Cholesterol: The Good, the Bad, and the Ugly

Cholesterol often gets a bad rap, and understandably so, thanks to dire warnings about the effects of high cholesterol. Let’s take a closer look.

Cholesterol: The Good, the Bad, and the Ugly

Cholesterol is a waxy, fat-like substance found throughout the body that plays several vital roles:

• It’s a key component in building cell membranes
• It’s used to produce hormones like testosterone and estrogen
• It helps make vitamin D and bile acids for digestion

So far, so good. There are two main types of cholesterol:

HDL (High-Density Lipoprotein): Known as “good” cholesterol. HDL helps remove excess cholesterol from the bloodstream and transport it to the liver for disposal.

LDL (Low-Density Lipoprotein): Often called “bad” cholesterol. High levels of LDL can lead to plaque buildup in arteries, increasing the risk of heart disease and stroke.

Our bodies produce all the cholesterol they need naturally in the liver. Additional cholesterol comes from animal-based foods in your diet. And that’s where things get bad.

Cholesterol Levels: The Good and the Bad

When you go to a health care professional to get your cholesterol checked, this test will usually check the levels of cholesterol and triglycerides in your body. (A cholesterol check is also called a lipid panel or lipid profile.) Cholesterol levels are measured in milligrams per deciliter (mg/dL) of blood. (A deciliter is about a drop of blood.) Optimal cholesterol levels are:

• Total cholesterol: The combination of LDL cholesterol, HDL cholesterol, and triglycerides: About 150 mg/dL
  • LDL cholesterol: About 100 mg/dL
  • HDL cholesterol: At least 40 mg/dL for men, 50 mg/dL for women
  • Triglycerides: Less than 150 mg/dL. Triglycerides are a type of fat in your blood that your body uses for energy.

High cholesterol (hyperlipidemia) is a total cholesterol above 200 mg/dL. The combination of high levels of triglycerides with either low HDL cholesterol or high LDL cholesterol levels can increase your risk for heart attack and stroke. (And that’s bad!)

The Ugly

From 2017 to 2020, 86.4 million US adults aged 20 or older had high or borderline high cholesterol (a total cholesterol level greater than or equal to 200 mg/dL). From 2009 to 2016, about 1 in 5 adolescents had an unhealthy cholesterol measurement.

High cholesterol can have several profound health implications if left untreated:

Cardiovascular Disease: High cholesterol is a significant risk factor for atherosclerotic cardiovascular disease caused by plaque buildup in the arteries, which increases the risk of heart disease and stroke.

Coronary Heart Disease: Cholesterol buildup in coronary arteries can lead to angina (chest pain) or heart attacks—the primary risk associated with high cholesterol.

Stroke: Cholesterol plaque in arteries leading to the brain can cause blockages, potentially resulting in a stroke.

Peripheral Artery Disease (PAD): Narrowing of the arteries in the legs due to plaque buildup can reduce blood flow, causing pain and increasing the risk of infection.

High Blood Pressure: Cholesterol plaque hardens and narrows arteries, forcing the heart to work harder to pump blood, leading to hypertension.

Diabetes Complications: High cholesterol can worsen diabetes by further damaging blood vessels and increasing cardiovascular risks.

Increased Risk of Heart Attack and Stroke: The combination of plaque buildup and potential blood clots significantly raises the risk of these life-threatening events.

Unfortunately, high cholesterol often has no symptoms, allowing damage to occur unnoticed until a serious event happens.

To prevent these complications, regular cholesterol screening and appropriate treatment (lifestyle changes and medication) are crucial, especially for those at higher risk due to factors like age, family history (familial hypercholesterolemia), or other health conditions.

What’s more, several medications can cause high cholesterol as a side effect.

Treating High Cholesterol

There are some practical ways to lower your LDL (bad) cholesterol naturally:

1. Diet Changes
2. Reduce saturated and trans fats
3. Limit red meat, full-fat dairy, and fried foods
4. Avoid trans fats found in processed and packaged foods

2. Increase Fiber Intake

• Eat more oatmeal, beans, apples, and other high-fiber foods
• Soluble fiber helps prevent cholesterol absorption

3. Consume Heart-healthy Fats

• Use olive oil and eat nuts, avocados, and fatty fish. These contain monounsaturated and polyunsaturated fats

4. Add plant sterols and stanols

• Found in some fortified foods like orange juice or yogurt drinks, they help block cholesterol absorption

Apart from dietary changes, you can naturally improve your cholesterol levels through 30 minutes of moderate aerobic exercise several days a week, losing excess weight, quitting smoking, limiting alcohol consumption, and taking supplements such as fish oil or psyllium fiber supplements

Combining these natural approaches can significantly lower your LDL cholesterol and improve your overall heart health. Remember that consistency is key and may take time to see results.

When Medications are Needed

There are several types of medications, taken orally or by injection or infusion, used to treat high cholesterol. Statins are the most commonly prescribed cholesterol-lowering medications. They work by reducing cholesterol production in the liver. Common statins include atorvastatin (Lipitor), rosuvastatin (Crestor), simvastatin (Zocor), and pravastatin (Pravachol).

Injections and Infusions

Other medications include cholesterol absorption inhibitors, PCSK9 inhibitors, bile acid sequestrants, and fibrates. Subcutaneous injections, such as Leqvio (inclisiran), work by blocking a protein called PCSK9, which helps the liver remove more LDL cholesterol from the blood

Leqvio is a relatively new injectable medication used to treat high cholesterol. It is typically prescribed for patients who have heterozygous familial hypercholesterolemia (an inherited condition causing very high cholesterol) or atherosclerotic cardiovascular disease and need additional LDL cholesterol lowering. After the first injection, there’s another dose at three months, followed by an injection every six months.

Evkeeza is an intravenous medication for treating high cholesterol, specifically in patients with homozygous familial hypercholesterolemia. 2. It is given as an intravenous infusion every four weeks, with each session lasting about 60 minutes. Evkeeza works by blocking a protein called angiopoietin-like 3 (ANGPTL3), which allows the body to break down cholesterol more effectively.

12Stone Health Partners: Making Injections and Infusions Easier

Although 12Stone is well-known for administering infusions, we “give shots,” too. We understand the difficulty of scheduling an appointment at your physician’s office for a simple injection, so we partner with healthcare providers and pharmacies to make receiving your medications as effortless as possible.

If you cannot come to one of our 21 infusion centers throughout Kentucky, Virginia, Tennessee or Georgia, we’ll happily come to your home—a great blessing for those who are homebound or have challenges with transportation.

Ask your healthcare provider if they recommend 12Stone Health Partners for your cholesterol medications. You’ll be glad you did.