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The highs and lows of cholesterol

High cholesterol can be silent and sneaky, and there are usually no warning signs until something serious develops. Anyone can have it without knowing, including kiddos and the fittest of athletes. 

The good news is that a simple test can check your cholesterol levels. Understanding when to get screened, what your “good” and “bad” numbers mean and how to stay in a healthy range are the keys to a healthy heart.


What is cholesterol?

Cholesterol is a waxy, fat-like substance found in your blood. That may sound gross and unhealthy, but cholesterol is actually a good thing that helps your body function in several ways.

Your body needs cholesterol to:

  • Build healthy cells.
  • Enable the liver to make bile, which is needed to digest food.
  • Support the body’s production of certain hormones (including sex hormones) and vitamin D.

But too much cholesterol can cause a build-up of fatty deposits in blood vessels, which can increase your risk of heart disease or stroke.


What’s the difference between “good” and “bad” cholesterol?

There are two types of lipoproteins that carry cholesterol in your blood to and from cells in your body. Here’s how the American Heart Association (AMA) breaks it down:

  • LDL (low-density lipoprotein) is considered the “bad” cholesterol because it contributes to fatty buildup in the arteries. That can reduce or block the flow of oxygen in the blood and lead to chest pain, heart attack and stroke.
  • HDL (high-density lipoprotein) is labeled “good” cholesterol because it carries the LDL away from the arteries and back to the liver where it’s broken down and passed from the body. Healthy levels of HDL may help protect against heart attack and strokes.

Indy tip: Struggling to remember which is which? When it comes to good vs. bad cholesterol, think “happy” for HDL and “lousy” for LDL. 

How are cholesterol levels measured?

A blood test called a lipid panel measures your total cholesterol and breaks out your “good” and “bad” cholesterol levels. A lipid panel also measures triglyceride levels. While this type of non-cholesterol fat also keeps your body functioning, high triglyceride levels can raise your risk for certain health conditions, including heart attack, stroke, and liver disease.

Your health care clinician may recommend fasting for 10-12 hours before your lipid panel blood test to ensure accurate results, although some panels may be administered without fasting. Guidelines published by the Journal of the American College of Cardiology say that people who are not taking cholesterol-lowering medications may not need to fast before their blood test.


What are normal HDL and LDL levels?

Your cholesterol numbers are important because they can tell you about your risk for heart disease and stroke. But what’s considered “normal” or ideal can vary based on various factors, including your age and sex assigned at birth.

The following chart shows what health care clinicians consider healthy for most people. 

cholesterol levels

Cholesterol numbers are just part of the equation. A health care clinician will also look at other factors to determine your risks when evaluating your test results.  

Bottom line? If your numbers don’t fall within what’s considered a normal range, there’s no need to freak out.


What are the main causes of high cholesterol?

Several factors can lead to high cholesterol, including those you can control and others that you can’t.  

Causes of high cholesterol include:

  • An unhealthy diet high in saturated and trans-fat.
  • Smoking and tobacco use.
  • Drinking too much alcohol.
  • Lack of physical exercise.
  • Excess weight. According to the Obesity Action Coalition, each 10 pounds of excess fat produces an additional 10 milligrams of cholesterol daily.
  • Chronic or long-term stress. 
  • Age and gender. Males tend to have higher levels of cholesterol throughout their lives than females. In females, cholesterol levels rise after menopause.
  • Family history of high cholesterol.
  • Some medications, including beta blockers for high blood pressure, diuretics and steroids.
  • Certain health conditions, such as diabetes, hypothyroidism, chronic kidney disease and HIV/AIDS.
  • Pregnancy and other conditions that increase levels of female hormones.
  • Low testosterone (in men).


When should I get my cholesterol checked?

It’s not unusual to have high cholesterol without knowing it. That’s why it’s so important to have your cholesterol levels checked on a regular basis. Health care experts also suggest cholesterol screenings begin during childhood.

Here are some general cholesterol testing guidelines:

  • The American Heart Association (AHA) recommends that healthy adults 20 years and older have their cholesterol numbers checked every 4 to 6 years, as long as their risk remains low. After age 40, a health care clinician will want to calculate your risk of having a heart attack or stroke.
  • The American Academy of Pediatrics (AAP) recommends that children and teens 19 years and younger get their first cholesterol test between the ages of 9 and 11.  

Beyond general recommendations, several factors can determine how often you should have your cholesterol checked, including age, family history, risk factors, and gender.


How can I lower my risk of high cholesterol?

Practicing a healthy lifestyle is the most important thing you can do to prevent high LDL cholesterol or improve your levels. 

Here are a few ways to reduce your risk:

  • Make healthy eating choices, including heating plenty of vegetables, fruits and whole grains, healthy fats and oils, and a variety of healthy, protein-rich foods.
  • Maintain a healthy weight. Body Mass Index (BMI) has long been the tool to measure healthy weight. But more and more, medical experts believe there’s no single, set formula to gauge a person’s health. A health care clinician can work with you to determine what’s healthiest for you.
  • Exercise regularly. As little as 20 minutes of exercise three times a week is all it takes. Make sure you start slowly and build up to 30 minutes five times a week. Walking is a great way to get moving.
  • Quit smoking. Lowering cholesterol is only one of the perks of kicking the habit, according to the American Lung Association.
  • Limit or eliminate alcohol. If you drink alcohol, do it in moderation. The American Heart Association recommends no more than one to two drinks per day for men and one drink per day for women.
  • Partner with a health care clinician. Managing your cholesterol is a team effort. At Indigo, our health care clinicians are here to help you lower your cholesterol risk and keep your numbers in check.

In addition to lifestyle changes, your health care team may prescribe one of several medications if you have high LDL cholesterol. The Centers for Disease Control and Infections (CDC) offers a handy chart of cholesterol-lowering medications and how they work.

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