Cholesterol Numbers – The Good, the Bad & the Ugly

Cholesterol Numbers - HDL, LDL, TotalWe get a lot of emails about cholesterol numbers, as many people are confused about what is considered healthy and what could potentially be a problem. This confusion is understandable though, as there is a lot of conflicting information out there. Even doctors who are supposed to be experts on this topic can also give you misleading information.

As a result millions of people end up taking cholesterol medication like Lipitor when they don’t even have to be on it. That’s why it’s important to educate yourself as much as possible. You certainly don’t want to be on a prescription medication that you don’t have to be, especially for long periods of time.

So let’s get into the numbers a little…

Good Cholesterol Numbers…HDL is Your Friend

When you hear someone talking about good cholesterol, they are referring to HDL, or high density lipoprotein. Lipoproteins are simply complexes that carry fat around the body. HDL’s job is to go around the body looking for bad cholesterol, or LDL which we will get to shortly. Once it finds LDL, it removes it from the bloodstream and brings it to the liver to be processed.

So HDL’s job is to clear out the LDL. So think of HDL as Batman and LDL is the Joker, the Riddler, the Penguin and all of their cronies. Every day your body’s supply of HDL is fighting the LDL in an ongoing battle for cardiovascular health.

So when people talk about good cholesterol numbers, they mean the amount of HDL in your bloodstream. So what is the ideal amount of HDL? Anything over 60 mg/dL is considered good. In general, it should be over 40 for men, and over 50 for women. Anything less than that is considered a risk for heart disease.

Now let’s take a look at HDL’s arch enemy…

Bad Cholesterol Numbers…LDL is Your Enemy

As we mentioned above, HDL’s job is to eliminate LDL, or low density lipoprotein. LDL is what builds up in artery walls, causing plaque and leading to heart disease and potential stroke. So those are the bad cholesterol numbers. As you might have guessed, we want these numbers to be as low as possible. The lower your LDL, the lower your risk of heart disease. It’s not a direct correlation, as there are other factors including CRP levels, homocysteine and triglycerides, but generally speaking, the lower your LDL the better.

So what should those numbers be? The recommendations for LDL are much more specific than those for HDL. Anything less than 100 mg/dL is considered optimal. Up to about 129 mg/dL is close to ideal. Once you get to about 130 and above that’s when it is considered high. If you are above 190 that’s very high and is considered a risk.

It’s interesting to note that if your LDL levels are high, it can be balanced out by high HDL levels. So it’s not so bad of you have elevated LDL concentrations if you have optimal HDL concentrations to counteract that. That’s why the cholesterol ratio is the most important number to look at.

We tend to focus on the total cholesterol number, i.e. anything over 200 mg/dL is considered a higher risk…but this number has become much less important as doctors are recognizing the importance of the concentrations of LDL and HDL, and not just the total amount.

Cholesterol Numbers…What’s the Bottom Line?

The takeaways here is that the amounts of HDL and LDL are more important than your total cholesterol levels. Just because your total numbers are above the “ideal” 200 mark doesn’t mean you are at a higher risk for heart disease. If your HDL levels are optimal and your triglycerides, homocysteine and CRP levels are low (three other very important risk indicators) then having higher than ideal LDL is not a big problem.

You have to look at the whole picture and not just one magic number. The ratio of LDL to HDL and total cholesterol to HDL is a much more telling figure than the total amount.