Bill Sias MPHC, Pn1, SFMA, FMSC2, YBT, FCS, M-CPT
This isn’t medical advice, and I’m not your doctor (unless I am, in which case, hi!). Talk to your healthcare provider before making any changes.
Let’s get one thing out of the way — arterial plaque is bad news. It’s like pouring wet cement into your blood vessels and hoping for the best. Over time, that plaque builds up, narrows your arteries, and sets the stage for heart attacks and strokes. Nobody’s arguing that.
But let’s talk about cholesterol — the molecule that gets dragged into the courtroom every time someone talks about heart health.
High cholesterol can be associated with plaque. Sure. But it’s not the whole story. Your cholesterol number is like the gas gauge in your car — useful, but not the same thing as opening the hood and seeing what’s going on inside.
Here’s the thing: cholesterol by itself doesn’t cause arterial plaque. It’s more like an innocent bystander caught at the scene of a crime. Sometimes the body ramps up cholesterol production in response to other issues: inflammation, oxidative stress, metabolic dysfunction — the real thugs lurking in the background.
So, when your doctor zeroes in on your cholesterol number and immediately prescribes a statin, you’ve got to ask:
“Is your doctor treating a patient or a number?”
Because treating a number is easy — prescribe, adjust dosage, retest, repeat. But treating you — the human with a life, habits, genetics, and a story — that’s harder. It involves asking the messy questions:
- Why is cholesterol high?
- Is there evidence of actual arterial plaque? (Hint: a coronary calcium scan can tell you.)
- How’s your inflammation? Your blood sugar? Your stress?
- Are you metabolically healthy, or just medicated into a “safe” lab result?
Here’s a truth bomb: plenty of people with “normal” cholesterol still end up with heart disease. And plenty of folks with “high” cholesterol live long, plaque-free lives. Context matters.
What Should You Do?
Instead of panicking over a single lab number:
- Ask for a complete lipid panel, which should include:
- Total Cholesterol — the grand total, but it doesn’t tell the whole story.
- LDL Cholesterol (Low-Density Lipoprotein) — often labeled “bad” cholesterol, but context matters (particle size and number are more important).
- HDL Cholesterol (High-Density Lipoprotein) — the so-called “good” cholesterol, helps clear excess cholesterol from the bloodstream.
- Triglycerides — fats in the blood; high levels can signal insulin resistance and metabolic trouble.
- VLDL (Very Low-Density Lipoprotein) — carries triglycerides, often calculated rather than directly measured.
- Non-HDL Cholesterol — total cholesterol minus HDL; a broader marker of all the “bad” lipoproteins.
- LDL Particle Number (LDL-P) and ApoB (Apolipoprotein B) — these are advanced markers that tell you how many particles are floating around, which is more predictive of plaque than just the LDL cholesterol number itself.
Quick note on particle size vs. particle number:
Imagine cholesterol particles like cars on a freeway. Big, fluffy LDL particles are like semis — fewer in number and less likely to crash into your artery walls. Small, dense LDL particles are like speeding motorcycles — more numerous, more dangerous, and more likely to cause a pileup (i.e., plaque). Standard cholesterol tests don’t tell you the difference — but advanced tests (like LDL-P and ApoB) do.
- Consider getting a coronary artery calcium (CAC) scan — it shows real plaque, not guesses.
- Look at inflammatory markers like CRP (C-Reactive Protein) — inflammation is the real matchstick in the powder keg.
- Dial in your lifestyle — food quality, strength training, sleep, and stress management aren’t just buzzwords; they’re the roots of actual heart health.
And maybe, just maybe, find a healthcare provider who’s interested in treating you, not just your blood work.
Ready for a Real Conversation About Your Health?
If you’re tired of being reduced to a lab number, I help women 40 and up dig deeper into what’s really driving their health. We’ll look at your full picture — labs, movement, nutrition, and lifestyle — and map out a strategy that’s about you, not just your cholesterol.
