Let’s discuss a comprehensive overview of dyslipidemia, its signs & symptoms (Khiffat and Shiddat), causes, classification of dyslipidemia, and most importantly Unani treatment for dyslipidemia.
“Dyslipidemia is a metabolic disorder in which abnormal fat levels occur in the blood. Hence, it is a lipoprotein disorder in which one or more lipoprotein levels increase or decrease. ”
What is lipoprotein & how does it affect the body?
Cholesterol and triglycerides are essential lipids. They are carried within lipoprotein to become soluble in aqueous plasma. Well, lipoprotein is classified into
- high-density lipoprotein (HDL),
- low-density lipoprotein (LDL),
- very-low-density lipoprotein (VLDL),
- and chylomicron.
Cholesterol is carried out in HDL & LDL particles. In comparison, triglycerides are carried out in chylomicron and VLDL particles.
In case you don’t know about HDL, LDL, and VLDL. HDL refers to the high-density lipoprotein, and it’s considered good cholesterol. High-density protein molecules are highly permeable. In contrast, LDL indicates low-density lipoprotein and is associated with bad cholesterol. LDL is bad because it builds up and forms clumps in the arteries. While HDL is good because it helps remove LDL from the body.
The most common goals of lipids in a healthy body are:
Below 200 mg/dL
Above 40 mg/dL
Below 100 mg/dL
Below 150 mg/dL
Below 200 mg/dL
Above 50 mg/dL
Below 100 mg/dL
Below 150 mg/dL
- LDL cholesterol: Below 70 mg/dL for diabetes or heart disease people.
Classification of Dyslipidemia
The term describes a wide range of medical conditions. Classification of dyslipidemia can be:
- Based on causes
- Based on the lipid levels in the blood
Classification Based on Causes
We can classify dyslipidemia into two major types based on causes.
- Primary Dyslipidemia
- Secondary Dyslipidemia
Primary dyslipidemia occurs when no secondary factors are present. Therefore, it is the result of genetic defects. The gene defects cause overproduction or defective release of triglycerides and LDL. It can also induce due to underproduction or excessive release of HDL. Hence, primary dyslipidemia is further categorized:
- Familial combined hyperlipidemia
Elevated LDL usually results from elevated cholesterol. So, the genetically elevated cholesterol causes familial hypercholesterolemia. Thus, it is a genetic disorder in which cholesterol and triglycerides increase in the blood. High LDL increases the risk of cardiovascular diseases and coronary heart disease. Well, it is found in teenagers and young adults 1. Management includes diet & lifestyle intervention in all patients and selective medication hypertension patients.
- Familial hyperapobetalipoproteinemia
The mutation in a group of LDL lipoproteins is called apolipoproteins. It is a common disorder associated with premature coronary artery disease 2. If apolipoprotein is due to genetic mutation, it is familial hyperapobetalipoproteinemia.
- Familial hypertriglyceridemia
The genetic disorder that causes high triglyceride levels is familial hypertriglyceridemia 3. Hypertriglyceridemia can be hereditary but is usually associated with secondary factors.
- Homozygous familial or polygenic hypercholesterolemia
A genetic mutation occurs in LDL receptors. It increases the cholesterol in the blood 4.
Factors such as poor diet, obesity, hypothyroidism, and organ diseases. Secondary dyslipidemia is an acquired disease. Hypertriglyceridemia is usually related to secondary factors.
Classification based on lipid levels
Dyslipidemia is classified into lipid levels :
- Hyperlipidemia: The abnormally increased fats in the blood. It also refers to the high level of LDL and triglycerides while low HDL level.
- Hypolipidemia: The abnormally decreased level of fats in the blood. It refers to critically low levels of LDL and triglycerides while high HDL level.
Never Confuse Dyslipidemia with these Terms
Dyslipidemia is an abnormal fat level disorder; it may be higher or lower. In contrast, hyperlipidemia is the excessive increase in lipid levels in the blood. However, dyslipidemia is branched into hyperlipidemia and hypolipidemia.
