Cholesterol Elevation Issue: Lessons from a Clinical Case

In September 2021, a 33-year-old woman visited a cardiologist clinic due to elevated cholesterol levels.

The patient had no complaints, but she was concerned about the results of laboratory tests, particularly regarding total cholesterol, low-density lipoproteins (LDL), and high-density lipoproteins (HDL).

To address the issue, she started taking dietary supplements (BADS), which only worsened the situation.

Medical History
Cholesterol levels first increased in 2014 after pregnancy, reaching 6.5 mmol/L. This greatly concerned the woman, as her uncle had a stroke at age 37, and her mother experienced a transient ischemic attack at 56.

Through social media, she found a nutritionist who recommended purchasing a complex of dietary supplements. However, after a 3-month course, her total cholesterol level increased even further. On November 28, 2020, a biochemical blood analysis showed:

  • Total cholesterol – 12.1 mmol/L;
  • LDL – 7.36 mmol/L;
  • HDL – 3.32 mmol/L.
    Other biochemical markers and thyroid hormone levels were normal.

After discontinuing the supplements, a new examination on June 13, 2021, showed a slight decrease in levels:

  • Total cholesterol – 8.88 mmol/L;
  • LDL – 5.9 mmol/L;
  • HDL – 2.61 mmol/L.

The patient does not smoke, and she does not abuse alcohol. She engages in fitness and adheres to healthy eating principles.

She gave birth in 2014. Over time, she developed amenorrhea, for which a gynecologist prescribed Divigel and Utrogestan. There are no chronic illnesses.

The woman weighed 58 kg with a height of 164 cm. Body mass index (BMI) was 21.5, within the normal range. There were no signs of pathology or external manifestations of hypercholesterolemia during examination. Blood pressure was 110/60 mmHg.

ECG, echocardiography, and color Doppler mapping of the brachiocephalic vessels did not reveal any deviations.

Secondary hypercholesterolemia.

Given the low cardiovascular risk, the main goal was to lower LDL levels to 3 mmol/L or below. The woman was prescribed a hypolipidemic diet and dynamic physical activities. She was also referred to a gynecologist for treatment correction.

About a year after amenorrhea treatment, her menstrual cycle was restored.

A lipid profile on November 10, 2021, also showed decreased levels:

  • Total cholesterol – 6.24 mmol/L;
  • LDL – 3.67 mmol/L;
  • HDL – 2.31 mmol/L;
  • Triglycerides – 0.58 mmol/L.

Subsequently, total cholesterol and LDL levels continued to decrease.

Against the background of discontinuation of the dietary supplement complex and correction of the hormonal profile, lipid profile indicators almost reached the target level.

The patient continues treatment with the gynecologist and monitors cholesterol levels using a lipid profile.

This clinical case demonstrates the importance of undergoing comprehensive diagnostics when cholesterol levels are elevated to understand the exact cause of the pathology. It is possible that cholesterol levels initially increased due to pregnancy, while subsequently developed amenorrhea was the true cause of hypercholesterolemia. Subsequent intake of drugs that have not undergone any clinical trials and are not intended for the treatment of such conditions only exacerbated the situation.

It is important not to panic. If you have a complicated medical history, self-treatment is even more dangerous. It is essential to consult a specialist who will recommend a truly effective drug, even if hypolipidemic therapy is necessary.