cholesterol total

A lot of the cholesterol in the blood is manufactured in the liver. Some people have a genetic propensity to make lots. A lot of the early work on reducing cholestrol was undertaken on people with familial hypercholesterolaemia. Your post reminded me of this rather chilling story from CHOLESTEROL, ATHEROSCLEROSIS AND CORONARY DISEASE IN THE UK, 1950–2000
The author is recalling his work in 1963

We set up a Lipid Clinic at Hammersmith. This was the first such clinic in Britain. Our first patient was a 10-year-old Iraqi
girl with extensive skin xanthomas present since age 4 and a plasma cholesterol level of 800–900mg/100ml. Both her parents were hypercholesterolaemic and her brother and sister had died from CHD aged 15 and 9. The patient’s plasma cholesterol level showed little or no response to corn oil, cholestyramine, Atromid, D-thyroxine or neomycin. We therefore decided to try the effect of plasmapheresis. In September 1964, on each of four consecutive days, 500ml of blood were taken from the patient. The blood was centrifuged and the red cells immediately transfused into her. This procedure resulted in a fall in plasma cholesterol from830mg/100ml to 525mg/100ml, but the level returned to the baseline value within a few weeks. We did not repeat the procedure. The patient died at age 13, after repeated attacks of angina at rest

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A level of 800mg/dl would be the same as a level of 20.688 mmol/l . I think that the original post is probably also in mg/dl; 500 mg/dl would be 12.93mmol/l.
This link from Heart UK http://heartuk.org.uk/cholesterol-health/what-is-fh/ tells you a bit more about FH. There are a lot of people in the UK that have raised levels from a genetic cause (not necessarily as high as the extreme levels of the girl in this case).
My OH is one of them and I'm extremely grateful for the work that these early researchers did producing the knowledge and drugs to enable he and his siblings to live beyond their 40s.(sorry bit of a rant but I get a bit frustrated at times with the prevailing attitude about lipids/heart disease and drugs on the forums )

(just realised that this in the T2 forum, I thought it was a general question; this child did not have any sort of diabetes)