I have extremely high cholesterol despite my efforts to manage it. What should I do?

**Understanding Familial Hypercholesterolemia (FH)** Familial Hypercholesterolemia (FH) is a genetic condition that causes extremely high cholesterol levels, which can lead to early heart disease if not treated properly. Unlike typical high cholesterol, which can often be managed with lifestyle changes like diet and exercise, FH is due to a genetic defect that affects how your liver processes cholesterol. **Key Points About FH:** 1. **Genetic Basis:** FH is inherited, meaning it runs in families. If one of your parents has FH, there's a 50% chance you will have it too. 2. **Cholesterol Levels:** People with FH have very high levels of LDL (bad cholesterol) from a young age. Untreated LDL levels over 190 mg/dL are a red flag. 3. **Health Risks:** High LDL levels can lead to the buildup of plaque in your arteries, increasing the risk of heart attacks and strokes at an early age. 4. **Diagnosis:** FH can be diagnosed with a simple blood test and a review of your family history. If you have a family history of early heart disease, it's crucial to get tested. 5. **Treatment:** While lifestyle changes are beneficial, they are not enough to manage FH. Medications like statins are often necessary to lower LDL levels effectively. 6. **Family Screening:** If you are diagnosed with FH, it's important to have your family members tested as well. Early diagnosis and treatment can prevent serious health issues. **What You Can Do:** - **Talk to Your Doctor:** If you suspect you have FH, discuss it with your healthcare provider. They can perform the necessary tests and recommend appropriate treatments. - **Medication:** Follow your doctor's advice on medications to manage your cholesterol levels effectively. - **Healthy Lifestyle:** Continue to maintain a healthy diet and exercise regularly. While these won't cure FH, they contribute to overall heart health. - **Family Awareness:** Inform your family members about FH and encourage them to get tested. Early detection can save lives. **Conclusion:** Understanding FH is crucial for managing your health and protecting your family. With proper diagnosis and treatment, individuals with FH can lead healthy lives and reduce their risk of heart disease. **Resources:** - [FH Foundation](https://thefhfoundation.org) - [American Heart Association](https://www.heart.org)