Cholesterol is important in determining your cardiovascular health outcomes. This is a parameter that is checked when you get your yearly physical, and something that is of important to keep within the indicated ranges per the guidelines as established by the American Heart Association.

As is common with many chronic disease states, dietary and lifestyle interventions are going to be the first recommendation for control. Medications come with cost and side effects, and if this is something that can be avoided, then it is valued to be able to do so. At Medication Management and Piedmont Pharmacy Care Network with our HealthMapRx program, we hope to help you understand and take a deep dive into your bloodwork so that you can take agency and ownership of what your values mean, and how you can impact them with interventions in your life or with medication.

The four values typically presented are your total cholesterol, HDL (high density lipoproteins), LDL (low density lipoproteins), and triglycerides. The HDL is the “good cholesterol” meaning that it is a carry protein of the LDL- cholesterol outside of the blood vessels where it does not belong into the liver to be recycled. It also helps to clean up the inner lining of the walls to stop the build up. Without this clean-up, there can be plague formation and atherosclerosis that eventually leads to heart attacks and stroke.

When looking at your LDL values (low density lipoprotein), you want to pay attention to not only the value stated that recommends LDL to be below 100, but to pay attention to LDL particle size as well. Most physicians will refer to your particle size being “fluffy”. You want that particle size HIGH (and fluffy) so that it’s not able to penetrate through the inner walls into your blood vessels. If your LDL value is higher than you would like it to be, but your particle size is high, then you are still in a good spot because it might not be able to get through. If your LDL is high and your LDL-particle size is low, then that means that it’s small and can get through those walls.

The other parameter to look at is your LDL particle NUMBER, which is referenced as your VLDL. You want your particle number to be low because with less particles, there is less penetration. To recap:

We want our LDL value below 100 (low). We want our LDL-particle size to be fluffy and large. We want our LDL particle number to be below 30 (low). Low number, large size keeps it out of the blood vessels where it presents as problems.

The last thing to monitor when reviewing your cholesterol is your blood glucose and inflammatory markers. If you have a high LDL, but your particle size is large, and your blood glucose and inflammation is low, then you have absolutely nothing to worry about. It might flag that your LDL is high, but that is not an indicator of high cardiovascular outcomes. We want to look at the full picture before making assumptions and starting medications.

At the end of the day, if your numbers are off, then it’s important to be proactive and take various medications that are on the market for cholesterol. Those include statins, Niacin, Gemfibrozil, or Fenofibrate. Your physician can help you make that distinction as well.

If you are in the North Carolina area, and taking a statin medication, then you might qualify for one of our trials, and can find that information at THIS LINK.

If you would like to reach out to us to see if you can participate, then feel free to fill out this form and we will be in touch asap!