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Some Insights Into Cholesterol

Probably everyone reading this entry had had their cholesterol levels checked a number of times.  When the laboratory report comes back, we see several numbers:

  • Total cholesterol
  • LDL (low density lipoprotein)
  • HDL (high density lipoprotein)
  • Triglyeride levels
  • Total cholesterol divided by HDL cholesterol ratio

When you peruse the “normal” levels, the total cholesterol should be less than 200, the LDL cholesterol less than 100 and “normal” HDL cholesterol should normally be greater than 39.  Triglyceride “normal” should be less than 150.    Concerning the ratio of Total Cholesterol/HDL, the lower the ratio the less chance of having heart disease in the future.  “Average” risk is 5.0 for males and 4.4 for females.  A ratio of 3.4 for men and 3.3 for women predict a ½ average risk of heart disease compared to the general population.  However, other risk factors for heart disease such as cigarette smoking, hypertension, diabetes, family history of heart disease and obesity play important roles in risk for developing coronary artery blockage.

About 85% of the cholesterol levels in the bloodstream is manufactured by the liver.  From a genetic standpoint, there are many people that have elevated cholesterol levels not because they are eating poorly, but rather, their livers manufacture lots of cholesterol.  Although the majority of cholesterol elevation is due to genetic factors, from a dietary standpoint, the more saturated fats and cholesterol containing food we take in, the more cholesterol will appear in our bloodstream.

When should prescription medications such as Lipitor, Zocor, Crestor or other statins be used?  I believe that the other cardiac risk factors need to be considered before making the recommendation for medication vs. no medication.  As an example, if someone comes in stating that every older relative in the family had heart disease at a relatively early age, and that person’s Total/HDL ratio is 4.8, this person should be aggressively treated with medication whereas the person with no family history of heart disease and same ratio should be managed by dietary means alone for a while before medication is prescribed.

If you have any questions about your cholesterol panel, feel free to send those to me ( and I will be happy to provide you with a free “opinion”.

And here is a totally ridiculous song called “The Cholesterol Song”

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