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Updated: Jul 18, 2023

“Cholesterol is an essential molecule without which there would be no life, so important that virtually every cell in the body is capable of synthesizing it”.

Cholesterol is a waxy substance that is an important part of cell membranes. Most of it is made in the liver, with the rest being absorbed through the diet.

Cholesterol is the raw material that your body uses to make sex hormones, vitamin D, and bile acids needed for digestion.

Cholesterol travels in particles called lipoproteins which we tend to know as HDL (high density lipoproteins) and LDL (low density lipoproteins).

HDL is known as the “good” cholesterol. It is thought that the higher the HDL levels, the better. The type of HDL subtype may be just as important as total HDL. Not all HDL is beneficial. In general, you want to have higher levels of the HDL-2 subtype than HDL-3. HDL-2 seems to be the most protective, having anti-inflammatory and anti-atherogenic properties. HDL-3 on the other hand is inflammatory. HDL seems to be much more tightly regulated by genetics than LDL.

LDL is known as the “bad” cholesterol. It can build up in the arteries, impeding blood flow. It is thought LDL levels should be kept low. As is the case with HDL, LDL is made up of different subtypes. LDL-A is a fluffy type of molecule that doesn’t cause harm as long as it isn’t damaged by oxidation (free radicals enable cholesterol to form plaque). LDL-B on the other hand is small, hard and dense, which can promote atherosclerosis. You therefore want to have more LDL-A.

LDL in the body isn’t really a problem until it becomes oxidized. Oxidized LDL can stick to arterial walls, contributing to plaque and causing further inflammation and injury.

Lp(a) may be the most important cholesterol particle of all but isn’t looked at in conventional tests. Lp(a) is a very small, highly inflammatory particle that can cause blood clots. In healthy people low levels of Lp(a) aren’t much of a problem. Lp(a) actually repairs damaged blood vessels but the more repairs you need on your arteries, the more Lp(a) is needed. Lp(a) builds up at the site of damage, binds with some amino acids within the wall of the damaged blood vessel, starts to promote the deposition of oxidized LDL into the wall, which leads to more inflammation and eventually plaque build-up.

Eating cholesterol doesn’t increase cholesterol

Eating cholesterol doesn’t always increase cholesterol in the blood. The effect of dietary cholesterol on blood cholesterol levels is very individual. For most people dietary cholesterol doesn’t have much effect on blood levels at all.

Saturated fat raises cholesterol, but it raises overall HDL and the good part of LDL (LDL-A) more than it raises the bad LDL.

The relationship between saturated fat in the diet and heart disease has never been convincingly demonstrated. There is research showing that replacing saturated fat in the diet with carbs, actually increases the risk for heart disease.

Cholesterol is not the best predictor of heart disease

Cholesterol numbers alone are a pretty poor indicator of heart disease. More than half the people hospitalized with heart attacks have perfectly normal cholesterol levels, and about half the people with elevated cholesterol levels have perfectly healthy, normal hearts.

“Abnormal cholesterol levels are not primary causes or indicators of coronary heart disease” – Dr Mark Houston

Some of the major causes of heart disease are inflammation, oxidation, sugar, and stress.

Sugar increases the number of bad LDL molecules, decreases the good ones, and damages the bad LDL particles. Sugar contributes to inflammation in the artery wall. Sugar can stick to proteins in the blood causing glycation, which damages LDL. It raises insulin which can increase blood pressure and raise cholesterol. Sugar can raise triglycerides.

Better ways to predict heart disease

Cholesterol to HDL ratio:

You want a cholesterol to HDL ratio of 3.5 or less. If it is above 5.5 then you have some problems that need to be addressed.

Triglyceride to HDL ratio:

You want to calculate the ratio of your triglycerides to your HDL. If you have a ratio of 2 you are doing well, regardless of your cholesterol levels. If you have a ratio of 5 though, this is problematic. (They used mg/dL but I think it still applies to our units of measure).

A high ratio indicates you have the more damaging type LDL particles.

Those with the highest ratios had 16 times the risk of developing heart disease than those with the lowest ratios, in a Harvard study that was published in Circulation.

Cholesterol and the brain

“The brain is rich in cholesterol and accounts for about a quarter of all the cholesterol we have in our bodies. The fatty myelin sheath that coats every nerve cell and fiber is about one-fifth cholesterol. Neuronal communication depends on cholesterol.” – Dr Sinatra.

Patients with depression who had high triglycerides, alleviated their depression by lowering their triglyceride levels. Other research has shown that modifying blood fats can influence hostility, aggression, and other aspects of mood.

“In one study, male psychiatric patients with cholesterol in the lowest one-fourth of the group were more than twice as likely to have made a serious suicide attempt than those with the higher cholesterol.” – Michael Schmidt, Brain Building Nutrition.

Michael Schmidt also explains that maintaining healthy levels of HDL may be among the keys to preserving brain function as we age. People with higher levels of HDL were much less likely to suffer from dementia.

“Sufficient dietary and cellular cholesterol is critical for healthy cognitive and memory function” – Nora Gedgaudas.

Cholesterol and the immune system

Cholesterol plays and important role in fighting bacteria and infections. When you have an infection, the total level of cholesterol goes up, but HDL goes down, because it is being used to fight the bacteria or infection.

Some things you want to look out for

  • High HDL (preferably HDL-2)

  • Lower LDL (Preferably more LDL-A particles than LDL-B)

  • Low triglycerides

  • Low triglyceride to HDL ratio

  • Low cholesterol to HDL ratio

  • Low Lp(a)

  • Low CRP

  • Low Homocysteine

  • Low fasting insulin

  • Optimal blood pressure levels

Problems with low cholesterol / statin drugs

If your cholesterol levels are too low you can become fatigued, lose strength, appetite, have muscle aches and pains, suffer memory loss, and become more prone to infection.

Statin drug benefits have been overexaggerated. They tend to only help middle aged men who have already had a heart attack.

Statin drugs deplete CoQ10, which is an important nutrient for the heart. When CoQ10 is depleted, it can lead to muscle weakness, muscle pain, and fatigue.

Statin drugs lead to a reduction in sex hormones and sexual dysfunction is a common side effect.

How you can improve your cholesterol levels / ratios

  • Manage inflammation and oxidation

  • Limit sugar / fructose / avoid refined carbs / control blood sugar levels

  • Exercise

  • Get enough sleep

  • Manage stress levels

  • Don’t smoke

  • Maintain a healthy weight / body fat level

  • Avoid trans-fat

  • Ensure optimal thyroid hormone levels

  • Consume omega-3 fatty acids

  • Take niacin, l-carnitine, iodine, vitamin E, pantethine, magnesium, vitamin K and vitamin D, and resveratrol, to name a few.


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