A cholesterol specialist, also known as a lipidologist, is your expert to help you navigate through the jungle of information and myths surrounding cholesterol and fat metabolism and develop a scientifically sound strategy for your heart health. High cholesterol levels are a key risk factor for heart attacks and strokes, but hardly any other topic is associated with so much uncertainty and half-knowledge. As your certified Cholesterol specialist (Lipidologist DGFF®) in Düsseldorf, it is Dr. Raphael Bruno's job to separate fact from fiction and work with you to find an individual and viable path to healthy blood lipid levels.
Why a cholesterol specialist is more important today than ever before
The internet is full of contradictory advice on cholesterol. Diet myths, blanket warnings about medication and supposed miracle cures unsettle patients. A Cholesterol specialist does not rely on opinions, but exclusively on scientific evidence from large, decades-long studies. They can accurately assess your personal risk, provide sound reasons for the need for treatment and manage the treatment in such a way that it brings maximum benefit with minimum side effects. This expertise is crucial for effectively combating the risk of arteriosclerosis („vascular calcification“).
Myth 1: „My cholesterol only comes from food“ - The role of genetics
This is one of the most persistent misconceptions. The truth is: Only about 20-30% of the cholesterol in our body comes directly from food. The lion's share of 70-80% is produced by our body, especially the liver. Your cholesterol level is therefore largely genetically predetermined. For this reason, even very slim, sporty and health-conscious people can have high cholesterol levels. A Cholesterol specialist knows this and will not demand an extreme diet across the board, but will take your genetic and metabolic profile into account when planning your therapy.
Myth 2: „High cholesterol doesn't hurt, so it's harmless“ - The silent danger
This assumption is life-threatening. High LDL cholesterol does not cause pain or other symptoms. It is a „silent“ risk factor that promotes arteriosclerosis over years and decades. The excess LDL cholesterol is deposited in the vessel walls and forms inflammatory plaques. These plaques constrict the arteries and can suddenly rupture, leading to a heart attack or stroke. The task of a Cholesterol specialist is to stop this silent process before such a dramatic event occurs.
Myth 3: „Statins only have bad side effects“ - What your cholesterol specialist says about this
Hardly any other group of drugs is as controversial as statins. The fact is that statins are among the best-studied and most effective drugs in cardiovascular medicine. They have been shown to have the potential to prevent millions of heart attacks and strokes - and dementia. As with any effective medication, side effects, most commonly muscle pain, can occur. An experienced Cholesterol specialist will always take these concerns seriously. It is his task to find a well-tolerated and at the same time highly effective therapy for you by carefully selecting the preparation, adjusting the dose, checking for interactions or using modern alternatives.
Cholesterol fact check
Widespread assumption | The scientific fact check | What this means for you |
„Eggs are bad for your cholesterol.“ | For most people, dietary cholesterol has only a minor influence on blood cholesterol. Much more dangerous is the intake of saturated fats and trans fats. | The moderate consumption of eggs is generally harmless. It is better to concentrate on an overall balanced, Mediterranean diet. |
„Only overweight people have high cholesterol levels.“ | Wrong. As described above, cholesterol levels are strongly influenced by genetics. Even very slim people can have familial hypercholesterolemia. | Do not rely on your weight. Only a blood test can provide information about your cholesterol levels. |
„A high HDL value compensates for a high LDL.“ | Yes and no. A high HDL („good cholesterol“) is protective, but cannot fully compensate for a very high LDL („bad cholesterol“). LDL remains the main driver of risk. | The primary therapeutic goal is always to reduce LDL cholesterol to the individual target value. |
„Natural remedies such as red rice are a gentle alternative.“ | Red rice contains monacolin K, which is chemically identical to the active ingredient in a statin. It is therefore not a „gentler“ drug, but a non-standardized drug with the same potential side effects. | Always discuss the use of such products with your doctor. Cholesterol specialist to correctly assess dosage and risks. |
The work of the cholesterol specialist: from the analysis to the individual target value
Modern cholesterol therapy no longer follows rigid limit values, but the principle of the individual target value. The higher your overall risk of cardiovascular disease, the lower your LDL cholesterol level must be. Determining this target value is one of the core tasks of the Cholesterol specialist.
