How Your Body Gets the Cholesterol It Needs
Your body produces about 80% of the cholesterol it needs during the day; the other 20% comes from food.
About 20% to 25% of the cholesterol that your body produces is created in the liver from fatty acids. Other places where your body manufactures cholesterol include your intestines, adrenal glands, and reproductive organs.
When you consume foods with cholesterol, your body uses it. If you consume a lot of cholesterol, your body will just decrease the amount that it produces itself. If you don’t consume much cholesterol, your body will simply increase the amount it produces on its own. So even if you eat all the bacon and eggs you can stomach (like I do), your overall cholesterol levels will probably stay about the same (as mine have).
Genetics, not diet, seems to play a larger role in your overall cholesterol levels.
Beyond Good and Bad Cholesterol: HDL and LDL Cholesterol
Cholesterol is transported in the blood attached to carrier proteins. These cholesterol-protein combos are called lipoproteins. Lipoproteins are typically broken up into two groups based on their density: high-density lipoproteins (HDL) and low-density lipoproteins (LDL).
For years, researchers and doctors have called HDL “good cholesterol” and LDL “bad cholesterol.” While that’s roughly accurate, recent research has given us a much more nuanced look at HDL and LDL cholesterol. For example, not all HDL is good and not all LDL is bad. Below, we break down everything you need to know about these two groups.
HDL Cholesterol. The reason doctors call HDL “good cholesterol” is because HDL removes the so-called bad LDL cholesterol from the body. HDL does this by transporting cholesterol away from the body’s tissues and back to the liver where it’s turned into bile and excreted out of your body. HDL is what gets rid of excess cholesterol in your body and prevents build-up in your arteries.
Because HDL is your body’s cholesterol garbage truck, the more you have, the better. Recent research suggests that your HDL should be more than 60 mg/dL.
While HDL as a broad category is good for you, recent research has shown that not all HDL is the same. There are two subtypes; one is good for you, the other not so much. HDL-2 particles are large, buoyant, and provide the most protection from the build-up of LDL cholesterol. These particles are also anti-inflammatory. HDL-3, on the other hand, is small, dense, and possibly inflammatory. So while you want a high overall HDL number, you’ll want to have more HDL-2 than HDL-3 in your system. Newer tests can suss out the difference between the two, and researchers are developing therapies to target lowering just HDL-3. However, for most folks, you don’t need to worry too much about the two sub-types. Just knowing your overall HDL will do.
To increase your HDL levels, get plenty of exercise, don’t smoke, and increase your consumption of healthy monosaturated fats that you’ll find in foods like olive oil, avocados, fish, and nuts.
LDL Cholesterol. LDL is considered “bad” cholesterol because it can build up in the arteries, blocking blood flow. Unlike HDL that transports cholesterol away from body tissue and to the liver, LDL delivers cholesterol to the body after the liver produces it.
While our body needs the cholesterol that LDL delivers, too much of it could create health problems by building up in the arteries. Consequently, researchers and doctors recommend that folks shoot for an LDL that’s lower than 100 mg/dL.
Just as with HDL, not all LDL is the same. There are two types of LDL particles. One is terrible for you and the other only causes problems when it’s oxidized. LDL-A is a big, fluffy molecule that won’t cause any harm to your system so long as it’s not damaged by oxidation, which occurs when free radicals attach to the LDL. When this happens, the cholesterol converts to plaque. Researchers believe LDL-A levels play little or no role in heart disease or other circulatory problems.
LDL-B, on the other hand, is the bad kind. It’s a small, hard, and dense molecule that causes your arteries to harden. While you should focus on lowering your overall LDL levels, you’re better off having more LDL-A and less LDL-B. Blood tests can measure both of these.
To lower your LDL levels, get rid of excess body fat and increase your HDL levels with the lifestyle suggestions above. Research has shown that increased consumption of saturated fat can help decrease the amount of LDL-B particles in your system.
Lp(a): The Alpha Wolf Cholesterol Particle. While HDL and LDL levels get the lion’s share of attention, there’s a third type of lipoprotein that likely has more of an influence on your risk for heart disease than both HDL and LDL levels. Lipoprotein(a), or Lp(a), is a very small, yet highly inflammatory particle that promotes the blood clotting that can lead to coronary heart disease and stroke. Lp(a) is so patently bad for you, cholesterol expert Dr. Stephen Sinatra calls it the “alpha wolf cholesterol particle.”
Lp(a) isn’t a problem in low amounts. In fact, it serves a useful purpose in that it helps repair and restore damaged blood vessels. The problems start whenever your body has to use Lp(a) frequently to perform this function, as often happens when folks have chronic inflammation.
Most cholesterol blood tests don’t measure Lp(a) levels so if you want to know yours, you’ll have to ask for a test that specifically measures it. Ideally Lp(a) levels should stay below 30 mg/dL. Lp(a) levels are primarily determined by genetics, so if you have a family history of early arterial diseases, you should get your Lp(a) levels checked.
The current recommended treatment for high levels of Lp(a) is 1-3 grams daily of niacin, also known as Vitamin B3. When you take niacin at such high levels, you’ll experience what’s called a “niacin flush,” a harmless yet uncomfortable reddening and warming of your skin. To manage the flush, start off your niacin supplementation at 100 mg and very slowly increase the dosage.
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