Your blood has it. Almost every cell in your body has it. It resembles wax. It is known as cholesterol. If this substance is in its normal level, it can do a lot of good to your body. Though your liver makes this substance, your body also gets it from the foods you eat. If your diet includes fat-rich foods such as milk-foods, eggs, meat, etc., your body gets too much of cholesterol. Of the various types of this fatty substance, two sub-types are considered as major ones. These are high density lipoprotein (HDL) and low density lipoprotein (LDL). But, what is VLDL cholesterol? Is it is good or bad? What is its normal level? Answers to these queries are required to maintain a healthy lifestyle.
Your body makes the needful amounts of cholesterol. As you can also get it from fatty foods, cholesterol levels may exceed its safe and healthy levels. In general, foods sourced from animals – such as poultry, meat, milk-based products supply more cholesterol than your body may actually need. What happens when the supply of cholesterol exceeds its demand? Excessive fats may start accumulating on the linings of your blood vessels – especially, arteries. Over a period of time, these deposits may turn into hard layers resembling plaque. A condition called atherosclerosis – shrinking of blood vessels – occurs and prevents a normal flow of blow through your blood vessels.
The most dangerous thing about the build-up of cholesterol is its ability to remain silent for a very long time. Once the condition becomes acute it shows up as a pain in your chest. If left unattended, it may lead to a cardiac arrest. Your doctor may suggest a blood test to check your cholesterol level. This test is called as a lipid profile test. It helps detect abnormal levels of cholesterol in the body. It mainly focuses on measuring the levels of three different types of fatty substances in your body. These are high density lipoproteins (HDL), low density lipoproteins (LDL) and triglycerides.
High density lipoproteins (HDL)
This is widely dubbed as good type of cholesterol. Why? It is because of its ability to send harmful fats to your liver. From the liver, these fats find their way out of your body. As the name indicates, the more you have it, the better it is for your health. A pronounced presence of this fat can contribute to lessening the likely risks of a heart failure or a cardiac arrest. Medications prescribed and diet plans focus on increasing the level of HDL in your blood. In terms of readings, HDL at less than 40 mg / dL (among men) and below 50 mg / dL (in women) is labelled as a risky proposition.
Low density lipoprotein (LDL)
This form of cholesterol is widely referred as bad cholesterol. It remains as one major reason for the constriction (narrowing) of your blood vessels. LDL plays an important role in increasing the risk factors of a likely heart attack. Your treating doctor will aim to reduce LDL levels as part of the treatment plan given to you. LDL readings of more than 190 mg / dL are referred as risky. Such conditions may require a comprehensive treatment plan. The plan usually comprises dietary changes (lesser intake of fats), starting a medication plan involving intake of statins as well as changes made to your lifestyle. You may be asked to pursue a more active lifestyle; in essence, say no to a sedentary way of living.
Triglycerides
This is another kind of fatty substance found in the blood; it is formed by using the extra calories you consume. Intake of foods with a higher percentage of calories (especially, carbohydrates) can lead of a greater share of triglycerides. In essence, these fats actually provide energy. However, a higher share of triglycerides can mean added risks of a cardiac disorder. It is considered as a normal condition if the level of triglycerides is measured below 150 mg / dL. It is a termed as risky situation if triglycerides are measured in the range of 250 – 500 mg / dL.
So, what is VLDL cholesterol?
VLDL stands for very low density lipoprotein. Like most fats, it is also made in your liver. You may need to stay aware that lipoproteins in general have a blend of proteins, triglycerides as well as cholesterol. In case of VLDL cholesterol, triglycerides constitute more than 50%. A higher presence of this type of cholesterol can directly lead to formation of deposits on your arterial linings and walls. In effect, a higher share of VLDL cholesterol can soon shrink the radius of your vessels. These processes can lead to hindrances to a regular or normal flow of blood to all parts of your body.
You need to know that VLDL cholesterol level is neither calculated as a direct measure nor is it listed as part of a regular lipid profiling (cholesterol) test. Then, how else is it measured? VLDL cholesterol is represented in relation to triglycerides. When VLDL cholesterol exceeds 30 mg / dL, it is termed as a risky level. How to reduce this type of fatty substances? A proven way to decrease this fatty substance is to reduce the level of triglycerides. This is not surprising because – as mentioned earlier – more than 50% of VLDL cholesterol is made of triglycerides.
How does VLDL differ from LDL?
You would have guessed by now that VLDL cholesterol is a bad type of fatty substance. But, what are the dissimilarities between LDL and VLDL cholesterol? The differences stem from the share of cholesterol each of these types carry in them. As VLDL cholesterol is responsible for supplying triglycerides all over the body, only 10% of it made of cholesterol. Proteins form nearly 10% and other fats make for a paltry 10%. The lion’s share of VLDL is made of triglycerides; this constitution makes way for the difference between LDL and VLDL. On the other hand – for LDL, triglycerides amount to only 10% in terms of weight. Cholesterol constitutes nearly 1/4th (25%) of LDL’s weight.
VLDL cholesterol supplies energy from unused calories. Regular intake of energy-rich foods can leave high traces of VLDL cholesterol in the blood. It is needless to state that in such conditions your body also has a high percentage of triglycerides. It is these excessive triglycerides that store up energies and get discharged whenever your body needs an additional supply of calories or energies. Such stack-up of energies can lead to strokes or heart failures. The key reasons are VLDL cholesterol can cause hypertension (increase in your blood pressure), inflammation of the walls of your arteries as well as bring down the level of good cholesterol i.e., high density lipoproteins (HDL).