Dyslipidemia is the condition in which the body has an abnormal concentration of fats in the blood. In comparison, hypercholesterolemia refers to specifically increased cholesterol levels in the body. It mainly indicates the increased amount of LDL in the blood. High Cholesterol refers to high triglycerides and high LDL levels.
Indication: Hypercholesterolemia: total cholesterol > 200 mg/dL
Dyslipidemia is a metabolic disorder that occurs due to increased or decreased cholesterol & triglyceride levels in the blood. At the same time, in hypertriglyceridemia, only triglycerides are affected. Hence, the increased level of VLDL or triglyceride occurs in hypertriglyceridemia. It generally occurs due to the overproduction of VLDL from the liver. High triglycerides are frequently a signal of other health conditions that amplify the risk of medical conditions such as stroke, heart diseases, and type-2 diabetes.
Endnote: Hypertriglyceridemia: total triglyceride >200 mg/dL
Dyslipidemia is the imbalance of lipids in the body while hypolipidemia is decreased plasma lipoprotein level 5. Hypodyslipidemia is also referred to as hypolipidemia.
- total cholesterol < 120 mg/dL
- low-density lipoprotein (LDL) cholesterol less than 50 mg/dL
Dyslipidemia is the abnormal lipoprotein level, In comparison, hyperlipoproteinemia results from an inability to break down lipids or fats in your body, specifically cholesterol and triglycerides. Hence, the amount of lipid in the blood increases and causes hyperlipoproteinemia.
Causes Of Dyslipidemia
Causes of dyslipidemia varies into primary and secondary factors:
- Genetic defect or mutation
- Genetic disorder
- Obesity, especially excess weight around the waist
- Alcohol use disorder, also known as alcoholism
- Metabolic syndrome
- Excessive consumption of fats, especially saturated and trans fats
- Polycystic ovary syndrome
- Cushing’s syndrome
- Inflammatory bowel disease, commonly known as IBS
- An abdominal aortic aneurysm
- Severe infections, such as HIV
Symptoms Of Dyslipidemia
Dyslipidemia shows less sign until it is dangerous or deadly. General symptoms of dyslipidemia are as follows:
- Chest pain
- Pressure and tightness on the chest
- Shortness of breath
- Pain in legs, especially when standing or walking
- Pain, stiffness, and stress in the neck, shoulders, and back area
- Indigestion and heartburn
- Sleeping problems along with daytime fatigue
- Heart palpitations
- Cold sweats
- Nausea and vomiting
- Swelling in the legs, ankles, feet, stomach, and veins of the neck
The symptoms vary according to the severity and type of dyslipidemia.
Dyslipidemia and Hypertension
Research have proven that dyslipidemia is correlated with hypertension. Variation in lipid level of blood causes hypertension. Elevated serum levels of triglycerides, LDL, and non‐HDL levels increase the risk of hypertension. But the increase or decrease in good cholesterol (HDL) can generate the risk of hypertension 6.
Dyslipidemia and Obesity
Most of the time, dyslipidemia is the cause of obesity, while sometimes obesity gives rise to dyslipidemia. Primary dyslipidemia is thought to be linked with obesity. But the research has shown that dyslipidemia can also occur due to insulin resistance in obese people. Hence, the metabolic disorder can majorly cause obesity first and then dyslipidemia. Dyslipidemia comprehends higher triglycerides, decreased HDL levels, and increased small, dense LDL particles. Weight loss and exercise is still beneficial for dyslipidemia, even if they do not result in normalization of body weight 7.
Dyslipidemia and Atherosclerosis
Dyslipidemia is directly correlated to atherosclerosis. As it is a major risk factor for causing CVD and eventually atherosclerosis 8.
Dyslipidemia and Diabetes
Diabetes (ziabetus) is a disease in which blood sugar levels increase mainly due to insulin resistance. The typical lipid pattern in diabetes consists of high triglyceride levels, low HDL levels, and small, dense LDL particles, which easily stick to artery walls. This lipid pattern induces central obesity and insulin resistance. And it can further cause dyslipidemia.
