Original publication date: December 19, 2023
Last Updated: February 8, 2024
Author: Max Skyler
Topic: Flight Physiology
Number of Comments: 0
High cholesterol is undeniably an adverse health condition that raises questions about its ramifications on a pilot’s ability to exercise the privileges of pilot-in-command. The Federal Aviation Administration (FAA) has comprehensively addressed the issue of high cholesterol, having established a set of guidelines and criteria for both Aviation Medical Examiners (AMEs) as well as for pilots seeking to obtain a medical certificate, to follow.
Being diagnosed with high cholesterol does not automatically disqualify you from becoming a pilot, nor from exercising the privileges of your pilot license. Having said that, high cholesterol can disqualify you from flying, if certain thresholds are exceeded and certain conditions are met. However, once you are able to demonstrate that your cholesterol has been brought under control, then the FAA may be able to clear you to fly.
In this resource guide, we will explore how high cholesterol impacts one’s eligibility to become a pilot or to maintain medical clearance to fly. We will also explore how the FAA evaluates cholesterol levels during the medical evaluation process.
Key Takeaways:
- The FAA has established a baseline of medical standards that all pilots must adhere to, of which your cholesterol level is one of the criteria that is evaluated.
- Having high cholesterol does not automatically disqualify you from becoming a pilot.
- If you have high cholesterol, you can work with healthcare professionals to manage your condition and meet the FAA’s requirements.
- In some cases, high cholesterol may disqualify a pilot from flying.
- The FAA’s medical evaluation process ensures the safety of aviation operations.
Understanding cholesterol and its impact on health
Cholesterol is a waxy substance that is produced by the liver and found in certain foods. While it’s often painted as a villain, cholesterol actually plays a vital role in the body, helping to build and repair cells, produce hormones, and aid in digestion.
There are two types of cholesterol: HDL (high-density lipoprotein) and LDL (low-density lipoprotein). HDL is often referred to as “good” cholesterol because it helps remove LDL from the bloodstream, while LDL is known as “bad” cholesterol as it can accumulate in the arteries and lead to blockages.
When cholesterol levels are too high, it can negatively impact health. The excess cholesterol can build up in the arteries, increasing the risk of heart disease, heart attack, and stroke. Other potential consequences of high cholesterol include high blood pressure, diabetes, and peripheral artery disease.
The key to maintaining healthy cholesterol levels is to adopt a balanced diet rich in fruits, vegetables, whole grains, and lean protein sources, while reducing intake of saturated and trans fats. Regular exercise and maintaining a healthy weight can also help improve cholesterol levels and prevent associated health risks.
Types of cholesterol and their functions
| Cholesterol Type | Function |
|---|---|
| HDL (High-Density Lipoprotein) | Helps remove LDL from the bloodstream, carries it to the liver for processing and elimination |
| LDL (Low-Density Lipoprotein) | Can accumulate in the arteries and lead to blockages, contributing to heart disease |
Risks associated with high cholesterol levels
- Increases the risk of heart disease, heart attack, and stroke
- Can contribute to the development of high blood pressure and peripheral artery disease
- May increase the risk of diabetes
It’s important to monitor cholesterol levels regularly, especially for individuals with a family history of high cholesterol or related health conditions. Speak with a healthcare professional to determine the appropriate frequency of testing and establish a plan for cholesterol management.
The Importance of Medical Evaluations for Pilots
Regardless of whether you aspire to become a commercial airline pilot or whether you wish to pursue general aviation as a hobbyist, the safety of passengers and crew onboard is of paramount importance, not to mention the safety of civilians on the ground as well. The FAA recognizes that pilots must maintain optimal health in order to be able to safely operate an aircraft. As such, the FAA has thus established detailed medical standards that all pilots must remain in conformity with. The FAA requires pilots to undergo regular medical evaluations, at fixed intervals, to ensure they possess the physical fitness necessary to perform their duties safely.
These evaluations are conducted by FAA-approved medical examiners who are specially trained to assess pilots’ medical conditions and ensure they meet the FAA’s strict requirements. The medical evaluation is conducted in accordance with FAA protocols and procedures to ensure a consistent standard of evaluation for all pilots.
During the evaluation, the medical examiner will ask you about your medical history, including any known medical conditions or medications you may be taking. You will be also required to undergo a physical examination and medical tests that may include vision and hearing tests, an electrocardiogram (EKG), and a urine test.
