The term “lipid disorder” covers a range of conditions that can cause abnormal levels of lipids, or fats, in the blood.
These fats include low-density lipoproteins (LDLs), also known as “bad” cholesterol, and fatty acids called triglycerides. High-density lipoproteins (HDLs), known as “good” cholesterol, are also present in the blood.
This article will look at the symptoms of lipid disorders, their causes, and what treatments are available, including lifestyle changes people can make to prevent or reduce high cholesterol.
A lipid disorder will typically increase levels of LDLs, triglycerides, or both. HDLs are known as good cholesterol because they help to transport bad cholesterol out of the body.
A buildup of LDLs and triglycerides can cause fatty materials to accumulate in the body’s tissues, including in the arteries. This can have serious consequences for cardiovascular health and increase the risk of problems such as heart disease.
The American Academy for Family Physicians say 1 in 3 adults in the United States have high levels of LDL cholesterol. This is why healthcare professionals advise people to cut down on fatty foods and increase their HDL levels to help remove the bad cholesterol.
It is important to point out that, most of the time, a person will have no symptoms of a lipid disorder until they experience a significant health problem, such as a stroke or heart attack.
However, the following symptoms have been occasionally observed in some people with very high lipid levels:
- yellowish, fatty bumps or yellow creases on the skin, formed by an accumulation of fatty deposits around tendons and joints (xanthomas)
- white arcs around the cornea of the eye (arcus senilis), which sometimes occur in younger people with high cholesterol
- raised, yellow lumps at the inner corners of the eyes (xanthelasma)
A range of factors can cause lipid disorders, including genetics, lifestyle, and other underlying health conditions.
Genetic factors
Many lipid disorders are inherited. Familial hypercholesterolemia (FH) for example, is when high cholesterol runs in a family.
FH affects an estimated 1 in 200–500 people worldwide but is more common in people of French Canadian, Ashkenazi Jewish, Lebanese, or Afrikaner (a South African ethnic group) descent.
Knowing their family history of cholesterol and heart disease may help people decide if they want to get a blood test to check if they have high cholesterol.
Diet and lifestyle factors
Foods that are high in saturated fats can also cause high blood cholesterol and high levels of triglycerides. Foods that contain saturated fats include:
- dairy products, such as cheese, cream, and butter
- sugary treats, such as cakes, cookies, and ice cream
- fatty or cured meats, such as sausages, bacon, and salami
- foods containing coconut oil, palm oil, or lard
Foods that contain trans fats are particularly dangerous, as they raise bad cholesterol and lower good cholesterol. Foods that contain trans fats include:
- baked goods such as cookies, pies, and pastries
- fried, fatty foods, such as fried chicken, french fries, and doughnuts
- shortening, certain margarines, and vegetable oils
- non-dairy coffee creamers
Other dietary and lifestyle factors that can elevate cholesterol include:
- smoking or exposure to tobacco smoke
- being physically inactive
- having overweight or obesity
- drinking too much alcohol
- taking certain medications, such as diuretics
Medical conditions
Underlying health conditions may increase cholesterol levels, including:
A doctor can run a blood test called a lipid profile or lipid panel to initially diagnose a lipid disorder. This measures levels of total cholesterol, LDLs, HDLs, and triglycerides, among other things.
If blood test results show elevated cholesterol, a doctor may order other tests to rule out underlying problems that may be causing it, such as thyroid or liver tests.
Occasionally, if a doctor suspects a patient needs intensive treatment, they may order advanced lipid testing. This checks the concentration of lipoproteins in the blood and helps to predict the risk of cardiovascular disease more accurately.
Treatment for a lipid disorder may depend on cholesterol levels, age, and what underlying health conditions are also present.
A healthcare professional will usually recommend lifestyle changes as a primary intervention to tackle high cholesterol. These changes may include:
- reducing or cutting out saturated and trans fats
- eating more healthily and following a diet with more oily fish, brown rice and pasta, and fruit and vegetables
- taking up moderate exercise to lose weight — at least
150 minutes a week - quitting smoking or vaping
- cutting down on alcohol
Medication may also be necessary to manage cholesterol levels, so many healthcare professionals may recommend a combination of medication and lifestyle changes. Medications for cholesterol management may include:
Statins
Statins are a group of medicines that block the liver from producing LDL cholesterol. They come as tablets that are taken orally once a day. People may need to take some statins at certain times of the day.
Commonly prescribed statins include fluvastatin (Lescol), atorvastatin (Lipitor), and pravastatin (Pravachol). A doctor may need to adjust the level of medication during treatment.
Cholesterol inhibitors
Cholesterol absorption inhibitors lower cholesterol by limiting the body’s ability to absorb cholesterol. A doctor may prescribe them alone, or in combination with statins. Ezetimibe (Ezetrol) is a common medication.
Bile acid sequestrants
These medications act to lower cholesterol by trapping and binding bile acids, which contain cholesterol. This prevents the body from absorbing them.
Bile acid sequestrants may be available in powder or tablet form. Some users report gastrointestinal problems, such as constipation, when taking these medications.
Fibrate therapy
Doctors may prescribe fibrates in combination with statins and cholesterol inhibitors. Fibrates work to reduce triglycerides and increase levels of good cholesterol in the blood.
Supplements
Omega-3 fatty acids help to reduce cholesterol. They are present in fatty fish such as salmon, and in plant oils. People with high cholesterol may wish to take a daily supplement of omega-3 fatty acid. Niacin, a B vitamin, can also help to lower triglycerides and boost good cholesterol.
People who wish to take niacin for high cholesterol should speak to their doctor first. This is because they will need to take it in larger-than-usual doses for it to be effective.
People who take niacin in a higher dose without medical advice may experience serious side effects, such as liver damage or brain bleed.
Green and black tea
A 2013 review of studies involving hundreds of participants found that black tea and green tea both produced significant reductions in LDL cholesterol. However, more research is necessary to be sure of the long-term benefits.
Lipid disorders, such as high cholesterol, are common in the U.S.
A healthy diet and lifestyle can help to reduce cholesterol, especially if combined with medication.
People who are worried about a family history of high cholesterol, or any symptoms associated with lipid disorders, should talk with a healthcare professional.