She thought she was too young, healthy for high cholesterol. She was wrong.

In her 20s, Alejandra Lavalley worked out two hours a day. She cooked nutritious meals at home and maintained a healthy weight. She was young and active, and yet blood tests kept telling her the same thing: high cholesterol.

"I was at my lowest adult weight, and my cholesterol was somewhere in the three hundreds," she said. A healthy total cholesterol is below 200.

Even statins, the drugs of choice for treating high cholesterol, weren't helping her numbers budge more than about 10 points.

"That's when we decided, as a family, we've got to talk to a cardiologist. This isn't normal," she said, recalling her cardiologist was the "first person to look at (her situation) and say, 'You're right. This isn't supposed to be happening to you.'"

But getting an answer about why her cholesterol was so high despite her efforts was complicated. She was adopted, so she didn't know her biological family's medical history.

But, after more tests and trials, she was officially diagnosed with familial hypercholesterolemia, or genetically-related high cholesterol, at 31.

"It was also such a relief, because it was like, I'm not doing anything wrong. I'm doing all these things right, but I can't help my genetics," Lavalley said. "It really gave me that weight off my shoulders and allowed me to just go, 'OK, what are the next steps?'"

Now on a different form of medication, a PCSK9 inhibitor, to manage her cholesterol, Lavalley is sharing her story to debunk the common misconception that you can be "too young" or "too healthy" for high cholesterol as part of Heart Health Awareness Month, which is observed in February.

How cholesterol impacts health

Dr. Laxmi Mehta, cardiologist with Ohio State Wexner Medical Center, says cholesterol is "often a forgotten thing, and people often don't think about it, but it really is problematic," adding it can lead to atherosclerosis or plaque buildup in the arteries.

"It's important for patients to understand what their cholesterol levels are, because that helps the clinician determine what their near-term and long-term cardiovascular risks are," Mehta, who was not involved in Lavalley's care, told USA TODAY.

Reducing LDL or "bad cholesterol" levels by 35 points, for example, can reduce cardiovascular disease risk by more than 20%, Mehta said.

"It's not just a number that we're treating, but we also see that it has secondary benefits of reducing overall cardiovascular disease risk," Mehta explained.

Lavalley had a first-hand look at how untreated cholesterol affects the heart. While she was dealing with her own journey with high levels, she was working at the Texas Heart Institute and saw a donor heart that she described as a "yellow gelatinous thing" that looked like a "huge softball."

Her colleague confirmed the heart was "no good," as it was "covered in cholesterol."

"Seeing that and knowing that my numbers weren't reflecting my lifestyle, it immediately put a panic in me, like, 'Oh my God, that is what my insides look like right now,'" she recounted.

While high cholesterol may be viewed as an older-person's issue, Lavalley's story proves that's not always the case.

Mehta says levels should be checked starting from age 18. After that, levels can be checked every five years if the results were normal or more frequently if they came back abnormal.

Lavalley also encourages people to speak more about the role genetics plays in cardiovascular health. And for people like her who don't know their family history, it's "even more reason to start charting your numbers," she said − though she acknowledged there are healthcare accessibility issues for many.

How do I know if my high cholesterol is genetic?

While blood tests will show your cholesterol levels, it doesn't determine if those levels are based on genetics, diet and lifestyle or a mix of the two.

For that very reason, it's important to meet and discuss your levels with a physician.

"Talking about, what are your cholesterol levels? What's your family history? And what is your lifestyle in terms of diet and exercise? Then coming up with a care plan of next steps," Mehta said.

How can I improve my cholesterol?

While lifestyle improvement is "foundational to all treatment," Mehta said, medications might be necessary for some patients depending on their levels and individual factors, especially those with familial hypercholesterolemia.

Lifestyle improvement includes making changes to diet and exercise.

"For everyone, dietary changes are necessary. We'll typically say to follow the American Heart Association diet or the Mediterranean diet. And if they want to be ultra aggressive, they could do a whole food, plant-based diet," Mehta said.

In terms of exercise, Mehta recommends everyone get at least 150 minutes of moderate intensity aerobic exercise per week, which also aligns with the American Heart Association's recommendations.