Lipids and Health

Hyperlipidemia, in general, can be divided into two subcategories , ie; Hypercholesterolemia, in which there is a high level of cholesterol. And  Hypertriglyceridemia, in which there is a high level of triglycerides, the most common form of fat. The majority of cases of hyperlipidemia in adults are not caused by primary  disorders. They are most commonly due to seondary causes. The most common secondary cause of hyperlipidemia in adults is a sedentary lifestyle coupled with excessive intake of saturated fat, cholesterol, and trans fats. Other secondary causes of dyslipidemia include diabetes mellitus, hypothyroidism, chronic use of alcohol, and chronic kidney disease.^1,2 Although dyslipidemia usually doesn’t cause symptoms, it can lead to symptomatic vascular disease, which includes coronary artery disease and peripheral arterial disease. Those with a high concentration of LDL in their blood can experience symptoms such as eyelid xanthelasmas and arcus corneae. Severe elevations of triglycerides can lead to the formation of eruptive xanthomas over the hands, knees, back, and elbows. The latest research shows that hyperlipidemia or dyslipidemia is also linked to erectile dysfunction.³ According to research, 20% of men who suffer from erectile dysfunction have dyslipidemia. Treatment of dyslipidemia is indicated for all patients who have cardiovascular disease and for some without. Treatment of dyslipidemia focuses primarily on reducing high levels of LDL cholesterol and secondarily on treating high levels of triglycerides, low levels of HDL cholesterol, and metabolic syndrome.⁴ For treating primary hyperlipidemia, statins, nicotinic acid, bile acid binding resins, psyllium husk and fibric acids are main drugs in common use. Bile acids in gastrointestinal tract bound to oral anion-exchange resin, like cholestyramine or psyllium are lost in the feces and depletion of the bile acid pool stimulates conversion of cholesterol to bile acid synthesis causing fall in intracellular cholesterol  in hepatocytes, and an increase or up-regulation of both LDL-receptors and cholesterol synthesis.⁵ For many years psyllium husk has been used as an agent for gastrointestinal disturbances but it has hypolipidemic effects too. Psyllium husk binds bile acids in the intestine, thereby interrupting the enterohepatic circulation of bile acids and increasing the conversion of cholesterol into bile acids in the liver.^{1-4, 6-10}