Cholesterol Tests for Kids: Necessary or Nonsense?

It’s time for your child’s check-up and you take him in to the doctor expecting his height and weight to be checked, and maybe an immunization for the chicken pox to be given. But are you ready for your pediatrician to order a cholesterol test for your 10 year-old who by all other accounts appears healthy? If a panel of government appointed health experts has its way, there will be widespread screening of children of cholesterol levels, and this could potentially lead to children taking statins – those cholesterol lowering drugs your parents might have in their medicine cabinet.

Panel Recommends Your Kids Have Cholesterol Screenings

Several months ago a panel of researchers weighed in and developed a set of guidelines, recommending that all U.S. children begin to undergo blood tests for cholesterol screening by the age of 9 years. This age would be lowered to even younger ages if your child has diabetes or a family history of heart disease. The goal is to catch the estimated 10% of children who do have unhealthy cholesterol levels and begin treatment to avoid future heart health issues.

The Critics Say Decision is Flawed

The critics, however, say that here is part of the problem – there is not enough evidence to support the idea that early identification of elevated cholesterol levels in kids will have effects on their heart health as adults. Widespread testing of children with no risk factors (such as obesity or diabetes) has not been proven effective that it will reduce future risks for these children of heart health issues. Not only does the testing appear to be unwarranted for the majority of the population, but it would also be costly and could potentially cause anxiety for kids to have these additional tests done.

Treating Kids with High Cholesterol with Grandma’s Medicine

While the current recommendations are that children who have high levels of cholesterol be treated with lifestyle modifications first, this widespread testing does open the door for children to be prescribed what is typically considered a drug for an older population. Statins, the drugs that block cholesterol (Lipitor, Crestor, etc.), have not gone through thorough testing for this young population. Even in adult consumers the statins have been linked to a rare muscle-damaging condition. As of today, the Mayo Clinic, a leader in healthcare, has not changed its recommendation on cholesterol screening: “…not all children need to be screened for high cholesterol.”

Beyond these direct implications for children is another deeper, somewhat darker issue. In an article published just this week in the journal Pediatrics, several researchers from the University of California at San Francisco criticize the panel’s motivations for their strong recommendations of widespread testing. Of the 14 person panel, 8 of the members have ties to pharmaceutical companies that could potentially benefit from a larger consumer base. In reaction to this criticism, proponents of the government appointed panel say that it is almost impossible to find anyone in the health field without ties to drug companies, and that the candidates were carefully vetted.

Widespread Testing is a Pandora’s Box

Is this conflict of interest in the best interest of my child? Absolutely not. I could start testing my child for anything and everything under the sun – there are many things for which they have a 10% or less risk of developing based on things like family history, gender, and ethnicity. It makes me very nervous as a parent that we might be moved to a time when we are mandated to test our children for other health conditions for which they show no signs or symptoms. What kind of Pandora’s Box are we opening?

  • Could children suffer adverse side effects from the medications that are far worse than the condition?
  • How will all of these tests be paid for, when in the United States we have a health care system that is monetarily already beyond repair at the current rate?
  • Could parents be criticized, or worse, for selecting not to have their children tested for this?
  • Could communities put to better use the funds for testing – such as toward athletic events for kids and other things that would encourage lifestyle changes needed for healthy living?

Until the benefits can be proven beyond a shadow of a reasonable doubt, among a class of panel members who aren’t rubbing the backs of pharmaceutical reps, I would be hard pressed to allow for this testing on my kids. This doesn’t mean that I don’t believe cholesterol is a big concern – and we do have family history of it. But if I start listing the medical family history my children have, we might as well preprint the toe-tags and start asking for prescriptions for all of us. Instead, I plan to keep encouraging and providing healthy lifestyles for my kids, diligently watch them for signs of something amiss, and listen to some common sense before I sign them up for the next quick test and fix.

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