You get your cholesterol checked at your annual physical, and a few days later, you get back your results. If you\u2019ve ever looked down the list of acronyms and felt at a loss of how to make sense of what you\u2019re looking at, you\u2019re not alone. Most lab reports list several numbers, and it\u2019s not always obvious which ones matter most.<\/p>\n
Simply put, not all cholesterol is bad, and the total number on its own doesn\u2019t tell you the whole story.<\/p>\n
Cholesterol numbers are a way to estimate your risk of a heart attack. Of everything on your chart, LDL cholesterol is the most important one to watch. This is considered your \u201cbad cholesterol\u201d because high levels are linked to plaque buildup in your arteries, which increases your risk for heart attack and stroke. For most people, an LDL under 100 is ideal. If you have heart disease or diabetes, your doctor may want it even lower. If your LDL is above 130, that\u2019s when treatment usually becomes part of the conversation.<\/p>\n
HDL cholesterol is protective. This is the \u201cgood cholesterol\u201d that helps remove LDL from your bloodstream. Higher is better here. For men, you want HDL above 40, and for women, above 50. However, a strong HDL number doesn\u2019t give you a free pass to partake in an all-you-can-eat steak and butter diet. Your HDL score doesn\u2019t tell your whole health story \u2013 only a piece of it.<\/p>\n
Triglycerides are a separate type of fat in your blood. They\u2019re influenced heavily by what you eat and drink, especially sugar and alcohol. Normal is under 150, while levels above 200 start to become concerning. High triglycerides can increase cardiovascular risk and may also be a clue that your metabolism needs attention. Triglycerides over 500 can cause pancreatitis, a serious and painful condition.<\/p>\n
Total cholesterol is the sum of LDL, HDL, and a portion of your triglycerides. This is a broad summary number, and it\u2019s the least useful on its own. For example, you can have a high total cholesterol because your HDL is high, which is actually a good thing. That\u2019s why doctors focus more on the individual components.<\/p>\n
When it comes to your cholesterol levels, genetics play a big role. Some people eat well and exercise regularly and still have high cholesterol because their liver produces too much. Others can get away with a less-than-perfect diet and have normal numbers. Diet, weight, physical activity and smoking all matter, but they\u2019re not the whole picture.<\/p>\n
If it\u2019s determined your cholesterol needs treatment, your doctor will consider your age, blood pressure, smoking status, diabetes and family history of heart disease, in addition to your cholesterol levels. Two people with the same LDL might get different recommendations based on their overall risk. Lifestyle changes are always the first step \u2013 replacing saturated fats (butter, fatty red meat, full fat dairy) with unsaturated fats (olive oil, nuts, seeds, avocado, fish), cutting down on refined carbs and added sugars, exercising more, and losing weight if needed. If that\u2019s not enough, statins and other medications can bring your numbers down and reduce your risk.<\/p>\n
If you take away one thing, it\u2019s that LDL and HDL are the numbers that matter most. If your LDL is high or your HDL is low, talk to your doctor about what you can do. Cholesterol is one of the most treatable risk factors for heart disease, but only if you know where you stand.<\/p>\n
This column does not establish a provider\/patient relationship and is for general informational purposes only. This column is not a substitute for consulting with a physician or other health care provider.<\/p>\n
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