What is cholesterol?

Read more about cholesterol

What is cholesterol? It is a substance that is produced by the liver in a waxy and fatlike form that does not dissolve in water. It helps to produce certain hormones, cell membranes, bile that helps digest fats, and vitamin D.
Cholesterol is an important component of body cells, making cell membranes strong and flexible(1). It cannot travel through the body on its own and therefore requires the help of certain molecules known as lipoproteins to move through the blood stream.

The molecules transporting cholesterol include the low density lipoproteins and high density lipoproteins.

Low density lipoprotein (LDL) is linked to the build-up of plaque in the arteries and are therefore referred to as the bad cholesterol (2).

The high density lipoprotein (HDL) is referred to as the good cholesterol because it helps to remove excess cholesterol from the body (2).

Do not consume too many fat-rich foods because doing so will increase your blood LDL, referred to as high cholesterol, hyperlipidemia or hypercholesterolemia.

If you have very high LDL levels or very low HDL levels, fats get deposited and built up in your blood vessels.

As the deposits accumulate, they obstruct the arterial lumina and make it difficult for the blood to flow through the arteries which will cause problems for the organs such as heart and brain supplied by the affected arteries.

Is Cholesterol unhealthy?

You know what? Only 25% of your blood HDL and LDL is from food sources while the remaining 75% is produced by your liver (3).

When you eat foods high in cholesterol, your liver scales down its production of cholesterol, and when your intake of dietary cholesterol is low, your liver produces more cholesterol to make up the shortfall(4).

Dietary cholesterol is not harmful because it does not have much impact on the levels of cholesterol in your body. Research has proven this to be true, and shown that no association exists between cholesterol from dietary sources and heart disease (5, 6, 7).

About 67% of the world’s population do not experience increase in their levels of cholesterol after eating foods rich in cholesterol (8).

However, few people may experience slight impact on their cholesterol levels after eating cholesterol-rich foods.

HDL and LDL hyper-responders or non-compensators

These people, also known as cholesterol hyper-responders or non-compensators, appear vulnerable to foods high in cholesterol. However, they easily return extra cholesterol to the liver where it is excreted(9).

You can check the level of your blood cholesterol with a blood test. The test you can do is the total blood cholesterol level. You have high blood cholesterol when your total cholesterol is above 240mg/dl.

Always consult with your doctor who recommends when you can have your blood cholesterol checked and how frequently, particularly if you have positive family history of high cholesterol.

Also, check your cholesterol level frequently if you have or are at risk for smoking, high blood pressure, overweight.
Try and check your blood cholesterol levels after turning 20 years of age and do regular cholesterol test every 4 years.

Your doctor may want you to check more frequently if you have a family history of high blood cholesterol, or you have high blood pressure, you smoke or you are overweight.

Symptoms of high cholesterol

Hypercholesterolemia is typically asymptomatic and even when high cholesterol does not cause symptoms, it causes serious damage and emergency events such as stroke or heart attack.

The emergency events only occur after high cholesterol has led to plaque formation in your arteries. The plaque narrows the arterial lumina and reduces the volume of blood passing through the arteries.

With the formation of plaque, there is a change in the make-up of the arterial lining which may result in complications.

Familial hypercholesterolemia

Familial hypercholesterolemia describes a genetic condition that causes an increase of LDL in people that have the genetic predisposition.

These people have cholesterol levels of 300mg/dl or higher and may experience a lump underneath the skin or an appearance of a yellow patch above the skin.

Cerebrovascular accident (Stroke)

If the lumina of your blood vessels supplying blood to your brain are blocked by plaque caused by LDL, then you are at risk of having blood supply to your brain reduced or cut off.

By cutting off blood supply to an important part of your brain, stroke will occur. A stroke is an emergency that is life-threatening.

The symptoms of a stroke include sudden dizziness, sudden loss of balance and coordination, confusion, inability to move, affecting particularly one side of the body, and facial asymmetry including eyelid and mouth drooping to one side of the body.

Other symptoms of a stroke include sudden severe headache, blurred vision, double vision, blackened vision, slurring words, and facial, arm or leg numbness, especially on one side of the body.

It is important to urgently seek medical treatment if you notice any of these symptoms of a stroke.