Unani treatment for dyslipidemia is categorized into three types:
- Regimental Therapy (Ilaj Bil Tadbeer)
- Diet Therapy (Ilaj Bil Ghiza)
- Pharmacotherapy (Ilaj Bil Dawa)
Regimental therapy (Ilaj Bil Tadbeer) for Dyslipidemia
Regimental therapy is a non-medicated procedure and the patient is advised to improve his habitat, lifestyle, and dietary habits. Ilaj Bil Tadbeer is firstly prescribed by an Unani physician for unani treatment for dyslipidemia. The aim of regimes is meant for Istifraagh-eakhlaat-e radiya (evacuation of morbid humor) from the body. The unani physician recommends dalak for metabolizing lipid levels in the blood.
Dalak-e-kaseer (prolonged massage) reduces body fats
One of the essential things in the natural treatments of dyslipidemia is to reduce body weight as well as perform regular exercise. Doing so will help to regulate blood cholesterol and decrease the high risk of developing cardiovascular diseases, especially coronary heart disease.
This is important in controlling high blood cholesterol, reducing the risk of coronary heart disease, and improving high-density lipoprotein (HDL) cholesterol. The mechanism of cigarette smoking will affect lipid profile that also enhances the oxidation of plasma LDL, which leads to endothelial function impairment.
Prohibit Alcohol intake
Alcohol has adverse effects on cholesterol and lipid levels, also raising serum triglyceride and HDL cholesterol levels. It has a minimal impact on LDL cholesterol, however it has effects on the body, including hepatic toxicity, cardiomyopathy, impaired reflexes, and psychosocial problems.
Exercise is important in reducing the chance of developing heart disease. In fact, it is important to reduce body weight, which can lead to reduced levels of fat and cholesterol. Physical activity and exercise can be important factors in improving cholesterol levels, increasing HDL, and lowering LDL and triglycerides. For instance, aerobic exercises can improve lipid profiles.
Diet Therapy (Ilaj Bil Ghiza) for Dyslipidemia
Ilaj Bil Ghiza is the process of curing the body via proper nutrients and diet. The Unani physician will recommend and restrict certain food (ghiza) items for treating the specific illness. Hence, Ilaj Bil Ghiza is one of the effective Unani treatments for dyslipidemia.
Dietary restrictions (Taqleel-e- Ghiza)
- Food containing too much sugar and carbohydrates.
- Hydrogenated and Trans or unsaturated fats increase cholesterol and additionally increase the risk of heart diseases.
- Red meat and other animal products can also increase the risk of dyslipidemia.
- Dietary fiber
- Red yeast rice
- Gum residue guggulipid
Pharmacotherapy (Ilaj Bil Dawa) For Dyslipidemia
If a patient is treated with medication (Dawa), it is the process of Ilaj bil Dawa. in this case, Unani physician would either recommend single herbs or Unani compound. Unani practitioner calculates the patient’s mizaj and recommends single herbs or formulations accordingly. The most effective Unani treatment for dyslipidemia is Ilaj Bil Dawa.
Single Herbs For Dyslipidemia Treatment
- Ginger (Zingiber officinale)
- Garlic (Allium sativum)
- Cinnamon (Cinnamomum verum)
- Artichoke (Cynara scolymus)
- Fenugreek (Trigonella foenum-graecum)
- Emblic Myrobalan (Phyllanthous officinalis)
- Cumin (Carum carvi)
- Star Anise (Foeniculm vulgare)
- Henbane (Trachyspermum ammi)
- Carom Seeds (Ptycotis ajowan)
- Aniseed (Pimpinella anisum)
Unani Compounds For Dyslipidemia Treatment
End Note: Unani medicines should be taken under the guidance of a certified Unani Physician. To get optimum results, patients are required to follow the regimen strictly.