High Cholesterol Symptoms

High Cholesterol Symptoms

High Cholesterol Symptoms

High Cholesterol Symptoms
In fact, high cholesterol does not exhibit any signs and symptoms as such and it does not make you feel sick. It is generally detected in routine medical check-ups. But we can enlist specific conditions which indicate high cholesterol levels. Some conditions indicate severely elevated cholesterol levels.

Chest discomfort
A heart condition
A dilemma with your pancreas
White patches about the eyes
Cholesterol deposits around the cornea
Whitish edges around the cornea
Corneal arcus (rings are observed around the cornea)
Yellow patches around the eyelids
Alter in the color of peripheral cornea
Skin changes fatty deposits observed beneath the skin and around the eyes
Fatty nodules over tendons
Due to create up of cholesterol and fat (fatty deposits or plaques) in the artery walls, there can be insufficient supply of blood to the organs. Leg pain even though walking or running, angina, diminished heart function or other heart diseases can be deemed as symptoms of high cholesterol.
A headache felt in distinct places of the head and neck, sometimes may possibly cause visual disturbances. This type of headache is acknowledged as migraine with “aura.” Nausea, vomiting and light sensitivity can be knowledgeable in case of severe migraine. Studies show that it can be one of the high cholesterol symptoms. Headache like a migraine with aura indicates high cholesterol levels.
High cholesterol symptoms in ladies are usually observed in ladies older than 55 years even though high cholesterol symptoms in males are frequently observed in males younger than 55 years. In common, aging increases the danger of high cholesterol. Obesity, lack of physical activity, eating excessive junk food, family members history, excessive stress, alcohol abuse, boost the danger of high cholesterol. If you notice any symptoms of high cholesterol, you want to check the cholesterol levels by performing a simple blood test. Certain way of life modifications and dietary changes such as such as more HDL cholesterol foods in your diet plan can aid lower cholesterol levels. It is necessary to monitor your cholesterol levels often by performing the specific blood tests under the guidance of your physician.

Herbal Remedies to Lower Cholesterol

The guggul tree (sometimes spelt as ‘guggulu’) is an indigenous Indian tree which found abundantly in the temperate climates of north India. It is a small shrub, not more than 4 meters in height. It has a thin bark with thorny branches and trifoliate leaves. It has red or pink flowers with four petals each.

The gum of the guggul tree is used extensively in Ayurvedic medicine. This gum is a yellowing resinous substance that is obtained from the stem of the guggul plant. The guggul plant is very well established in Ayurveda. Even in Sushruta Samhita, one of the most detailed works on Ayurvedic medicine, the virtues of the guggul in the treatment of obesity and rheumatism are recorded. Guggul is commercially available for the treatment of cholesterol and triglyceride deposits in the body. Western research has proven that guggulsterone, a chemical available in the guggul gum is the main beneficial factor in lowering cholesterol. Guggulipid, an extract of the guggul gum is also effective in lowering blood cholesterol.

The guggul is famous in the west with the name mukul myrrh tree. Biologically, it is named Commiphora wightii or Commiphora mukul. In Ayurveda, guggul is rarely taken in its pure form. Whenever it is prescribed for direct oral medication, the guggul needs to be purified. This method of purifying the guggul herb is known as the shodhana. Shodhana is done by boiling the herb in either cow’s milk or its urine. This makes the drug more acceptable to the human body, but it reduces its volatile oil content and hence makes the drug a little less effective in therapeutic terms.

Properties

Guggul is known to have the following properties:-

(i) Guggul disintegrates the cholesterol accumulated in the body. Hence it is used in the treatment of various cardiovascular problems.

(ii) Guggul flushes out the toxins from the body and promotes easy digestion of foods. It has a mild laxative effect.

(iii) Guggul is known to be a liver stimulator.

(iv) Guggul purifies the blood.

(v) Guggul has a treating effect on the nervous system.

Uses

(i) Cervical Spondylosis

Cervical spondylosis is a special type of arthritis which affects the cervical vertebrae, i.e. the vertebrae of the neck region. For the treatment of this disease, guggul is by far the best remedy. It is used in the form of its preparation Simhanada Guggul. The dosage prescribed for the patients is two to four tablets twice a day, followed by a glass of hot water or milk. Due to its laxative effect, it also removes the ama, i.e. the toxic buildup of waste materials in the body. If the bowels move in a regular fashion, the pains of spondylosis are very much reduced. In fact it is only after treating constipation first that any medication for the spondylosis would work.

