There are many causes of elevated total cholesterol in blood lipids, such as obesity and overweight, which may cause high blood lipids secondary to the presence of obesity. Some patients have a high-fat diet and exercise less, which can also lead to elevated total cholesterol. Other patients may have elevated lipids secondary to abnormal glucose tolerance, diabetes or hypothyroidism, Cushing’s syndrome, systemic lupus erythematosus, or nephrotic syndrome. When a patient has elevated lipids, the cause can be further identified and if treated for the primary disease, the lipids will be better controlled. In elderly patients with elevated total cholesterol, it is likely that their metabolism is slower and they have less exercise on a regular basis, which can lead to elevated total cholesterol accordingly.