This includes the following steps:
- Analysis of all risk factors: We not only record your blood lipid values, but also your blood pressure, diabetes status, smoking status and family history.
- Calculation of the 10-year risk: We use scientific scores to calculate your statistical risk of suffering a heart attack or stroke in the next 10 years.
- Assessment of existing damage: Using ultrasound of the carotid arteries, we look for existing plaques. Their detection immediately increases your risk.
- Consideration of special markers: If necessary, we also determine special risk markers such as lipoprotein(a) [Lp(a)], which further clarify the picture.
Only this mosaic results in your personal LDL target value, to which the therapy is geared.
Frequently asked questions for your cholesterol specialist
Here we answer common questions that we are asked during consultation hours.
What is the most important cholesterol level to look out for?
By far the most important value is LDL cholesterol. It is the direct cause of arteriosclerosis. All modern therapy is aimed at lowering this one value to the individually required level. Your Cholesterol specialist will focus primarily on your LDL level.
Can I stop taking my statins if my values are good?
No. The good values are the result of the therapy, not the reason to stop it. The statin only works as long as you take it. Stopping it would inevitably lead to a renewed rise in cholesterol and thus the risk. Think of it like high blood pressure: therapy is an ongoing task.
My doctor wants me to take statins, but I want to try diet first. Does that make sense?
With slightly elevated values and an otherwise low risk, a three-month lifestyle change is often the first step. However, in the case of very high initial values or an already high overall risk (e.g. after a heart attack), a change in diet alone is not sufficient to achieve the necessary significant reduction. In this case, immediate drug therapy is essential for effective risk reduction.
Why is my cholesterol high despite a vegan diet?
As explained above, food has only a minor influence. The body's own production is the main factor. If you have a genetic predisposition to high cholesterol production, your LDL level may be too high even with an optimal diet. This is a classic case for the Cholesterol specialist.
What is lipoprotein(a) or Lp(a) and why is it important?
Lp(a) is a special, hereditary blood lipid particle that greatly increases the risk of heart attack and stroke. It is often not detected by standard cholesterol tests and can hardly be influenced by lifestyle. A Cholesterol specialist will determine this value if the risk is unclear or high, as it can significantly influence the treatment decision.
Is there an alternative if I really cannot tolerate statins?
Yes, modern lipidology has several alternatives. Drugs such as ezetimibe, bempedoic acid or the highly effective PCSK9 inhibitors (as injections) are excellent options. A Cholesterol specialist knows the entire spectrum and will find the right alternative for you.
Does sport lower cholesterol?
Regular endurance sport has a very positive, but usually moderate effect. Above all, it can slightly raise the „good“ HDL cholesterol and lower the triglycerides. The influence on the crucial „bad“ LDL cholesterol is often less than that of a change in diet.
Do I have to fast before the blood test for the cholesterol values?
For an accurate measurement, especially of triglycerides, a fasting period of 12 hours is traditionally recommended. However, more recent guidelines state that fasting is no longer mandatory for the assessment of LDL and HDL cholesterol. Your Cholesterol specialist will give you precise instructions.
How quickly does cholesterol drop under therapy?
The effect of statin therapy is relatively rapid. A significant reduction in LDL levels can be measured after just four to six weeks. Therefore, the first control blood test is usually scheduled within this time frame in order to check the success and adjust the dose if necessary.
What does a certified lipidologist (DGFF®) do differently?
Certification by the German Society for Combating Lipid Metabolic Disorders (DGFF) is proof of a high level of expertise in this field. A certified Cholesterol specialist like Dr. Bruno is familiar with the latest scientific findings, current guidelines and the entire spectrum of modern therapies.
Facts instead of myths: your path to healthy blood lipid levels
Treating high cholesterol levels is one of the most effective methods of cardiovascular prevention. Don't be put off by myths and half-knowledge. Rely on the scientific expertise of a proven specialist. At our practice in Düsseldorf, you will receive a sound diagnosis and individualized therapy based on facts. Make an appointment for a consultation.
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