Table of contents:
- Elevated blood lipids: diagnosis
- How is the diagnosis made
- When are the values increased?
- Total cholesterol / HDL quotient
- Whom can I ask?
- How are the costs going to be covered?
Video: Increased Blood Levels - Cholesterol And Triglycerides
Elevated blood lipids: diagnosis
Elevated blood lipids cause no symptoms and are therefore usually discovered by chance. The existence of a lipid metabolism disorder can never be concluded from individually measured laboratory values. Slight deviations from the reference range also occur in healthy people. Due to the distinction between LDL and HDL cholesterol, an assessment of the total cholesterol level is only of limited significance. The distribution in LDL and HDL cholesterol is more interesting.
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How is the diagnosis made
A blood test is used to diagnose elevated blood lipid levels. To do this, it is important that the patient is fasted for at least twelve hours. The total, HDL cholesterol and triglyceride levels in the blood are determined. LDL cholesterol is usually not measured directly, but calculated using a formula (Friedewald formula).
Note LDL determination using the "Friedewald formula": LDL cholesterol (mg / dl) = total cholesterol (mg / dl) - [triglycerides (mg / dl) / 5] - HDL cholesterol (mg / dl)
If elevated blood lipid levels can be seen in the blood, the doctor tries to determine the causes and connections. In the anamnesis interview, it is therefore asked whether an elevated cholesterol level is known in direct relatives (parents, siblings). It is also relevant whether your family has any cases of (early) heart disease. The doctor will measure your blood pressure, conduct a clinical examination if necessary, and check the body for cholesterol deposits, especially in the eyes and (Achilles) tendons.
Further examinations may be required, for example:
- TSH level (indication of thyroid disease),
- Blood sugar (indication of diabetes),
For the doctor, the pattern of blood lipid values in relation to one another and the level of the values can already be informative. In the case of extremely high triglyceride and / or extremely high LDL levels, a genetic defect (primary lipid metabolism disorder) can be assumed. An ultrasound examination of the carotid arteries can reveal early changes in the sense of arteriosclerosis.
When are the values increased?
Specifying a normal value for total cholesterol is considered less useful. Instead, the doctor orients himself to the cardiovascular risk of a person: the higher the risk, the lower the value for bad (LDL) cholesterol should be.
Total cholesterol / HDL quotient
Due to the distinction between LDL and HDL cholesterol, an assessment of the total cholesterol level is only of limited significance. If the total cholesterol is high, the ratio of LDL to HDL cholesterol must be determined. Further information can be found in the laboratory section under What is normal? and fat metabolism.
Common target reference values in laboratory medicine are
- Total cholesterol: below 200 mg / dl
- LDL cholesterol: below 160 mg / dl
- HDL cholesterol: over 45 mg / dl
- Triglycerides: 50 to 150 mg / dl
Whom can I ask?
As part of a preventive check-up, the most important blood lipid values are also collected via the blood sample. For more information, see How a preventive medical check-up works.
The first point of contact for clarification of a possible lipid metabolism disorder is the
A visit to the following offices may be necessary for further clarification:
- Specialist in internal medicine, in particular with additional training in endocrinology and metabolic diseases,
- Metabolism outpatient department (outpatient department for internal medicine).
How are the costs going to be covered?
The costs of diagnosing a lipid metabolism disorder are normally covered by the health insurance providers. Your doctor or the outpatient clinic will generally settle accounts directly with your health insurance provider. However, you may have to pay a deductible with certain health insurance providers (BVAEB, SVS, SVS, BVAEB).
However, you can also use a doctor of your choice (ie doctor without a health insurance contract) or a private outpatient clinic.
For more information, see Costs and Deductibles.
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