10 Steps Before You Refer For: Lipids

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10 Steps Before You Refer For: Lipids

3. Exclude a Secondary Cause


Common secondary causes of dyslipidaemia in primary care include hypothyroidism, obesity, glucose intolerance and diabetes, excess alcohol and some drug treatments (notably sex hormones and steroids, retinoic acid, thiazides and beta blockers, protease inhibitors, ciclosporin and antipsychotics). Less common causes include pregnancy, liver and renal disease (nephrotic syndrome), anorexia nervosa and bulimia, and immunoglobulin excess (multiple myeloma).

Simple tests to perform include fasting blood glucose, liver, renal and thyroid function, and urine testing (for proteinuria to exclude nephrotic syndrome, microalbuminuria if glucose intolerant).


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