What is Dyslipidemia?

Hearing that you have high cholesterol from a physician is truly bad news because it often means abstaining from your favorite foods, or suffering the consequences. High cholesterol may be a sign of a condition called dyslipidemia, which means the patient has abnormal lipid levels in their blood. The patient either has high levels of low-density lipoproteins (“bad” cholesterol) or low levels of high-density lipoproteins (“good” cholesterol). There are two types of dyslipidemia: primary and secondary, categorized according to the cause.

Dyslipidemia can cause atherosclerosis, in which plaque builds up in the arteries and causes them to narrow. Patients may also suffer from a heart attack or stroke. It also doubles the risk of heart disease, which is the leading cause of death in the United States.

What is Cholesterol?

The liver produces cholesterol, but it is also present in meat, fish, dairy products and eggs. The body needs it to produce cell walls, hormones and vitamins, but high cholesterol levels are harmful. There are two agents that transport cholesterol in the veins—low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL can accumulate in veins as plaque that eventually blocks blood flow. This condition is called atherosclerosis, which causes high blood pressure, heart disease, heart attacks or strokes. HDL, on the other hand, helps the body remove cholesterol. To have healthy lipid levels, a patient should have low LDL and high HDL.

According to a 2019 update from the Center for Disease Control and Prevention, 73.5 million adults in the United States have high cholesterol, but less than half of that population receives treatment.

Symptoms of Dyslipidemia

Lipid disorders do not usually cause noticeable symptoms. However, patients with high cholesterol may show physical signs. It may cause yellow lumps around the tendons and joints—the hands, feet and elbows. The eyes may also have a white arc around the cornea. Cholesterol deposits can cause growths around the eyes. Studies also suggest a connection between cholesterol and hair loss. Researchers discovered that dietary fat intake can cause patients to lose their hair. Other symptoms include heartburn, chest pain, shortness of breath, dizziness, vomiting and nausea and disrupted sleep patterns. The patient may also experience pain in the legs from walking or standing, as well as swelling in the legs, ankles, feet, stomach and veins in the neck.

Complications of Dyslipidemia

If patients do not receive treatment for dyslipidemia, the condition can cause complications. For example, patients can develop atherosclerosis, in which plaque builds up in the arteries and blocks them, limiting blood flow throughout the body. This condition causes peripheral arterial disease (PAD) and coronary artery disease (CAD). PAD usually affects arteries in the legs, while CAD affects the coronary arteries that send blood flow to the heart. These disorders can trigger heart attacks and strokes.

Causes of Dyslipidemia

There are two categories for dyslipidemia: primary and secondary. Each category is defined by the factors that trigger the abnormal cholesterol levels.

Primary Dyslipidemia

Primary dyslipidemia is inherited, caused by genetic factors. Abnormal blood lipid levels may develop from birth if the fetus is unable to remove LDL from the blood. For example, familial combined hypercholesterolemia develops in teenagers and young adults. They may eventually develop high cholesterol.

Other conditions include genetic mutation in apolipoproteins, a type of LDL lipoprotein (familial hyperapobetalipoproteinemia) and high levels of triglycerides, another type of fat (hypertriglyceridemia). Polygenic hypercholesterolemia also results from a genetic mutation in LDL receptors. Research links genetically high triglyceride levels to metabolic syndrome, diabetes, heart disease and stroke.

Secondary Dyslipidemia

Lifestyle Factors and Drugs

In some cases, the condition develops as a result of lifestyle factors or medical conditions. For example, cholesterol levels can rise if a patient has an unhealthy diet high in fat. High alcohol intake may also increase triglyceride levels and smoking and some drugs can cause dyslipidemia. For example, synthetic estrogen and progestin, corticosteroids and anabolic steroids may interfere with healthy cholesterol levels.

Medical Conditions

The endocrine system contains glands that produce hormones and endocrine disorders, such as thyroid disease, can raise lipid levels. Also, diabetes often causes high LDL and triglyceride levels and low HDL levels. Diabetic dyslipidemia is linked to insulin resistance. Lastly, atrial fibrillation is a condition that causes an irregular heartbeat. Researchers also discovered a connection between atrial fibrillation and abnormal cholesterol levels.

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Treatment for Dyslipidemia

Medical Treatment

Usually, a doctor recommends diet and lifestyle changes to regulate cholesterol levels. However, patients with hereditary high cholesterol may need medication.There are several different medications that doctors may prescribe to lower lipid levels in the blood.

However, treatment depends on whether the patient has coronary artery disease or shows risks for it, such as diabetes. They may reduce the risk of heart attack or stroke. For example, statin medications are one type of lipid-lowering drug that reduces the amount of LDL cholesterol the body absorbs from food. Other lipid-lowering medications include bile acid binders, fibric acid derivatives, niacin and omega-3 fatty acid supplements.

If a patient cannot take medication, they may benefit from LDL apheresis. In this procedure, the doctor takes blood plasma from the body and runs it through a machine that removes LDL. It lowers levels by up to 83 percent, but the patient must receive the treatment every two weeks. It is also an option for patients with familial hypercholesterolemia.

Lifestyle Changes

Doctors usually recommend lifestyle changes before medication to lower cholesterol. For example, a doctor will recommend weight loss and a healthy, balanced diet. According to experts, at least 150 minutes of moderate-intensity exercise every week and quitting smoking will improve lipid levels in the blood. Patients with high cholesterol should avoid certain foods and replace them with healthier options.

