Doc, why do I have such high cholesterol levels yet I’m thin?


In case it's true what can be done?

Tuesday March 17 2020

Dr Flo,
During a random medical check-up at our workplace recently, I was told I have high cholesterol. I am wondering how this is possible yet I am quite thin. In case it is true, is there any medication for it? And will I have to lose the little weight that I have?

Dear Mash,

It is possible to have high cholesterol levels in the blood even though you are thin. It is true that obesity is associated with high cholesterol levels, but it is not the only factor. Other risk factors include eating diets that have a lot of starch and refined sugars, lack of exercise, smoking, excessive alcohol intake and diabetes. There are also some people who have an inherited disease that interferes with how the body deals with cholesterol, leading to very high blood cholesterol levels.
High cholesterol levels are dangerous because they form deposits, called plaques, on the walls of the blood vessels. These deposits can then cause narrowing of the blood vessels and weakening of their walls, leading to stroke, kidney failure, heart disease and heart attacks, and even blindness. This happens because of reduced or blocked blood flow to organs such as the brain, the kidneys, the heart and the retina.
There are two kinds of cholesterol: the “good” HDL cholesterol and the “bad” LDL cholesterol and triglycerides. The target is to have more of the good type and less of the bad type. To avoid having high levels of bad cholesterol, reduce on the amount of starch you take, especially refined types; eat whole grains, oatmeal, whole wheat bread and pasta, and brown rice; eat more vegetables and fruits, and other high fibre foods; eat fish, seeds and nuts; and use unsaturated fats (like olive oil, sunflower oil, corn oil); reduce on eggs, whole milk and red meat. Also, exercise regularly for the sake of being healthy and not necessarily to lose weight.
You can also be given medicine to reduce the cholesterol levels if the above measures do not work within a few months.

Dr Flo,
I always have a runny and sometimes stuffy nose, itchy throat and itchy eyes. I have tried managing it by taking a lot of water, avoiding food that may trigger it, but there has been no change. Please let me know if there is something else I can do.

Dear Eric,
It seems that you have atopy. This is a genetic condition where your body has an exaggerated allergic reaction to common environmental irritants like cold, dust, strong smell and pollen. These are called triggers and they cause your body to overreact, causing symptoms like itching of the eyes and/or skin, itchy throat, sneezing, a runny and blocked nose. This is usually in the genetic make-up of a person, which means it can be passed from parents to children and it cannot be eradicated. It causes allergy conditions like allergic rhinitis, allergic skin rashes, allergic cough, recurrent itching of the eyes (allergic conjunctivitis) and asthma. Someone may have one or a combination of several of them. The condition cannot be cured, but it can be controlled by avoiding the triggers like cold, dust, strong smell, pollen and smoke and also by taking anti-allergy medicines. Nasal sprays can also be used to control the runny and blocked nose. You can be followed up on by an allergy specialist and have allergy testing, so that you know exactly what to avoid.

Dr Flo,
My partner and I have been living together for the past two years and I have been unable to get pregnant. My husband has an eight-year-old child from a previous relationship, so it’s obvious that I am the problem. This is causing problems even with my in-laws and I am feel embarrassed whenever I attend family functions. What should I do? It’s very painful.

Dear Ashamed,
Concerns about fertility arise after one year of having regular, unprotected sex. About 15 per cent of couples are unable to conceive after one year of trying. Of these, a third of the time the problem is in the woman, a third of the time, the problem is in the man, and in the other third, both partners have a problem, or no problem can be found at all.
Problems affecting fertility can arise later in life so that someone may be fertile one time, then due to a particular medical issue or injury, they develop fertility problems later.
In women, infertility can be caused by abnormal ovarian function, hormonal disorders, Fallopian tube obstruction and abnormalities of the uterus. Some factors that can increase the risk of infertility are alcoholism, smoking, obesity, severe weight loss, extreme physical or emotional stress and being over 35 years of age.
In men, infertility can be caused by a disruption of the function of the testicles, ejaculatory dysfunction, hormonal disorders and genetic disorders.
Some factors that can increase the risk of infertility include diabetes, alcoholism, smoking, use of steroids, injury to the testicles, being overweight or as a consequence of exposure to some drugs, toxins or radiation.
You should visit a gynaecologist for check-ups for both of you. For the woman, these include a pelvic ultrasound to check the pelvic organs, a hysterosalpingogram (HSG) to check the Fallopian tubes and a hormone profile to check the hormones. The man may have a seminalysis done to check the quality and number of the sperms, and a hormone profile, if necessary.
Treatment is given depending on what is found. For example, the woman may be given medication to help with ovulation or to control hormones, or surgery may be done if there is scarring, endometriosis or the Fallopian tubes are blocked. The man may also be put on medication if necessary. You may also benefit from assisted conception through intrauterine insemination or in vitro fertilisation.

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