(ii) Constipation

Guggul is a laxative. It facilitates the movement of the bowels and keeps the digestive system clean.

(iii) Obesity

Guggul is used primarily in the treatment of obesity. It is used in a very unconventional way. The gum resin of the guggul is used to make incense sticks. These are lighted and the fumes are inhaled. Guggul can also be given internally for obese people. Both Navaka Guggul and Triphala Guggul are effective in the treatment of obesity.

(iv) Rheumatism

Yogaraj Guggul is extensively used in the treatment of rheumatism. Two to four tablets twice a day need to be taken. The dose must be followed by a glass of hot water or milk.

(v) Sciatica

Guggul is very effective in treating problems related to the nervous system. It is given to the patient of sciatica in the form of Yogaraja Guggul, of which guggul is the main ingredient. The dosage is two tablets four times a day along with warm milk or water.

Special Ayurvedic Preparations

(i) Guggul Tiktaka ghrita

Guggul Tiktata ghrita is elaborately prepared by boiling guggul in a special kind of butter.

(ii) Navaka Guggul

Navaka Guggul is a combination of guggul with other important herbs. It is generally used in weight loss.

(iii) Simhanada Guggul

Simhanada Guggul is a preparation with guggul with the main ingredient which is used as treatment for cervical spondylosis.

(iv) Triphala Guggul

Triphala Guggul is a compound extract (of triphala) to which guggul is added.

(v) Yogaraja Guggul

Yogaraja Guggul is a very special preparation with guggul as the main ingredient. It is a mixture of about twenty powder extracts, among which guggul is the chief ingredient. It is used as a carminative, for lowering cholesterol and as an antipyretic.

Apart from these, there are many other guggul preparations being widely used such as Gokshuradi Guggul, Salai Guggul, Amrutadi Guggul, Kaishora Guggul, Kanchanara Guggul, Trayodashanga Guggul and Maha Yogaraja Guggul.

Precautions

The use of guggul must always be done under the supervision of an Ayurvedic physician. Excess of guggul almost always causes a rash on the body. But there are other more serious problems associated with an over-intake of guggul. For one, guggul interferes with the liver functions. Hence people with liver conditions must not use guggul. Guggul is used in the treatment of digestive problems. But an excess of guggul can worsen the conditions. People having constant problems such as diarrhea and inflammatory bowel disorder must avoid taking guggul.

Familial hypercholesterolemia

Familial hypercholesterolemia is a disorder of high LDL ("bad") cholesterol that is passed down through families, which means it is inherited. The condition begins at birth and can cause heart attacks at an early age.

Alternative Names

Type II hyperlipoproteinemia; Hypercholesterolemic xanthomatosis; Low density lipoprotein receptor mutation

Causes

Familial hypercholesterolemia is a genetic disorder caused by a defect on chromosome 19.

The defect makes the body unable to remove low density lipoprotein (LDL, or "bad") cholesterol from the blood. This results in high levels of LDL in the blood. High levels of LDL cholesterol make you more likely to have narrowing of the arteries from atherosclerosis at an early age. Those with familial hypercholesterolemia are more likely to have a family history of high cholesterol and heart disease at a younger age than normal.

The condition is typically passed down through families in an autosomal dominant manner. That means you only need to get the abnormal gene from one parent in order to inherit the disease.

In rare cases, a child may inherit the gene from both parents.When this occurs, the increase in cholesterol levels is much more severe, greatly increasing the risk for heart attacks and heart disease.

Symptoms

Symptoms that may occur include:

·                        Fatty skin deposits called xanthomas over the elbows, knees, buttocks, tendons, and around the cornea of the eye

·                        Cholesterol deposits in the eyelids (xanthelasmas)

·                        Chest pain (angina) or other signs of coronary artery disease; may be present at a young age

Exams and Tests

A physical examination may reveal fatty skin growths called xanthomas and cholesterol deposits in the eye (corneal arcus).

The doctor will ask questions about your personal and family medical history. There may be:

·                        A strong family history of familial hypercholesterolemia or early heart attacks

·                        High levels of LDL in either or both parents

Individuals from families with a strong history of early heart attacks should have blood tests done to determine lipid levels.

