Have you ever received results from a lipid panel test results and had no idea what those numbers meant? If they were even good or bad? Or the difference between good cholesterol and bad cholesterol? You are not alone.
Out of all the topics related to cardiovascular disease, cholesterol is by far the most controversial and confusing. Cholesterol is a soft waxy substance that is manufactured in the body by the liver. It also comes from dietary sources, specifically animal products such as meat and dairy.
The Lipid Panel Test & Cholesterol
Although cholesterol has been criticized for many years as being a primary culprit of cardiovascular disease, it’s actually extremely important for your health. It plays a role in building new cells, regulating nutrients into and out of your cells, hormone production, and synthesizing vitamin D from UV rays from the sun.
When you have a lipid panel blood test, it measures your LDL, or “bad,” cholesterol, your HDL, or “good,” cholesterol, and the amount of blood fat. However, the problem with standard lipid panel tests is it doesn’t paint a full picture. Don’t worry, I’m going to tell you about the problem with standard lipid panel tests, how a comprehensive lipid panel can give you the full picture of your risk for heart disease, and how you CAN lower your risk for heart disease. First, let’s talk about what the lipid panel blood test measures.
What does a Lipid Panel Test Measure?
Your blood can tell a lot about your health, from red and white blood cell counts, to hormone levels, to kidney function, to enzyme levels, and your risk for heart disease. To determine your heart disease risk, your doctor may order a lipid panel blood test.
A lipid panel blood test measures the amount of lipoproteins – or lipids – in your blood.1 Lipoproteins are fatty substances used as energy by your body. The lipoproteins measured in a lipid panel include:
- LDL (low-density lipoprotein), also known as “bad cholesterol.”
- HDL (high-density lipoprotein), also known as “good cholesterol.”
- Total cholesterol
- Triglycerides, which make up most of the fat cells in your body.2
Lipid panel blood tests may also measure the ratio between total cholesterol and “good cholesterol” and the ratio of “good cholesterol” and “bad cholesterol.”
LetsGetChecked’s home diabetes testing is a great way to test hemoglobin A1c levels. They also offer at-home diabetes and heart test, which also tests triglycerides, cholesterol, HDL cholesterol, LDL, cholesterol, and HDL% of total cholesterol. You can also get a basic at-home lipid panel test. The results are available online so you can share them with your functional medicine doctor.
However, what’s not measured in traditional lipid panel tests is the size of the lipoproteins. A standard lipid panel blood test only measures total LDL and HDL cholesterol levels. It does not distinguish the size of the lipoprotein. I’ll talk more about this and the types of lipoproteins later. Now, let’s discuss cholesterol and what it does.
What is Cholesterol?
As I mentioned earlier, cholesterol is confusing, and understanding your cholesterol numbers from a lipid panel test can be even more difficult. It doesn’t have to be this way.
Think of cholesterol as wax, because it actually has the texture of a waxy substance. It is one of two types of lipids, along with triglycerides. The difference between triglycerides and cholesterol is that triglycerides are unused calories that provide your body with energy, while cholesterol is used to build cells and hormones.
Your body needs cholesterol to build cells, create hormones, and synthesize vitamins. Cholesterol comes from two sources: your liver and the food you eat, primarily in animal products and dairy food. I do not recommend anyone eat cow’s dairy because it contains whey and casein, which is a protein that has the same structure as gluten. As you know if you’ve read anything about The Myers Way®, gluten should be avoided as it can lead to leaky gut.
Healthy fats such as olive oil, avocados, and wild-caught fish, have been shown to improve cholesterol levels. Saturated fats from fatty meat, fried foods, processed snacks, and margarine contain high levels of triglycerides, which contributes to the hardening of the arteries and increases the risk of heart disease.
Causes of High Cholesterol
Because there are no symptoms of high cholesterol, most people don’t take it seriously until they have a heart attack or stroke. Some causes of high cholesterol are out of your control, such as genetics. You can even be born with high cholesterol.3
The good news is that most factors of high cholesterol are in your control, and you can lower your cholesterol levels. These include:4
- Having a poor diet: The Standard American Diet is one of the most unhealthy diets you can eat. It is full of processed and inflammatory foods that are typically high in sodium, trans fats, refined sugars, and lacks healthy fats.
- Being overweight: If you have a body mass index (BMI) of 30 or higher, you are at a much higher risk of having high cholesterol!
- A sedentary lifestyle: Exercise boosts your body’s HDL cholesterol, which can help lower your LDL cholesterol levels.
- Smoking: The plaque from cigarettes clogs your arteries and lowers your HDL cholesterol levels.
- Alcohol consumption: Drinking too much alcohol can increase your total cholesterol levels.