You may be at a relatively high level of risk if your family history includes hypertension, if you are diabetic and if you have had prior heart problems. Other risk factors include excessive body weight, habits such as smoking, leading an inactive / sedentary lifestyle as well as eating an unbalanced diet with a higher percentage of animal fats.
Treatment of VLDL cholesterol
Approaches recommended to treat VLDL cholesterol include intake of foods rich in fiber as well as increasing the share of vegetables and fruits in your daily diet. In essence, a diet with low levels of fats is highly recommended. Regular workouts and exercising for at least half hour every day can help decrease VLDL cholesterol levels. An active and non-sedentary lifestyle can also bring a lot of changes – for example, exercises can trigger a decrease in body weight. Your treating doctor may also advise you to reduce the intake of alcohol and kick the butt (i.e., stop smoking). Your treatment plan may turn intricate if you are diabetic. In such instances, your blood glucose levels are actively monitored. A lead indicator of this is the A1c level (i.e., hemoglobin) in your blood.
Medications used for the treatment of VLDL cholesterol
In some cases, the treating doctor may prescribe a few medications. Fibrates (sourced from fibric acid) belong to a family of drugs widely used for reducing the levels of triglycerides. These drugs decrease your liver’s capability to make VLDL cholesterol, and also help discharge triglycerides from the blood. You may need to understand that these drugs are also prescribed for the treatment of LDL (i.e., to reduce the levels of bad cholesterol in the blood).
A high level of triglycerides in blood is also linked to a possible swelling of the pancreas. This condition may get triggered when triglycerides exceed beyond 900 mg / dL. In some extreme cases of low HDL and high proportion of triglycerides, drugs like feno-fibrate (Tricor) are taken along with statins. Such a combination is found to reduce bad cholesterol (LDL), increase the quantum of HDL (good cholesterol) and lessen the share of triglycerides in the blood.
Fibrates may trigger a few side effects. Most common side effects include diarrhea, nausea or abdominal problems. Regular intake of the drug can lead to formation of stones in your gallbladder. In some rare instances, fibrates have triggered mild problems (such as irritation) in the liver. However, such problems are largely reversible with the discontinuation of the intake of fibrates.
Fibrates – especially, drugs such as gemfibrozil – can trigger a few problems in your muscles. This is known to occur when fibrates are combined with statins such as lovastatin, simvastatin, etc. The key reason behind this is the interference of fibrates (like, gemfibrozil) in the metabolism of aforesaid statins. Once the breaking down of statins is disturbed, your blood may witness an increased share of statin-compounds in your blood. This subsequently may lead to a build-up of residues in the muscles. In general, statins must not exceed more than 20 mg if administered along with fibrates. The only exception however is pravastatin. Studies done on combinatorial therapy show that taking fibrates along with pravastatin shows limited toxic effects on your muscles. However, these studies do not completely rule out some likely risks.
Fibrates may also intervene in the action of anticoagulants or blood thinning drugs, especially drugs such as warfarin, etc. These interactions are more pronounced when fibrates are taken along with blood thinning drugs. It is hence very important to tell your doctor about all the other drugs you are currently taking or if you are pursuing any other treatment plans. In case of blood thinning drugs, your doctor may lessen the strength of such medicines to prevent likely risks of bleeding or a possible loss of blood.
Gemfibrozil 300 mg
This medication is taken for the case management of increased share of lipids. Its main activity rests in controlling the fat uptake of the liver and also decreasing the production of VLDL cholesterol in the body. Its most common side effects include an altered sense of taste, stomach problems such as indigestion, pain in your lower abdomen, etc. In some cases, it may trigger appendicitis. You may need to inform your treating doctor beforehand if you have conditions such as liver disorders, formation of gallstones, disorders with your sexual organs – especially testicles, etc. This drug – as mentioned – is likely to interact with blood thinning drugs as well as with a few cholesterol-reducing statins. It is important to inform your doctor about the medications you are already consuming. This information needs to be shared well ahead of starting to take this fibrate.
Fenofibrate 145 mg
This medicine is administered for the treatment of abnormal levels of lipids in the blood. The main functions of this medication include lessening of lipoproteins and also helping to lower cholesterol levels. It decreases lipids by activating a few types of receptors (i.e., peroxisome-proliferator-activated receptor-alpha). These medications are categorized as lipid-reducing drugs. Some of its side effects include nausea, blocks in your nasal passages, headache, back pain, etc. If you have prior medical conditions such as diabetes, kidney problems, hepatic disorders, etc., you are advised to inform your treating doctor about such conditions. It may interact with a few statins and select types of antibiotics.
In sum, VLDL is a short form of Very Low Density Lipoprotein. It is produced by the liver. It is made of a mixture of triglycerides, cholesterol and proteins. In terms of weight, triglycerides constitute more than 50% of this type of cholesterol. An increase in this type of cholesterol leads to thickening of your arterial walls. This action – if left unchecked – can shrink the size of arteries and cause disturbances to the normal flow of blood. Medications such as gemfibrozil, fenofibrate, etc. are used to lower abnormal levels of lipids. But, you may need to be aware of the side effects of these drugs as well as the potential risks of interactions with other drugs – especially, with statins and blood thinning drugs.
Education: Master’s in Nursing (MSN) from Johns Hopkins University. Experience: 7 years writing for online health portals and nursing journals, specializing in patient education and chronic illness management.
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