Cholesterol and triglycerides, which are fat molecules, may be measured by a routine blood test. Individuals that have high levels of cholesterol and triglycerides are placed on therapeutic lifestyle changes, including a healthy diet and an exercise regimen. When lifestyle changes are not sufficient to lower levels, patients are placed on medical therapy.
Cholesterol Levels
A total cholesterol of 200mg/dL is a desirable level. A measurement between 200 and 239 mg/dL is considered borderline high and a level above 240 mg/dL is considered high. LDL is the "bad" cholesterol and should be below 100mg/DL, while the "good" cholesterol, HDL, should be above 60mg/dL. A desirable triglyceride level is below 150ml/dL, according MayoClinic.com. A level between 150 and 199 mg/dL is borderline high and anything between 200 and 499 mg/dL is high. Any level more than 500 is considered very high. Your physician can measure these levels via a routine blood test.
Medications
High cholesterol is treated with the bile acid resins, BARs, HMG Co-A reductase inhibitors, niacin or ezetimibe. According to "Pharmacotherapy: A Pathophysiologic Approach," HMG Co-A reductase inhibitors, or statins, are the first choice because they are the most potent in lowering LDL cholesterol. The statins include atorvastatin, simvastatin, rosuvastatin, fluvastatin, pravastatin and pitavastatin. Niacin, ezetimibe, and BARs, which include cholestyramine, colestipol and colesevelam, may be given alone or in combination with the statins. The fibrates, which include gemfibrozil and fenofibrate, are used to lower triglycerides as well as increase HDL cholesterol. Niacin and prescription omega-3 fatty acids also lower triglycerides. Combination therapy may necessary when one medication does not achieve desired levels.
Side Effects
The cholesterol-lowering medications may produce gastrointestinal side effects, including stomach pain, nausea, vomiting and constipation. Omega-3 fatty acids may cause belching and a fishy taste in the mouth. Niacin may cause facial flushing, which is characterized by feeling heat in the face and redness in the face and chest. The statins may cause general weakness and fatigue, states MayoClinic.com. These side effects do not indicate a serious reaction and does not require medical attention. If any side effects worsens, however, speak with your physician.
Monitoring
Your physician will perform periodic blood tests to check your cholesterol levels. Before starting therapy with a statin, fibrate, or niacin, your physician will obtain a baseline liver function tests, or LFTs, according to the "Drug Information Handbook." LFTs measure liver enzymes; elevated liver enzymes may require a discontinuation of therapy. Do not miss you doctor appointments so your physician can adjust the dose of your medications or switch to another medication as needed.
References
- MayoClinic.com: Cholesterol levels: What Numbers Should You Aim For?
- "Pharmacotherapy: A Pathophysiologic Approach"; Joseph T. Dipiro, Robert L. Talbert, et al.; 2008
- MayoClinic.com: Cholesterol Medications: Consider the Options
- "Drug Information Handbook"; Charles F. Lacy, Lora L. Armstrong, et al.; 2009
