The Skinny on Large Cholesterol

November 19, 2011


We are bombarded by commercials about statins to lower cholesterol levels. We're made to believe that cholesterol is a bad thing and needs to be reduced as much as possible.

Numerous studies show the benefit of a healthy cholesterol profile. In fact, a recent study looking at muscle mass gain from exercise, showed that those with higher circulating cholesterol gained more muscle mass than those with lower cholesterol or on cholesterol lowering medications.

Low cholesterol levels are increasingly associated with increased risks for depression, anxiety, cancer, infection suicidal ideation and low libido.

There are numerous studies showing this link but the authors are all hesitant to say stop taking your statins as most patients are diagnosed as having statin deficiencies by their physicians.

If we look at studies and healthy physiology carefully, we can find that healthy people (people who are still insulin sensitive) have large bouyant LDL particles. As people become more insulin resistant and therefore closer to being a diabetic, they develop smaller LDL particles that are dense. Small, dense LDL particles are atherogenic, meaning they can lead to plaque in the vessels.

The biggest risk factor for a sudden cardiac event or MI, is small dense LDL and elevated levels of C reactive Protein, not high levels of LDL. Yet, the majority of physicians do not even test for these things. The reason being high levels can be lowered with statins. The treatment for an elevated C reactive protein( or CRP) and dense LDL are not treated with a single pharmaceutical. And, since the pharmaceutical industry has spent billions "educating" physicians how to handle cholesterol issues, they focused on the single issue they had a drug for.

LDL levels can be affected by particle size which is actually more important than the number. Low cholesterol is often associated with small dense LDL. Particle size is dependent upon a few things, one of them being insulin resistance or IR.
IR is related to how much insulin is needed to handle a specific amount of carbohydrate or sugar. The more needed, for a certain amount due to resistance or attenuation, the greater the risk of triglyceride and VLDL formation and hence small dense LDL.

In my Chicago area office, I always use a Lipid subfraction test on my patients. A standard lipid profile is missing vital information.

I treat small dense LDL and elevated CRP levels with a combination of dietary and lifestyle changes. If the LDL is very small and dense, I might recommend a liver cleanse
as the IR occurs at the liver..

If you have not had a lipid subfraction test, you don't know your real cardiac profile or risks.