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Cholesterol is fatty substance that is a by-product of normal liver metabolism. While many people become alarmed at the mere mention of the word, cholesterol is actually necessary for a number of biological processes. For instance, the body requires cholesterol in order to manufacture vitamin D. It is also needed to produce bile acid to promote proper digestion and to manufacture androgenic hormones. However, there is a key difference between good cholesterol and bad cholesterol.
Since various cells utilize cholesterol, it must be transported through the bloodstream to get where it is needed. This is especially true since cholesterol is insoluble in blood. The vehicle comes in a type of lipid called a lipoprotein. Lipoproteins are designated as being either low-density or high-density. Good cholesterol is also known as HDL cholesterol because its mode of transportation comes from high-density lipoproteins. In contrast, bad cholesterol, or LDL cholesterol, is moved through the blood steam via low-density lipoproteins.
In addition to the mode of transport, there is a difference in destination between good cholesterol and bad cholesterol. LDL cholesterol is considered "bad" because it generally never makes it out of the bloodstream. In fact, it tends to just keep circulating there. This allows cholesterol to collect in arterial walls and eventually form deposits of a hard substance known as plaque. Since the arteries supply blood to the brain and heart, a blockage or narrowing of these routes can significantly increase the risk of a heart attack or stroke.
Good cholesterol, on the other hand, is termed as such because it is carried by high-density lipoproteins. This is meaningful because HDL lipids tend to transport cholesterol out of the arteries and return it to the liver where it is eventually eliminated as waste. In addition, LDL cholesterol left circulating in the bloodstream is often caught up in the process before it has a chance to accumulate and form plaque in the arteries. This is why having a greater serum concentration of good cholesterol is considered beneficial to reducing the risk of heart disease and other complications.
Cholesterol levels in the blood are checked by the measurement of three values: LDL (bad cholesterol), HDL (good cholesterol), and triglycerides, another kind of fat made from unused calories that is also transported via low-density lipoproteins. This blood test may require several hours of fasting first, or else it may not be possible to determine LDL cholesterol and triglycerides levels accurately. Whether or when to have your cholesterol checked depends on a variety of factors, including diet, lifestyle, family history, and age. In addition, high risk factors for heart disease, such as smoking, excessive alcohol consumption, or high blood pressure, may necessitate initial cholesterol testing at an earlier age and with greater frequency after that.

There are four different types of cholesterol medication. These include statins, niacin, bile-acid resins, and fibric acid derivatives. Each one works in a different way to treat high cholesterol. In many cases, patients are prescribed more than one drug, or more than one type of drug, to achieve desired results.
Statins block cholesterol production in the liver. These medications are the first line of defense for treating high cholesterol. They lower low-density lipoproteins (LDL), or “bad” cholesterol, and mildly raise high-density lipoproteins (HDL), or “good” cholesterol. They are also effective in lowering triglyceride levels. Side effects of statins include intestinal problems, liver damage, and in rare cases, muscle weakness.
Niacin is a B vitamin complex found in food and in higher levels by prescription. It effectively lowers LDL cholesterol and raises HDL cholesterol. Niacin obtained from supplements or food sources should not be used to treat high cholesterol. Only a qualified medical professional can prescribe the adequate amount of niacin on an individual basis. Over-the-counter formulas are also available, but should only be used under a doctor’s supervision. Side effects of niacin include itching, tingling, flushing and headache.
Bile-acid resins are prescription medications that decrease LDL and total cholesterol levels. They bind with bile in the intestines, where they prevent it from being absorbed into the circulatory system. Bile is made primarily of cholesterol, and bile-acid resins work by limiting the body’s overall supply.
Side effects of these medications include upset stomach, constipation and gas. They may also interfere with the body’s absorption of some vitamins and other medications. Informing a physician of all over-the-counter and prescription medications and supplements is necessary before taking bile-acid resins.
Fibric acid derivatives, also known as fibrates, are used to lower LDL cholesterol and triglycerides, while increasing HDL cholesterol. Science is unclear on how this cholesterol medication works. It is believed that fibrates increase the breakdown of triglyceride particles, decrease the production of lipoproteins, and simultaneously induce the creation of new HDL particles in the body.
Side effects of fibric acid derivatives include upset stomach, tiredness, nausea, vomiting, dizziness, headache, and blurred vision. Fibrates may interact with other cholesterol medication such as statins, causing muscle breakdown and possible kidney damage. Other interactions may occur in patients taking blood thinners such as warfarin, causing excessive bleeding.