My mother has hyperlipidemia and is not under medication. Can you please suggest what to do?

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I went through the reports (attachment removed to protect the patient's identity). It shows that her cholesterol is certainly too elevated, and TSH (thyroid-stimulating hormone) is mildly elevated, which is fine. Her Vitamin B12 and Vitamin D were low in her first report, so I hope she had supplements for that. Even after completing a course of these vitamins, she should intermittently have the supplements for Vitamin D like Calcirol sachets (Cholecalciferol granules 60,000 IU/gm) once a month for the next six months after completing the weekly course. Intermittently, she should have vitamin supplements like the tablet Neurobion forte to keep her stores up. Now regarding cholesterol, she has to be on long-term medications besides diet control. As diet is already limited, diet alone is unlikely to affect cholesterol levels significantly. However, she should avoid oily stuff like fried food and reduce oil and ghee consumption in meals, have a light dinner, and have a regular walk for at least 30 minutes a day. There is some scope for weight loss as well. The body's calorie requirement is shallow at this age, so it is fine if she further reduces her calorie intake and focuses on green vegetables, salads, and fruits. She should start taking medication. This time, we should change the molecule to tablet Atorvastatin 10 mg bedtime, equivalent to tablet Crestor 5 mg. It is a low dose, and if she tolerates it well, we can move on to 20 mg once daily at bedtime. This has to be continued on a long-term basis, as cholesterol will bounce back once it is stopped. Also, she should undergo cardiac screening tests like ECG (electrocardiograph), echo (echocardiography), and CT coronary angiography (computerized tomography) whenever possible, as she must be harboring some blockages in her arteries. With this cholesterol level and age, I advise her to take a low-dose tablet of Aspirin 75 mg at bedtime till we rule out coronary artery disease on a CT scan. I hope this helps you get back if you have any more doubts.

Thank you.

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Her echo was fine. It is not urgent, you can get the tests done after the situation improves. However, she should be on tablet Atorva 10 milligrams or tablet Storvas 10 milligrams (Atorvastatin 10 milligrams) and tablet Ecosprin 75 milligrams (Aspirin 75milligrams), both to be taken once daily and at bedtime after dinner. Tablet Atorva 10 mg should be increased to 20 mg after a week or two. You can also buy combination medication like capsule Ecosprin AV 75 (Aspirin 75milligrams and Atorvastatin 10 milligrams).

Thank you.

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Before moving on to an alternate daily strategy, we should try the tablet Ezetimibe 10 milligrams once daily at bedtime. If she tolerates this, then it should be continued, or else we can move to an alternate daily strategy with statins.

Olive oil may be used, but whatever oil it may be, it should be used in small quantities. Avoid putting extra oil over the food, and avoid oily, fried products, ghee, and sweets.

Regarding the treadmill, she should walk at the usual speed (like a routine walk), and rather than distance, it should be time-bound. She should ideally walk for at least 30 minutes a day and five times a week. It may not be possible at first but gradually should be increased.

Around 1600 calories per day would be enough for her. Calories consumption depends on the metabolic requirement, and if one is obese or has visible fat deposition on the body, then calorie consumption may be reduced much beyond the recommended level.

All the best.

Thank you.