Genetic Cholesterol: What It Is, How It Affects You, and What You Can Do

When we talk about genetic cholesterol, a condition where your body produces too much low-density lipoprotein (LDL) cholesterol because of inherited genes. Also known as familial hypercholesterolemia, it doesn’t care if you eat salad every day or run marathons—it’s built into your DNA. About 1 in 250 people have it, and most don’t know. That’s scary because high LDL from genetics can lead to heart attacks as early as your 30s or 40s—long before most people think about cholesterol at all.

This isn’t the same as cholesterol from fried food or sugar. familial hypercholesterolemia, a specific genetic disorder that causes LDL levels to soar from birth means your liver can’t clear cholesterol the way it should. Your body keeps making it, even when you don’t eat any. That’s why diet alone won’t fix it. You need meds—usually statins, a class of drugs that block cholesterol production in the liver. Some people need more than one type, or even injectable treatments like PCSK9 inhibitors. And if you have it, your kids have a 50% chance of getting it too.

What’s worse? Many doctors miss it. A person might have total cholesterol over 300 mg/dL, xanthomas (fatty bumps under the skin), or a family history of early heart disease—and still be told to "just eat less butter." But if your cholesterol is high from birth, you need more than lifestyle advice. You need testing, monitoring, and long-term treatment. That’s why the posts below cover everything from how genetic cholesterol shows up in blood tests, to how it interacts with other meds like those used for heart valve disease or autoimmune conditions. You’ll find real stories about people who didn’t know they were at risk until it was almost too late. And you’ll see how drugs like cyclosporine or warfarin can complicate things if you’re also managing high LDL. This isn’t theoretical. It’s personal. And if you’ve been told your cholesterol is high but nothing changes, this collection is for you.