Great news! Despite the common misconception that high cholesterol or Hyperlipidemia is a genetic disorder, the latest evidence suggests this condition is in fact a lifestyle disease. The predictable sequence of events is that a patient has zero symptoms and therefore no concern until a high result on a Lipid Panel done for an annual visit or a biometric screening. Sometimes, high cholesterol is found during an ER visit for chest pain. If the labs are high enough, the patient will then be prescribed a lipid-lowering medication also known as a statin drug. This is where it gets interesting. If you were to ask your physician how long you should take the medication, the answer would likely be "indefinitely" or "as long as it is effective" with the plan to switch to an alternative lipid-lowering medication or add another if the first one isn't effective, or side-effects are encountered. If the labs are borderline high, your doctor will likely tell you to "eat right and exercise."
Growing up, my Father was told his cholesterol was high and he was prescribed statins. He immediately experienced side-effects, and was switched from dose-to-dose and drug-to-drug in the search of an effective yet tolerable regimen. He took statins for decades, assuming they were safe as long as he didn't have any immediate side-effects. Along the way, he was diagnosed with Metabolic Syndrome / Prediabetes / Type 2 Diabetes and placed on another medication for this new condition. It wasn't until he had already passed, that I learned about the link between statin use, especially long-term, and an increased risk for Type 2 Diabetes.
If statin medications have common and notorious side-effects and they increase the risk directly or indirectly for Type 2 Diabetes, why would doctors prescribe them so often? Your average doctor has decided for their patient that they won't change their lifestyle because lifestyle change requires effort on the part of the patient. Prescribing a pill seems to be a win-win. The patient's cholesterol is controlled, and the doctor gets the credit, and continues to manage this condition for the patient by monitoring labs regularly with physical exams and providing refills as necessary.
What if you did nothing? High cholesterol is nearly always without symptoms, so if you decide you feel fine and don't get checked or don't change anything, you would be un-knowingly at an increased risk for a cardiovascular incident such as a heart attack or stroke. If you think "it won't happen to me", it probably will. Remember, Heart Disease has been the number one killer among civilized populations for decades, and it is called a "silent killer" because often the first symptom is a deadly heart attack or debilitating stroke.
What is the alternative to the biochemical band-aid that is the lipid-lowering drug? Lifestyle modification is the original first-line treatment for this condition, before statins became the most-prescribed medication in history. Lifestyle Medicine is the specialty of utilizing lifestyle and dietary modifications based on the latest evidence to treat the cause of conditions instead of treating their symptoms with daily medications or supplements. As a bonus, the side-effects of Lifestyle Medicine are all good ones such as: excess weight loss, improved mood, increased energy, decreased inflammation or pain, and normalized lab values. We are proud to be Kansas City's only Board-Certified Lifestyle Medicine Specialists accepting all major insurance. We would love the opportunity to help you achieve your health goals! Please contact us if we may be of assistance.