Cholesterol Management
Healthy cholesterol levels are essential to the function of a healthy heart and circulatory system, but when excess cholesterol builds up in your arteries, it can form a fatty plaque, causing atherosclerosis and an increased risk for heart disease and stroke.
What is Cholesterol?
Cholesterol is a lipid, or fat, that you’ll find in every cell in your body. It’s an essential component in each cell membrane, and helps make vitamin D, hormones, and plays a role in digesting food.
Your body makes about 75% of the cholesterol your body needs, while approximately 25% comes from dietary sources of fat.
Cholesterol makes up a little less than half of the fat in each cell membrane, and although your brain is only 2% of your body weight, it contains up to 20% of your body’s cholesterol.
So why does cholesterol have such a bad reputation, and should we be worried about keeping cholesterol levels low?
The INTERHEART study, which looked at the incidence of heart attacks in every inhabited continent in the world (in 52 countries), found that most risk factors include modifiable dietary and lifestyle actions.
Root Causes & Risk Factors for High Cholesterol
The modifiable risk factors for high cholesterol include:
- Metabolic dysfunction (type 2 diabetes, NAFLD, etc.)
- Smoking
- Sedentary lifestyle
- Obesity
- A diet high in refined sugars or trans fats
- Gut function & dysbiosis
- Thyroid issues
- Toxins, heavy metals, or underlying infections
- Genetics such as familial hypercholesterolemia
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Healthy Cholesterol Levels
Unhealthy cholesterol levels, known as dislipidemia, may increase risk for heart attack and stroke. These occur when fatty, cholesterol-containing deposits, called plaque, build up and block the flow of blood and oxygen to the heart over time
Starting in your 20s, it’s recommended to get your cholesterol levels measured once every 4-6 years. There are several different markers that your integrative doctor will discuss with you concerning your cholesterol levels.
Basic cholesterol tests include:
- High-density lipoprotein (HDL) – “good cholesterol”
- Low-density lipoprotein (LDL) -“bad cholesterol”
- Total cholesterol
- LDL to HDL ratio
- Triglycerides
- Very low-density lipoprotein cholesterol (VLDL)
Additional tests can show particle size and subtypes of cholesterol, which may be a better predictor of heart health.
Total cholesterol, which should ideally be under 200. If your total cholesterol is over 200, this is considered ‘high’ and you’ll want to pay special attention to the ratios of the type of cholesterol that make up this number (3).
High-density lipoprotein (HDL) – Optimal HDL is 60 or above. For men, HDL is considered low if below 40, and for women, below 50. Genera
Low-density lipoprotein (LDL) should optimally be 100-129, and under 100 if you’re already at risk for heart disease.
Triglycerides should be below 150, with an optimal range being about 100. One significant risk factor for heart disease is your ratio of triglycerides to HDL.
If triglycerides are high, and HDL is low, you’ll want to consult your integrative medicine doctor to determine which functional treatments, diet & lifestyle changes can improve your cholesterol levels.
Lipoprotein particle profile (LPP) — Provides metabolic information and levels of inflammation that affect cholesterol levels.
Vertical auto profile (VAP) — Measures even more lipoprotein classes, such as Lp(a), LDL, and VLDL. VAP can identify risk factors for cardiovascular disease that cannot be identified using the standard lipid panel.
Healthy cholesterol levels are important for overall cardiovascular health. For current and potential patients, the only way to know whether you have high cholesterol is to get your cholesterol levels checked.
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Functional Medicine For Healthy Cholesterol Levels
All the above measures are effective in promoting healthy cholesterol levels, although they’re more beneficial when combined with holistic diet and lifestyle changes to maximize effectiveness. For example, the heart-healthy benefits of a diet low in refined sugars is most effective when paired with exercise, stress reduction, and the right supplements.
An integrative doctor will also advise you about other risk factors which can negatively impact heart health, such as high blood pressure, high stress, underlying infections, and poor gut health. The goal of functional medicine for high cholesterol is to find a treatment plan that is tailored specifically to each person.
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Supporting Services for High Cholesterol Treatment
Health Coaching
A health coach works with you and your provider to implement lifestyle changes to promote healthy cholesterol levels. Your health coach also provides education on the topics of nutrition, physical activity, as well as creating and maintaining behavior change, and integrative treatment strategies.
Even if you have a genetic predisposition to high cholesterol levels, living a heart-healthy life can still dramatically influence your lipid metabolism for the better.
Weight Management
A healthy weight can be enough to improve your cholesterol levels. Being overweight or obese can raise your chances of high triglycerides and high total cholesterol, as well as risk factors like insulin resistance and elevated inflammation.