This article is the third in a series entitled: “How to Interpret Your Blood Tests”. Here I’ll discuss the lipid (including cholesterol) profile of a blood test.

This set of blood markers is often the most scrutinized because of all the hype around cholesterol and fats these days. Most Americans appear to be pressured and confronted with having to be concerned with matters of heart disease and whether or not to take medication to lower cholesterol. This is obviously a concern, however cholesterol levels alone don’t show a big enough picture to determine a person’s cardiovascular (or general) health and/or risks. Regardless, here are the markers:

Total Cholesterol This is self-explanatory and includes LDL, HDL, and vLDL.

HDL Cholesterol Also known as “good” cholesterol because of its function in transporting cholesterol away from the tissues (especially arteries) to the liver

Non-HDL Cholesterol Again, self-explanatory – made up of the sum of LDL and vLDL cholesterol

LDL Calculated Also known as “bad” cholesterol because of its ability to help deposit cholesterol in arteries and other tissues

Triglycerides These are fats in the blood that can come from diet or triglyceride production by the liver. And if more calories are consumed than can be used by the cells immediately – the body will convert the excess into triglycerides to be stored. Typically triglycerides are in excess because of too much sugar, caffeine, or alcohol; essentially with blood sugar imbalances.

For more in-depth information of cholesterol, see my article titled: “Understanding Cholesterol“.

Over the years, the ability to assess cardiovascular disease (CVD) has been improved. One good type of testing includes testing the particle size of both LDL and HDL cholesterol. Essentially, it’s better to have LDL cholesterol particles that are large (or “Pattern A”). When the particles are large, it implies less surface area for that cholesterol to be oxidized (which is when cholesterol really becomes problematic and contributes to CVD). When the particles of LDL are small (or “Pattern B”), there is more surface area that can be oxidized, thus compounding the problem.

The exact opposite is true of HDL. HDL is best when the particle size is small.

In conclusion, it should be noted that most of the time when I see cholesterol and triglycerides elevated, it is due to insulin resistance or other issues with blood sugar management. This is basically the result of imbalances in other systems typically due to diet and stress hormone levels. Another possibility is low thyroid function. This will decrease metabolism in every cell of the body, and slow the metabolism of cholesterol leading to a higher level. Lastly, microbial imbalances in the intestinal tract can contribute to high cholesterol due to bile salt analogue production (a topic for another article).

High cholesterol is not usually the most pertinent issue I see in my practice. That just has to do with the patients that walk through the door. And when I do see (functional) high cholesterol on a patient, I don’t simply give natural cholesterol “blockers” like red rice yeast. I see high cholesterol as a symptom, not a primary disease process. Keep in mind that some people do truly have genetically-based high cholesterol, but I don’t find that to be the norm. If genetically-high cholesterol is something that is suspected (because of extremely high levels or levels that are non-responsive to care), a lipid electrophoresis can be run to determine if in fact a genetic lipid disorder exists known as hyperlipoproteinemia.

There are even more cholesterol markers that can be run nowadays, for example oxidized cholesterol and apolipoprotein studies. Again, I don’t often see this, but will deal with it when necessary. I often see more issues with low cholesterol in my practice. Yes, a person can have too little an amount of cholesterol. Cholesterol is a necessary ingredient in every cell in the body.

Dr. Robert D’Aquila – NYC Chiropractor – Applied Kinesiology

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