The results of these evaluations are then compared to the FAA’s medical standards to determine if you meet the necessary criteria to hold a medical certificate. If you meet all the requirements, your medical certificate will be issued, allowing you to continue operating as a pilot. If you do not meet the standards, you may need to address any medical issues before undergoing a reevaluation.
It is important to note that medical evaluations are not just a one-time requirement but rather an ongoing, recurring requirement that pilots must meet in order to maintain their eligibility.
Pilots must undergo evaluations every 6 to 60 months, depending on their age and the type of flying they do (sport, general aviation, commercial, or cargo / passenger transport).
The Significance of Medical Evaluations
Medical evaluations are critical in ensuring that pilots are in good health and can perform their duties safely. They help to identify symptoms and possible health risks that may affect the pilot’s ability to operate an aircraft. Medical examinations also provide an opportunity for pilots to receive a diagnosis and treatment for any medical conditions that may affect their flying ability.
The Consequences of Skipping Evaluations
Skipping medical evaluations could have serious consequences. It could result in a pilot operating an aircraft despite having an undiagnosed medical condition, posing a significant safety risk to passengers and crew. Furthermore, flying without a valid medical certificate is a violation of FAA regulations and could result in the revocation of your pilot’s license.
The Bottom Line
Medical evaluations are an essential part of being a pilot. It is imperative to take them seriously and schedule regular appointments with an FAA-approved Aviation Medical Examiner (AME) to ensure your eligibility and maintain the safety of aviation operations.
FAA Medical Requirements for Pilots
To ensure safe aviation operations, the Federal Aviation Administration (FAA) has established specific medical requirements that all pilots must meet to hold a valid pilot’s license. These requirements are designed to ensure that pilots are physically fit to perform their duties and maintain their health over time.
When it comes to cardiovascular health, including cholesterol levels, the FAA has set standards that pilots must meet to hold a medical certificate. These standards vary depending on the type of certificate and the class of medical examination required.
Classes of Medical Certificates
There are three classes of medical certificates that pilots can hold: first class, second class, and third class. Each class corresponds to different privileges and responsibilities as a pilot and has specific medical requirements that must be met.
| Class of Medical Certificate | Authorized Flight Privileges | Validity Period |
| 1st Class | Airline Transport Pilot | 6 months if over age 40; 12 months if under age 40 |
| 2nd Class | Commercial Pilot | 12 months |
| 3rd Class | Private Pilot / General Aviation | 24 months if over age 40; 60 months if under age 40 |
| BasicMed | Private Pilot / General Aviation (with some restrictions) | 24 months for online medical course; 48 months for medical exam |
However, it is important to note that if a pilot has a condition that affects their ability to fly, their may need to apply for what is known as a Special Issuance Medical Certificate. A special issuance medical certificate is conditionally issued based on the satisfactory demonstration that your potential health concern or potentially disqualifying medical condition is under control.
Cholesterol Levels and FAA Medical Certificate Eligibility
When it comes to cholesterol levels, the FAA has set specific criteria that pilots must meet to be eligible for a medical certificate. These criteria are based on total cholesterol levels, as well as the levels of High-Density Lipoprotein (HDL) or “good” cholesterol and Low-Density Lipoprotein (LDL) or “bad” cholesterol.
For first-class medical certificate holders, the maximum total cholesterol level allowed is 240 mg/dL, while for second-class and third-class medical certificate holders, it is 400 mg/dL. Additionally, pilots must have an HDL level of at least 40 mg/dL and an LDL level of less than 160 mg/dL to be eligible for a medical certificate.
Other Cardiovascular and Medical Requirements
Along with cholesterol levels, the FAA has a number of other cardiovascular and medical requirements that pilots must meet to obtain and maintain a medical certificate. These include requirements related to blood pressure, vision, hearing, and neurological conditions, among others.
If a pilot has been diagnosed with high cholesterol or any other condition that may affect their eligibility for a medical certificate, they should consult with an aviation medical examiner for guidance on the steps they need to take to maintain their certification.
Cholesterol and the FAA Medical Evaluation Process
If you’re a pilot with high cholesterol levels, it’s important to understand how these levels are assessed during the FAA medical evaluation process. The FAA has established thresholds for acceptable cholesterol levels based on age and gender. For example, for male pilots under the age of 40, the acceptable level of total cholesterol is 240 mg/dl or less, while for females in the same age group, it’s 260 mg/dl or less. It’s important to note that these levels may be subject to change, so it’s essential to stay updated on current FAA regulations.