Blood tests may show:

·                        High levels of total cholesterol

o                                      Greater than 300 mg/dL in adults

o                                      Greater than 250 mg/dL in children

·                        High LDL levels

o                                      Greater than 170-200 mg/dL in children

o                                      Greater than 220 mg/dL in adults

·                        Normal level triglycerides

Other tests that may be done include:

·                        Studies of cells called fibroblasts to see how the body absorbs LDL cholesterol

·                        Genetic test for the defect associated with this condition

Treatment

The goal of treatment is to reduce the risk of atherosclerotic heart disease. Those who inherit only one copy of the defective gene may respond well to diet changes combined with statin drugs.

LIFESTYLE CHANGES

The first step is to change what you eat. This is tried for several months before drug therapy is added. Diet changes include reducing total fat intake to less than 30% of the total calories you eat.

You can reduce your saturated fat intake by:

·                        Decreasing amounts of beef, chicken, pork, and lamb

·                        Substituting low-fat dairy products for full-fat ones

·                        Eliminating coconut and palm oils

You can reduce your the amount of cholesterol you eat by eliminating egg yolks and organ meats.

Dietary counseling is often recommended to help people make these adjustments to their eating habits. Weight loss and regular exercise may also aid in lowering cholesterol levels.

MEDICATIONS

If lifestyle changes do not change your cholesterol levels, your doctor may recommend medication. There are several types of drugs available to help lower blood cholesterol levels, and they work in different ways. Some are better at lowering LDL cholesterol, some are good at lowering triglycerides, while others help raise HDL cholesterol.

The most commonly used and effective drugs for treating high LDL cholesterol are called statins. The include lovastatin (Mevacor), pravastatin (Pravachol), simvastatin (Zocor), fluvastatin (Lescol), atorvastatin (Lipitor), and rosuvastatin (Crestor).

Other cholesterol-lowering medicines include:

·                        Bile acid-sequestering resins

·                        Ezetimibe

·                        Fibrates (such as gemfibrozil)

·                        Nicotinic acid

Those with more severe forms of this disorder may need a treatment called extracorporeal apheresis. This is the most effective treatment. Blood or plasma is removed from the body. Special filters then remove the extra LDL-cholesterol, and the blood plasma is then returned.

Back to TopOutlook (Prognosis)

How well you do greatly depends on whether or not you follow your doctor's treatment recommendations. Diet changes, exercise, and medications can lower cholesterol levels for those with the milder form of this disorder, and may significantly delay a heart attack.

Men and women with familial hypercholesterolemia typically are at increased risk of early heart attacks.

Risk of death varies among patients with familial hypercholesterolemia. Persons who inherit two copies of the defective gene have a poorer outcome. That type of familial hypercholesterolemia causes early heart attacks and is resistant to treatment.

type of Lipid

Type of Lipid and their Functions

Physicians talk of the lipid profile, or lipid type while most patients want to know about their cholesterol.  We really are on the same team, looking for the same goals of reducing the risk of heart and artery disease caused by abnormally levels of the types of lipids that lead to atherosclerosis.  We just have different words we use.  The jargon physicians use can be confusion, and lipid type is a good example.  First some definitions:

Lipid: really another word for fat.  A lipid is a substance that disolves in alchohol but not in water.  Examples of lipids are wax, oil and other fats.

Cholesterol: a specific lipid that is used for many purposes in the body including cell membranes, hormones, vitamin D production and bile production.  It consists of a sterol carbohydrate ring with specific side chains.

Lipoprotein: a particle manufactured in the liver that consists of lipids and protein that circulates in the bloodstream.

Triglyceride: molecule made up of a three carbon molecule glycerin with three long carbon chain fatty acids attached, i.e. “tri” for three + glyceride. Practically these are the fatty particles in the blood stream that did not get packaged into lipoproteins in the first pass of the blood from the gut through the liver.

HDL cholesterol: (High density lipoprotein) Think good cholesterol here.  The HDL  lipoprotein particle consists of more proteins which are more dense, and less lipids which are less dense, so the lipoprotein is high in density.  There are several subsets of HDL, but in general a high HDL level is good.  HDL cholesterol functions in part to remove cholesterol from places it does not belong and return it to the liver to be repackaged and better used.

LDL cholesterol: (Low density lipoprotein) Think bad cholesterol here.  A lipoprotein that is higher in lipid and lower in protein making it low density.  In general high levels of LDL cholesterol are not good, as they increase the risk of atherosclerosis and heart disease.  LDL cholesterol is the primary vehicle for carrying cholesterol in the blood stream.  When present in large amounts cholesterol is often put where it can cause harm, like on the lining of blood vessels.

