Have you ever received results from a lipid panel blood test 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’re not alone. Interpreting these lipid panel tests can be confusing!

Out of all the topics related to cardiovascular disease, cholesterol is by far the most controversial and confusing. It’s been portrayed as the villain of cardiovascular disease, but the truth is your body needs cholesterol. Your liver makes cholesterol. It’s important for hormone production, vitamin absorption, and even building healthy cells. It also comes from dietary sources, specifically animal products such as meat and dairy. 

When it comes to understanding cholesterol levels and what they really mean for your health, a traditional lipid panel blood test doesn’t always tell the full story. That’s what we’re diving into today in this article. 

The Lipid Panel Test & Cholesterol

Although for years, many have criticized cholesterol as public enemy number one of cardiovascular disease, it’s actually extremely important for your health. It plays a role in building new cells and regulating nutrients into and out of your cells. It’s also involved in hormone production and synthesizing vitamin D from UV rays from the sun.

A lipid panel blood test measures your LDL ('bad' cholesterol), HDL ('good' cholesterol), and blood fat levels. However, the problem with standard lipid panel tests is it doesn’t paint a full picture. 

No need to worry — in this article, I’ll tell you about the problem with standard lipid panel tests. You’ll also learn 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. It tells us about your red and white blood cell counts, hormone levels, kidney function, 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 tests, which test triglycerides, cholesterol, HDL cholesterol, LDL, cholesterol, and HDL% of total cholesterol. You can also get a basic at-home lipid panel test. You can access the results online and share them with your functional medicine doctor.

Nevertheless, traditional lipid panel tests don’t measure lipoprotein size. 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. For now, let’s discuss cholesterol and what it does.

What is Cholesterol?

As I mentioned earlier, cholesterol is confusing. 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 give your body energy. Meanwhile, 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 don’t recommend anyone eat cow’s dairy because it contains whey and casein, which is a protein that has the same structure as gluten. If you’ve read anything about The Myers Way®, you’ll know gluten should be avoided as it can lead to leaky gut.

Healthy fats such as olive oil, avocados, and wild-caught fish, can improve your cholesterol levels. On the other hand, saturated fats from fatty meat, fried foods, processed snacks, and margarine contain high levels of triglycerides. These contribute to the hardening of the arteries and increase the risk of heart disease.

Causes of High Cholesterol

Because there are no symptoms of high cholesterol, most people don’t take it seriously. That is, 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? You control most factors affecting cholesterol and can take steps to lower your levels. These factors include: (4)

• Having a poor diet: The Standard American Diet is one of the most unhealthy diets you can eat. It contains processed and inflammatory foods typically high in sodium, trans fats, and refined sugars. It also lacks healthy fats.

• Being overweight: If you have a body mass index (BMI) of 30 or higher, you’re at a much higher risk of having high cholesterol!

• A sedentary lifestyle: Exercise boosts your body’s HDL cholesterol. This in turn, can help lower your LDL cholesterol levels. Another good reason to lace up those tennis shoes and work up a sweat!

• Smoking: Smoking damages blood vessels, leading to plaque buildup in the arteries and lowering HDL (good) cholesterol levels. This increases the risk of heart disease.

• Alcohol consumption: Drinking too much alcohol can increase your total cholesterol levels.

So, 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.

Bile Salts and Cholesterol 

We’ve already established that your body needs cholesterol to function properly. But did you know that one of cholesterol’s biggest jobs is to make bile salt?

Bile salts are like your digestive system’s cleaning crew. They’re made in your liver from cholesterol. Then they’re stored away in your gallbladder to wait for you to eat a fatty meal. 

Once you do, they spring into action! Your gallbladder releases bile — which contains bile salts — into your small intestine. There, they help break down fats so your body can absorb them. But that’s not all! 

Bile salts don’t just help with digestion. They play an important role in cholesterol balance. Once bile has done its job, it mostly gets reabsorbed and recycled. However, a small portion of it gets excreted — and with it, some cholesterol. In other words, bile also helps remove excess cholesterol from the body. 

To help support your digestion and bile production, I created Bile Builder Complete. This supplement contains a potent complex of amino acids and ox bile to stimulate bile production, support digestion, and promote gall bladder and liver health. Whether you want to support your fat digestion or build on your current gut health regimen, Bile Builder Complete can help you.

Now that we’ve taken a deep dive into cholesterol, let’s explore how your body transports cholesterol and triglycerides.

What are Lipoproteins?

Cholesterol and triglycerides need proper transportation through the bloodstream. These lipids attach to proteins that carry them 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 they absorb cholesterol and carry 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. That said, the difference is LDL mainly carries cholesterol to your tissues, while VLDL primarily carries triglycerides. 

A lipid panel blood test doesn’t measure VLDL since there’s no direct way to assess 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.

Chylomicrons

These are the largest lipoproteins, measuring 75 to 500 nm in diameter, and experts classify them as 'bad cholesterol' because they contain very little cholesterol. These ultra-low-density lipoproteins are about 95% triglycerides and contain only 1% of cholesterol. 

The intestines produce chylomicrons and send them 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. As you can see, this is important information being left out. 

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.

LDL cholesterol comes in different forms, and not all are equal. Remember, each of the four lipoproteins has a different size. The smaller the LDL particle, the easier it is 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. This allows for measuring the subtypes such as VLDL and chylomicrons. Talk with your functional medicine 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

I want to assure you that the power is in your hands. 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! To that end, 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 damage 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

• Berries

• 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. This nutrient supports a healthy blood flow and viscosity and can support an optimal hormonal balance.

2. Reverse Your Autoimmunity

Heart disease and autoimmunity share a strong connection. What’s more, 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. This protocol will help you address the true underlying causes of autoimmune disease. I have seen the success of this protocol firsthand, in my clinic and as a patient myself. Now, people everywhere can benefit from this medical breakthrough!

3. Relieve Your Stress

Managing stress isn’t always easy, especially with work-life balance struggles and constant technology use.

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 fresh air and physical activity is key.

• Sweating and detoxing in my infrared sauna.

• Laughing and playing with my daughter Elle – laughter is indeed the best medicine!

4. Balance Your Hormones Naturally

For women, the transition into perimenopause and menopause comes with a higher risk of heart disease. As estrogen levels decline, that risk increases, making heart health more important than ever.

Doctors often prescribe hormone replacement therapy to treat low estrogen levels 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, the Women’s Health Initiative study found no benefits from hormone replacement therapy. In addition, it found that women given synthetic hormone replacement therapy showed a slight increase in 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. Even more, they neutralize oxidative damage from free radicals. Think of them as anti-aging shields for your blood vessels. They help to keep them youthful and flexible.

The Final Word on Your Lipid Panel Blood Test

Cholesterol is far more complex than just a single number on your lipid panel. Traditional lipid panel blood tests measure your cholesterol, LDL, HDL, and triglycerides. However, they don’t give you the full picture of your heart health. 

Knowing the size and type of lipoproteins gives a clearer picture of heart disease risk—something a standard lipid panel doesn’t provide.

The good news is that you have the power to take control of your health. 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. 

But testing is just one piece of the puzzle. Your daily choices are also important. Eating nutrient-dense whole foods, managing stress, and exercising regularly will all go a long way toward supporting your heart health. 

A healthier heart starts with awareness, the right tests, and daily habits that set you up for lifelong wellness!