Leafy vegetables

Heart disease

Heart disease, also known as coronary artery disease, is a major cause of death worldwide and affects both sexes equally. Heart disease presents in many ways with the symptoms differing between males and females.

The most common symptoms of heart disease include extreme fatigue, numbness or coldness in extremities, shortness of breath, nausea, neck pain, upper abdominal pain, jaw pain, back pain, angina and chest pain.

Peripheral arterial disease

Peripheral artery disease is a condition that occurs when plaque builds up in the arterial wall and blocks the flow of blood in the arteries supplying blood to the arms, stomachs, kidneys, legs and feet.

The symptoms of early peripheral arterial disease are fatigue, discomfort in the legs and feet, body pain, cramps, and intermittent claudication (leg pains during physical activity).

Progression of peripheral arterial disease leads to more frequent symptoms which occur even when there is no physical activity or exercise, and in fact when the patient is resting.

Late symptoms of peripheral symptoms include burning sensation in the toes, leg pain that continues at rest, foot and leg ulcers that do not heal or heal slowly, gangrene (tissue death caused by lack of blood supply), paleness, shininess or thinning on the skin of the legs and feet.

Other symptoms of peripheral arterial disease include reduced hair growth on the legs, toes turning blue, thick toenails, decreased temperature of one lower leg or foot compared to the other leg, and leg cramps.

People that have peripheral arterial disease have a higher risk of stroke, limb amputation and heart attack.

Heart attack

Plaque can build up in the arteries supplying blood to the heart causing gradual narrowing of the arterial lumina. This is called atherosclerosis and it occurs slowly over time without the patient having any symptoms.

As the plaque deposits increase, a piece of plaque may break off. The piece of plaque may be circumscribed by blood clot which can block blood flow to the heart muscle, depriving it of nutrients and oxygen.

The deprivation of oxygen and nutrients is called ischemia. A heart attack occurs when the heart or part of it is damaged, or die due to lack of oxygen. Medically, this is called myocardial infarction.

The American Heart Association said that one person has myocardial infarction every 34 seconds in the United States of America.

The symptoms of a heart attack include difficulty in breathing, dizziness, nausea, fatigue, indigestion, heartburn, anxiety, tightness in the chest or arms, feeling of impending doom, fullness, squeezing or pain in the chest or arms.

When a heart attack occurs, prompt treatment must be provided in the first few hours after the attack, otherwise the damage to the heart could become fatal or irreversible.

A heart attack is therefore a medical emergency that requires an emergency treatment. If you experience any of the above symptoms, act fast and seek medical treatment.

Healthy, cholesterol rich nuts

Diagnosing high cholesterol levels

This brings us to the process of diagnosing high cholesterol. It is easy to diagnose high cholesterol using a blood test that is known as lipid panel or lipid profile test.

When you go for the test, your doctor will tell you not to eat food or drink anything for at least 12 hours before doing the test.

Your doctor will take a sample of your blood and send it to the laboratory where it will be analyzed.

The lipid panel measures the levels of four cholesterol molecules including total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides.

For normal levels, the Centers for Disease Control and Prevention (CDC) posit that HDL should be 60mg/dl or higher; LDL should be less than 100mg/dl; and triglycerides should be less than 150mg/dl.

If your total cholesterol measures between 200 and 239mg/dl, it is considered borderline high, and if it is above 240mg/dl, it is considered high.

For your LDL, it is borderline high if the level is between 130 and 159mg/dl while it is high if it is above 160mg/dl.

Your HDL is considered low if the level is below 40mg/dl.

Final thoughts on cholesterol

It is important that you make good lifestyle choices because high LDL levels are asymptomatic in the early stages. Engage in regular physical activity and eat healthy diet. Ensure you monitor your cholesterol levels by doing the test in the hospital.

According to American Heart Association, it is recommended that you have your LDL and HDL levels checked every 4 to 6 years if you are above the age of 20 and healthy. But if you have a high risk of high LDL, check your cholesterol more often and as may be requested by your doctor.

Also, if you have a positive family history of hypercholesterolemia, or heart attacks that affected your parents or grandparents, then you need a more frequent check of your LDL and HDL levels.

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