Cholesterol screening: are you testing as often as you should?

High cholesterol is not always the result of a poor diet and lack of exercise

You can have high cholesterol even if you're not overweight. An underactive thyroid gland, certain medications (such as beta-blockers, some types of birth control, antivirals, anticonvulsants, growth hormones and corticosteroids), chronic kidney failure and alcohol abuse can all be contributing factors to elevated cholesterol levels, too.

Some people even have naturally high blood cholesterol levels due to a rare hereditary condition called familial hypercholesterolaemia. This condition makes the body unable to remove low-density lipoprotein (LDL) cholesterol from the blood. However, for many people it's something we have an influence over in the way we eat and choose to live (like choosing not to exercise enough).

Since high cholesterol doesn't usually present obvious symptoms before it becomes damaging to various tissues or organs, a blood screening test is the only way to know your cholesterol levels. This is why it's so important to make cholesterol testing part of your regular physical health screening appointments.

A complete cholesterol test is called a lipid panel. It gives an estimated insight into your risk of developing cardiovascular disease and helps your doctor decide what cholesterol-lowering treatments you may need.

The test measures two kinds of cholesterol: low-density lipoprotein (LDL) and high-density lipoprotein (HDL).

• LDL cholesterol (low-density lipoprotein) , also known as "bad" cholesterol, moves through the body, where it's used to repair cell membranes or make hormones.
• HDL cholesterol (high-density lipoprotein) , also known as "good" cholesterol, moves through the liver, where it removes excess cholesterol from the body's tissues and disposes of it before it can do any harm.

It is calculated through an equation called the Friedewald formula. LDL cholesterol is calculated by taking your total cholesterol, minus your HDL cholesterol, minus your triglyceride levels (a type of fat that circulates in the blood which we get from foods we consume that are high in sugar, saturated fats, trans fats and lacking in fibre) and dividing this number by five.

TIP 1: Ask your doctor about fasting before your test

An analysis by the American College of Cardiology shows that groups at higher risk may benefit from fasting. This is because the equation used to find the LDL level tends to underestimate the levels of LDL and triglycerides in people who do not fast.

Due to this, it is always best to go on your doctor's recommendation. Always ask your doctor ahead of time if you should avoid eating or drinking for up to 12 hours before the test.

TIP 2: Share a full list of your current medications with your doctor

Certain medications, like oral corticosteroids (man-made drugs that closely resemble cortisol) can affect the results of a cholesterol test. Because of this, your doctor may want you to stop using certain medications for a day or two before your test.

To best prepare yourself, have a full list of the medications you take regularly on hand. This should also include herbal and dietary supplements.

TIP 3: Make sure your doctor is aware of any recent illnesses or events that have affected your health

Before scheduling your cholesterol test, make sure your doctor is fully aware of health-related events like recent surgeries, infections, a recent pregnancy, or serious illnesses. For accurate results, a doctor will often advise that you wait at least two months after such events before testing.

TIP 4: Book your test

The simplest and most convenient way to get your cholesterol checked is to book a Health Check. Health Checks are a financially beneficial way for Discovery Health Medical Scheme members to unlock more cover through the WELLTH Fund. You can also get your other physical health screening and preventive tests done in one sitting.

Try to schedule a morning appointment so that if you have been instructed to fast before your test, it is not too long a stretch from your previous evening's meal.

Learn about Discovery Health Medical Scheme's WELLTH Fund, how you and your family can gain full access to it and what this benefit covers.

TIP 5: Avoid consuming alcohol and fatty foods 24 hours before your test

Alcohol and fatty or sugary foods can affect your cholesterol levels. To make sure you get an accurate reading, it's best to avoid them entirely for 24 hours before your cholesterol test. Some particularly fatty foods to steer clear of include fried and greasy meals, sugary treats, fatty meats like pork and lamb, and full-fat dairy items.

TIP 6: Drink water to stay hydrated before your test

Research shows that dehydration during fasting increases serum lipids and lipoproteins, which can skew cholesterol test results. So, if you are fasting, avoid unnecessary physical activity, keep cool in hot weather, and remember to drink enough water.

Preparing for a cholesterol screening is easy enough, but it does require some planning. By following these simple steps, you can make sure your test results are accurate. This will mean you can make the changes needed to manage your cholesterol levels and reduce your risk of heart disease and stroke. When you have an upcoming cholesterol test and have concerns, it's always best to speak to your doctor ahead of time.

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