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Today in Health & Wellness
HEALTH CONDITIONS

Lipid Disorders

Overview
Symptoms
Risk Factors
Commonly Prescribed Drugs
Treatment and Management
Doctors to Consult
Overview

Lipid disorders include conditions with elevated levels of cholesterol and/or triglycerides. The levels of low-density lipoprotein (LDL) cholesterol and triglycerides are considered when diagnosing a lipid disorder.

Low-density lipoprotein (LDL) cholesterol is also called the bad cholesterol. It is mostly made up of cholesterol and combines with other substances to form plaques in the arterial walls. This leads to atherosclerosis or the narrowing of the arteries which increases the risk of heart attack and stroke. Triglyceride is another form of fat in the body. It can be obtained from food or the conversion of excess calories to fat. Increased levels of triglycerides raise the risk of heart and vascular diseases.

An unhealthy diet and some medical conditions increase the levels of cholesterol and triglycerides. A diet high in saturated fat and/or trans fats increase the cholesterol levels of the body. Saturated fat is commonly found in cheese, milk, and butter while trans fats are present in peanut butter, margarine, and potato chips. Cholesterol levels also increase when there is lack of exercise and when a patient smokes. Triglyceride level increase in patients with high cholesterol levels, heart disease, and diabetes.

Lipid disorders do not present with characteristic signs and symptoms. Some symptoms only appear when significant damage has been done. A lipid profile is obtained through a blood test. This summarizes the total cholesterol and triglyceride levels of the patient. Fasting for at least 12 hours is required before the blood sample is obtained. It is advisable for adults at least 20 years old to measure their lipid profile every 4 to 6 years.

Normal, borderline and high levels of LDL, total cholesterol, and triglycerides.

 

LDL

Total Cholesterol

Triglycerides

   Normal (mg/dL)

≤ 100

≤ 200

≤ 149

   Borderline (mg/dL)

130 – 159

200 – 239

150 – 199

   High (mg/dL)

≥ 160

≥ 240

≥ 200

 

Symptoms

Lipid disorders rarely present with signs and symptoms. Very high lipid levels can present the following symptoms:

  • Xanthomas – bumps on the skin and tendons due to fat deposits
  • Opaque white or gray rings around the edge of the cornea

Very high triglyceride levels can present with the following:

  • Enlargement of the liver or spleen
  • Tingling or burning feeling of the hands and feet
  • Difficulty breathing
  • Confusion
  • Pancreatitis presenting with severe abdominal pain
Risk Factors
  • Diet high in saturated fat and/or transfat
  • Heart disease
  • Diabetes
  • Hypothyroidism
  • Metabolic syndrome
  • Cushing’s syndrome
  • Polycystic ovarian syndrome (PCOS)
  • Kidney disease
  • Sedentary lifestyle. Lack of exercise increases LDL cholesterol levels
  • Smoking
  • Family history of high blood cholesterol
  • Overweight
Commonly Prescribed Drugs

Lipid-lowering drugs are beneficial for patients with very high cholesterol levels or risk factors for heart attack or stroke. These drugs prevent the occurrence of coronary artery disease and reduce the risk of early death.

  • HMG-CoA reductase inhibitors or statins block the enzyme responsible for the start of cholesterol synthesis. This ultimately blocks cholesterol formation. Total cholesterol, LDL cholesterol, very low-density lipoproteins (VLDL) cholesterol, and triglyceride levels decrease while high-density lipoprotein (HDL) levels increase. Thus, these drugs can be used in patients with high blood cholesterol and/or triglyceride levels. Examples of this class include atorvastatin, lovastatin, pravastatin, rosuvastatin and simvastatin. Side effects: bloating, fatigue, loose stools, muscle aches due to inflammation or degeneration (rare)
  • Bile acid binders are drugs that increase the excretion of bile acids from the intestines. This causes the liver to obtain LDL cholesterol from the bloodstream and utilize it for bile production. It ultimately decreases the levels of LDL cholesterol in the blood. Examples of this class include cholestyramine, colesevelam, and colestipol. Side effects: abdominal pain, bloating, constipation, reduced effectiveness of some drugs
  • Ezetimibe inhibits the absorption of cholesterol in the small intestines. This decreases the levels of LDL cholesterol. Its advantage from other lipid-lowering drugs is its few serious side effects. Side effects: loose stools, face & lip swelling and muscle aches (rare)
  • Fibric acid derivatives decrease high triglyceride levels while increasing HDL production. These drugs also inhibit the production of VLDL, the lipoprotein used to produce LDL cholesterol. This class of drugs include fenofibrate and gemfibrozil. Side effects: bloating, gallstones, high liver enzyme levels
  • Niacin is beneficial for patients with low HDL levels. It can increase the levels of HDL in the body as well as decrease triglycerides. Niacin is less commonly prescribed and usually considered only when a patient cannot tolerate statins. Side effects: stomach upset, flushing, itchiness, gout
Treatment and Management
  • Maintaining a healthy lifestyle is the key to prevent and lower high blood cholesterol and triglyceride levels. Before considering lipid-lowering medications, proper diet and adequate physical activities are usually implemented first.
  • Reduce and control weight to maintain a normal BMI (body mass index) between 18.5 to 23 kg/m2. Limit intake of fats and increase consumption of fiber. Exercise for at least 30 minutes for 5 or more days every week.
  • Patients with high triglyceride levels should also limit their consumption of sugar, refined flour and starchy food.
  • Limit or avoid alcohol consumption.
  • Quit or avoid smoking.

 

Prevention

  • A healthy diet prevents high blood cholesterol and triglyceride levels. Only less than 6% of the daily caloric intake should be composed of saturated fat while transfat is limited to less than 1%.
  • The majority of the diet should be composed of whole grains, fruits and vegetables.
  • For meat products, avoid skin with visible fat and choose lean meats in moderate servings.
  • Only consume dairy products that are low-fat or fat-free.
  • Polyunsaturated and monounsaturated fats are preferred in the diet. These are commonly found in nuts, corn, sesame seeds, sardines, salmon, olive oil, canola oil, almonds and avocado.
Home Remedies
Doctors to Consult
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