[Schedule a Consultation] and let’s get under the hood.
Cholesterol: The Number We Love to Hate
Let’s get one thing out of the way — arterial plaque is bad news. It’s like pouring wet cement into your blood vessels and hoping for the best. Over time, that plaque builds up, narrows your arteries, and sets the stage for heart attacks and strokes. Nobody’s arguing that.
But let’s talk about cholesterol — the molecule that gets dragged into the courtroom every time someone talks about heart health.
High cholesterol can be associated with plaque. Sure. But it’s not the whole story. Your cholesterol number is like the gas gauge in your car — useful, but not the same thing as opening the hood and seeing what’s going on inside.
Here’s the thing: cholesterol by itself doesn’t cause arterial plaque. It’s more like an innocent bystander caught at the scene of a crime. Sometimes the body ramps up cholesterol production in response to other issues: inflammation, oxidative stress, metabolic dysfunction — the real thugs lurking in the background.
So, when your doctor zeroes in on your cholesterol number and immediately prescribes a statin, you’ve got to ask:
“Is your doctor treating a patient or a number?”
Because treating a number is easy — prescribe, adjust dosage, retest, repeat. But treating you — the human with a life, habits, genetics, and a story — that’s harder. It involves asking the messy questions:
- Why is cholesterol high?
- Is there evidence of actual arterial plaque? (Hint: a coronary calcium scan can tell you.)
- How’s your inflammation? Your blood sugar? Your stress?
- Are you metabolically healthy, or just medicated into a “safe” lab result?
Here’s a truth bomb: plenty of people with “normal” cholesterol still end up with heart disease. And plenty of folks with “high” cholesterol live long, plaque-free lives. Context matters.
What Should You Do?
Instead of panicking over a single lab number:
- Ask for a complete lipid panel, which should include:
- Total Cholesterol — the grand total, but it doesn’t tell the whole story.
- LDL Cholesterol (Low-Density Lipoprotein) — often labeled “bad” cholesterol, but context matters (particle size and number are more important).
- HDL Cholesterol (High-Density Lipoprotein) — the so-called “good” cholesterol, helps clear excess cholesterol from the bloodstream.
- Triglycerides — fats in the blood; high levels can signal insulin resistance and metabolic trouble.
- VLDL (Very Low-Density Lipoprotein) — carries triglycerides, often calculated rather than directly measured.
- Non-HDL Cholesterol — total cholesterol minus HDL; a broader marker of all the “bad” lipoproteins.
- LDL Particle Number (LDL-P) and ApoB (Apolipoprotein B) — these are advanced markers that tell you how many particles are floating around, which is more predictive of plaque than just the LDL cholesterol number itself.
Quick note on particle size vs. particle number:
Imagine cholesterol particles like cars on a freeway. Big, fluffy LDL particles are like semis — fewer in number and less likely to crash into your artery walls. Small, dense LDL particles are like speeding motorcycles — more numerous, more dangerous, and more likely to cause a pileup (i.e., plaque). Standard cholesterol tests don’t tell you the difference — but advanced tests (like LDL-P and ApoB) do.
- Consider getting a coronary artery calcium (CAC) scan — it shows real plaque, not guesses.
- Look at inflammatory markers like CRP (C-Reactive Protein) — inflammation is the real matchstick in the powder keg.
- Dial in your lifestyle — food quality, strength training, sleep, and stress management aren’t just buzzwords; they’re the roots of actual heart health.
And maybe, just maybe, find a healthcare provider who’s interested in treating you, not just your blood work.
Ready for a Real Conversation About Your Health?
If you’re tired of being reduced to a lab number, I help people dig deeper into what’s really driving their health. We’ll look at your full picture — labs, movement, nutrition, and lifestyle — and map out a strategy that’s about you, not just your cholesterol.
Reach out anytime—we’re here to help. Contact us for a free strategy session and let’s get under the hood. 231-329-8835 Bar.and.Plate@gmail.com