How to Read & Understand Your Cholesterol Numbers

Ever wonder what those cholesterol numbers in your blood test really mean? By the end of this video you’ll know what each cholesterol type is and when you need medications to treat it.

Majd MD -- Your YouTube Family Doctor.

SHOW RESOURCES:
Framingham Score Calculator: cvriskcalculator.com/

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SHOW SCRIPT:
If you have your last cholesterol test results, pull it out and let’s review it together. Here’s an example.

Note that lab normal ranges will differ depending on where you have your blood drawn.

What many people initially notice is the “total” cholesterol. 200 is often the normal cut-off value here. However, I wouldn’t get too excited if this number is elevated, especially if your other cholesterol values in the panel are at goal. The total is a reflection of all of the various cholesterol types, and takes into account your good cholesterol too. So if your good cholesterol is high, this will drive up your total, too. For this reason, as a doctor, I don’t find the total cholesterol as valuable as its individual components.

Let’s talk about the LDL value next, or the Low Density Lipoprotein -- this is the “bad” cholesterol that contributes to plaque formation in the blood vessels. And the one that’s been most linked to heart disease. For most people, the goal is less than 130. However, those with diabetes, heart disease or chronic kidney disease, your doctor may be more aggressive in lowering it. Statin medications, which you may have heard of, target LDL cholesterol specifically.

Next is the HDL – or high density lipoprotein. This is your good cholesterol that transports the bad cholesterol away from the blood vessels back to the liver. You want a higher HDL (NOT lower), preferably over 40. Exercise can increase it. However, I had a good discussion on whether or not too high of an HDL is actually harmful based on recent studies -- check out my video interview with Monica Reinegal, a dietician who podcasts on the Quick and Dirty Tips network. (link is above in Related Videos section of this description)

And lastly, Triglycerides, which are also bad. Normal is typically below 150. Values over 400 have been associated with acute pancreatitis and are more worrisome. Interestingly, something you may not be aware of: this is the only value in the entire cholesterol panel that will change if you’re not fasting. Yep. Alcohol, high carb consumption, and uncontrolled DM can increase TG’s, as can some genetic disorders. So if you have any of these risk factors, or a history of elevated TG’s, consider a blood draw after a 12 hour fast in order to obtain an accurate value.

Now when do we treat cholesterol with a medication? Just because you have high cholesterol values doesn’t mean you need a drug to lower it. It all depends on your risk factors. Doctors use a formula called a “Framingham Score” to determine your risk of developing heart disease in the next 10 years, and whether or not a cholesterol lowering treatment is warranted – this formula takes into account your age, sex, and your risk factors for heart disease (like whether or not you have DM, HTN, or smoke). I’ll place a link to one you can use online to determine your score.

#cholesterol #HeartDisease #MajdMD #Health #HeartHealth #Lipids