What is Cholesterol — And Why Isn’t Lower Always Better?

Cholesterol is commonly referred to as something that negatively affects our health — but you may have a one-dimensional concept of cholesterol. According to Dr. Alice Nguyen, cholesterol isn’t always associated with damaging health effects. She describes the rationale behind this common misconception: “It’s a Goldilocks situation. Too much of it is potentially bad while too little of it is also potentially bad.” Let’s take a closer look into cholesterol and why it matters when it comes to our health.

What Exactly is Cholesterol?

Cholesterol can be defined as a waxy, fat-like compound found in most body tissues. It is made in the liver but located in the blood and all of our body’s cells. It’s essential to our health because it’s needed to make cell walls, tissues, hormones, vitamin D, and bile acid.

The American Heart Association notes that cholesterol is not inherently bad for our health. It becomes harmful to our health when there is too much of it.

Cholesterol is a Small Piece in a Big Puzzle

Most medical doctors will only look at the most basic four pieces of the puzzle when testing blood: total cholesterol, LDL, HDL, and triglycerides. When doctors only examine these four puzzle pieces, they’re missing the entire (lipid) picture. Dr. Alice says, “A lot of doctors will not run a full panel at this point. They’re going to run a complete blood count, comprehensive metabolic panel, and run your four lipids. That’s it. The total cholesterol is the total lipoproteins in your blood. Think of LDL as the trash in your veins — it’s the bad cholesterol. HDL should be thought of as the trash man — it’s the good cholesterol. Triglycerides are the fat in the blood.”

She continues, “Whenever I see LDL is high, I’m going to ask three questions. Number one: how inflamed are you? Number two: how much of that LDL is oxidized or the damaged variety? Number three: how much of that LDL is the small variety, also known as the small dense LDL?”

It’s important to find doctors like Dr. Alice who will ask the appropriate questions to better understand your lipid profile. Your blood looks different if you have high numbers of everything in your lipid profile. When your blood is collected and tested, it sits for approximately ten minutes while the red blood cells are separated through spinning. People with healthy lipid profiles will have a serum that rises — it emerges as a clear or golden color. If a person has high lipid numbers, medical professionals will see something described as ‘tomato soup.’ Instead of being clear or golden, it will appear translucent to opaque (and creamy).

What is the Average Person Told About Cholesterol That Isn’t True?

Conventional doctors are taught that lower cholesterol is better. If you have a stroke or heart condition, most doctors will try to drive down your cholesterol as much as possible. What’s the problem with that? Research found 75% of patients hospitalized for a heart attack had cholesterol levels that would indicate they were not at high risk for a cardiovascular event. Further, approximately 50% of these patients had LDL levels that would be considered optimal.

Some doctors believe driving down LDL is bad because LDL is necessary to shuttle energy to our brain cells. So, the next time you think about skipping eating the egg yolk for breakfast or the delicious steak for dinner — think about the entire scope of how cholesterol affects our bodies. Balance really is everything!