If periodic rechecks of lipid levels show little response to changes in diet and exercise, your doctor may recommend lipid-lowering medications. Some medications have their biggest effect on LDL cholesterol, others on triglycerides, and others on HDL cholesterol. Despite their potential for being beneficial, medications are reserved for people in whom diet and activity alone have not been sufficiently successful or people with more severe hyperlipidemia. There are several reasons to be conservative with the use of medications. All entail an expense. There is always the potential for side effects, and occasionally they can be severe. Taking-medications is at least a little disruptive of daily routine activities. Nevertheless, if other measures have failed, medications are warranted.
Whether you need medications is a decision best made by you and your physician. These factors enter into the decision:
the severity of the cholesterol glyceride abnormalities
the presence of other unmodifiable risk factors (such as family history of heart attacks at a young age)
evidence of existing coronary artery disease
ineffectiveness of dietary and exercise changes
As a rule, if two risk factors are present (or if there is already evidence of coronary disease) and if dietary measures have not succeeded in changing your lipid profile out of the higher-risk range, then the use of medications is advisable.
One aspect of evaluating and treating high cholesterol and triglyceride levels is to determine whether they may be caused by another problem that can be treated itself. High blood lipids can be caused by low thyroid function, diabetes, kidney disease, and liver disease.