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Hypercholesterolemia

Hypercholesterolemia (literally: high blood cholesterol) is the presence of high levels of cholesterol in the blood. It is not a disease but a metabolic derangement that can be secondary to many diseases and can contribute to many forms of disease, most notably cardiovascular disease. It is closely related to the terms "Hyperlipidemia" (elevated levels of lipids) and "Hyperlipoproteinemia" (elevated levels of lipoproteins). more...

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Signs and symptoms

Elevated cholesterol does not lead to specific symptoms unless it has been longstanding. Some types of hypercholesterolaemia lead to specific physical findings: xanthoma (thickening of tendons due to accumulation of cholesterol), xanthelasma palpabrum (yellowish patches around the eyelids) and arcus senilis (white discoloration of the peripheral cornea).

Longstanding elevated hypercholesterolemia leads to accelerated atherosclerosis; this can express itself in a number of cardiovascular diseases:

  • Angina pectoris, leading to PTCA or CABG
  • Myocardial infarction
  • Transient ischemic attacks (TIAs)
  • Cerebrovascular accidents/Strokes
  • Peripheral artery disease (PAOD)

Diagnosis

When measuring cholesterol, it is important to measure its subfractions before drawing a conclusion on the cause of the problem. The subfractions are LDL, HDL and VLDL. In the past, LDL and VLDL levels were rarely measured directly due to cost concerns. VLDL levels are reflected in the levels of triglycerides (generally about 45% of triglycerides is composed of VLDL). LDL was usually estimated as a calculated value from the other fractions (total cholesterol minus HDL and VLDL); this method is called the Friedewald calculation; specifically: LDL ~= Total Cholesterol - HDL - (0.2 x Triglycerides).

Less expensive (and less accurate) laboratory methods and the Friedewald calculation have long been utilized because of the complexity, labor and expense of the electrophoretic methods developed in the 1970s to identify the different lipoprotein particles which transport cholesterol in the blood. As of 1980, the original methods, developed by research work in the mid-1970s cost about $5K, US 1980 dollars, per blood sample/person.

With time, more advanced laboratory analyses have been developed which do measure LDL and VLDL particle sizes and levels, and at far lower cost. These have partly been developed and become more popular as a result of the increasing clinical trial evidence that intentionally changing cholesterol transport patterns, including to certain abnormal values compared to most adults, often has a dramatic effect on reducing, even partially reversing, the atherosclerotic process. With ongoing research and advances in laboratory methods, the prices for more sophisticated analyses have markedly decreased, to less than $100, US 2004, by some labs, and with simultaneous increases in the accuracy of measurement for some of the methods.

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Hypercholesterolemia & hormones
From Townsend Letter for Doctors and Patients, 8/1/04 by Jule Klotter

Life Extension (September 2003) published an article by Sergey A. Dzugan, PhD, and R. Arnold Smith, MD, that proposes that hypercholesterolemia is the result of a multihormone deficiency. The body uses cholesterol as a basic component of cell membranes, bile acids, vitamin D3, and as the precursor to steroidal hormones such as pregnenolone, DHEA, testosterone, progesterone. The authors propose that the body responds to a deficiency of these hormones by overproducing cholesterol.

To test their hypothesis, the doctors performed a clinical study from July 1997 to April 2003, involving 41 patients with high cholesterol levels. The patients, ages 25 to 81, received combinations of multiple humanidentical hormones. "If even one steroidal hormone is left out, then the body may respond to this deficiency by synthesizing more steroidal hormonal precursor, (i.e. cholesterol)," the authors explain. The hormones were given in individualized, physiologic ratios, designed to produce "youthful physiologic (not 'normal') serum levels." The doctors determined each patient's dosage by periodically measuring serum hormone levels. Dose schedules simulated natural human production cycles.

All 41 patients responded to the therapy. Mean serum total cholesterol decreased from a baseline of 254.6 mg/dL to 188.8 mg/dL after treatment, a decrease of 25.6%. Serum HDL levels (the lipoprotein that scavenges free cholesterol and transports it back to the liver) also dropped (19.6%), "but remained much higher than undesirable levels in all cases." The authors view the decrease in HDL as a sign that cholesterol levels had normalized and that extra HDL was unnecessary. The doctors also noticed that the multiple steroid hormone therapy had improved thyroid function. All patients reported a "significant improvement in quality of life."

Dzugan, Sergey A., PhD. & Smith, R. Arnold, MD. Treating High Cholesterol by Replacing Hormones Lost to Aging. Life Extension September 2003

COPYRIGHT 2004 The Townsend Letter Group
COPYRIGHT 2004 Gale Group

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