The Good Cholesterol

Dr. Aram Neuschatz is an inpatient medicine specialist at Lutheran Medical Center.

If you are a person who maintains a healthy body weight, exercises aerobically for at least 150 minutes (about 2 and a half hours) a week, eats a healthy diet consisting of a variety of colorful fruits and vegetables, low in saturated fats and devoid of refined carbs and sugar,  and if you are a non-smoker who is not exposed to secondhand smoke who consumes alcohol only in moderation, then you do not need to read this article. If, however, your lifestyle choices have room for improvement, you may want to read on.  

Many of us have been conditioned to worry about our cholesterol levels and the associated risk of heart disease and stroke, but is cholesterol so bad?  

The liver is the main producer and regulator of cholesterol. For most, dietary intake of cholesterol from animal sources is a small contributor to our overall cholesterol levels.   

Cholesterol is a necessary substance in our bodies responsible for cell structure and function. It is a building block of bile, which is needed for absorption of fat-soluble vitamins A, D, E and K from the diet. It is used in the production of cortisol, a stress hormone, as well as the production of the sex hormones estrogen and testosterone.  

About 20 percent of the body’s cholesterol is in the brain, which has its own cholesterol metabolism. It insulates nerve cells and is necessary for brain synapse and neurotransmitter function. As a bonus, cholesterol is converted to vitamin D when our skin is exposed to sunlight. These are things that our bodies just cannot do without it. 

Low density lipoprotein (LDL – aka “bad” cholesterol) delivers cholesterol to our cells. High density lipoprotein (HDL – aka – “good” cholesterol) picks up excess LDL and returns it to the liver where it is reprocessed. 

Of course, there can be too much of a good thing. Elevated levels of LDL contribute to atherosclerosis (hardening of the arteries) which can lead to heart attack or stroke. Higher levels of HDL help clear away LDL, lowering the risk of atherosclerosis. A simple fasting blood test called a lipid panel can determine your LDL and HDL. 

If your LDL is too high and HDL is too low, start with the above lifestyle changes to improve their balance. Sometimes our genetic makeup dictates the result of our lipid panel. You can calculate your risk of heart disease or stroke using a risk calculator. Here is one provided by the American Heart Association:  

Many studies have shown that the use of cholesterol-lowering statins reduces the risk of heart disease and stroke in high-risk individuals. If you read this far, it might be time to speak to your health care provider about your risk. 

Dr. Neuschatz is an internal medicine physician at Lutheran Medical Center. 

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