A New Look At Cholesterol: It’s Not Just the Numbers

If you go strictly by the numbers (and what you’ve been conditioned to think), you will  believe that cholesterol is bad. If your total cholesterol number or your LDL cholesterol is high, some health care providers might recommend that you make dietary and lifestyle changes to bring down your cholesterol levels (that is, if you are lucky). Or if you happen to flag a certain higher level of total cholesterol or LDL, you could be instructed to take a statin drug like Lipitor or Zocor right away.

But what happens when your cholesterol drops too low because of statin drugs? Not a pretty picture! You need cholesterol to make your steroid hormones, like pregnenolone, DHEA, progesterone, testosterone, and estrogen. And you want those hormones at optimal levels for good sex drive and happy mood, brain sharpness, to preserve your muscles, and so much more. So, too low isn’t good either.

The good news is that when it comes to cutting edge cholesterol testing, it’s not strictly a numbers game anymore. Recent technology advancements not only have created smart phones, pad computers, Facebook, and Twitter, but also advanced analysis when it comes to all kinds of health measures, including heart health and cholesterol testing.

For example, I was recently tested for my total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. In addition, I was also tested for the size, density, and number of LDL and HDL particles. My total cholesterol was 214 and my LDL was 135, a little high according to conventional standards if you go strictly by the numbers. Dangerous?  A red flag? Not necessarily. Here’s why: My HDL was good and my triglycerides were low. And I had normal levels of the small dense LDL particles. These small dense LDL particles are atherogenic (meaning they deposit fats and calcium in the arterial lumen) to form problematic plaque. Think of small dense LDL particles as small sticky guys that can easily penetrate the endothelial wall and create trouble. Lp(a) is another small, dense LDL that is involved in thrombosis –which is the formation of a blood clot inside a blood vessel. I was fortunate to have low levels of this particle, as well. In the world of LDL particles, it goes beyond number…it’s also a matter of size. Less is better and bigger is better!

New advancements in testing can help you get a better picture of what is really going when it comes to your heart health and help you make a better decision, along with your doctor, about whether or not you need to be concerned or go on a statin drug. After all, most drugs have side effects and the decision to start a drug needs to be carefully evaluated with your doctor.

To help you better understand the overall effects of cholesterol on your body, please take a look at the handy chart I’ve included with this post. (And be sure to read my next blog post for more about statin drugs, including some of the side effects like memory loss, depression and diabetes.)

Excerpt from FDA NEWS RELEASE Feb. 28, 2012

FDA announces safety changes in labeling for some cholesterol-lowering drugs: 

“Important safety changes to the labeling for some widely used cholesterol-lowering drugs known as statins are being announced today by the U.S. Food and Drug Administration.”

“These products, when used with diet and exercise, help to lower a person’s “bad” cholesterol (low-density lipoprotein cholesterol). The products include: Lipitor (atorvastatin), Lescol (fluvastatin), Mevacor (lovastatin), Altoprev (lovastatin extended-release), Livalo (pitavastatin), Pravachol (pravastatin), Crestor (rosuvastatin), and Zocor (simvastatin). Combination products include: Advicor (lovastatin/niacin extended-release), Simcor (simvastatin/niacin extended-release), and Vytorin (simvastatin/ezetimibe).”

Two major changes to the statin labels include:

“Certain cognitive (brain-related) effects have been reported with statin use. Statin labels will now include information about some patients experiencing memory loss and confusion. These reports generally have not been serious and the patients’ symptoms were reversed by stopping the statin. However, patients should still alert their health care professional if these symptoms occur.”

“Increases in blood sugar levels (hyperglycemia) have been reported with statin use. The FDA is also aware of studies showing that patients being treated with statins may have a small increased risk of increased blood sugar levels and of being diagnosed with type 2 diabetes mellitus. The labels will now warn healthcare professionals and patients of this potential risk.”



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