CRP: (C-reactive protein or hsCPR for highly sensitive CRP) is a marker of inflammation, and is used sometimes to assess risk of heart disease when the cardiovascular risk based on the rest of the lipid measurements and the other risk factors do not lead to a clear decision on lipid management.

Non-HDL cholesterol: This is simply calculated by subtracting the HDL cholesterol level from the total cholesterol level.  non-HCL cholesterol is a secondary target for treating lipids, after the LDL goal is met.

Direct LDL: usually the LDL level is calculated using the formula:

Total Cholesterol – HDL cholesterol – Triglycerides/5 = LDL cholesterol

This formula is quite accurate except when the triglyceride level is over 400-500.  High triglyceride levels make this calculation less accurate, so in those cases a more expensive test is used to measure the LDL cholesterol directly.

Physicians use these numbers along with a patients other risk factors to decide on whether to treat them with medication for abnormal lipid measurements.  In general the more risk factors for heart disease a patient has the more likely they are to warrant medication treatment.

The risk factors recommended by the National Institute of Health (through the NHBLI)  for this decision making include:

Table 3. Major Risk Factors (Exclusive of LDL Cholesterol) That Modify LDL Goals*

- Cigarette smoking

- Hypertension (BP ³140/90 mmHg or on antihypertensive medication)

-Low HDL cholesterol (<40 mg/dL)†

-Family history of premature CHD (CHD in male first degree relative <55 years; CHD in female first degree relative <65 years)

-Age (men ³45 years; women ³55 years)*

* In ATP III, diabetes is regarded as a CHD risk equivalent.

† HDL cholesterol ³60

(table from the NIH site)

The levels of cholesterol are broken down into categories:

Table 2. ATP III Classification of LDL, Total, and HDL Cholesterol (mg/dL)

LDL Cholesterol

<100                                       Optimal

100-129                                 Near optimal/above optimal

130-159                                 Borderline high

160-189                                 High

>190                                       Very high

Total Cholesterol

<200                                Desirable

200-239                          Borderline high

³240                                  High

HDL Cholesterol

<40                                    Low

>60                                     High

(table from the NIH site)

The recommendations for goal LDL cholesterol are as follows:

Three Categories of Risk that Modify LDL Cholesterol Goals

Risk Category LDL Goal (mg/dL)

CHD and CHD risk equivalents           <100

Multiple (2+) risk factors*                   <130

Zero to one risk factor                           <160

* Risk factors that modify the LDL goal are listed in Table 3

(from the NIH site)

Using these recommendations a woman age 67 who does not smoke, has a BP < 140/90 on no blood pressure medication, has an HDL cholesterol of 38, and has no coronary heart disease in her mother, father, or siblings would have 2 risk factors (age plus low HDL cholesterol) making her goal LDL <130.

Similarly a man age 40 who smokes, is on BP medication, and whose father had his first heart attack at age 50 with an HDL of 33 would have three risk factors (smoking, blood pressure and family history)  so his goal LDL cholesterol would be <130 unless his Framingham calculated risk of developing Coronary disease in the next 10 years is >20%.

Here is a link to the calculator provided by the NIH  to calculate Framingham Risk:

Framingham Risk Calculator

Using this calculator the 10 year risk of the man above would be 22% if his current systolic BP was 130 on medication, so he falls into the CHD equivalent category and has a goal of <100 for LDL cholesterol.

Treating LDL cholesterol is usually pretty straightforward.  We try to get patients to eat a diet low in total fat and saturated fat (primarily animal fat) to avoid trans fatty acids, and to lose weight.  If this is not adequate we usually add a medication in the statin family.  Many generic statins are available and can keep costs of treatment fairly low, and most patients tolerate statins well.  Some patients do not and red yeast rice is sometimes tolerated by those patients.  It has a statin-like effect.  Statins can lower LDL cholesterol by 25-55% in most patients.  If statins are not tolerated, or if you are a woman who may become pregnant (absolute contraindication to statins) then other medications are sometimes used.

Treating low HDL cholesterol is more difficult, and often slow release niacin is used for this purpose, but it is sometimes difficult to tolerate because of flushing and itching side effects.

Treating triglycerides is important if they are extremely high.  Levels >500 can put you at risk for pancreatitis, and need to be treated.  Levels between 150 and 500 are suboptimal, and are sometimes treated.

In general the goals for non-HCL cholesterol are the LDL goals + 30.