Lipid Disorders

Overview

Lipids, such as cholesterol and triglycerides, are building blocks for important processes in your body. Cholesterol, for example, is essential to cell membrane and hormone production.

Common lipids include:

• Low-density lipoprotein (LDL) cholesterol — High levels of LDL, known as “bad” cholesterol, contribute to plaque formation (atherosclerosis) along the walls of the arteries.
• High-density lipoprotein (HDL) cholesterol — This lipid, known as “good” cholesterol, helps prevent plaque formation in the arteries and should be kept as high as possible.
• Triglycerides — High levels of these lipids may increase your risk of heart and vascular disease.

What Causes Lipid Disorders

Many people develop unhealthy levels of certain lipids due to their genetic profile or lifestyle factors, or as a result of other health conditions. You are more likely to have a lipid disorder if you have the following risk factors:

• Chronic kidney disease
• Familial hypercholesterolemia or familial hypertriglyceridemia (inherited conditions)
• High-fat diet
• Hypothyroidism (underactive thyroid gland)
• Lack of exercise
• Obesity
• Type 2 diabetes

By keeping your lipid disorder under control, you may be able to lower your risk of heart attack, stroke and other complications.

Treatment

IU Health specialists work with you and your primary care provider to identify the cause of your lipid disorder and treat even the most challenging and complex cases. If your lipid disorder has a strong inherited component, has failed to respond to medicines or has other complicating factors, your cholesterol and triglyceride levels can be moved into safer ranges.

Counseling, education and lifestyle changes are always a part of a successful treatment plan. In addition, you may be treated with a combination of therapies.

Lipid-lowering Medicines

A variety of medicines can reduce your LDL (“bad”) cholesterol and triglycerides, and some also raise your HDL (“good”) cholesterol. You may need to take two or more medicines to treat your lipid disorder. Options include:

• Bile acid sequestrants
• Nicotinic acid
• Selective cholesterol absorption inhibitors
• Statins

These medicines work in different ways and affect specific lipids. At times, “orphan” drugs that have received special U.S. Food and Drug Administration approval for treatment of a rare inherited lipid disorder may be prescribed. You may also need treatment for any underlying conditions that are contributing to high cholesterol.

Low-density Lipoprotein (LDL) Apheresis

This procedure takes blood from the body, removes LDL cholesterol and returns the blood in a process resembling dialysis. LDL apheresis is appropriate for certain patients when diet and lipid-lowering medicines do not bring very high LDL levels to a healthier range. You typically receive this treatment every two weeks for two to three hours. During treatment, an intravenous (IV) line is placed into each of your arms. One session removes 60 percent or more of the LDL from your blood, and it may also clear other particles that pose a risk to your cardiovascular health. Your body continues to produce LDL, but medicine and a healthy diet help control the level until your next apheresis session.