Causes, Concerns, and Next Steps

High cholesterol

During enrollment, blood tests are conducted for health checks, but I'm not sure if every school and hospital uses similar standards for evaluation.
In my first year of high school, my total cholesterol was over 300, but my blood glucose, urine, and other values were normal; only the cholesterol was abnormal.
By my first year of college, my total cholesterol increased to over 400, yet my blood glucose levels remained normal.
I wonder if this could be genetic, as my grandmother has diabetes.
If further testing is needed, what steps should I take for consultation?

Hblcm, 10~19 year old female. Ask Date: 2016/01/05

Dr. Chen Bozhang reply Family Medicine

Dear Ms.
Hblcm,
In your letter, you mentioned that during your freshman year of high school, your cholesterol level was above 300 mg/dL, and during your freshman year of college, your total cholesterol rose to above 300 mg/dL again.
Both of these values are significantly high, as the ideal total cholesterol standard is between 130-200 mg/dL.
Cholesterol metabolism is influenced by genetic factors as well as personal lifestyle habits, particularly physical activity levels.

I recommend that you visit a family medicine or general internal medicine clinic.
The physician will assess your high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol levels, commonly referred to as "good" and "bad" cholesterol, and will inquire about other factors to evaluate your cardiovascular disease risk associated with your cholesterol levels.
This will help determine the appropriate management plan.

Everyone has a unique physiological makeup, so there is no need to worry excessively at this stage.
Discussing your concerns with a physician in a clinic is the correct first step.
I hope this information is helpful to you.
Sincerely,
Dr.
Chen Bozhang
Department of Family Medicine
Keelung Hospital, Ministry of Health and Welfare

Reply Date: 2016/01/05

More Info

High cholesterol, or hypercholesterolemia, is a significant health concern that can lead to cardiovascular diseases, including heart attacks and strokes. Understanding the causes, concerns, and next steps for managing high cholesterol is crucial, especially given your family history and the consistently high cholesterol levels you've reported.

Causes of High Cholesterol
1. Genetics: Familial hypercholesterolemia is a genetic condition that can lead to high cholesterol levels. If you have a family history of high cholesterol or related conditions, such as heart disease or diabetes, it is possible that your elevated cholesterol levels are hereditary.

2. Diet: A diet high in saturated fats, trans fats, and cholesterol can contribute to increased cholesterol levels. Foods such as red meat, full-fat dairy products, and processed foods can raise your LDL (low-density lipoprotein) cholesterol, often referred to as "bad" cholesterol.

3. Lifestyle Factors: Lack of physical activity, obesity, smoking, and excessive alcohol consumption can also contribute to high cholesterol levels. Regular exercise and maintaining a healthy weight can help manage cholesterol levels.

4. Other Health Conditions: Certain medical conditions, such as diabetes, hypothyroidism, and kidney disease, can also affect cholesterol levels.

Concerns Related to High Cholesterol
High cholesterol can lead to the buildup of plaques in your arteries, a condition known as atherosclerosis. This can narrow the arteries and restrict blood flow, increasing the risk of heart disease and stroke. The American Heart Association recommends that adults have their cholesterol levels checked every four to six years, but more frequent monitoring may be necessary if you have risk factors such as a family history of heart disease or diabetes.

Next Steps for Management
1. Consult a Healthcare Provider: Given your consistently high cholesterol levels, it is essential to consult with a healthcare provider. They can evaluate your overall health, family history, and lifestyle factors to determine the best course of action. This may include blood tests to measure your lipid profile, which includes total cholesterol, LDL, HDL (high-density lipoprotein), and triglycerides.

2. Lifestyle Modifications:
- Diet: Adopt a heart-healthy diet that includes plenty of fruits, vegetables, whole grains, and lean proteins. Limit saturated fats and avoid trans fats. Foods rich in omega-3 fatty acids, such as fish, walnuts, and flaxseeds, can also help improve cholesterol levels.

- Exercise: Aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity each week. Regular physical activity can help raise HDL cholesterol and lower LDL cholesterol.

- Weight Management: If you are overweight, losing even a small amount of weight can help improve your cholesterol levels.

3. Medication: If lifestyle changes are not sufficient to lower your cholesterol levels, your healthcare provider may recommend medication. Statins are commonly prescribed to help lower LDL cholesterol. However, the decision to start medication will depend on your overall risk factors and cholesterol levels.

4. Regular Monitoring: After initiating lifestyle changes or medication, regular follow-up appointments are essential to monitor your cholesterol levels and assess the effectiveness of your treatment plan.

Conclusion
In summary, high cholesterol is a multifactorial issue that can be influenced by genetics, diet, lifestyle, and other health conditions. Given your family history and the significant elevations in your cholesterol levels, it is crucial to seek medical advice. A healthcare provider can help you understand your risk and develop a personalized plan to manage your cholesterol effectively. Making lifestyle changes, such as improving your diet and increasing physical activity, can have a significant impact on your cholesterol levels and overall heart health. Regular monitoring and follow-up are key to ensuring that your cholesterol levels remain within a healthy range.

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