Healthy man with questions about cholesterol

Surprising Answers to your Questions about Cholesterol

Feb 10, 2023 Family Medicine Share:

How much do you really know about cholesterol?

You may have a sense that you need to keep an eye on your cholesterol and that high cholesterol can be bad for your health, but cholesterol can often be misunderstood.

We’re taking a look at the surprising answers to these five common questions about cholesterol.

Is all cholesterol bad?

Believe it or not, cholesterol isn’t inherently bad. In fact, your body makes and uses cholesterol, and it’s necessary for many of your body’s key functions. Cholesterol is found in every single cell of your body and throughout your bloodstream.

Your liver and brain produce all of the cholesterol your body needs. Cholesterol is responsible for many building processes in your body, such as:

  • Repairing tissues
  • Helping your body make hormones, such as estrogen and progesterone
  • Making Vitamin D from sunlight
  • Building cell membranes
  • Making bile acids in your liver, aiding in fat digestion

Cholesterol is also essential for healthy brain function. Your brain needs cholesterol to form myelin, a protective sheath on your neurons that aids in processing. It also plays a role in the communication of neurotransmitters (like dopamine and serotonin).

The bottom line is: you need cholesterol. But too much of a specific type of cholesterol can be harmful to your health.

What's the difference between HDL and LDL?

You’ve probably heard about good cholesterol and bad cholesterol. And while those nicknames may be helpful, they’re actually a little inaccurate.

HDL (high-density lipoprotein) is commonly known as “good cholesterol” and LDL (low-density lipoprotein) is commonly known as “bad cholesterol”. But you may be surprised to learn that these aren’t really cholesterol at all. Instead, these lipoproteins actually serve as a carrier for cholesterol in your bloodstream.

LDL, or low-density lipoproteins, are transport proteins that deliver cholesterol to your tissues, allowing cholesterol to carry out all of its important functions. Without LDL, cholesterol can’t get to your cells. However, an overabundance of LDL can cause it, along with other materials, to accumulate in your blood vessels.

HDL, or high-density lipoproteins, carry cholesterol back to the liver from your tissues. HDL serves as the cholesterol clean-up crew for your body, clearing excess cholesterol from your bloodstream.

When you receive a package, it usually comes in a box. Once you take what you need out of the box, you can break down the box and put it in the recycling bin. On collection day, you take your recycling bin to the street. Your waste management company will empty your bin, taking the boxes and other recyclables to the recycling center. Regularly taking the recycling out will prevent it from accumulating in the bin. In the same way, HDL actively removes LDL from the bloodstream.

But HDL can only do so much. If you have a hundred boxes to put in your bin, they may not all fit. You may need to hold some back until the next time your recycling is collected. If you continue accumulating a hundred boxes each week, your recycling service isn’t going to be able to remove all of your boxes. Eventually, you’ll end up with an overwhelming overflow of boxes. Like the boxes, LDL will collect in your bloodstream over time if the HDL is unable to keep up with your body’s LDL production.

You need both HDL and LDL in your body, but you need them in the right relationship with one another: enough HDL to remove excess LDL, and not so much LDL that your body's HDL can't remove it.

How does cholesterol impact your heart?

Cholesterol - even LDL cholesterol - isn’t bad. LDL is an important transport protein that your body needs. But as it builds up in the lining of your blood vessels alongside fats and other substances, it can harden. This buildup is known as plaque.

Plaque in your blood vessels is very similar to a plaque on your teeth: it’s a hard, natural substance that is very difficult to get rid of. Plaque accumulates gradually over time, and as it does, it can narrow and weaken your blood vessels.

Plaque buildup in the blood vessels, also known as atherosclerosis, can lead to several cardiovascular issues:

  • High blood pressure: As your blood vessels narrow, your heart has to work harder to pump blood throughout your body, increasing your blood pressure. Uncontrolled high blood pressure can lead to kidney damage, heart attack, heart failure, stroke, and aneurysm.
  • Blood clots: Plaque can become unstable and break off, forming a blood clot. Clots can also narrow or block arteries.
  • Blockages: A blocked artery can occur when plaque buildup is extensive enough to completely block the flow of blood through that artery. Chest pain can be a symptom of a blocked coronary artery.

Plaque buildup can also lead to other conditions, including heart disease, kidney disease, and stroke. The risks of developing these conditions may increase if you have a family history of these diseases, smoke, or have diabetes.

What are the symptoms of high cholesterol?

You may be surprised that there are no symptoms of high cholesterol. There’s no way to know if you have high cholesterol without a blood test, especially if you have no other complications. And anyone can have high cholesterol, whether you’re male or female, thin or overweight, active or sedentary, young or old. While some factors may increase your risk of high cholesterol, everyone should have their cholesterol checked by their primary care doctor.

Your primary care doctor will check your cholesterol by ordering a lipid panel. This routine blood test will include measurements of HDL, LDL, and Triglycerides. Triglycerides are the most commonly occurring fat in your body and serve as a storage container for excess energy.

There are normal ranges for each measure, but the relationship between these numbers is also important. Doctors typically want to see your HDL higher than your LDL, but that number also needs to be in balance: you don’t want to see your HDL too high. High LDL alongside high triglycerides puts you at a greater risk of heart disease and stroke. Your primary care doctor will interpret your lipid panel for you.

How do you lower your LDL?

Plaque buildup happens gradually in your arteries; if you lower your cholesterol, you can stop further buildup from forming. While your dentist is able to scrape plaque off your teeth, it isn’t as easy to remove plaque from your blood vessels. However, lowering your LDL cholesterol can make the plaque smaller and more stable, halting further narrowing of your arteries and reducing your risk of blood clots.

If your LDL is too high, your primary doctor will make recommendations for lowering your cholesterol. Your doctor may recommend lifestyle changes, medications, or a combination of both. The approach your doctor takes will be tailored to your specific medical needs; however, common lifestyle recommendations include:

  • Exercise: Daily, moderate exercise can both lower your triglycerides and raise your HDL, helping your body flush LDL from your bloodstream.
  • Changing your diet: A diet that is lower in carbohydrates, low in saturated fats, high in fiber, and high in Omega-3s has been proven to reduce LDL cholesterol levels.
  • Limit alcohol and sugar: Heavy alcohol consumption can lead to high triglycerides and high LDL cholesterol. Diets high in sugar also contribute to the excess production of LDL and triglycerides.
  • Quit smoking or vaping: Smoking can increase LDL production while also decreasing the ability of HDL to remove it from your bloodstream. Vaping has similar effects on cholesterol.

Statins are a type of drug commonly used to treat high cholesterol. These drugs decrease your body’s natural production of LDL cholesterol while also increasing HDL, supporting your body’s ability to remove LDL cholesterol from the bloodstream. While statins are a proven and effective treatment for high cholesterol, they are not without side effects. Your primary care doctor can determine whether or not statins are an appropriate treatment for your high cholesterol.

High LDL cholesterol can lead to a number of health issues. But the only way to know you have high cholesterol is to have it checked. High cholesterol can impact anyone, so if you’ve never had your cholesterol tested, it’s time to schedule an appointment with your primary care doctor.

Primary care doctors at all five MedHelp locations are accepting new patients. Call the MedHelp clinic near you to schedule an appointment. We can help you find a doctor that meets your needs and fits your schedule.

Need your cholesterol checked?

High cholesterol is a condition that has no symptoms and can impact anyone. Schedule an appointment with your primary care doctor today to get tested. But if you don't have a primary care doctor, we can perform primary care lab tests on a walk-in basis at any of our five urgent care clinics.