Does Familial Hypercholesterolemia always require medication?

Answer 1

Familial hypercholesterolemia almost always requires medications in addition to weight loss, diet, and exercise. This is in part true as those with this condition are predisposed to premature (age <55 for men < 65 for women) cardiovascular events (such as heart attack and stroke) but also because with newer and safer medications the goals for LDL are much lower and in this case likely to be <70 mg/dL. That having been said I would not consider pharmacologic intervention without sophisticated testing which would include not a traditional lipid profile but also direct LDL measurement, LDL and HDL particle sub types, cardiac CRP, and likely a few others.

Answer 2

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Answer 3

I believe the answer is "most of the time." However, since everyone is different, it's possible one may not require medication. Diet and exercise have a lot to do with cholesterol levels in addition to the genetics of it all. That being said, you definitely should:
A) See your doctor for blood tests and a physical examination to determine if you truly have familial hypercholesterolemia B) Follow recommended diet and exercise regimens C) If medication is prescribed to you, take it exactly as directed and be sure to follow-up with your physician for the recommended blood tests as some of the medications for lowering cholesterol can affect the liver.

Answer 4

"In families with a history of familial hypercholesterolemia, genetic counseling is of benefit, especially if both parents are affected. Prevention of early heart attacks requires recognition of existing elevated LDL levels, and a low-cholesterol, low-saturated fat, high-unsaturated fat diet in high-risk people may help to control LDL levels."

The first step is to change what you eat. This is tried for several months before drug therapy is added. Diet changes include reducing total fat intake to less than 30% of the total calories consumed. Saturated fat intake is reduced by decreasing the amounts of beef, pork, and lamb; substituting low-fat dairy products; and eliminating coconut and palm oil. Cholesterol intake is reduced by eliminating egg yolks, organ meats and sources of animal-derived saturated fat.

Further reductions in the percentage of fat in the diet may be recommended after the initial trial period. Dietary counseling is often recommended to assist people with these adjustments to their eating habits.

Exercise, especially to induce weight loss, may also aid in lowering cholesterol levels.

Drug therapy may be initiated if diet, exercise, and weight-loss efforts have not reduced the cholesterol levels after an adequate trial period. Various cholesterol-reducing agents are available including:

bile acid sequestrant resins (cholestyramine and colestipol)
nicotinic acid
lovastatin and other 'statin' drugs
gemfibrozil
probucol "

A support group can be found here: http://www.medped.org/

Answer 5

I would think that with diet and proper exercise you wouldn't necessarily need medicine