The Truth About Cholesterol
Unless your primary care provider is particularly enlightened on the subject of cholesterol, there’s a good chance you’ve been told that “high cholesterol” is bad and puts you at an increased risk for developing cardiovascular disease. It’s also possible you’ve been told the easiest way to address “high cholesterol” is with cholesterol-lowering medications (usually a statin).
Unfortunately, this somewhat black and white approach to evaluating a patient’s cholesterol is outdated, and medications like statins are anything but benign.
The truth is…cholesterol levels are a relatively poor predictor of cardiovascular disease risk. That said, having a solid understanding of what cholesterol is and what it means relative to your health can be critical to your wellbeing.
What is cholesterol?
Here are the basics…
Cholesterol is a waxy fat produced mostly by your liver. It’s an essential raw material used by your body to perform critical functions like synthesizing hormones, vitamins, and the bile acids needed for digestion. Cholesterol is also inherent to the structure of your body’s cells. The bottom line is…your body can’t function properly without this important substance.
Other important cholesterol facts? 25% of the cholesterol in your body can be found in your brain, where it is crucial for healthy brain function. It can also be found in the myelin sheath that coats and protects your nerve cells. Cholesterol even plays an important role in fighting infections. Again…cholesterol is essential.
Another interesting fact: the vast majority of the cholesterol in your body is made by your body—not ingested. The cholesterol you eat actually has only a minimal effect on the cholesterol levels in your blood.
It’s also important to know that not all cholesterol is the same—there are actually a number of different types of cholesterol in your body.
Because cholesterol is bound to proteins while being carried through your bloodstream, it is often referred to as being a “lipoprotein” (the most familiar categories of lipoprotein being HDL and LDL).
Good vs. Bad
Again…unless your PCP is really up to date on the subject, you’ve likely been told cholesterol falls into two simple categories: “good” and “bad” (heavy emphasis on the quotes here).
“Good” cholesterol, often referred to as high-density lipoprotein (or HDL), is used by your body to eliminate excess cholesterol by binding to it and transporting it to the liver where it can be filtered out of your blood. HDL gets its name from the dense proteins that are bound to it. Because HDL helps to eliminate excess cholesterol from your body, more of it is generally considered to be a good thing.
Low-density (or LDL) cholesterol gets its so-called designation as being “bad” cholesterol because it has the potential for leaving cholesterol deposits on the walls of your arteries. Over time, these deposits can turn into plaque. And if too much plaque develops over time, blockages will form that can result in strokes or heart attacks.
Most PCPs will order what’s called a lipid panel when they want to check your cholesterol levels. A basic lipid panel will typically provide a level for total cholesterol, HDL, and LDL.
This is what PCPs are generally looking for:
- A total cholesterol level that is less than 200 mg/dl
- An LDL level that is less than 100 mg/dl
- An HDL level that is greater than 50 mg/dl
But…doctors who are studied on this subject would consider these metrics to be outdated. Why?
For one thing…not all LDL is created equal. Some LDL is buoyant, fluffy, and harmless, so long as it isn’t damaged by oxidation. Meanwhile, another form of LDL (LDL-B, specifically) is small and dense and can promote atherosclerosis (or hardening of the arteries). And then there’s Lp(a), a very small and highly inflammatory cholesterol particle that is clotting in nature. But…even the latter two types of cholesterol aren’t inherently bad. The bottom line is…it matters what kind of LDL particles you have in your body and in what proportions. But what’s most important is what happens to the cholesterol in your body relative to oxidation. More on this in a moment…
Remember….as we mentioned earlier, cholesterol levels are not a good predictor of cardiovascular disease. So you may be wondering…what is?
Inflammation: The Real Culprit
So why is cholesterol a problem…sometimes? And not a problem other times?
The answer is: inflammation. But not just any form of inflammation. Chronic inflammation, in particular. This type of inflammation is insidious because it often goes undetected, and yet it plays a role in just about every degenerative condition you can think of (including cardiovascular disease).
And what causes chronic inflammation? One of the primary causes is oxidation (which leads to oxidative damage). What does this have to do with cholesterol? The only time cholesterol causes trouble is when it becomes damaged by oxidation. Because it is oxidized/damaged LDL that sticks to the lining of your arteries.
What Causes Oxidation and Inflammation
Let’s cut to the chase. There are four primary things you can do to reduce oxidation and inflammation in your body, thereby reducing cardiovascular disease risk:
- Eliminate sugar and carbohydrates from your diet as much as possible.
- Eliminate trans-fats and processed foods from your diet as much as possible.
- Reduce stress as much as possible.
- Supplement your diet with antioxidants and other heart healthy nutrients like CoQ10, L-carnitine, magnesium, D-ribose, vitamin E (with mixed tocopherols only), vitamin C, B vitamins (B3 and B5 in particular), and Omega-3 fatty acids.
You may be wondering: if a basic lipid panel (as described above) isn’t a good predictor of cardiovascular disease, what lab tests are? Following are some lab tests that actually yield meaningful information:
- Lipoprotein fractionation. This test will provide a comprehensive cholesterol profile, complete with a breakdown of LDL particular size and type.
- Lp(a), as described above.
C-Reactive Protein (a marker for inflammation).
- ESR (another marker for inflammation).
- Homocysteine (a marker for cardiovascular disease risk).
- Fibrinogen (which measures the “stickiness” of your blood).
- Ferritin. You want enough iron in your system, but not too much—because excess iron oxidizes—and as discussed above, oxidation is not helpful.
- Interleukin-6 (another inflammation marker).
Scratching the Surface
This blog is meant to just skim the surface in terms of what you need to know about cholesterol. Interested in a deeper dive? We recommend two books: “The Great Cholesterol Myth” by Jonny Bowden and Stephen Sinatra; and “Cholesterol Clarity” by Jimmy Moore.
At Renew Youth, we can order any of the tests listed above. We can also make sure that balanced hormones are supporting your health overall.
Call us at 800-859-7511 or use our contact form to set up your free 30-minute consultation.