While nearly everyone has heard of cholesterol, it is often misunderstood. Often it is only talked about in terms of the dangers of having too much of it, a condition known as hypercholesterolemia. Here are some facts that may surprise you about this vital natural substance:

1. Cholesterol Does Important Work In Your Body

While too much cholesterol can be dangerous to your health, cholesterol performs some essential functions in your body:

• It helps make the outer coating of cells.
• It makes up the bile acids that work to digest food in the intestine.
• It allows the body to make Vitamin D and hormones, like estrogen in women and testosterone in men.

(Source: The Harvard Medical School Guide to Lowering Your Cholesterol)

2. Most of the Cholesterol In Your Body Doesn’t Come From Your Diet

Your body produces all of the cholesterol it needs without relying on external sources. This means that even if you were able to eat a diet that contained zero cholesterol, your body would still make the approximately 1,000 mg it needs for digestion, cell development and vitamin and hormone production. Almost all cells can make cholesterol, but the liver can produce and export additional cholesterol the cells may need, as well as metabolize excess cholesterol and recycle it. If your liver doesn’t function properly or you eat too many foods high in saturated and trans fats, you can develop hypercholesterolemia.

3. Not All Cholesterol Is the Same

Low-density lipoproteins (LDL) and high-density lipoproteins (HDL) are two different particles that transport cholesterol in the body. Since cholesterol is a fat and blood is a water-like liquid, the cholesterol can’t float freely and needs to be carried in “packages,” which are a combination of protein and lipid (fat). Particles with more fat and less protein have a lower density (LDL) than their high-protein, low-fat counterparts (HDL).

LDL moves cholesterol to the parts of your body that need it. Too much LDL in your bloodstream leads to the excess cholesterol being deposited in your arteries, which can cause plaques and lead to heart disease. That is why hypercholesterolemia is such a serious and dangerous condition.

4.High Cholesterol Can Be Inherited

Familial Hypercholesterolemia (FH) is a genetic condition in which an individual inherits one or, in rare cases, two abnormal chromosomes that make the liver ineffective at regulating LDL, resulting in high cholesterol. This hereditary condition leaves people vulnerable to premature heart disease caused by narrowing of the arteries and plaques, such as heart attacks and strokes or the need for bypass or stents. FH is what is known as an autosomal dominant genetic disorder, meaning that only one parent needs to have the condition for his or her children to inherit it. The abnormal gene is dominant, so even if the child receives a healthy gene from the second parent, the altered gene will override the normal one. Those with one parent with FH have a 50 percent chance of inheriting the condition.

5.High Cholesterol Can Have an Effect Even Before Birth

If both parents have FH, their children have a greater risk of having a form of FH that can lead to aggressive and very early heart disease. If both parents have FH, each child will have a 50 percent chance of inheriting one FH gene (heterozygous FH), and a 25 percent chance of inheriting two FH genes (homozygous FH or HoFH).  Individuals with HoFH may experience narrowing and blocking of the blood vessels that starts even before birth and progresses very rapidly, if left untreated.  

6.Hereditary High Cholesterol Is More Common Than You May Think

About 1 in 200 to 500 people worldwide have Familial Hypercholesterolemia (FH). In the United States, between 620,000 and 1.55 million people live with FH. At least 90% of them have not been properly diagnosed. In families with a pattern of early heart disease or high cholesterol, the American Academy of Pediatrics recommends that children undergo cholesterol testing as early as age two, and before age 10. FH is even more common in certain populations, including French Canadians, Ashkenazi Jews, Christian Lebanese, and South African Afrikaners. In these populations FH may be found as frequently as 1 in every 67 people.

7.Even Hereditary Hypercholesterolemia Is Treatable

Thankfully, FH is treatable.  There are many medications available to treat Familial Hypercholesterolemia, including statins and other lipid lowering therapies.  There are new therapies approved for the treatment of HoFH and additional therapies for treating FH are currently in clinical trials.  Early diagnosis and appropriate treatment can decrease the risk of early heart disease associated with inherited hypercholesterolemia.