Joseph R. Anticaglia MD
Medical Advisory Board
Some people think of cholesterol as a bad actor. Actually, your body needs cholesterol to function well. It helps to build cells, make vitamin D, hormones and it aids with digestion. However, too much of “bad” cholesterol can lead to clogged arteries, stroke and heart attacks.
Cholesterol is a waxy substance, a type of fat found in the blood and cells of the body. About 85% of cholesterol is manufactured by the liver and the rest comes from the food we eat, such as meat, poultry and dairy products.
Two types of cholesterol are: HDL (high density lipoprotein, “good or healthy” cholesterol) and LDL (low-density protein, “bad or lousy” cholesterol. A healthy lifestyle is essential to prevent an unacceptable increase in blood cholesterol.
Consider the situation of Henry, a 47 y/o car salesman who has gained 19 pounds over the past year. He has been under stress at work and at the urging of his wife, he was examined by his family doctor whom he hadn’t seen in 41/2 years.
“Well, what did the doctor say?”
“She told me how other people quit smoking, to exercise more, cut out fast foods for lunch and put me on this diet to lose weight. My heart and blood pressure are fine. Oh yes, her assistant drew blood and they’ll let me known the test results in a few days.”
“What tests?”
“I don’t know — something about cholesterol. What are we having for dinner?”
Henry’s doctor ordered cholesterol tests, commonly referred to as a lipid panel or lipid profile. They’re blood tests that measure fats and fatty substances (lipids) that circulate in the blood; in particular, cholesterol and triglycerides — a major form of fat in the body.
When a doctor orders a basic lipid panel, she/he wants to determine the concentration of the following four fatty substances in the blood:
- Total cholesterol
- LDL
- HDL
- Triglycerides.
Abnormal results can lead to treatment and lifestyle changes for patients, so they can act to avoid hardening of the arteries, metabolic diseases, stroke and heart disease. Ordinarily, you need to fast 12 hours before taking the lipid panel blood test.
measures the four fatty substances noted above. Below are the components of the panel:
1) Total or Complete Cholesterol
Total cholesterol (TC) is the sum of the lipids in the blood. Using a formula and the laboratory numbers of LDL, HDL and triglycerides, one can calculate your total cholesterol.
2) LDL (Low Density Lipoprotein)
The fatty deposits of this “bad” cholesterol can build up in the walls of arteries in the heart and brain forming plaques reducing blood flow to these vital organs. Sometimes the plaques break free leading to heart attacks or strokes. The lab report of a high LDL is a disturbing red flag.
3) HDL (High Density Lipoprotein)
HDL cholesterol is “good” or “healthy” cholesterol. It is thought that HDL removes unhealthy LDL deposits from the arteries and directs them back to the liver where they are broken down and eliminated from the body. A high HDL is a favorable sign.
4) Triglycerides
Triglycerides are lipids that account for the majority of the fat in the body. They are stored in fat cells for extra energy If you skip a meal and are low on energy, the body releases triglycerides and turns their unused calories into energy. The report of high triglycerides is another red flag.
Back to Henry; two days after the visit with his physician he received a “wake up” call concerning the results of the lipid panel. She informed him:
Total cholesterol is high
The bad cholesterol (LDL) is dangerously elevated
The good cholesterol is too low
The triglycerides are too high.
In no uncertain terms, Henry was told that he is a setup for a stroke or a heart attack. The message registered, but like many others, he’s still struggling to quit smoking completely.
References
Cleveland Clinic; Lipid Blood Tests
American Heart Association; What Your Cholesterol Levels Mean
Addendum
Adult laboratory goal values
Triglycerides: Less than 150 mg/dl
TC: 100-199 mg/dL for those over age 21
LDL: Less than 130 mg/dL for low risk coronary disease individuals.
HDL: Greater than 40 mg/dL
This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.