Cholesterol is a waxy, fat-like substance naturally produced by your liver and found in certain foods. While your body needs cholesterol to build healthy cells and produce essential hormones, too much cholesterol in your blood can significantly increase your risk of heart disease and stroke. Understanding cholesterol levels is crucial for maintaining optimal cardiovascular health throughout your life.
Cholesterol travels through your bloodstream in packages called lipoproteins, which come in two main types. Low-density lipoprotein (LDL) is often called "bad" cholesterol because it can build up in your artery walls, forming dangerous plaques that narrow blood vessels. High-density lipoprotein (HDL) is known as "good" cholesterol as it helps transport cholesterol away from your arteries back to your liver for disposal.
Several factors can contribute to high cholesterol levels, including:
High cholesterol typically shows no symptoms, making regular testing essential. The Heart Foundation of Australia recommends cholesterol checks every five years for adults, or more frequently if you have risk factors.
Australia's Pharmaceutical Benefits Scheme (PBS) provides access to various effective cholesterol-lowering medications. These medicines work through different mechanisms to help reduce cholesterol levels and protect your cardiovascular system. Your doctor will determine the most appropriate medication based on your cholesterol levels, overall health, and individual risk factors.
Statins are the most commonly prescribed cholesterol medications in Australia and work by blocking an enzyme your liver uses to make cholesterol. Popular options include atorvastatin (Lipitor), simvastatin (Zocor), and rosuvastatin (Crestor). These medications are highly effective at reducing LDL cholesterol and have proven cardiovascular benefits.
For patients who cannot tolerate statins or need additional cholesterol reduction, several alternatives are available:
These medications require prescription and regular monitoring by your healthcare provider to ensure optimal effectiveness and safety. Many are subsidised under the PBS, making them accessible for eligible Australian patients.
Prescription cholesterol medications, particularly statins, are typically recommended when lifestyle changes alone haven't achieved target cholesterol levels. Your GP may prescribe these medications if you have significantly elevated LDL (bad) cholesterol, a history of cardiovascular disease, or multiple risk factors such as diabetes, high blood pressure, or family history of heart disease. In Australia, the Pharmaceutical Benefits Scheme (PBS) subsidises many cholesterol medications, making them more accessible for patients who meet specific criteria.
Several OTC options are available in Australian pharmacies to support cholesterol management. Plant sterols and stanols, found in specially formulated margarines and supplements, can help reduce cholesterol absorption in the intestines. Omega-3 fatty acids, particularly EPA and DHA from fish oil, may help lower triglycerides and support overall heart health. These supplements are regulated by the Therapeutic Goods Administration (TGA) and should display an AUST L number on their packaging.
Many Australians seek natural alternatives for cholesterol management. Common options include:
Red yeast rice contains naturally occurring compounds similar to statins and is available in Australian pharmacies. However, the concentration of active ingredients can vary significantly between products. The TGA has specific regulations regarding red yeast rice supplements, and some formulations may require a prescription. It's essential to discuss red yeast rice with your pharmacist or GP, especially if you're considering it as an alternative to prescribed statins or have liver conditions.
Before starting any cholesterol management regimen, it's crucial to consult with your GP or pharmacist. They can assess your individual risk factors, review current medications for potential interactions, and recommend the most appropriate treatment approach. Regular monitoring through blood tests is essential to track progress and adjust treatment as needed.
While cholesterol medications are generally well-tolerated, some patients may experience side effects. The most commonly reported include mild digestive issues such as nausea, constipation, or diarrhoea. Some people may also experience headaches, dizziness, or skin rashes. These side effects are usually temporary and may diminish as your body adjusts to the medication. If side effects persist or worsen, consult your healthcare provider for alternative options.
Muscle-related side effects are among the most concerning for patients taking statins. These can range from mild muscle aches (myalgia) to more serious conditions like muscle inflammation (myositis) or, rarely, severe muscle breakdown (rhabdomyolysis). Symptoms to watch for include:
Regular liver function monitoring is essential when taking cholesterol medications, particularly statins. Your GP will typically order blood tests before starting treatment and periodically thereafter to check liver enzymes. In Australia, standard practice involves testing liver function within 6-12 weeks of starting treatment and then annually or as clinically indicated. Elevated liver enzymes may require dose adjustment or medication changes.
Cholesterol medications can interact with various other medicines and supplements. Important interactions include certain antibiotics, antifungal medications, and some heart rhythm drugs. Grapefruit juice can significantly increase statin levels in the blood, potentially leading to increased side effects. Always inform your pharmacist and GP about all medications, supplements, and herbal products you're taking to avoid potentially dangerous interactions.
Seek immediate medical attention if you experience severe muscle pain, weakness, or dark urine while taking cholesterol medications. Contact your healthcare provider if you develop persistent side effects, signs of liver problems (such as yellowing of skin or eyes, severe fatigue, or abdominal pain), or if you need to start new medications that might interact with your cholesterol treatment. Your local pharmacist is also an excellent resource for addressing concerns about side effects or medication interactions.
Managing cholesterol effectively requires a comprehensive approach that extends beyond medication. In Australia, healthcare professionals emphasise the importance of lifestyle modifications as the foundation of cholesterol management.
Following a heart-healthy diet is crucial for managing cholesterol levels. The Heart Foundation of Australia recommends reducing saturated and trans fats whilst increasing omega-3 fatty acids, soluble fibre, and plant sterols. Focus on incorporating more vegetables, fruits, whole grains, lean proteins, and healthy fats like those found in avocados and nuts.
Regular physical activity can significantly improve cholesterol profiles. The Australian Government Department of Health recommends at least 150 minutes of moderate-intensity exercise weekly. Activities such as brisk walking, swimming, cycling, and strength training can help raise HDL (good) cholesterol whilst lowering LDL (bad) cholesterol.
Effective cholesterol management requires ongoing monitoring and collaboration with your healthcare team. Regular assessment ensures your treatment plan remains optimal and adjustments can be made as needed.
Most Australians should have their cholesterol levels checked every five years from age 45, or from age 35 for Aboriginal and Torres Strait Islander peoples. However, those with existing cardiovascular conditions or risk factors may require more frequent monitoring, typically every 6-12 months, as determined by their GP or specialist.
Target cholesterol levels vary based on individual cardiovascular risk. Generally, LDL cholesterol should be below 2.0 mmol/L for most people, whilst those at high cardiovascular risk may need levels below 1.8 mmol/L. Your healthcare provider will determine appropriate targets based on your specific circumstances and risk factors.