Changing your diet, losing weight, exercising for 30 minutes a day, quitting smoking, and not drinking alcohol can lower cholesterol levels and decrease your risk of heart disease. I recommend a diet full of organic whole foods. I understand that can be expensive, so at the very least your meat should come from grass-fed and organic sources.
Let’s discuss how cholesterol and triglycerides are transported through your body.
What are Lipoproteins?
Cholesterol and triglycerides cannot do their jobs without proper transportation through the bloodstream. These lipids attach to proteins as they are carried through your blood. This combination is known as lipoproteins.
To fully understand your lipid panel blood test, you need to know the difference between the types of lipoproteins. There are four types of lipoproteins: low-density lipoproteins (LDL), high-density lipoproteins (HDL), very low-density lipoproteins (VLDL), and chylomicrons, however a traditional lipid panel test only measures total cholesterol and the levels of triglycerides, HDL cholesterol, and LDL cholesterol.5
It does not measure VLDL and chylomicrons.
High-Density Lipoproteins (HDL)
These are the smallest lipoprotein with a diameter of 10.8 nanometers and have the highest protein to lipid ratio. High-density lipoproteins are considered “good cholesterol” because it absorbs cholesterol and carries it back to the liver. The liver then flushes it from the body. Optimal levels for HDL is above 60 mg/dl.6
Low-Density Lipoproteins (LDL)
Low-density lipoproteins are much larger than HDL with a diameter of 22 to 29 nm. These lipoproteins have a core that contains large amounts of cholesterol and triglycerides. LDL is considered “bad cholesterol” because it builds on the walls of your arteries, making them hard and narrow. Optimal levels of LDL are below 100 mg/dl. If you have diabetes, optimal LDL levels are below 70 mg/dl.
Very Low-Density Lipoproteins (VLDL)
These lipoproteins have a diameter of 30 to 80 nm. They are synthesized by the liver and have one job: to carry triglycerides to your tissues. VLDL is considered “bad cholesterol” as well and is similar to low-density lipoproteins, however the difference is LDL mainly carries cholesterol to your tissues while VLDL primarily carries triglycerides. Your VLDL is not measured in a lipid panel blood test, since there isn’t a way to directly measure VLDL levels.7 Instead, your lipid panel measures the amount of triglycerides in your blood, which does not give an accurate count of VLDL cholesterol. Optimal triglyceride levels are below 150 mg/dl.
These are the largest lipoproteins with a diameter of 75 to 500 nm, and considered “bad cholesterol” because they actually contain very little cholesterol. These ultra-low density lipoproteins are about 95% triglycerides and contain only 1% of cholesterol. Chylomicrons are synthesized in the intestines and transported to the liver. When you eat a fatty meal, your blood is so full of chylomicrons that it makes it look milky.8 Chylomicrons are not measured in a standard lipid panel.
The Problem With a Standard Lipid Panel Test
Most of us have had a lipid panel blood test and were told all these different numbers. The problem with this is that conventional medicine only looks at the total number because that’s all the information they have.
A standard lipid panel measures the amounts of total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. Conventional medicine focuses on LDL numbers, however many people diagnosed with heart disease have LDL levels that aren’t particularly high.
Not all LDL cholesterol is created equal. Remember, each of the four lipoproteins have a different size. The smaller the LDL particle, the easier it is for it to get into the arteries. Larger LDL particles have a much harder time getting into the narrow canal of your arteries.
Standard lipid panel blood tests do not measure the size of these lipoproteins, nor do they measure VLDL and chylomicrons. So you’re not getting a clear picture of your risk for heart disease. This is why I recommend getting an advanced lipid panel blood test.
An advanced lipid panel analyzes the makeup of HDL and LDL cholesterol, which allows for measuring the subtypes such as VLDL and chylomicrons. Talk with your functional medical doctor about getting an advanced lipid panel blood test. I used advanced lipid testing from the Cleveland Heart Lab to help my patients get a better picture of their risk for heart disease.
How to Lower Your Risk of Heart Disease
You don’t have to wait on an advanced lipid panel test or be told you have high cholesterol to take steps to lower your risk of heart disease. I recommend following five steps to help support healthy heart function and optimize your cardiovascular health.
1. Optimize Your Diet
A diet high in processed foods, refined sugars, and unhealthy fat will do extensive damage to your heart over time. That’s why it’s important to eliminate toxic and inflammatory foods and eat a nutrient-dense diet that includes:
- Wild-caught fatty fish such as salmon
- Green leafy vegetables
- Healthy fats such as avocado, olive oil, and wild-caught fish. Almonds, pecans, and walnuts are also good sources of healthy fat, however only if you’ve done an elimination diet and can tolerate nuts.
