“You have high cholesterol.” This phrase is one that is uttered by many physicians on a daily basis but what does it mean and should you be concerned?
First, let’s stop thinking that cholesterol is bad. There is no such thing as bad cholesterol. Cholesterol is a hormone made for your body and it has many different functions: to repair arteries, make sex and stress hormones, help with Vitamin D synthesis and more. We are usually told that we need a total cholesterol level under 200 with the thought being that if you have any higher than that, it can gunk up your arteries and cause heart attacks, strokes, and a whole host of other bad things. I would generally agree with this, but your body doesn’t make high cholesterol to kill itself, but instead it does it to protect itself.
Let me give you an analogy: You notice that your living room needs to be repainted so you decide to spend the day painting it. First, you have to start with preparing the wall by spackling the cracks and holes. This process doesn’t take long. Next, you need to sand down the spackle, put tarps down on the carpet, tape the molding and open the paint cans. You’re finally able start painting and afterwards, you allow the paint to dry. After a few coats of paint, you have beautiful new walls. Now, let’s take this analogy and apply it to cholesterol. The way you spackle the holes in your walls is via the so-called “bad” (LDL) cholesterol. This “bad” cholesterol travels in your bloodstream and finds an artery that needs some repairing. It then lays down some spackle to fill in the hole. After this dries, you need to sand the spackle to make it uniform with the rest of the wall. This is where the so called “good” (HDL) cholesterol comes into play. It sands down the walls and puts the leftover spackle in the trash. The total of these two types of cholesterols, along with triglycerides is called your “total cholesterol”. High total cholesterol can become a bad thing when your body has many holes to repair. So your body, in all its wisdom, starts increasing your total cholesterol to keep fixing the walls but this does not address the underlying reason: why are the walls so damaged? Maybe it is due to inflammation, diet, medication, stress, etc. It is these specific areas that need to be addressed to prevent damage to your arteries. I usually find that the main culprit for high cholesterol is lifestyle and poor eating habits. After all, you do not have a deficiency of statins (drugs) in your diet.
When I prescribe treatments, I make sure they address multiple areas of the pathology of high cholesterol i.e. reduce inflammation, increase HDL, reduce LDL, and fix the underlying reason. Covering these areas can help mediate symptoms and cause your vasculature to heal, which in turn prevents your body from needing to increase its cholesterol. My first prescription for a patient is a personalized diet and lifestyle plan that is geared for you, the individual.
I cannot undersell the importance of diet and lifestyle changes as this is one of the big things I do in my medical practice. Some of the information that I use to make a health plan includes blood type, laboratory data, nutritional deficiencies, GI health, medical history, phenotypical expressions, SNP/ genetic information and much more.
So in brief, I like to meet my patients where they are at, address the underlying cause of why they have high cholesterol, educate my patients, and work on true prevention.
If you are interested in learning more or you would like to schedule an appointment with Dr. Brody please contact the Center of Excellence in Generative Medicine at 203-366-0526.