More frequently referred to as high cholesterol, hyperlipidemia is the medical term used to describe unusually elevated blood levels of lipids (fat molecules). Though it's possible to inherit hyperlipidemia, most cases can be traced back to lifestyle choices and environmental factors. Hyperlipidemia itself causes no symptoms, but it does adversely impact your health—most notably by increasing your risk of developing coronary artery disease.
Read on to learn how hyperlipidemia develops, 14 risk factors for hyperlipidemia, how doctors diagnose hyperlipidemia (as well as the different types), and natural treatments for hyperlipidemia.
1. How Does Hyperlipidemia Develop?
To understand how high cholesterol develops, you must first have a basic grasp of some essential facts about cholesterol itself. Cholesterol, a type of fat made in the liver, makes vital contributions to the functioning of the human brain, development of membranes surrounding cells, production of hormones, and storage of vitamins.
In order to travel through the bloodstream, cholesterol pairs with proteins to form lipoproteins. There are two forms of lipoproteins—high-density lipoproteins (HDL) and low-density lipoproteins (LDL)—each of which carry out different functions.
- Low-density lipoproteins (LDL): Because LDL cholesterol has been linked to the development of cardiovascular disease, it's known as "bad cholesterol." LDL cholesterol moves cholesterol molecules through your arteries, and when levels get too high, fatty deposits begin to build up on the walls of your arteries. This leads to atherosclerosis, the hardening or narrowing of the arteries, which in turn raises your risk of heart disease.
- High-density lipoproteins (HDL): HDL cholesterol, or "good cholesterol," can actually counterbalance the negative effects of LDL cholesterol. That's because HDL transports unused cholesterol molecules back to the liver, where they can be excreted. This prevents the development of high blood cholesterol levels and the associated adverse health outcomes, such as heart attack and coronary heart disease.
If your doctor elects to perform a lipid profile, they will likely measure your triglyceride levels too. Your body stores any calories not required for immediate energy needs in the form of triglycerides. Regularly consuming more calories than necessary to fuel your body, particularly if you consume a diet high in carbohydrates, is likely to result in high triglyceride levels (technically speaking, hypertriglyceridemia).
High cholesterol levels in the blood, as touched on in our discussion of LDL cholesterol, causes deposits of fat to accumulate in the blood vessels. As these deposits grow, they can restrict blood flow through the arteries. If a deposit spontaneously breaks loose, it can create a clot that triggers a heart attack or stroke.
This makes it important to monitor and manage your cholesterol levels. For HDL cholesterol, this means keeping your levels at or above a certain threshold while for LDL cholesterol, it means making sure they do not rise too high. Optimal levels for total, HDL, and LDL cholesterol as well as triglycerides are impacted by whether or not you have heart disease, diabetes, or other conditions that put you at higher risk of developing high cholesterol.
The guidelines for each category are as follows:
- Overall cholesterol
- Optimal: Under 200 milligrams per deciliter (mg/dL)
- Concerning: 200-239 mg/dL
- High: 240 mg/dL and higher
- HDL cholesterol
- Optimal: 60 mg/dL and higher
- Adequate: 50-59 mg/dL for women and 40-59 mg/dL for men
- Low: Under 50 mg/dL for women and 40 mg/dL for men
- LDL cholesterol:
- Optimal for those with heart disease or diabetes: Under 70 mg/dL
- Optimal for those at risk of heart disease: Under 100 mg/dL
- Adequate for those with no heart disease, concerning for those with heart disease: 100-129 mg/dL
- Concerning for those with no heart disease, high for those with heart disease: 120-159 mg/dL
- High for those with no heart disease, very high for those with heart disease: 160-189 mg/dL
- Very high: 190 mg/dL and higher
- Optimal: Under 150 mg/dL
- Concerning: 150-199 mg/dL
- High: 200-499 mg/dL
- Very high: 500 mg/dL and higher
2. What Factors Raise Your Risk of Hyperlipidemia?
As we covered in the last section, hyperlipidemia results from an unbalanced ratio of LDL cholesterol to HDL cholesterol. While certain types of hyperlipidemia have a genetic component (meaning it's important for you to know if you have a family history of hyperlipidemia), most result from lifestyle choices.
According to a study published in 2017, both age and sex influence a person's likelihood of developing high levels of LDL cholesterol or triglycerides. The cross-sectional study, which enrolled 2,000 individuals, also found correlations between hyperlipidemia and lifestyle choices such as smoking, physical inactivity, and the consumption of fatty meats. Meanwhile, individuals who ate more fruits and vegetables were less likely to develop high cholesterol.
