I was recently told that my cholesterol is way too high. I really  try to avoid oily foods and I also eat as healthily as possible. So how can this be? What should I do to get my cholesterol levels back to normal?

Angelina, 27, Kimicanga

Dear Angelina,

I am curious to know why you went to have you cholesterol tested in the first place because you are still young.  Was it part of a routine medical checkup or did you have some problems before. Do any of your blood relatives have high cholesterol levels?  You have also not specified as to whether a total lipid profile was done which shows levels of good and bad cholesterol.

Cholesterol is part of the lipids found in the blood. It helps to transport substances including proteins in the blood and also carries some hormones. It can be high due to many reasons. Dietary factors like taking saturated fats, alcohol consumption, smoking and lack of exercise can be responsible for it. Heredity factors also contribute to the increase in cholesterol levels. High cholesterol levels can also occur due to metabolic disorders like diabetes, hypothyroidism and even prolonged starving.  High cholesterol levels aggravate the process of deposition of fat in blood vessels thus clogging them. This increases the risk of hypertension, heart diseases, strokes and cramps in limbs. 

Food substances which have high cholesterol should be avoided. These include eggs, white sugar and confectionary, red meat, fried foods, cheese, butter, etc. One should quit alcohol and smoking. The food should include plenty of fresh vegetables, fruits, whole grains, cereals, milk, nuts and fish.

Regular physical exercise is equally important to help reduce high cholesterol levels.  Brisk walking, light jogging, yoga, and swimming are all good exercises in this regard.  Keeping the body weight in control also helps to prevent high cholesterol and related problems.

If there are no physical problems with high cholesterol or levels of bad cholesterol (LDL) are not high, an individual can take a correct cholesterol free diet and do regular physical exercise for at least 3 months. This should bring down the cholesterol levels. If not, cholesterol lowering drugs like statins or fibrates can be given for 3 to 6 months or till the cholesterol comes to a normal level. Some people with problems related to high cholesterol levels need maintenance dose of these drugs for life.

But if the cholesterol levels are very high, as you claim, or there are physical problems related to high cholesterol, one can take anti-cholesterol drugs immediately. These drugs are started in a low dose which is increased if needed as per the response. One or 2 tablets are taken at night after food. While taking these tablets one should be careful because these drugs can cause muscular pains, cramps and are toxic to the liver.

Dr Rachna Pande is a specialist in internal medicine at Ruhengeri Hospital.