What is Cholesterol?

Cholesterol is a type of fat produced in the body’s cells and found in blood serum. Cells need cholesterol for normal functioning. Since fats do not dissolve in water, cholesterol must be carried by fat-transporting proteins, known in medicine as lipoproteins.

Some lipoproteins carry cholesterol into the bloodstream, while others carry it back to the liver and tissues. Low-density lipoprotein (LDL) transports cholesterol into the blood, while high-density lipoprotein (HDL) carries it back to the liver and tissues.

For easier understanding, HDL is often called the “Healthy Lipoprotein” and LDL the “Lousy Lipoprotein.” Total cholesterol is the sum of LDL and HDL. When cholesterol levels rise, deposits form in the arteries, which may develop into plaques, narrowing or blocking vessels. Depending on which organ is affected, different diseases may result.

High LDL cholesterol can lead to deposits in artery walls, causing atherosclerosis (hardening of the arteries). Sometimes plaques rupture, leading to clots. If this occurs in coronary arteries, it can cause a heart attack; in brain arteries, it may result in a stroke.

Cholesterol may also be inherited genetically. Those with a genetic predisposition must be even more cautious with lifestyle choices.

Prevention and control

• Healthy diet, exercise, and avoiding smoking and alcohol are usually enough to maintain normal cholesterol levels.

• If high cholesterol persists, cholesterol-lowering medications may be necessary under specialist supervision.

“Good” cholesterol (HDL) carries fats to the liver for breakdown, which is why it is considered beneficial.

Causes of High Cholesterol

• Unhealthy diet, inactivity, alcohol, and smoking raise LDL and lower HDL.

• The LDL/HDL ratio is an important marker:

  • Below 2.5: very good

  • 2.5–3.3: acceptable

  • Above 3.3: high, requiring treatment

Target values

• Total cholesterol: <200 mg/dl = normal; 200–240 = borderline; >240 = high

• LDL: <130 mg/dl = normal; 130–159 = borderline; >160 = high

• HDL: <40 mg/dl = abnormal

What should we do?
✔ Eat fruits and vegetables
✔ Prefer olive oil over animal fats
✔ Choose fish over red meat
✔ Bake or boil instead of frying
✔ Maintain a healthy weight
✔ Walk at least 40 minutes daily
✔ Avoid alcohol and smoking
✔ Manage stress

High cholesterol does not produce symptoms itself; it is detected through laboratory tests. Complications arise depending on which organ’s vessels are affected.

Final note to young doctors
As a physician with 32 years of experience, I advise my colleagues: don’t just treat lab results and scans—treat the patient. Listen to your patients; they will often tell you their illness if you know how to ask.

Stay healthy.

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