Ok, first of all , I can see you eyes rolling through the screen! If you have lived in America sometime in the last 30 years you have heard someone mention cholesterol. In the 80’s every egg we ate was killing us if our brains weren’t frying first… Get it, my 80’s peeps??? 😁 OK, OK, Ok, so what is cholesterol, why do we do these screening, what do the numbers really mean, and what are the general treatment options??
Cholesterol is simply a fatty waxy substance that is essential to your body and it’s functions. It helps to build the walls of your cells, it helps to build your hormones, vitamin D, and your liver uses it to produce that nasty bile that your body uses to digest food. Fun fact: Did you know that gallstones are made of cholesterol??? Another reason to be healthy! The problem with cholesterol is that Americans in particular like too much of a good thing, and cholesterol is particularly bad for you when you have too much!
The frequency of screening for cholesterol should be at least every 4-6 years for adults according to the CDC, however, with expanding waistlines and an increase in diabetes, every couple of years would not be too frequent. If you are currently on a prescription for diabetes , check it at least yearly, or per your PCP’s recommendation. Children need to be screened at least once around 11-12. Unfortunately, I have seen lately that several insurance providers do not want to pay for screenings.
So, without getting overly complicated I will discuss 5 basic cholesterol numbers:
1: Total cholesterol: is the measure of ALL cholesterol in your body, good, bad, and ugly. As a provider I don’t tend to focus on this number as much as the good and bad.
2: Low density lipoprotein-LDL-this stuff is the glue or snot that sticks to your arteries, hardens them and causes you to have plaque, heart disease, and heart attacks!!! The target number for you LDL is around 70, although it can range from 40 to over 200! Remember, you want the “L” to be low.
3: High density lipoprotein-HDL-this is the good stuff! I tell my patients that these guys are like little pac-mans running around your body eating up or helping to remove the bad (LDL) cholesterol. This bad cholesterol is then removed by your liver and out the door. You want this number to be high! The higher the better! I mostly see patients with numbers in the 30’s so when I mean high, I like to see it above 40 and 60-70 is even better! You want those Pac-Man’s in your body! Remember-“H” is high!
4:Triglycerides-are a nasty little fat molecule. They serve really no good purpose. When you eat too much (that nighttime ice cream) your body takes those extra unneeded calories, turns it into a fat molecule called a triglyceride, and that little bugger is stored in your fat cells!!! 😳🤢 GROSS!
5: ASCVD Risk-so this one tries to be more complicated. We basically take your total cholesterol and your HDL and put it in a mixer and come up with a percentage. That percentage gives you a 10-year risk of developing heart disease, based on your current numbers. Less than 5% you are at low risk. 5-7.5% borderline, 7.5-20% intermediate, and >20% high risk. I have seen a 10 point increase in the HDL reduce your risk significantly! Remember HDL is your friend!!
So I have thrown A LOT AT YOU today with cholesterol and numbers. That is enough. My next post will be about meds and treatments that both pharmacologic and nonpharmacologic. until then soak this in and be cholesterol wise!
sources: https://en.wikipedia.org/wiki/Cholesterol https://www.everydayhealth.com/high-cholesterol/symptoms/things-you-didnt-know-about-cholesterol/ https://www.cdc.gov/cholesterol/myths_facts.htm https://www.templehealth.org/about/blog/8-facts-about-high-cholesterol
Becoming Wellness Wise 