If you have taken a cholesterol test and found your cholesterol levels to be higher than the recommended limits, then there are two courses of action to reduce them back to within a range that will significantly decrease your likelihood of developing heart disease.

The first step is to examine your lifestyle and make changes that are known to be beneficial in lowering cholesterol levels. None of this is rocket science: it is well known that being overweight, eating fatty foods, drinking, smoking and not taking enough exercise are significant contributory factors in causing high cholesterol. So the obvious recommendation is to stop doing these things and see if that alone is sufficient to bring about the necessary reduction in cholesterol levels.

This is something you can do on your own initiative – you certainly don’t need medical advice or supervision, but do begin slowly; if you have become unfit and/or overweight then suddenly going out for a long run for example could make you seriously ill (or even cause a heart attack).

When adopting self-help measures to lower cholesterol it’s helpful to understand that there are broadly 2 types of cholesterol – HDL which is considered “good” and LDL cholesterol which is considered “bad”.

LDL is most affected by what you ingest, so a healthier diet and cutting down on the fags and booze will help lower LDL cholesterol levels. HDL on the other hand is influenced by exercise and can be increased by being more active; higher levels of HDL cholesterol are in turn likely to bring down LDL levels. So as you can see, both watching what you eat and doing more physical exercise can be highly effective in lowering cholesterol levels.

But what should you look out for in your diet? Put simply, saturated fat. This is most commonly found in butter, hard cheese, red meat, cakes/biscuits/pastries and the like. Some types of food actually contain cholesterol (known as “dietary cholesterol”) but these don’t affect the cholesterol in your bloodstream to anything like the degree that saturated fats do. Examples include shellfish, liver, kidneys and eggs.

As well as reducing saturated fat content, there are foods that can actively help to lower cholesterol. Soluble fibre, which is present in most vegetables, fruit, oats (but not wheat) and beans, as well as plant sterols (commonly found in cholesterol lowering spreads), can help reduce LDL cholesterol levels.

Indeed, before you decide (or are compelled) to go down the route of prescription medication you might want to consider adding natural supplements based on plant sterols to your daily intake. The relationship between the acai berry and cholesterol provides an interesting example of how what you eat can quite significantly affect your cholesterol levels.

In addition to keeping an eye on what you eat, you may also need to monitor how much you eat. Shedding excess weight can also lower LDL and boost HDL cholesterol levels.

If the “self-help” route outlined above doesn’t appear to lower your cholesterol levels sufficiently after a couple of months you should consult a doctor as the cause of your high cholesterol may be due to other factors (such as genetically inherited familial hypercholesterolemia – FH for short), or it may be that your body needs a helping hand.

You can be sure though that any medical professional will still expect you to play your part and modify your lifestyle in conjunction with any drug treatment they may prescribe and since they get to periodically check your blood test results and take your weight they can easily tell who’s not sticking to the rules.

The standard medical treatment for hypercholesterolemia (high cholesterol) is a class of drugs called statins. These work by depressing production of LDL cholesterol in the liver and are available in a range of potency. The most commonly prescribed (together with their brand names) are listed from weakest to strongest below:

  • pravastatin (Lipostat)
  • simvastatin (Zocor)
  • atorvastatin (Lipitor)
  • rosuvastatin (Crestor)

Generally there are few side-effects from taking statins (which incidentally are supplied in pill form) but they can cause damage to muscle tissue and the liver, particularly at high doses.

Getting the right type and dose of statin can be more of an art than a science since there is no reliable way to determine how effective they might be in any given individual. If your doctor decides to prescribe statins for you it is likely that they will request further blood tests to monitor their effectiveness and to also check for signs of any side-effects.

You might also be asked to take other drugs such as the cholesterol-absorption inhibitor ezetimibe (Ezetrol) in combination with statins and if your hypercholesterolemia has gone undetected for some time it is also likely you may be prescribed fibrates, nicotinic acid, aspirin and/or medication to lower your blood pressure.




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