- Foods high in magnesium such as spinach and walnuts
- Dark chocolate
Your body doesn’t naturally produce fatty acids such as omega 3, which has been shown to lower LDL cholesterol levels, so it’s important to get these vital nutrients through food or supplements. Foods such as wild-caught salmon contain high levels of omega-3s, which support a healthy blood flow and viscosity and can support an optimal hormonal balance.
2. Reverse Your Autoimmunity
Autoimmunity and heart disease are closely linked and inflammation is a major driver of autoimmune disease. The good news is that you CAN reverse your autoimmunity.
By following The Myers Way®, my simple and proven dietary and lifestyle protocol, you can reclaim your health by addressing the true underlying causes of autoimmune disease. I have seen the success of this protocol firsthand, in my clinic and as a patient myself, and now people everywhere can benefit from this medical breakthrough.
3. Relieve Your Stress
Relieving your stress isn’t always easy. Struggling with work-life balance and our constant connection to technology makes it even more difficult.
Our stress response evolved primarily as a means of self-preservation from our ancestors facing immediate, life-threatening situations. Unfortunately, that response isn’t ideal for the type of chronic, ongoing stress we face today. That’s why it’s so crucial to make time to de-stress!
Some of my favorite stress-reducing activities include:
- Meditation and breathing exercises – I recommend the app HeartMath.
- Going for a hike with my family – getting some fresh air and physical activity is key.
- Sweating and detoxing in my infrared sauna.
- Laughing and playing with my daughter Elle – it’s true that laughter is the best medicine.
4. Balance Your Hormones Naturally
For women, perimenopause and menopause can increase your risk of heart disease. Once you reach perimenopause your estrogen levels decrease, which can increase your risk of heart disease.
Hormone replacement therapy is often used to treat the decreased levels of estrogen during menopause. However, there’s still some debate over whether or not hormone replacement therapy benefits your heart health or offers no benefits. In fact, a study conducted by the Women’s Health Initiative found that there were no benefits from hormone replacement therapy, and that women given synthetic hormone replacement therapy showed a slight increase for stroke and blood clotting.9
If you’re experiencing hormonal imbalance symptoms, I recommend discussing non-synthetic hormone therapy with your functional medicine doctor or considering natural solutions.
5. Support Your Heart Health
Nutrients such as CoQ10 and activated B vitamins support healthy cholesterol levels, circulation, and vascular health and neutralize oxidative damage from free radicals.
Cholesterol is very complex and cannot be truly measured by a total number. Now that you have the tools to take control of your heart health, don’t wait. Getting an advanced lipid panel test and talking with your functional medicine doctor will give you a better understanding of your risk of heart disease. Increasing your knowledge, making lifestyle changes and supporting your heart health is the best defense against heart disease in women.
FAQs About Lipid Panel Tests
What is a normal lipid panel test?
What is a normal lipid panel test?
A lipid panel blood test measures lipids such as cholesterol, triglycerides, high-density lipoproteins (HDL cholesterol, or “good cholesterol,” and low-density lipoprotein (LDL cholesterol, or “bad cholesterol”).
What are optimal ranges for a lipid profile test?
What are optimal ranges for a lipid profile test?
Optimal ranges for total cholesterol are 100-129 mg mg/dl on a lipid panel blood test. Optimal levels of LDL are below 100 mg/dl. If you have diabetes, optimal LDL levels are below 70 mg/dl. For triglycerides, optimal levels are below 150 mg/dl, while optimal levels for HDL are above 60 mg/dl.
What is a lipid panel blood test for?
What is a lipid panel blood test for?
A standard lipid panel is used to assess your risk of heart disease by looking at the levels of cholesterol in your blood. Conventional medicine focuses on LDL numbers, however many people diagnosed with heart disease have LDL levels that aren’t particularly high. An advanced lipid panel test looks at the size of the lipoproteins as well as the number of them in your blood. It can paint a better picture of your heart disease risk.
- Lipid Panel Overview. Healthwise Staff. University of Michigan Health. 2020.
- Cholesterol Testing and the Lipid Panel. Matthew Hoffman MD. WebMD. 2021.
- What to Do When High Cholesterol Runs in Your Family. Seth Shay Martin, M.D., M.H.S.. Johns Hopkins Medicine. 2021.
- High Cholesterol Overview. Mayo Clinic. 2021.
- Introduction to Lipids and Lipoproteins. Kenneth R. Feingold, MD. Endotext. 2000.
- Lipid Panel Test Overview. Lab Tests Online. 2021.
- CLDL Cholesterol Overview. MedlinePlus. 2021.
- Medical Definition of Chylomicron. Melissa Conrad Stöppler, MD. MedicineNet. 2021.
- Menopausal Hormone Therapy and Health Outcomes During the Intervention and Extended Poststopping Phases of the Women's Health Initiative Randomized Trials. JoAnne E. Manson, et al. JAMA vol. 310. 2013.