Seeing the word "lipid" in our title, some people actually have come to our office seeking liposuction. Lipids are fats. But unfortunately they can't simply be vacuumed out.

Cholesterol and trigylcerides are two forms of lipids. Our bodies need both to function but in excess they create blockages in arteries, leading to heart attacks and strokes. Most Americans have five times more cholesterol than their bodies require, and more than double the amount of triglycerides.

It's no wonder more than half of Americans die from diseases related to artery blockages. Most of this damage is self-inflicted from diet and lack of exercise. But there are a small number of people who have genetic disorders that cause their bodies to produce wildly elevated levels of cholesterol. Dr. Ziajka specializes in treating such challenging patients.

Years ago, most cholesterol tests gave us a single number - how much total cholesterol we had in our blood. Those who had in excess of 200 milligrams of cholesteroal per deciliter of blood were considered at risk.

But as our knowledge of cholesterol evolved, so did the test. We now break down the total number into "good" HDL cholesterol and "bad" LDL cholesterol. What is the difference? To put it simply, HDL is incoming cholesterol, that which is on its way to being processed out of the body. LDL is cholesterol that is outgoing cholesterol, that which is headed out into the body, where it can damage arteries.

So this next generation test gave us deeper insight into cholesterol management and the need to maintain healthy HDL and LDL levels. The current standard for someone who never has had heart disease is an LDL level below 130 mg/dL, and an HDL level above 45.

Most cholesterol medications work by lowering the LDL number.
The pharmeceutical companies still are tackling the tougher task of coming up with a medication that raises HDL. Exercise and diet remain our best tools to raise HDL. This is where the current state of cholesterol testing and knowledge now stands with the public and also with many family doctors who face the impossible task of keeping up with advances in countless specialties. Those advancements are here in cholesterol management.

There now are a new generation of tests, known as Advanced Lipid Profiles. As noted earlier, the current test breaks down total cholesterol number into into HDL and LDL particles. These new tests break down the total HDL and LDL numbers into even smaller particles.

Not all HDL is equal. One form is much more protective than the other. So a test revealing an adequate level of HDL may give a false sense of security because the bulk of the HDL is in the less beneficial form. Likewise, within LDL, there are some components that are more dangerous than others.

It is only a matter of time before such advanced testing is incorporated in mainstream medical practices. The U.S. Food and Drug Administration currently is evaluating them with Dr. Ziajka testifying before FDA panels. Doctors also must be trained in how to analyze the tests and respond with the proper medications.

However, you do not have to wait to benefit from an Advanced Lipid Profile as the tests now are available. The minimal cost they add to a standard test is well worth the information they provide. Experts such as Dr. Ziajka also are available to analyze the tests and work with family doctors in prescribing medications. Dr. Ziajka strongly recommends this for anyone with a family history of heart disease or anyone now taking cholesterol medication.

Disclaimer: It is a goal of FLI to provide timely and informative medical information and education regarding cholesterol management to interested consumers in a manner that makes such in-depth clinical information easy to understand. This site does not provide on-line individualized medical advice, diagnoses or treatment and no physician-patient relationship or healthcare professional-patient relationship is formed by accessing or using this site.

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