Most people are familiar with the effects of high cholesterol, but despite the massive amount of information about the dangers of this condition, there are some misconceptions. Dyslipidemia is an abnormal amount of blood lipids in the body. It can affect both HDL and LDL cholesterol levels, triglycerides, or a combination of these. The primary concern with dyslipidemia is an increased risk of cardiovascular disease and stroke.
The most common type of dyslipidemia is hyperlipidemia or high lipid levels. In some cases, yellow bumps called xanthomas appear on the body when lipid levels are extremely high. The less common type of dyslipidemia is hypolipidemia, wherein the lipid levels are too low, often due to hyperthyroidism or cancer. A diagnosis of primary dyslipidemia indicates one or more mutated genes causes the increased lipid levels. Secondary dyslipidemia has more to do with lifestyle and pre-existing medical conditions and is more common.
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Fat-like substances in the blood are called lipids and are an important component of living cells. Cholesterol is one type of lipid, and there are two types of cholesterol. LDL, which is often called the “bad” variety, transports cholesterol from the liver to the blood vessels. Too much cholesterol can clog them. HDL or “good” cholesterol helps the cholesterol travel from the blood vessels to the liver for disposal. Triglycerides are lipids that enter the bloodstream through the food we eat; they store energy until the body needs it.
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Every cell in the human body carries cholesterol, a waxy substance similar to fat. Cholesterol produces hormones like estrogen and testosterone, as well as vitamin D and other substances that help the digestive system dissolve foods. But because of its waxy consistency, too much cholesterol becomes a hindrance. It sticks to other substances and forms plaque, which adheres to the walls of the arteries, causing atherosclerosis, the predecessor to coronary artery disease. The liver produces a majority of the body’s cholesterol. It needs about 1000 mg to perform the functions required.
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It can be. The increased glucose levels in the bloodstream associated with diabetes create plaque deposits on the interior walls of blood vessels. High risk of cardiovascular disease is a concern for those diagnosed with diabetes, so regulating lipid levels in the blood is an important part of controlling the disease. Many individuals diagnosed with diabetes also have high triglyceride levels, low HDL levels, and compact LDL particles that adhere easily to the artery walls. Lipid panel workups allow physicians to keep an eye on the issue.
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Familial hypercholesterolemia (FH) causes premature cardiovascular disease. Those who develop the disorder have increased LDL levels because their livers cannot remove excess LDL from their bodies. Heterozygous FH is inherited from one parent and occurs in about one out of every 250 people. A rarer form of the disorder is Homozygous FH, which is inherited from both parents and occurs in only one out of a million people. Researchers suspect large numbers of children, teens, and adults may have this treatable disorder but are undiagnosed.
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When diagnosed in children, severe dyslipidemia is primarily genetic. However, even more severe are those that are both genetic and intensified due to environmental factors such as diets high in saturated fats and cholesterol. The problem with childhood dyslipidemia is that there are few symptoms. Familial hypercholesterolemia is the exception, having numerous physical signs including yellow bumps on the Achilles tendon, feet, elbows or knees, or a grayish or yellowish ring in the corneas of both eyes. Other forms of dyslipidemia are due to kidney disease, diabetes, obesity, or certain drugs.
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Short periods of stress are unlikely to affect cholesterol levels. However, chronic stress can lead to high cholesterol. Studies show psychological factors, including stress, are significant risk factors for dyslipidemia. Chronic stress causes the body to release cortisol and adrenaline, the two “fight or flight” hormones. These hormones trigger increased LDL cholesterol by releasing triglycerides and free fatty acids and may reduce HDL cholesterol levels. Research to better understand the relationship between stress and blood lipid levels is ongoing.
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Unless there is a genetic link to familial hypercholesterolemia, there aren’t any physical signs for dyslipidemia. Doctors most often discover the condition during a routine exam. A lipid panel can then determine total cholesterol, HDL, LDL and triglyceride levels in the body. The doctor may also order other tests depending on the individual’s age, risk factors, family history, medical conditions, and any recent health issues.
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Besides diabetes, other hormone disorders can lead to dyslipidemia. Polycystic ovary syndrome (PCOS), hypothyroidism, and metabolic syndrome can cause high levels of blood fat. Cushing syndrome creates abnormally high levels of cortisol in the bloodstream. High cortisol levels lead to fat accumulations around the waist, which is a risk factor for dyslipidemia. Smoking causes a loss of HDL, more often in women than men.
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A large part of controlling dyslipidemia individuals must undertake themselves. Changing an unhealthy daily diet and getting more exercise are two of the primary ways to control the condition. Adding more fruits, whole grains, vegetables, and lean proteins can make a big difference. In some cases, doctors may prescribe medications, including lipid-lowering drugs. It is important that the individual continues taking the medications even after cholesterol levels go down to maintain control of the condition. Overall cholesterol levels should be below 200 mg/dL.
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