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Why Lipid Testing Should Start at Age 8 (Yes, Really)

May 19, 2025 by Functional Heart

It might sound extreme at first, testing an eight-year-old for cholesterol? Really?

But hang on. This isn’t about overmedicalizing childhood. It’s about catching a silent threat before it quietly builds up steam for decades. Because here’s the sobering truth: atherosclerosis plaque buildup in arteries can begin early. Very early. And in rare but dangerous cases, it can be well underway before your child even hits high school.

Not Just a Grown-Up Problem

We tend to think of heart attacks as things that happen to tired, overworked adults. But the groundwork for those emergencies? Often laid in childhood. Hidden lipid disorders, especially familial hypercholesterolemia (FH), are genetic time bombs. 

They don’t care if you eat kale or hit the gym. If your genes are wired for sky-high LDL cholesterol, your arteries are under assault before your permanent teeth are even in.

So what’s the solution? A simple one, actually: start lipid screening at age 8.

Why Age 8?

It’s not an arbitrary number. Pediatric guidelines recommend it for good reason. This is the age when inherited lipid disorders like FH can be reliably detected, and more importantly, when they can still be managed before damage is done.

And here’s the twist: most kids with these conditions look healthy. They’re playing sports, doing cartwheels, begging for dessert. Meanwhile, their LDL cholesterol levels might be pushing 200 or more, putting them at risk for heart attacks by age 30.

Here’s what early lipid testing can catch:

  • Homozygous FH: 

The rare but severe form, often from both parents, with LDLs in the 400–600 range. These kids can have heart attacks in grade school.

  • Heterozygous FH: 

One bad gene from one parent. Less dramatic, but still serious, and far more common.

  • Other inherited lipid disorders that don’t present obvious signs until it’s too late.

But My Pediatrician Didn’t Mention It…

And that’s the problem. Most pediatricians aren’t trained lipidologists. If your child has an LDL over 140 and the doctor says “we’ll just watch it,” it’s time for a second opinion, preferably from a pediatric lipid specialist (yes, they exist).

Statins aren’t for every kid, of course. But for those with severe inherited disorders? They’ve been approved and can be life-saving starting at age 8 or 9.

Conclusion

Early testing gives you time. Time to adjust diet, time to start treatment if needed, time to rewrite a future that might otherwise be cut short. It’s not about fear, it’s about foresight. And it’s not just for kids with obvious symptoms. It’s for every child whose genes might be hiding something the eye can’t see.

If you’re a parent, ask about a lipid panel. Just a simple blood test, at an age where it could matter most.

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