Basic Understanding of Cholesterol

There are many misunderstandings about cholesterol.

A lot of people think cholesterol is bad, should be avoided, and holds only a negative role in the human body; cholesterol is actually a vital component to our good health.

Here are some common questions I receive about cholesterol:

What is Cholesterol?  

When you do a “Google search” for cholesterol, this is the answer that is provided– “cholesterol is a waxy substance found in your blood. Your body needs cholesterol to build healthy cells, but high levels of cholesterol can increase your risk of heart disease. With high cholesterol, you can develop fatty deposits in your blood vessels.”

Now, let’s compare that to the definition in my Human Anatomy & Physiology book from college.  

Cholesterol- “a lipid produced by body cells used to synthesize steroid hormones and excreted into the bile.” [P 698, Hole’s Human Anatomy & Physiology, 10^th edition]

When we compare these two sources, we learn that the Human Anatomy & Physiology book is giving an unbiased definition of what cholesterol actually is.  The definition that a Google search provides is an excerpt from the Mayo Clinic; this is not a definition but is an interpretation, which includes the negative impact cholesterol might have on the human body.  It leads us to believe that cholesterol is bad, and we lack understanding of the purpose or functional role that cholesterol has in the human body. 

Now that we know the Human Anatomy & Physiology definition of cholesterol, I recognize that there may be some words that not everyone knows the meaning of within that definition.  So, let’s define those words before we move on.

• Lipid: a fat, oil, or fat like compound that usually has fatty acids in its molecular structure.
• Cells: the structural functional unit of an organism
• Steroid Hormones: fat soluble hormones, formed from cholesterol (some examples include estrogens, testosterone, aldosterone, cortisol)
• Bile: a fluid secreted by the liver and stored in the gallbladder. 

Isn’t it better if we had zero cholesterol? My conventional doctor said the lower the better?

No, humans cannot live with zero cholesterol and the “lower the better” is a misunderstanding.  Cholesterol plays an important role in our health, cellular function, tissue repair, and hormone production. 

If I stop eating high cholesterol foods won’t my cholesterol go down?

Let’s look back at the definition– “cholesterol is a lipid produced by body cells used to synthesize steroid hormones…”. Cholesterol doesn’t only come from your food, it is also produced in your liver. Yes, in fact approximately 80% of cholesterol is produced by your body and only about 20% is directly derived from the food we eat.  This is why it is important to understand, diet can impact cholesterol levels, but your body needs cholesterol and will continue to create it as fuel, when more fuel is needed.

My conventional medicine doctor said my total cholesterol number and my LDL are high.  What about VLDL, HDL and triglycerides? I’ve heard these matter too?

The total cholesterol is truly a number that is somewhat useless without knowledge of the individual numbers for LDL, HDL and triglycerides.  Here is what each of these mean:

• Total cholesterol: this is a sum of the LDL, HDL plus 20% of the triglycerides.  The HDL is commonly referred to as good and LDL is commonly referred to as bad because the LDL type of cholesterol is the kind that is found in blocked arteries.
• HDL or high-density lipoprotein: this is the type of cholesterol that cleans up the “bad” cholesterol in the blood and takes it back to the liver.  Because of this function, this is the cholesterol that is known to protect us from cardiovascular diseases such as a heart attack and stroke.  For both men and women, HDL should be over 60mg/dL.  When I get my cholesterol labs done, mine is 90-100! The higher the better!  Foods like wild caught salmon and other fish, walnuts, and flaxseed oil can increase your HDL count!
• LDL or low-density lipoprotein: this is the type of cholesterol that can increase with a poor diet, lack of exercise, and increase in stress.  The American Heart Association reports that studies show a link to higher LDL and lower HDL that directly correlates to the level of a person’s stress at work.  Stress encourages the body to produce more metabolic fuels for energy, this causes the liver to make more LDL aka “bad cholesterol”.  A healthy diet and stress reducing lifestyle habits – including exercise and sleep – are important for correcting these numbers.  It is well understood that because cholesterol is the primary fuel required for stress hormones, such as cortisol, that the body will increase its cholesterol when more cortisol is being made in response to stress.  A normal LDL for conventional medicine labs is widely referred to as less than 100mg/dL.  However, it is important to understand VLDL, especially when LDL is high.
• VLDL or very low-density lipoprotein:  this is primarily composed of triglycerides.  It is important to know your LDL number in relation to the mathematical equation that provides VLDL for us.  VLDL should be less than 19 for a very healthy individual.  
• Triglycerides: created when we do not fully utilize the food we eat as immediate energy. This “unused” fuel gets stored in adipose/fat tissue as triglycerides.  When we are not eating, a hormone called HSL (hormone sensitive lipase) gets activated and helps us mobilize energy from the stored triglycerides- insulin can block that process. Insulin is a hormone that is triggered based on our blood glucose levels.  For someone who has a diet high in sugar, snacks often, or eats late at night, the body may begin storing too many of these unused energy particles as triglycerides.  Intermittent fasting, low carbohydrate diets, elimination and reduction of processed foods and sugars all help reduce unwanted high triglyceride numbers.

My cholesterol is high, what do I do?

If you have been told that your cholesterol is “high”, find out each of the numbers for your HDL, LDL, Triglycerides and VLDL and let your practitioner or myself know.  If you don’t have your VLDL, we can calculate it for you at your next visit.  We will review each of these individual numbers with you in order to help you determine next steps for your diet, supplements, and lifestyle to help correct any unwanted low or high cholesterol numbers. Another missed step by many doctors, both conventional and alternative, is looking at the trend of labs.  It is always important to determine if your labs are in an overall improving trend or not.  For example- if you haven’t had your labs drawn in 5 years, we should establish at least 3 follow up labs to determine the trend.  If you don’t have a primary care doctor that will run your cholesterol labs, let us know and we can help get that done for you. 

The least meaningful cholesterol number in our health practice is the “total cholesterol” because you cannot take proper action with diet, lifestyle or supplements based on that calculated number alone.

Yours in health and longevity,