Posted by: rina | 2006/11/14

Cholesterol or not?

hi, I have noticed that my friend has small yellow/cream coloured
blisters under his one eye, on the soft "bag". I want to know if this could be a sign that he has cholesterol? As one other friend of ours has, and his is very prominent. I know u will suggest going for a blood test in order to know, but is this not a tell tale sign as well? And do some Pharmacies do this type of test? Thanks

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Our expert says:
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Dear Rina,

This is called Xanthelasma : these consist of cholesterol-filled plaques found on the inner (near the nose) aspect of BOTH eyes usually, and occur mainly in older adults. There is a very strong association with raised cholesterol levels, but they have occasionally been documented in patients with normal levels.

As this is not 100% absolutely predictive, your friend would be strongly advised to have a blood test. He could be one of the rare people with xanthelasma and a normal cholesterol, but in our country the link is very strong indeed. He would therefore be doing himself a great service to find out his cholesterol status, and then treat if necessary. It is highly likely that he will have a very raised total cholesterol.

Now for a word of caution. Yes, some pharmacies do this test. However, the test they do is so worthless that medical aids will not pay for it, and very few doctors would start treatment based on their result. The pharmacy test is based on a fingerprick quantity of blood, no allowance is made for fasting/fat consumption, and only the total cholesterol is measured. The correct and reliable test is a Full Fasting Lipogram. This means that after an overnight fast, the patient eats and drinks NOTHING WHATSOEVER until a blood sample is drawn the next morning for analysis. This is to allow enough time for the cholesterol and fats eaten in the previous meal to be totally cleared from the bloodstream. In this way, the test measures YOUR BODY’S cholesterol, not that of your last meal.

The information provided by the lipogram is vital:
(1.) The full lipogram measures your total cholesterol, and
(2.) also its composition. Your will get values for the “bad” cholesterol, LDL, and the “good” one, HDL, as well as a calculation of your risk ratio ( for cardiovascular problems such as heart attack and stroke) based on these readings.
(3.) Your total Free Fatty Acids are also measured. This is important because there is a condition in which this level can be extremely raised, and contributes to the overall total. Treatment for this is different from “ordinary” raised cholesterol. None of these factors are measured in the pharmacy test, which is why it can be done so cheaply. Also, even if your (pharmacy) total does register as within normal limits, if it is composed of all LDL and almost no HDL, then you are at greater risk than someone with a higher total, but who has little LDL and lots of HDL.

There is a place for these pharmacy test though. I guess they are better than nothing, but provided their limitations are recognised, they can be used as follow-up checks, in between regular 3-monthly blood tests, once you have a proper test value as a starting point.

I hope your friend has a full blood test, and that his problem is easily managed.


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