Hyperlipidemia : The silent accomplice
Definition
Hyperlipidemia is cholesterol which is a waxy substance made by the liver and important for healthy cell membranes, brain, hormones, fat soluble vitamin (vitamins A,D,E,K). Too much cholesterol leads to vascular diseases of different kinds including heart disease, stroke, peripheral artery disease. Smoking and increased inflammation worsens the possibility of developing atherosclerosis.

Causes
- Diet
- Familial
- Excessive alcohol consumption
- Obesity
- Taking medications, such as hormones or steroids
- Diabetes and metabolic syndrome
- An underactive thyroid gland, or hypothyroidism
- Sedentary lifestyle

Prevention
The best way to prevent excessive cholesterol is to eat moderately, not drink excessively or smoke, exercise regularly

Treatment
- Nutrition : The more whole foods plant based we adopt the better it is. There is strong data to show a whole-foods plant- based diet helps to control cholesterol.
- Exercise : Exercise minimum 150 minutes weekly. It can be broken up into any blocks. I recommend aerobic exercise 30 min 3x week and strength training 2x week. It is important to do stretching before and after exercising.
- Stress : High stress increases cortisol which increases the production of cholesterol because it is the building block needed to make cortisol. Also, when we are stressed we eat the wrong foods which of course increases our cholesterol.
- Sleep hygiene : Lack of sleep seems to be associated with increased triglycerides and decreased good cholesterol particularly in women, however we do not have enough definitive data. It is very important that we get an adequate amount of sleep, 7-8 hours.
- Supplements : There are many options out in the marketplace. Some are good and others are not. Please discuss with your doctor.
Medications
- Statins are the most common medication used for high cholesterol. They have the most data to suggest possible benefits and all can agree to disagree on this point. A thorough discussion must be made with your doctors regarding the validity of the various concerns.
- Niacin is a good option if you can tolerate the natural flushing and itching associated with it.
- Fibrates are particularly directed to elevated triglycerides.
- PCSK9 inhibitors are newer injectable medications that are promising for those who have failed all other therapies.


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