Is Knowing Your Cholesterol Number Still a Thing?

Yes, testing your cholesterol, is still a thing to get accurate information and know what blood fat testing, including cholesterol number, shows about you and your physiology. But there are also biomarkers that are more sophisticated that your primary care MD is a good resource to review with. And remember, the important fact is that lower cholesterol is healthier.

Cholesterol number of under 200 used to be a bit of a badge, and that’s pretty much the only number we thought mattered. But long ago we began to talk about other aspects of our health: our heart rate , our blood pressure, our BMI, your blood sugar, your fitness level. In your yearly chat with your health care provider, but what about knowing their cholesterol number, is that important, is that a thing?

Everyone needs cholesterol in order to keep their body functioning. But, too much can cause serious problems for our health. There is new evidence that too aggressively lowering cholesterol is bad for brain health since the brain needs fats to function properly. But most studies still show low LDL cholesterol is good for our health and doesn’t back up any specific heart risks from making that number too low.

I was once sitting at the hair dresser and we got on the topic of cholesterol. Too many of his friends had just had heart attacks so we got to talking about where our cholesterol levels should be. Fortunately, there is a simple test that can be done at your gyno or primary care physician to get those numbers checked, but, the bottom line is: Get those numbers down! In fact, even if you never knew your total cholesterol number, it’s always good to try and lower your cholesterol levels, which might mean changes in your diet and lifestyle.

But, we still need cholesterol in our bodies, so how do I know what’s good and what’s bad?

There are two types of cholesterol: high density lipoprotein (HDL), the “good cholesterol”, and low density lipoprotein (LDL), the “bad cholesterol”. Researchers have found LDL is the type of cholesterol that can lead to various cardiovascular diseases by causing more vascular blockage. It’s recommended to get those levels down, tracking with blood tests is the best way to monitor the success of any strategy.

The LDL collects on the walls of your arteries, essentially blocking them, which leads to a higher risk of heart failure, heart attack, and stroke, as your heart muscles are being deprived of oxygen. It is recommended for adults to be under 200 mg/dL. If a test reads above 240 mg/dL, that is considered to be very high and concerning.

According to modern research, cholesterol levels and the risk associated with it can’t just be dumbed down to decreasing the intake of the “bad” cholesterol. Your risk can also rely on your HDL, or “good” cholesterol, levels. But HDL and LDL aren’t the only factors that can increase risk to cardiovascular diseases. Here are some others to be aware of:

– LpA (of lipoprotein A) levels should also be assessed. Lipoproteins are particles that carry cholesterol and triglycerides throughout our bodies. Levels above 50 mg/dL are considered very high risk.

– High levels of TG (or triglyceride) are also an indicator of risk to diseases such as coronary artery disease, among others.

– Another factor to be aware of are our Apo B levels. Apo B make up some of the lipoprotein particles, which help transport cholesterol in our bodies. When our lipoproteins are made up of Apo B, they are more likely to enter the wall of our arteries, making it very dangerous when those lipoproteins are carrying LDL. High levels of Apo B (above 125 mg/dL) can very telling of one’s risk to certain cardiovascular diseases.

– Cholesterol particle number can also be an indicator of risk, more specifically LDL particle numbers. A high number of LDL particles can be more telling of risk in comparison to just knowing one’s LDL cholesterol levels. In fact, one can have low LDL cholesterol levels, but a high LDL particle number, and therefore still be at risk for cardiovascular diseases.

– Cholesterol particle size can also indicted risk, specifically LDL particle size. If LDL particles are small and dense, the likelihood of developing cardiovascular disease triples.

Treatment options to get your numbers to where they should be are many and should be monitored by your primary care physician.

– As mentioned briefly above, diet can be a huge benefactor to getting those cholesterol levels down. Meats, fish, cheese, and poultry are rich in cholesterol, so limiting the intake of those can benefit in the long run. Additionally, foods with high sugar, trans fats, and saturated fats can increase the production of cholesterol in the body, so decreasing those types of foods in your diet can also help. BUT diet is an impractical way to lower cholesterol, medicines are better and face it, positive dietary changes are hard to sustain in the long term. 

– In fact, weight loss as a whole can really help get those levels down, so adding some exercise (even if it’s only a few minutes a day) can really help in the long run.

– If you already have cardiovascular disease, taking medication that lowers your LDL cholesterol has proven to be very beneficial (a popular example is Statin).

– Supplements such as fish oil, soy protein, and garlic can also help.

Even if you don’t think you’re at risk, it’s still really important for you to find out your total cholesterol count. High LDL, Apo B, TG, and/or LpA levels can cause serious damage to your blood vessels, which will in turn, restrict oxygen flow that is vital to the survival of your internal organs.

There are newer markers of cardiovascular disease. On Medscape they say, “The biomarkers in question are really the big guns in this space: troponin, a marker of stress on the heart muscle; NT-proBNP, a marker of stretch on the heart muscle; and C-reactive protein, a marker of inflammation. In every case, higher levels of these markers at baseline were associated with a higher risk for cardiovascular disease in the future.”

The special case of PCOS makes these women more vulnerable

There are also special classes of women, especially those with severe forms of PCOS, which includes being overweight and having cardiac risk factors of diabetes and/or hypertension. These women are termed to have the Metabolic Syndrome. Women with Metabolic Syndrome and 1.5 times more likely to get a stroke. You are likely to have this syndrome if you have a large waist circumference, high blood sugar, high TG, high BP and high LDL. These women can benefit from taking Statin, a medication mentioned above.

I’m gaining weight because I’m stressed. Is there anything that can help with that?

Now, some might argue that cholesterol isn’t the only factor (or even the leading factor) when it comes to heart attacks. And the lowering of heart disease risk with GLP-1s is the newest strategy that may be helpful whether you are trying to or need to lose weight. Stress alone is believed to be the cause of many health problems. There is some truth to stress being an influential factor for you to munch on a box of chocolates instead of a piece of fruit. But how do we combat stress? What other tests can be done? We’ll debate that one next time! Come in to discuss nutritional management!