Wednesday, November 30, 2016
Wisdom Wednesday: Lipid Panel
There are four basic markers in the lipid panel – total cholesterol, triglycerides, HDL and LDL. This week we focus on cholesterol only as there is so much misinformation about this blood test.
The laboratory range for the total cholesterol is 130-200 mg/dL while the functional range is 180-220 mg/dL. Cholesterol is a component of cell membranes, the myelin sheath and bile salts. It is the precursor for steroid hormones. Every cell in the body is able to produce cholesterol. The diet provides only 25% of the total cholesterol in the body as 75% is synthesized in the liver, intestines and skin.
The primary focus of general practice and cardiology has been on lowering total cholesterol as the key to preventing cardiovascular disease. Physicians often believe that the lower the cholesterol and LDL levels the better. However, there are several problems associated with reduced cholesterol.
Low cholesterol weakens cellular membranes and the quality of the myelin sheath that covers and protects the peripheral nervous system. It impairs memory and the ability to think. It results in poor steroid hormone production (e.g. cortisol, estrogen, testosterone, progesterone). It also impairs the immune system.
Levels below 180 mg/dL are associated with a 200% increase in cerebrovascular accidents, lung disease, depression, suicide and addictive behavior. A 300% increase in liver cancer is also noted.
High cholesterol (above 220mg/dL) can indicate poor metabolism of fats and impaired gallbladder function. It can occur in the early stages of diabetes, insulin resistance and metabolic syndrome. As noted above, it can be indicative of atherosclerosis but also occurs with hypothyroidism, poor diet and in hypertension.
The most common cause of high cholesterol is a diet high in refined carbohydrates. The second most common cause is hypothyroidism. Third is dysbiosis – unhealthy bacteria produce an estrogen analog as a waste product. Although it is not true estrogen, the body resorbs this pseudo hormone from the colon. Then the estrogen analog stimulates cholesterol production in the liver. Last is FH (familial hyperlipidemia) – that’s a genetic issue that causes high cholesterol and will be discussed when we look at the L(p)a serum test.
The Bottom Line:
Total cholesterol has a healthy range. Levels above or below that range of 180-220 mg/dL are of concern. The key is to determine why cholesterol is abnormal and correct that imbalance, not just drive the cholesterol down with statin drugs.