A few months ago, I went for a yearly check up. Of course, my check up resulted in a blog post about the cholesterol myth. My doctor sent me to take a blood sample for the lipid panel.

Long story short, she said she’d call me if there was anything wrong with my cholesterol results.

One week later, I got a phone call. The doctor told me that my cholesterol’s too high and I’m setting myself up for a heart attack. My doctor recommended me to a clinical dietitian to help bring me back to “health”. Longer story even shorter, the dietitian fed me the same load of shi’t that the rest of the country has been fed.

The Cholesterol Myth

My Cholesterol numbers are as followed:

Total Cholesterol – 273
HDL – 66
LDL – 199
Triglycerides – 38

At first glance, most people would agree with my doctor’s decision to send me to a dietitian, but let’s take a closer look at this cholesterol myth. The mainstream breakdown of cholesterol numbers goes something like this:

Total Cholesterol

Less than 200 mg/dL	Desirable level that puts you at lower risk for coronary heart disease. A cholesterol level of 200 mg/dL or higher raises your risk.
200 to 239 mg/dL	Borderline high
240 mg/dL and above	High blood cholesterol. A person with this level has more than twice the risk of coronary heart disease as someone whose cholesterol is below 200 mg/dL.

HDL

Less than 40 mg/dL (for men) Less than 50 mg/dL (for women)	Low HDL cholesterol. A major risk factor for heart disease.
60 mg/dL and above	High HDL cholesterol. An HDL of 60 mg/dL and above is considered protective against heart disease.

LDL

Less than 100 mg/dL	Optimal
100 to 129 mg/dL	Near or above optimal
130 to 159 mg/dL	Borderline high
160 to 189 mg/dL	High
190 mg/dL and above	Very high

Triglycerides

Less than 100 mg/dL	Optimal
Less than 150 mg/dL	Normal
150–199 mg/dL	Borderline high
200–499 mg/dL	High
500 mg/dL and above	Very high

 The Formula of Measure

Ever wonder how doctors measure your cholesterol? Well, the traditional cholesterol test works by spinning blood in a high-speed centrifuge to separate the lipids (fats). This standard test, called a lipid profile, distinguishes three lipid categories:  high-density lipoproteins, or HDL; low-density lipoproteins, or LDL; and triglycerides, the main form of fat in the body. The problem here is that they don’t actually measure your LDL. They use a formula called Friedewald Equation. The equation is:

LDL = Total Cholesterol – HDL – Triglycerides/5.0

There are flaws in the formula. Let’s plug in my numbers and see the results. I’ll work backwards here to make it easier.

273  – 66 – 38/5.0 = LDL

273 – 66 – 7.6 = 199.4
(TC – HDL – Trig = LDL)

Round that off and my LDL is 199!

The problem here is that my triglycerides are really low. In an equation where someone has very low triglycerides and a high HDL is the result of the test coming back with high LDL. Let’s  raise my triglycerides by 100 (which is still in good healthy range) and see what happens.

273  – 66 – 138/5.0 = LDL

273 – 66 – 27.6 = 179.4
(TC – HDL – Trig = LDL)

Round that off and now my LDL is 179 which is still high, but not deadly. So how do I lower my LDL folks? You guessed it, by increasing my triglycerides. What’s the fastest way to raise triglycerides (fat in the blood)? Eat refined sugar and fast digesting carbohydrates.

We all know LDL is the “bad cholesterol” but what not many people know is that there are two type of LDL cholesterol. Unfortunately, the Friedewald equation under the conventional lipid profile can’t tell you which type of LDL you have.

Two Different LDL

Let me start out by saying that LDL and HDL are not actually cholesterol. LDL stands for “low density lipoprotein” and HDL are “high density lipoprotein”. They are actually the proteins transporting cholesterol around your body to places that need them.

There are actually two types of LDL transporting particles. There are “Pattern B” LDL particles which are small and dense. Pattern B LDL particles are bad because if there is inflammation in the arteies, these particles are small enough to penetrate the artery wall, become oxidized and cause plaque build up.

“Pattern A” LDL particles are large, light and fluffy. Pattern A LDL are good because they can’t get under the artery wall. These are harmless and actually beneficial to our health.

How do we know what type of LDL we have? Well, there is a direct correlation between triglycerides and LDL. A very low triglyceride is a good indicator that you carry more Pattern A LDL particles. High triglycerides are directly correlated with a Pattern B, small dense LDL.

A More Accurate Cholesterol Test

The correlation between LDL particle density and high/low triglycerides is very consistent. If you’d like to be accurate in your cholesterol numbers, I suggest inquiring about a VAP test (Vertical Auto Profile). You’d likely have to go to a special lab to get this test done. Your general doctor can help you find a place that does the test.

Don’t let your cholesterol numbers scare you. My doctor sent me to a dietitian that told me I eat too much fat, gave me a “balanced” diet full of sugar with very little fat and told me I should follow it if I want to live. It’s scary stuff, but if you’re educated and up to date with the dietary and health literature, there’s nothing to worry about!

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