If your cholesterol levels exceed the FAA’s thresholds, restricted medical certification is a possibility. This means that you may be required to undergo additional testing or treatment to bring your levels down before being deemed fit to fly. Additionally, pilots with high cholesterol may be required to provide additional documentation regarding their condition to the FAA.
Pilots who meet any of the medical criteria listed in this Guide for Aviation Medical Examiners, published by the FAA, may be required to obtain a special issuance medical certificate. Cholesterol is specifically addressed on page 384. This would require pilots to demonstrate that their cholesterol levels are under control, through the use of one of the approved drugs.
It’s worth noting that while high cholesterol is a concern for pilots, it’s not the only factor considered during the medical evaluation. The FAA takes a comprehensive approach to aviation safety, which includes assessing a pilot’s overall health and fitness for duty. Therefore, it’s essential that you work closely with your healthcare provider to manage your cholesterol levels effectively.
Cholesterol thresholds set by the FAA for certification
| Age (years) | Male (mg/dl) | Female (mg/dl) |
|---|---|---|
| Under 20 | 180 | 190 |
| 20-29 | 220 | 240 |
| 30-39 | 240 | 260 |
| 40-49 | 250 | 270 |
| 50-59 | 270 | 280 |
| 60 and older | 280 | 290 |
Working in partnership with healthcare professionals can help you manage your cholesterol levels effectively and meet FAA requirements. Doing so can help you maintain not just your eligibility to fly but also your overall health and well-being.
Managing High Cholesterol as a Pilot
Being diagnosed with high cholesterol does not necessarily mean that you will be disqualified from being a pilot. Instead, you can take proactive steps to manage your cholesterol levels and meet the FAA’s medical requirements. Here are some strategies:
- Implement healthy lifestyle changes: You can make simple changes to your diet and exercise routine to help manage your cholesterol levels. Incorporate more fruits, vegetables, and whole grains into your diet, along with lean protein sources and healthy fats. Engage in regular physical activity, such as walking, cycling, or swimming, to improve your heart health.
- Take medication as prescribed: Your healthcare professional may prescribe medication to help manage your cholesterol levels. It’s essential to take these medications as directed to optimize their efficacy.
- Regularly monitor your cholesterol levels: Working with your healthcare professional, you can regularly monitor your cholesterol levels and track progress toward your goals. This can also facilitate early detection of any changes in your cholesterol levels that may require additional intervention.
If you have been diagnosed with high cholesterol and are a pilot, it’s crucial to work closely with your healthcare professionals to develop a personalized action plan to manage your condition effectively. This will also ensure that you meet the FAA’s medical requirements and can continue to pursue your passion for flying.
Can I Take Cholesterol Medications As A Pilot?
The FAA has subjected the various types of cholesterol medications under a great deal of scrutiny.
Based on their assessment, they have published a list of cholesterol medications, in which they have classified them into three different categories:
- acceptable
- conditionally acceptable
- unacceptable
What is interesting is that the FAA has not specifically called out any cholesterol medications on their “Do Not Issue” list of prohibited drugs.
According to Pilot Medical Solutions, Inc., the following medications are permitted by the FAA for the hyperlipidemia or for the management of cholesterol:
Medications denoted with an asterisk below, may require some measure of no-fly / wait-time after their consumption, and may require additional documentation to be submitted to the FAA for clearance to fly.
- Caduet (Amlodipine Besylate + Atorvastatin Calcium) *
- Colestid (Colestipol) *
- Crestor (Rosuvastatin Calcium)
- Lescol (Fluvastatin)
- Lipitor (Atorvastatin)
- Livalo (Pitavastatin)
- Lopid (Gemfibrozil)
- Mevacor (Lovastatin)
- Niacin (Nicotinic Acid)
- Praulent (Alirocumab) *
- Pravachol (Pravastatin)
- Precose (Acarbose)
- Questran, Cholestyramine, Locholest, Prevalite (Cholestyramine Resin)
- Tricor (Fenofibrate)
- Vytorin (Ezetimibe / Simvastatin)
- WelChol (Colesevelam Hydrochloride)
- Zetia (Ezetimibe)
- Zocor (Simvastatin)
Pilots who are taking any of the above cholesterol medication will still be able to fly.
FAA Policy on Cholesterol Screening
According to Aviation Medicine blood testing is not routinely required nor is any level of cholesterol disqualifying, per se. However, nearly every cardiovascular condition requiring evaluation for the FAA includes a mandatory report of the pilot’s cholesterol, triglycerides and glucose levels.
