what is cholesterol?

Cholesterol is a lipid molecule synthesized by the liver that performs many important functions for our body. First of all, it is an essential component of cell membranes, and it is also fundamental for the synthesis of bile acids, hormones, and vitamin D.

Once synthesized, cholesterol travels in the blood carried by so-called lipoproteins, the famous LDLs, which transport it to peripheral tissues.

High cholesterol

However, when blood cholesterol levels become too high, these lipoproteins can accumulate inside the arteries making them less elastic, eventually forming actual plaques that can grow over time and obstruct blood flow. It is therefore very important to maintain total cholesterol levels below 200mg/dL and, specifically, LDL levels, the well-known bad cholesterol, below 100 mg/dL.

Understanding Good Cholesterol

This term refers to HDL, transport proteins that transfer cholesterol from peripheral tissues to organs where it will be used or eliminated. They act just like street sweepers, able to remove excess circulating cholesterol and much of what has been deposited in blood vessels.

This is why it’s desirable to try to maintain high HDL cholesterol levels, specifically above 60 mg/dl.

What can lead to increased cholesterol?

The underlying causes can be metabolic diseases, poor eating habits, smoking, and lack of physical exercise. As a first intervention, we generally try to modify lifestyle, increasing physical activity and reducing the intake of saturated fats in the diet (usually present in meat and dairy products) while increasing the consumption of foods rich in polyunsaturated fatty acids, omega 3, found for example in nuts and oily seeds.

When these precautions are not sufficient, your doctor may consider the use of supplements such as those containing red rice or more specific medications.

What are the solutions?

Statins Among the most prescribed medications are certainly statins, which by blocking the action of an enzyme called HMG-CoA reductase, responsible for cholesterol synthesis, consequently lead to lower cholesterol levels. These medications require strict medical supervision to determine the right dosage, as they can cause very serious side effects, especially if taken in combination with other medications.
Bile acid sequestrant resins which, as the name indicates, bind to bile acids. Since without cholesterol there is no production of bile acids, if these are sequestered by the medication, circulating cholesterol will be consumed to provide for their production, and its levels will decrease.

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