Foods to Include

• Healthy oils (olive, corn and soybean)
• Fish, lean meat and chicken
• Low-fat dairy products
• Fruits and vegetables
• Whole grains, beans, nuts and seeds

Foods to Avoid

• Shortening, lard, butter and margarine
• Fatty, processed and organ meats
• Whole-fat dairy products
• Fried, processed, refined and sugary foods and snacks
• Sugary drinks and alcohol

Supplements for Regulating Cholesterol

There are several natural supplements that may help patients normalize lipid levels. As with all supplements, it is always best to talk to a doctor if you are experiencing problems with your health. Supplements are by no means a substitute for legitimate medical advice. Instead, they aim to improve general health and well-being.

Berberine

Extracted from the phellodendron plant, berberine is a plant alkaloid that may maintain healthy cholesterol levels and promote heart health. Studies suggest that it may regulate blood lipids more effectively than standard medication. According to research, it significantly lowered subjects’ LDL by 25 percent, triglycerides by 35 percent and total cholesterol by 29 percent. The subjects’ HDL increased remarkably and insulin resistance reduced.

As a dietary supplement, the recommended dosage for berberine HCL powder is 500 mg (rounded ¼ tsp) twice a day, or as directed by a physician. Do not use this supplement for more than three months without a physician’s approval and diabetics should consult a medical professional.

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L-Carnitine 

L-carnitine is an antioxidant amino acid that improves heart, muscular and cognitive health. It may also improve energy and athletic endurance. In studies, it prevented patients from experiencing the adverse side effects of statins. It also lowered cholesterol and insulin resistance and improved dyslipidemia in patients undergoing hemodialysis.

The recommended dosage for L-carnitine base powder as a dietary supplement is 500 mg up to four times a day. Taking it with GABA, CLA and Coenzyme Q10 may produce better results, but consult a doctor first. Those who suffer from heart problems, fatigue or a thyroid condition or who take other supplements or medication should consult with a physician before using L-carnitine.

Alpha Lipoic Acid (ALA)

ALA is a compound in several different plant and animal foods. Alpha lipoic acid powder is an antioxidant and anti-inflammatory which may boost energy, heart health and weight loss. In several studies, it improved lipid profiles in patients with heart disease, diabetes, obesity and polycystic ovary syndrome, as well as those who suffer from strokes. As a dietary supplement, take 600 mg of R-alpha lipoic acid (R-ALA) powder one to two times a day.

Niacin

A form of Vitamin B3, the body produces niacin naturally but it is also present in foods. It may benefit heart health, memory and focus. Niacin can also enrich a vegetarian diet lacking in tryptophan from meat. According to studies, it is an effective treatment for lowering HDL by up to 25 percent and raising HDL by up to 35 percent. Researchers concluded that it keeps the body from removing HDL and lowers triglycerides by up to 50 percent. It may also be effective in people with diabetes and metabolic syndrome. The recommended dosage for niacin (Vitamin B3) powder as a dietary supplement is 100 to 500 mg a day with a meal, or following a physician’s instructions.

Red Yeast Rice

Fermented with Monascus purpureus yeast, red yeast rice contains monacolin K, a chemical identical to lovastatin. In studies, red yeast rice significantly lowered LDL, triglycerides and total cholesterol and increased HDL. It also lowers blood pressure and may have antidiabetic properties. In combination with berberine and Coenzyme Q10, it may effectively lower blood lipids and sugar. People who cannot tolerate statins may be able to use red yeast rice. As a dietary supplement, take 600 mg of red yeast rice extract powder up to twice a day with Coenzyme Q10 for optimal results.

Astragalus

Part of traditional Chinese medicine, astragalus is a root extract. Studies have suggested it may effectively modify lipids, lower cholesterol and protect the heart. The recommended dosage for astragalus extract powder is 1300 mg twice per day with a meal, with a physician’s approval.

Coenzyme Q10 (COQ10)

An antioxidant found in animals and bacteria, Coenzyme Q10 (COQ10) is involved in energy production and maintaining immune health. According to studies on heart disease, it significantly improved LDL, total cholesterol and HDL levels and it also lowered blood pressure. In other studies, adding COQ10 to statin therapy significantly reduced adverse effects. As a dietary supplement, the recommended dosage for Coenzyme Q10 (COQ10) powder is 50 to 200 mg, or following a physician’s instructions.

The Bottom Line

Dyslipidemia is a condition characterized by abnormal cholesterol levels in the body. Either the patient’s low-density lipoproteins (“bad” cholesterol) levels are high or their high-density lipoproteins (“good” cholesterol) levels are too low. Usually cholesterol abnormalities do not cause any symptoms. However, lipid content can build up and form in clumps on the body, usually around the joints and tendons or the eyes.

Dyslipidemia can trigger a chain reaction of serious conditions in the body. For example, high cholesterol can cause atherosclerosis, in which plaque builds up and blocks the arteries. It restricts blood flow to the heart and other organs. This condition can lead to high blood pressure, heart disease, heart attack or stroke. Usually doctors recommend exercise and dietary changes to regulate cholesterol. But some patients may require medication. Also, there are supplements that research suggests may help manage lipid levels and reduce the risk of further complications. However, supplements are not a proper treatment for any medical condition. They are only intended to promote overall health.