Research points to other risk factors as well, such as having a large waist circumference and consuming excessive quantities of alcohol. There are also links between elevated cholesterol levels and several health conditions, such as: kidney disease, polycystic ovary syndrome (PCOS), and decreased thyroid activity. Certain medications affect cholesterol levels too, like steroids, progestin, retinoids, diuretics, and in some cases, beta blockers.
Other factors shown to raise your risk of developing hyperlipidemia include:
- Sedentary lifestyle: Failing to engage in physical activity on a routine basis can skew your cholesterol levels. It appears that exercise increases production of HDL cholesterol and increases the size of LDL cholesterol molecules, rendering them less harmful.
- Use of tobacco products: Scientists have observed that smoking cigarettes injures blood vessel walls, which increases the odds that fat will build up on them. Smoking also appears to adversely impact HDL cholesterol levels.
- Consumption of saturated and trans fats: Studies show that regularly eating foods that contain saturated fats (for instance, fatty meats) and trans fats (commonly included in processed foods like crackers, microwave popcorn, cookies, and more), leads to higher cholesterol levels.
- Blood sugar levels: Analysis reveals a connection between high blood sugar and high levels of very-low-density lipoprotein (VLDL), a particularly unhealthy type of cholesterol, as well as lower levels of HDL cholesterol.
- Body fat percentage: Researchers have also found a link between how much body fat a person has and their likelihood of having hyperlipidemia.
- Overall physiology: As you age, your liver becomes less effective at removing LDL cholesterol, making you more likely to develop hyperlipidemia.
3. How Do Doctors Diagnose Hyperlipidemia?
Hyperlipidemia itself causes no noticeable symptoms, which is why it's important for doctors to routinely check cholesterol levels, particularly for individuals who have a higher risk of developing the condition.
They do this, as touched on previously, with a test called a lipid panel. This simple blood test allows doctors to measure your total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. In order to ensure accurate results, your physician may ask that you fast for between 8 and 12 hours leading up to the blood draw.
However, recent research trends toward a consensus that fasting may not be necessary. According to a study published in JAMA Internal Medicine in 2019, fasting prior to a lipid profile produced negligible differences to total, LDL, and HDL cholesterol levels. Triglyceride levels were consistently slightly higher for participants who did not fast.
The study enrolled close to 8,300 participants, all of whom had documented cardiovascular risk. Each participant had fasting and nonfasting lipid profiles done with a minimum of 1 month's time in between the tests. The fasting protocol used required them to abstain from eating or drinking anything except water for 8 hours before the test. By following participants for a median of 3 years, the authors were able to determine that whether or not individuals fasted prior to the lipid profile did little to impact doctors' ability to predict their risk of future health problems. This is exciting news not only because just about everyone dreads fasting, but more significantly, because fasting can cause issues for older individuals as well as those with diabetes.
5 Different Types of Hyperlipidemia
Experts have categorized the different types of hyperlipidemia that have a genetic component based on the different fats involved in each as well as how each affects the body.
- Type I, hyperlipidemia familial lipoprotein lipase deficiency: This inherited condition interferes with the mechanisms by which the body breaks down fats. It can cause abdominal pain, chronic pancreatic infections, and swelling of the liver and the spleen. It's one of the more severe types of hyperlipidemia, and tends to develop during childhood.
- Type IIa, familial hypercholesterolemia, and type IIb, familial combined hyperlipidemia: Both type IIa and type IIb lead to elevated levels of LDL cholesterol. As the names of these types indicate, they do have a genetic component. They're also one of the few types that can cause visible symptoms—specifically, deposits of fat under the skin and near the eyes. Both types put individuals at increased risk of heart problems.
- Type III, familial dysbetalipoproteinemia: This type involves increased total cholesterol and triglyceride levels in combination with decreased HDL levels. It, too, can cause visible symptoms—orange or yellow discoloration of the palms and the development of yellowish deposits of lipids in the skin over the elbows and knees. This type also raises your risk of cardiovascular disease.
- Type IV, familial hypertriglyceridemia: This type is differentiated from the others by the fact that it involves elevated levels of triglycerides, not cholesterol. It has been linked to obesity, high blood glucose, and high insulin levels. Typically, this condition remains unnoticed until early adulthood.
- Type V, mixed familial hyperlipoproteinemia: This type is quite similar to type I, but it also involves elevated levels of VLDL cholesterol. It's quite common among patients diagnosed with metabolic syndrome.
Hyperlipidemia without a genetic component, also known as acquired hyperlipidemia, tends to mimic the forms described above.
4. Are There Natural Treatments for Hyperlipidemia?
There are a variety of prescription drugs on the market that can decrease cholesterol and triglyceride levels, such as:
- Cholesterol absorption inhibitors
While these drugs do effectively treat hyperlipidemia, they can cause seriously unpleasant side effects. Statins, the first option most doctors will try, have been known to cause muscle aches, digestive upset and mental cloudiness. In rare cases, they can also cause liver damage and rhabdomyolysis, a serious condition that results in intense muscle pain, liver damage, and if left untreated, kidney failure and death.
