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If heart disease comes up in conversation with your doctor, you can be sure that comments about your cholesterol levels aren’t far behind. It’s common practice for medical professionals to suggest lowering your cholesterol, since too much can contribute to plaque buildup and blockages in your arteries.

Those of you who have experienced a cardiac event know the drill: eat less unhealthy food, lose weight, or order some medications to keep your numbers in check. You may not have felt bad before, and you don’t feel better now, but you’re committed to following what the doctor said — even if you’re not seeing results.

Does this sound like you? You’re not alone. 

Americans have been given inaccurate information about cholesterol’s effect on cardiovascular health, and don’t understand why they’re not feeling better even while taking statins or fibrates.

The truth is, there’s usually no need to take medications that lower your cholesterol.

In fact, these may actually hurt rather than help your body recover from the risks of heart disease.

Let me explain.

What is cholesterol?

Cholesterol is a fatty substance excreted by the liver and stored within cell membranes. It has multiple purposes: to make hormones, carry vitamin D, and repair damaged tissues inside the body. Contrary to popular belief, the body manufactures about 80% of its daily cholesterol needs, with only 20% coming from food.

There are three different kinds of cholesterol to be aware of:

  • LDL: Low-density lipoprotein is sometimes referred to as the ‘bad’ cholesterol. When too many of these particles build up in the blood, blockages occur within the arteries of your heart.
  • HDL: High-density lipoprotein is typically referred to as the ‘good’ cholesterol. These particles gather unnecessary cholesterol in the blood and bring it back to the liver for removal.
  • VLDL: Very low-density lipoprotein is somewhat similar to LDL, with one caveat. While LDL focuses on transporting cholesterol, VLDL primarily carries triglycerides.

The equation seems simple at first glance: have more good cholesterol in your body than bad cholesterol to stay healthy.

But the relationship between cholesterol and heart health is much more nuanced than that.

How cholesterol impacts heart health

Cholesterol and heart health do share a close relationship — just probably not in the way you’ve been told.

The body synthesizes about 1,000 mg of cholesterol per day to accomplish basic functions, including the reparation of tissue damage caused by inflammation.

Inflammation can be caused by several factors — sugar, pathogens, and exposure to toxins are some of the most common — but the result is always the same: damage to the body’s internal structures that require the help of cholesterol.

Cholesterol levels in the blood will rise and fall to accommodate your internal damages. Short-term inflammation from illness, for example, will only raise your cholesterol levels for a short amount of time. However, chronic inflammation from a metabolically unhealthy lifestyle can spike LDL for months or even years, indicating serious organ damage.

You can think of cholesterol like builders contracted to repair your roof. They’re doing all they can to get the situation under control, but with branches continuing to fall while they work, the problem may get worse instead of better.

Now imagine that you fire all your builders or send them home early (i.e., take medications). You’re essentially getting rid of the only people who can repair your roof, leaving you with a deteriorating condition that worsens over time — leading to a life-altering or life-ending event. 

This is why solely focusing on lowering your cholesterol isn’t the right move. Unless you ask yourself why internal damage has occurred to spike your cholesterol levels, buying more statins or avoiding egg yolks won’t do you much good.

What to do if you have high cholesterol

As you can see, cholesterol is not the metabolic monster many people think it is. However, high levels in your bloodstream may still indicate a major problem that should be addressed immediately. If your total cholesterol is higher than 200 mg/dL, you may be metabolically unhealthy and have a serious risk for heart disease.

I recommend:

  • Focusing on whole, real foods. When your body is treated to leafy greens and animal proteins rather than processed foods and sugar, it will have an opportunity to rest and repair inflammation. Less cholesterol will be needed as you eat less inflammatory foods, allowing your LDL levels to return to normal.
  • Find an exercise plan you can stick to for the long haul. Regular exercise stimulates enzymes that round up excess LDL and remove them from the body. Resistance exercises are particularly good for heart health and develop more metabolically active tissue as well.
  • Chat with your primary care provider about getting your cholesterol tested. It’s never a bad idea to consider a full blood panel, especially if you’ve never established baseline metrics. You can order tests from a doctor, work with a metabolic health coach, or order labwork on your own and interpret the results yourself.

You’re welcome to learn more about cholesterol in my introduction to labwork and understanding cholesterol courses. In just a few short videos, I’ll walk you through CBC, CMP, and advanced lipid testing, explain the triglyceride:HDL ratio, and teach you how to interpret raw numbers on your own.

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