The 5 Critical Numbers Every Pilot Should Know
According to Dr. Glenn R. Stoutt, Jr., a Senior Aviation Medical Examiner, in his FAA publication, “Just For The Health Of Pilots”: “Pilots know all the critical airspeed numbers for their aircraft; but, unfortunately, most of them do not know the few (only five) critical numbers for blood fats (lipids)… you are far more liable to die from dangerous cholesterol levels than dangerous airspeeds.
He points out the irony in the fact that ignorance of the critical numbers pertaining to cholesterol levels is more likely to cause death, than the risks inherent with flying itself.
Here are the 5 critical numbers he says every pilot should know:
| TOTAL BLOOD CHOLESTEROL |
| • Less than 200 mg/dl = desirable blood cholesterol |
| • 200-239 mg/dl = borderline-high blood cholesterol |
| • 240 mg/dl or more = high blood cholesterol |
| TRIGLYCERIDES |
| • Under 200 mg/dl |
| LDL CHOLESTEROL |
| • Under 130 mg/dl |
| HDL CHOLESTEROL |
| • Over 35 mg/dl |
| TOTAL CHOLESTEROL TO HDL CHOLESTEROL RATIO |
| • Not over 5 to 1; ideally, 3.5 to 1 |
Dr. Stoutt goes on to make the following points in this publication:
Cholesterol and Health Risks: High levels of “bad” low-density lipoprotein (LDL) cholesterol can lead to clogged arteries and heart attacks. Reducing cholesterol levels significantly lowers the risk of heart disease.
Good Cholesterol (HDL): High-density lipoprotein (HDL) cholesterol is beneficial as it removes bad cholesterol from the blood. Knowing total cholesterol, HDL cholesterol, and triglycerides levels is essential.
Ideal Cholesterol Levels: The American Heart Association recommends a total cholesterol level of about 160 mg/dl and an HDL level over 35 mg/dl, with higher HDL being better.
Dietary Sources of Cholesterol: Cholesterol comes from animal-based foods and is also produced by the liver. Dietary fat, especially saturated fat, is a major contributor to cholesterol levels.
Types of Dietary Fats: Saturated fats (mostly from animal sources) are harmful, while polyunsaturated and monounsaturated fats (from fish oils and vegetable oils) are healthier options.
Trans Fats and Health: Trans fats, found in many processed foods, are harmful as they can harden arteries. Limiting intake of trans fats is crucial for maintaining good health.
Lifestyle Changes for Cholesterol Management: Diet and exercise can reduce cholesterol levels by about 20%. Soluble fiber, like oat bran, can also help reduce cholesterol absorption.
Medical Intervention: If lifestyle changes are insufficient to lower cholesterol below 240, medication may be necessary and is usually effective.
Recommendations: Pilots should get a lipid profile, understand the numbers, and consult a physician if needed. A low-fat diet, regular exercise, and maintaining ideal body weight are key to good health and safe flying.
Working with Healthcare Professionals to Meet Requirements
If you’ve been diagnosed with high cholesterol, working with healthcare professionals is crucial in order to meet the FAA’s medical requirements. Doctors, nutritionists, and other healthcare providers can help you develop a personalized treatment plan that is tailored to your specific situation.
In partnership with your healthcare team, you can identify the most appropriate course of action for managing your high cholesterol. This may include lifestyle changes such as improving your diet and increasing your physical activity, or medication if necessary. By following an actionable plan with tangible goals, you can develop the habits needed to keep your cholesterol levels within acceptable limits.
It’s important to maintain regular check-ins with your healthcare providers to monitor progress and make any necessary adjustments to your treatment plan. This will also ensure that you are promptly alerted to any potential issues with your cholesterol levels and can take the appropriate steps to address them.
Remember, working with healthcare professionals is key to meeting the FAA’s medical requirements as a pilot. By taking a collaborative approach to your cholesterol management, you can ensure that you are taking the necessary steps to protect yourself and your passengers while in the air.
Example Treatment Plan
| Goal | Action Item | Target Completion Date |
|---|---|---|
| Reduce LDL Cholesterol levels | 1 hour of moderate exercise per day | 3 months |
| Improve overall diet | Meet with nutritionist to develop healthy eating plan | 1 month |
| Monitor progress | Regular check-ins with healthcare provider to track cholesterol levels | Ongoing |
Instances where high cholesterol may disqualify a pilot
While high cholesterol may not automatically disqualify someone from becoming a pilot, there are scenarios where elevated cholesterol levels could lead to disqualification. The FAA maintains strict medical requirements to ensure the safety of aviation operations, and cholesterol levels are one of the factors taken into consideration during the medical evaluation process.
