What’s the Real Story on Cholesterol?
Cholesterol is always a big concern for my clients and since a new study showing how statins can raise the risk of diabetes I thought it appropriate time for a blog.
So what about your cholesterol panel? If your cholesterol is high, do you just go on a statin drug? How do you determine if you are at risk?
The different components of the cholesterol panel are as follows:
- Total cholesterol
- LDL cholesterol
- HDL cholesterol
- Triglycerides
It is routinely recommended that your total cholesterol be less than 200. However, the most essential part of the cholesterol panel may be the other parts, which point to issues with heart disease.
Sometimes, a person can have a perfect cholesterol panel with ideal numbers and still have plaque in the arteries. Conversely, someone can have high levels of cholesterol with clean arteries.
LDL cholesterol stands for low-density lipoprotein cholesterol, which is classically known as the “lousy” or bad cholesterol. However, there are actually 2 kinds of LDL cholesterol – large buoyant LDL, and small dense LDL. The large buoyant ones carry no risk.
It is the small dense LDL that cause plaque build-up and increase your risk for a heart attack.
Many people go on cholesterol meds since their “total” LDL is high but that does not show the breakdown of which one is high or if they really need a medication.
Recent research has shown that a value known as Apo B is a better indicator of the appearance of the atherosclerotic process (i.e. plaque in the arteries) than the cholesterol value, and a more accurate measure of the risk of vascular disease than measuring LDL cholesterol.
ApoB is a direct measurement of the number of “bad” LDL particles.
HDL cholesterol stands for high-density lipoprotein cholesterol, also known as the “happy” or good cholesterol. HDL is sort of a scrubbing agent that rids the body of bad cholesterol. So, the higher number of HDL the better (greater than 50 is recommended). Low HDL cholesterol (approximately less than 40) is associated with insulin resistance or metabolic syndrome and an increased risk of heart disease.?
Triglycerides are the storage form of fat and are associated with carbohydrate sensitivity in the body. An ideal level is below 150.
Several researchers in the field of cardiology have shown that testing cholesterol values may soon be a thing of the past.
However, till that time have your cholesterol panel routinely checked AND ask your physician to measure “fractionated lipids” which will show the breakdown of cholesterol, small dense LDL, ApoB, etc. It may help determine whether you truly need medication or just having your lifestyle adjusted.
