LDL Cholesterol: 132 mg/dL

What does an LDL level of 132 mean? Are there any symptoms associated with this level?

An LDL level of 132 mg/dL is considered elevated. Although cholesterol is involved in several important functions in the body, elevated LDL cholesterol may put you at greater risk for heart disease. A healthy LDL level is <100 mg/dL. 

Elevated LDL cholesterol doesn’t have symptoms, which is why it’s important to know your levels. Lowering them will lower your risk of developing heart disease and other health issues. 

If you already have heart disease, lowering your LDL cholesterol can reduce your odds of serious complications, like a heart attack or stroke. 

Factors that could contribute to a level of 132: 

• Diet: Diets that are low in fiber and high in saturated fats, trans fats, and added sugar can cause LDL cholesterol to rise.

• Weight. Being overweight also tends to increase cholesterol levels, including LDL cholesterol. 

• Physical inactivity. Not being physically active can increase LDL (bad) cholesterol and lower HDL (good) cholesterol levels. 

• Smoking. Smoking lowers your HDL (good) cholesterol which can contribute to a higher level of LDL (bad) cholesterol.

• Medications: Some medications, like corticosteroids, beta-blockers, thiazide diuretics, antivirals, retinoids, and growth hormones can increase cholesterol levels. .

• Diseases: Certain diseases like chronic kidney disease, diabetes, and HIV/AIDS can elevate total cholesterol and LDL.

• Age and Sex: Premenopausal women tend to have lower LDL cholesterol levels than men of the same age. However, cholesterol levels tend to increase with age in both women and men. After the age of menopause, women's LDL (bad) cholesterol levels tend to rise.

• Genetics (heredity): High blood cholesterol can run in families. This is because your genes partly determine how much cholesterol your body makes. 

• Race. Certain races may have an increased risk of high blood cholesterol. For example, Blacks/African Americans typically have higher HDL and LDL cholesterol levels than Caucasians.

What to do if your level is 132?

Improving your diet and adopting healthier habits can help reduce your LDL cholesterol level. Here are some things you can do to help lower your LDL:

• Aim to get 30-40 g of fiber each day from fiber-rich foods like veggies, fruit, whole grains, and legumes. 

• Limit sources of refined carbs and added sugars such as soda, chips, candy, baked goods, sweetened yogurt, and ice cream. 

• Avoid trans fats (partially hydrogenated oils) and reduce your saturated fat intake to < 10% total calories. 

• Eat small, fatty fish at least twice a week. Good options include salmon, sardines, and trout. 

• Move your body daily. Aim to get 30-60 minutes of physical activity 5x/week. 

• Incorporate plant sterols and stanols daily (2g) in the form of food or a supplement. 

• Lose weight if you are overweight or obese.

• Quit smoking.

• If you have diabetes, achieve and maintain good blood sugar control (HbA1c).

Medications and supplements used to improve results

Medications and supplements can help reduce your LDL cholesterol if diet and lifestyle changes are not enough.

Medications

Medications are typically prescribed if diet and lifestyle changes do not lower LDL cholesterol levels enough on their own. Some common cholesterol medications include:

• Statins: Statins reduce cholesterol production in your liver. Some common statins include atorvastatin, simvastatin, and rosuvastatin. Because they typically need to be taken for life, statins are only prescribed if diet and lifestyle changes aren’t enough [3].

• Ezetimibe can be helpful for those with familial hypercholesterolemia and/or who have side effects with statins. 

• Lomitapide: Usually prescribed if you have familial hypercholesterolemia. Lomitapide requires liver enzyme monitoring as it can cause liver damage and is commonly taken with vitamin E.

• Bile acid sequestrants: These medications block cholesterol-rich bile acid from being absorbed into the bloodstream and can be prescribed in place of or in addition to a statin. 

• PCSK9 inhibitors: This medicine is injected under your skin every 2 or 4 weeks and may be prescribed with a statin if you are at high risk of heart attack or stroke, or have familial hypercholesterolemia.

Supplements

• Plant sterols and stanols: Found in plant cell membranes, plant sterols and stanols (also called phytosterols) are similar in structure to cholesterol in the body and block dietary cholesterol from being absorbed. Phytosterols can be found in small quantities in vegetable oils, nuts, legumes, whole grains, fruits, and vegetables, however, the average daily intake (500 mg)  is typically not enough to lower cholesterol. Studies show consuming 2000 mg (2 g) of plant sterol and stanols daily from diet and/or supplements to be most effective [4]. Plant sterol and stanol supplements are taken before or with meals can help lower total cholesterol in parallel with other recommended diet and lifestyle changes [4]. 

• Beta-glucan: Beta-glucan is a form of soluble fiber that has been shown to help lower cholesterol levels. It’s found naturally in whole grains like barley, oats, rye, and wheat, mushrooms, and seaweed, and is also available as a nutritional supplement. For cholesterol-lowering benefits, consume 3-7 g/day from your diet and/or a supplement.

• Psyllium: Made from the husk of psyllium seeds, psyllium is another type of soluble fiber. It is good for digestive health and regularity, and can also be helpful in lowering cholesterol. Psyllium supplements are sold in powder form and can help reduce lipid levels when taken at a dose of 8-12g/day. 

• Alpha-lipoic acid: A potent antioxidant made in the body, alpha lipoic acid is also found in foods including carrots, beets, spinach, broccoli, potatoes, and red meat. Research indicates that 600 mg/day of alpha-lipoic acid from your diet and/or a supplement may help lower total cholesterol and LDL (bad) cholesterol [8]. 

• Bergamot extract: Taking bergamot extract (made from the juice of the bergamot fruit) may help lower cholesterol and triglyceride levels in adults with high cholesterol [9,10]. One study suggests taking bergamot extract daily for a month may be as effective as taking a low dose of the cholesterol-lowering drug called rosuvastatin (Crestor) [10]. A recent research review indicates that 1000 mg/day may be most effective for lowering cholesterol. 

• Green tea extract: Green tea extract is a natural supplement made from the leaves of the Camellia Sinensis plant that has been shown to help lower LDL (bad) and total cholesterol [11]. A daily dose of 400 mg may help lower your cholesterol but check with your doctor first as green tea extract can interact with certain medications, including beta-blockers and blood thinners. In addition, green tea extract may also have a stimulant effect.

• Berberine: A compound extracted from a variety of medicinal herbs, some studies suggest berberine can reduce LDL (bad) cholesterol and triglycerides in type 2 diabetics, as well as slightly increase HDL (good) cholesterol [12]. A standard dose of berberine is 900-2000 mg/day (divided into 3-4 doses), taken with or just after a meal.