For instance, if a pilot has very high cholesterol with an increased risk of developing cardiovascular disease, it could disqualify them from holding a valid medical certificate. If their cholesterol levels exceed the thresholds set by the FAA, they may be required to undergo further medical testing to determine their eligibility to fly safely.
Additionally, if a pilot’s high cholesterol levels are accompanied by other medical conditions that could affect their ability to perform their duties safely, such as impaired vision or hearing, disqualification may also be necessary.
It’s important to note that disqualification due to high cholesterol is not necessarily permanent. Pilots can work with healthcare professionals to implement effective cholesterol management strategies and reapply for medical certification once their cholesterol levels have improved.
Medical Certification Standards Related to Cholesterol Levels
The table above outlines the different medical certification standards associated with various levels of cholesterol. As demonstrated in the table, cholesterol levels above a certain threshold can impact medical certification eligibility for pilots. However, the FAA will take into account other cardiovascular risk factors and the overall health of the pilot when evaluating eligibility.
Conclusion
As a pilot, it’s essential to prioritize your health and well-being to ensure the safety of yourself and others during flight operations. If you have been diagnosed with high cholesterol, it does not necessarily disqualify you from pursuing your passion for flying.
The FAA’s medical evaluation process accounts for cholesterol levels, along with other factors, to evaluate the eligibility of pilots. By working closely with your healthcare professionals, you can develop personalized strategies for cholesterol management and meet the FAA’s requirements.
Remember, managing high cholesterol is not only important for your pilot eligibility, but also for your overall health and well-being. Implementing lifestyle changes, such as a healthy diet and regular exercise, can have a positive impact on both your cholesterol levels and your ability to fly safely.
So, if you have high cholesterol, don’t let it deter you from pursuing your dreams of becoming or remaining a pilot. Work with your healthcare providers and stay committed to maintaining your cardiovascular health to ensure a safe and successful aviation career.
FAQ
Q: Does having high cholesterol disqualify you from being a pilot?
A: No, having high cholesterol does not automatically disqualify someone from being a pilot. The Federal Aviation Administration (FAA) considers various factors, including cholesterol levels, during the medical evaluation process. Pilots with high cholesterol can work with healthcare professionals to manage their condition effectively and meet the FAA’s requirements.
Q: What is cholesterol and how does it impact health?
A: Cholesterol is a waxy substance found in the body that plays a vital role in various bodily functions. However, high levels of cholesterol can have negative effects on health, increasing the risk of heart disease, stroke, and other cardiovascular problems.
Q: Why are medical evaluations important for pilots?
A: Medical evaluations are crucial for pilots as they ensure that they are physically fit to perform their duties safely. The FAA has established rigorous standards to promote flight safety and protect pilots, passengers, and the general public.
Q: What are the FAA’s medical requirements for pilots?
A: The FAA has specific medical requirements that all pilots must meet to hold a valid pilot’s license. These requirements include assessments of cardiovascular health, including cholesterol levels. The FAA differentiates between classes of medical certificates, each with its own criteria and standards.
Q: How does the FAA evaluate cholesterol levels during the medical evaluation process?
A: The FAA has established thresholds for acceptable cholesterol levels. During the medical evaluation process, pilots undergo tests to determine their cholesterol levels. Depending on the readings, there may be further restrictions or additional tests required. However, high cholesterol alone does not disqualify a pilot.
Q: Can pilots manage high cholesterol effectively?
A: Yes, pilots diagnosed with high cholesterol can manage their condition effectively through lifestyle changes and medical interventions. By working closely with healthcare professionals, pilots can develop personalized strategies to lower cholesterol levels and meet the FAA’s medical requirements.
Q: Why is it important for pilots to work with healthcare professionals?
A: Collaborating with healthcare professionals, such as doctors and nutritionists, is crucial for pilots with high cholesterol. These professionals can provide guidance, develop tailored treatment plans, and monitor progress to ensure that pilots maintain their cardiovascular health and meet the FAA’s requirements.
Q: Are there instances where high cholesterol may disqualify a pilot?
A: While many pilots with high cholesterol can manage their condition and meet the FAA’s medical requirements, there may be situations where high cholesterol poses significant risks to flight safety. In such cases, pilots may face disqualification or restrictions based on the severity of their condition and its potential impact on their ability to safely perform their duties.