Cholesterol is a waxy, fat-like substance found in the cell membrane and is transported in the blood plasma of all animals. Our body needs cholesterol to a certain level to work properly, but if excess of cholesterol enters blood, it can make sticky deposits to the walls of the arteries leading to its narrowing and blockage. High cholesterol shoots up the risk of getting various cardiovascular diseases such as Atherosclerosis, Cardiac Arrest, Stroke, Heart Attack, etc.

Types of Cholestrol:
There are two types of cholesterol viz., Low density lipoprotein (LDL) and High density lipoprotein (HDL) LDL is harmful Cholesterol and HDL is the useful one. Hypercholesterolemia indicates that, HDL is decreased and LDL is increased.

Desirable Levels of Cholestrol:

• 200mg/dl is the desirable level.
• High but Manageable: 200mg/dl-239mg/dl
• High- above 240mg/dl

Causes of Hypercholesterolemia:

• Heredity: High levels of cholesterol may be inherited because genes may influence the metabolism of LDL (bad) cholesterol.
• Foods high in saturated fats and Cholesterol: This is the most common cause of hypercholesterolemia as excess of saturated fats may modestly increase LDL (bad) cholesterol level.
• Other diseases: Some people suffering from diabetes may have high levels of cholesterol.
• Lifestyle Changes: Changes in lifestyle has lead to decrease in exercise which may lead to increase in fat and cholesterol levels.

Risk Factors of Hypercholesterolemia:
Some important risk factors for high cholesterol are:

• Obesity
• Eating a diet high in saturated fat and trans fatty acids
• Not getting enough exercise
• Diabetes
• Family history of heart diseases
• High blood pressure
• Drinking alcohol
• Smoking

Diagnosis of Hypercholesterolemia:

Blood test called as Lipoprotein profile is used to diagnose the cholesterol levels in the blood. Lipoprotein profile gives the information about total cholesterol, LDL, HDL and Triglycerides.

Concept of Cholesterol in Ayurveda

As stated earlier, Ayurveda emphasizes the importance of metabolic processes in health promotion as well as disease management. “AGNI”, literally “fire”, is the term used in Ayurveda for defining collectively all the bodily metabolic actions. Ayurveda classifies AGNI into several varieties: JAATARA AGNI – located in the alimentary tract and performing major metabolic processes, DHATU AGNI – situated at tissue levels and capable of processing metabolic requirements of individual tissues, and BHOOTA AGNI – subtle metabolic processes that happen at the cellular level.8

Metabolic processes maintain the normal quantity, quality and function of the DOSHA and DHATU. When in abnormal states due to various causative factors relating to body and the mind; metabolites that are not assimilated by the body tissues will be produced. The resultant product of such metabolic action is called AAMA.

AAMA is the primary cause of all metabolic disorders in Ayurveda. Once formed it is capable of obstructing the metabolic pathways and causing diseases. Cholesterol is considered as one such product that originates due to metabolic impairment in the alimentary tract and fat tissue (MEDA).

There is no precise term for hyperlipidemia in the Ayurvedic classics. Literature shows that scholars have tried to use distinct nomenclature for hyperlipidemia, e.g., Rasagata Sneha Vriddhi (increase in lipids in plasma), Rasa Raktagata Sneha Vriddhi (increase in the lipids in plasma and blood), Medovriddhi (generalized lipid increase), Medoroga or Medodosha (obesity), AAMA Medo Dhatu (abnormally formed adipose tissue). A detailed study of hyperlipidemia reveals its similarity to Asthayi Medo Dhatu Vriddhi (abnormal increase in circulating lipids) with regard to the pathophysiology. This excessively increased circulating lipid is AAMA in nature, resulting in further complications.

Pathology According to Ayurveda

The abnormal MEDA (fats) formed due to an aberrant state of metabolism circulates in the channels of the body and gets deposited, producing various symptoms like flabbiness of the body parts such as abdomen, breasts, etc. It clogs and blocks the flow of lymph and blood, causing lethargy, difficulty breathing, excess sleep, excessive perspiration, a foul body odor, weakness, lack of stamina and loss of libido. Ultimately the excess of fats gradually pathologically involve DOSHA and DHATU in the body and cause maladies such as hypercholesterolemia, hypertension, diabetes mellitus, heart problems, joint disorders and obesity.

Ayurvedic Treatment Principles for Managing Hypercholesterolemia

Ayurvedic approach to hypercholesterolemia involves methods to increase the digestive fire to digest the AAMA, regulating assimilation and elimination and controlling the causative factors. Several individual herbs and combinations of herbs are used in Ayurveda for the management of Medo Dhatu Vriddhi (increased lipids), AAMA and metabolic disorder.