7 surprising reasons for high cholesterol

Elevated cholesterol levels are often associated with an unhealthy diet and lack of exercise, but the reality is more complex. Many completely healthy and actively exercising individuals can experience increased cholesterol levels for surprising reasons that are not directly related to diet or exercise habits. Changes in hormonal function, sleep quality, stress, and even the method of coffee preparation can significantly affect blood cholesterol levels. In this article, we will explore seven often-overlooked reasons that may explain elevated cholesterol levels – and why understanding them is important for heart health.

Hypothyroidism slows down the body's metabolism, which also affects the processing of cholesterol in the liver.As a result, the concentration of LDL cholesterol ("bad cholesterol") in the blood can increase significantly. Untreated hypothyroidism is a known medical cause of high cholesterol – even severe hypercholesterolemia – despite having a healthy lifestyle. This is surprising to many, as cholesterol elevation is typically associated with diet rather than, for example, hormonal disorders. If cholesterol is elevated without an obvious reason, measuring thyroid hormone levels is important, as treating hypothyroidism can restore cholesterol to normal levels.

In women, hormonal changes that occur during menopause can raise cholesterol levels surprisingly high.When the level of estrogen hormone in the body decreases, unfavorable changes occur in blood lipid values: the amount of LDL cholesterol increases and the amount of good HDL cholesterol decreases, often accompanied by an increase in triglycerides. Studies have shown that during menopause, LDL cholesterol levels begin to rise, even if they were previously good. This explains why a woman living healthily may suddenly experience a spike in cholesterol at midlife. The reason is the loss of estrogen's protective effect on blood vessels, which makes cholesterol values less favorable. The increase in cholesterol caused by menopause is a surprise for many, so monitoring cholesterol during this life stage is recommended.

Few consider that the method of coffee preparation can affect cholesterol.Coffee contains fat-soluble diterpenes, such as cafestol, which can raise total and LDL cholesterol levels if they are present in the brew. Drinking unfiltered coffee (such as boiled coffee, French press coffee, or coffee from many capsule machines) has been associated with elevated cholesterol levels. Filter paper effectively removes cafestol, so regular filtered coffee does not have the same effect. Surprisingly, the cholesterol impact of coffee can be quite significant: one estimate suggests that a daily intake of five cups of unfiltered coffee can raise blood cholesterol by about 5–10%. This makes the method of coffee preparation an important detail for individuals with elevated cholesterol without other obvious causes.

Sleep apnea is a sleep-related breathing disorder that impairs sleep quality and causes a constant state of stress in the body.Nighttime breathing interruptions and recurrent awakenings elevate levels of stress hormones (such as cortisol and adrenaline), which affects the body's metabolism. Due to this constant state of stress, individuals with sleep apnea often exhibit elevated cholesterol levels. Studies have shown that effective treatment of sleep apnea (for example, with a CPAP device) has reduced elevated LDL cholesterol concentrations in the blood, indicating that correcting the sleep disorder also improves cholesterol balance. The impact of sleep apnea on cholesterol may come as a surprise to many, as sleep disorders are not immediately associated with heart health. However, the hormonal and metabolic strain caused by poor sleep can explain why even otherwise healthy individuals may experience increased blood lipid levels.

Chronic stress – for example, continuous work pressure or financial worries – is a unique risk factor that can also reflect on cholesterol levels. Prolonged elevation of stress hormones (such as cortisol) in the body may increase liver cholesterol synthesis and adversely alter fat metabolism. It has been observed that even short-term intense psychological stress can quickly raise total and LDL cholesterol levels in the blood. In prolonged stress, the effect can accumulate: in certain life situations (such as the threat of unemployment), significant increases in cholesterol levels have been noted alongside stress. The impact of stress on cholesterol is often overlooked because it is not as concrete a factor as, for example, diet.However, chronic stress is a surprising factor that can explain elevated cholesterol levels even in individuals with healthy lifestyles, and stress management may therefore also benefit cholesterol level control.

Several commonly used medications can raise cholesterol as a side effect:

• Thiazide diuretics (e.g., antihypertensive medications) can mildly increase LDL and triglyceride levels.

• Corticosteroids (such as prednisone) stimulate liver lipoprotein synthesis and may increase LDL cholesterol.

• Immunosuppressive medications, such as cyclosporine, are used among others.In organ transplant patients, they can significantly raise blood cholesterol levels.

Studies have shown a connection between low vitamin D levels and elevated LDL and total cholesterol levels. The mechanism is not fully understood, but vitamin D influences the regulation of cholesterol metabolism in the liver as well as inflammatory processes that may indirectly affect lipid values.