You exercise regularly. You are very careful about what you eat and drink. You take the medicine prescribed by the doctor on time. But... when you get the report, your cholesterol is still high. "Why on earth is this happening?" You may be wondering. Sometimes, there are hidden reasons that we don't even think about and that we can't see. Don't worry, this is a problem that many people have. Today, let's talk about what those hidden reasons are that your cholesterol levels are not decreasing as expected.
This may be something you have inherited from your ancestors.
Heredity is the main reason why some people develop high cholesterol. We call this Familial Hypercholesterolemia (FH) . Simply put, it is a genetic condition. You can inherit this condition from either your mother or your father, or maybe both.
If you have FH, your body can't properly manage cholesterol, meaning it can't process it and get rid of it. This means you may have high levels of LDL (Low-Density Lipoprotein), the "bad" type of cholesterol, from birth. But most of the time, symptoms don't appear until you're older.
Because the body can't get rid of cholesterol, it gradually builds up in your blood vessels, where blood flows. It's like dirt building up in a water pipe. We call this atherosclerosis . When this happens, blood flow is obstructed, and the blood vessels become a little stiff. Over time, this puts you at a higher risk of developing heart disease. In fact, someone with FH is about 20 times more likely to develop heart disease than someone without it.
FH can cause cholesterol to build up in other parts of the body. Symptoms may include:
| Body part | The visible feature |
|---|---|
| Skin | Yellowish fatty deposits (like lumps) on the skin of the hands, elbows, knees, or around the eyes. |
| Tendons | Thickening of the Achilles tendon in the heel or some tendons in the hand. |
| Eyes | A white or gray ring around the black eye. |
Although cholesterol levels can be difficult to control due to FH, it can be treated. You may need to take more than one type of cholesterol-lowering medication. For example:
- Statins: These work by reducing the production of cholesterol by the liver.
- Ezetimibe: Reduces the amount of cholesterol absorbed by the body from the foods we eat.
- PCSK9 inhibitors: These work by helping the liver absorb more LDL ("bad" cholesterol) from the blood.
Some people with very severe cases of FH may need special treatments to filter out excess cholesterol from their blood. In very rare cases, this may even lead to a liver transplant.
You may be eating "hidden fats" without even realizing it.
You may think that eating foods labeled "cholesterol-free" is good for your heart. But it's even more important to be aware of saturated fat and trans fat . When you buy something at the store, look at the label to see how much saturated fat, trans fat, and calories it contains.
Simply put, these hidden oils are almost certainly present in packaged and processed foods. They are common in things like biscuits, cakes, some types of instant noodles, and sausages.
The best thing is to limit things like this as much as possible.
| 👍 Eat more of these things | 👎 Limit these things |
|---|---|
| Fresh fruits and vegetables | Red meats like beef, pork, and processed meats like sausages |
| Whole grains such as buckwheat, oats, and brown rice | Creamy milk, cheese, butter, yogurt |
| Skinless chicken, fish | Deep-fried food |
| Nuts like cashews, peanuts, almonds | Bakery products made from bread flour, sweetened beverages |
| Vegetable oils like olive oil, canola oil | Limiting the use of coconut oil and palm oil |
Do you want to change your exercise routine?
Think about your exercise routine. Are you getting enough, the right kind of exercise? To lower your cholesterol, you need to do exercises that get your heart rate up and work more than one muscle group at a time . Doing this type of exercise at least 5 days a week, for at least 30 minutes a day, is a good idea.
But don't suddenly go overboard. Doing so can lead to accidents and even ruin your long-term fitness.
Here are some exercises that are very suitable:
- Brisk walking
- Cycling
- Swimming
- Yoga
Do other medications you take also affect it?
This is something that many people don't think about. Some medications you take for other conditions can also increase your cholesterol levels.
- Some medications taken for diseases like asthma and rheumatoid arthritis.
- Some medications containing vitamin A (retinoids) are given for acne.
- Some birth control pills can lower "good" cholesterol (HDL) and increase "bad" cholesterol (LDL).
So, if your cholesterol levels aren't lowering, talk to your doctor about any other medications you're taking. He or she can determine if that medication is causing the problem and switch you to another medication if necessary.
Another important thing! If you are taking statins to lower cholesterol, avoid drinking grapefruit juice in the morning. A chemical in grapefruit can interfere with the activity of enzymes that break down statins in the body. So ask your doctor about that too.
Are you still smoking?
Smoking is not only bad for your cholesterol, but it's also bad for your entire body. The thousands of chemicals in cigarette smoke damage your blood vessels and raise your cholesterol levels.
Simply put, a chemical called acrolein in cigarette smoke prevents our "good" cholesterol (HDL) from doing its job. The job of HDL is to collect bad cholesterol that has built up in our blood vessels and take it to the liver. It is in the liver that this cholesterol is processed into waste products and excreted from the body. When this process is stopped due to smoking, more cholesterol builds up in our blood vessels and they begin to narrow (atherosclerosis).
Therefore, if you are trying to control your cholesterol, it is essential to quit smoking completely.
Take-Home Message
- If your cholesterol levels aren't lowering no matter how hard you try, there could be reasons you're not aware of. Don't worry.
- You may have a genetic condition (FH) that is passed down from generation to generation. Talk to your doctor about it.
- Don't be fooled by the "cholesterol-free" label. Be aware of hidden saturated and trans fats in packaged foods.
- Medications you take for other conditions can also affect cholesterol levels. Tell your doctor about all medications you take.
- Smoking severely interferes with cholesterol management. Quitting is one of the biggest investments you can make in your health.
- If in doubt about anything, always seek advice from your doctor or physician, rather than relying solely on information found on the internet.
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