Depending on which type of hyperlipidemia you have, as well as the results of your lipid profile, it's possible that lifestyle changes and natural cholesterol treatments will allow you to avoid the use of potentially harmful prescription drugs. And even if a drug is necessary to manage your risk of more serious health problems like a heart attack or stroke, lifestyle shifts will still be an important part of your overall treatment plan.
Here are five lifestyle changes and natural treatments that can bring your cholesterol and triglyceride levels into the healthy range.
1. Develop a Healthy Diet
There's no one right way to eat, but there are certain science-backed elements you can use to build a healthy diet that works for you.
When it comes to lowering bad cholesterol levels and raising good ones, the fats you eat make a big difference. Saturated fats found in red meat, bacon, and sausage and trans fats found in fried and processed foods are particularly problematic. Omega-3 fatty acids, on the other hand, have a wealth of heart-health benefits. Fatty cold-water fish like salmon and mackerel contain plenty of these good fats, as do walnuts and flaxseeds.
It's also important to consume plenty of soluble fiber, which has been shown to lower LDL cholesterol levels. Load up on fiber-rich vegetables and fruits, legumes, and oats.
2. Engage in Physical Activity
Researchers have found that your physical activity levels have a pronounced impact on your HDL cholesterol levels. The more you exercise, the better those levels will be. And the less you exercise, the lower they'll drop.
It appears that for cholesterol-management purposes, you should shoot for 40 minutes of moderate to vigorous exercise on 3 or 4 days of the week. Aim for a minimum of 150 minutes of exercise total per week.
If you have the time necessary to try swimming laps at the pool or joining a game of pick-up basketball, that's wonderful. But finding ways to incorporate exercise into your daily routine, like biking to work or picking up the pace when you take your dog for a walk, can also help you hit that physical activity threshold.
3. Stop Smoking
As mentioned earlier, smoking causes HDL cholesterol levels to fall and triglyceride levels to rise. Furthermore, it independently increases your risk of developing heart disease. If you're a current smoker, no matter which type of high cholesterol you have, quitting will be an important part of your treatment plan.
As you're almost certainly aware, it can be quite a challenge to quit. It may be helpful to talk to your doctor about strategies for doing so, like using a nicotine patch, or to seek support from others who have successfully kicked the habit.
4. Evaluate Your Weight
There can be a connection between body weight (particularly fat mass) and cholesterol levels. Research has shown that by adopting dietary strategies designed to produce sustainable weight loss, individuals were able to raise their HDL cholesterol levels and lower their LDL cholesterol levels.
Learn more about strategies for pursuing healthy weight loss here.
5. Incorporate Proven Supplements
If you're committed to pursuing natural methods of lowering your cholesterol, you can find more in-depth advice about proven methods for doing so, as well as the rationale behind choosing a natural approach, in this article.
For our purposes, it will suffice to say that supplements can play a very important role in naturally addressing hyperlipidemia.
For instance, compelling research has revealed that taking an essential amino acid supplement can produce highly desirable results on cholesterol levels.
Studies have shown that essential amino acids, which stimulate the synthesis of the proteins that transport lipids out of the liver as well as those that flush fatty acids into safe storage areas, can lower levels of total cholesterol, LDL cholesterol, VLDL cholesterol, and triglycerides in the liver as well as the bloodstream. These results have been seen with a dosage schedule of two 11-gram doses, twice a day.
These all-natural, completely safe compounds bring benefits for your overall health and—it's important to note—they can be combined with statins without any ill effects. In fact, they actually make them more effective, per the findings of an Italian research team.
If you're curious about amino acid supplementation, this primer is a great place to begin.
Hyperlipidemia is the medical term for high blood levels of lipids. It can stem from genetic causes, but the majority of the time, it results from behavior choices and environmental factors such as an overly sedentary lifestyle, the use of tobacco products, or excessive alcohol consumption.
As it causes no symptoms itself, it's vital that health care practitioners routinely screen for this silent condition, which has been linked to an increased risk of cardiovascular disease.
There are a variety of prescription medications available that can be used to get cholesterol levels under control, but they can cause unpleasant side effects. And even if the benefits of using one of those drugs outweighs the risks, it's still important to make lifestyle changes such as developing a healthy diet that facilitates lower levels of LDL cholesterol and higher levels of HDL cholesterol as well increasing physical activity. It can also be quite valuable to incorporate supplements with proven benefits for bringing cholesterol levels into a healthy range, such as essential amino acids.