Much of What Passes for High Cholesterol is Harmless

by Dr. Stephen Sinatra
Filed Under: Heart Health, Cholesterol
Last Reviewed 02/06/2014

Much of what passes for September is National Cholesterol Education Month, so I thought this was a good time to debunk one of the biggest myths—that high cholesterol is harmful. We know our bodies have many forms of cholesterol, some harmful and some not. Plus, manufacturers have created drugs to lower some components of cholesterol and to raise others.

Despite the great strides we’ve made in educating ourselves about cholesterol, a huge number of myths still abound.  One of them is that what passes for “high cholesterol” is in fact harmless.

Because your body makes more cholesterol on its own than you could possibly consume, the numbers from a total cholesterol test don’t really mean much. You need to pay more attention to the fraction patterns than your total cholesterol numbers.

An unhealthy cholesterol reading is one that contains a dominant pattern of dense, small cholesterol particles, which are the most highly inflammatory and dangerous cholesterol particles. Ideally, your cholesterol particles should be predominantly large and “fluffy.” In fact, dense HDL particles can be more harmful than light LDL particles.

Since the common cholesterol tests don’t check for fraction patterns, I recommend asking your doctor to prescribe the VAP test or the lipoprotein particle test. From what I understand, both are covered by Medicare and most insurance plans.

If it turns out you have a lot of small, dense particles I suggest taking niacin (vitamin B3), which research shows helps neutralize the toxic particles. Because niacin can cause flushing, I recommend starting with a low dose of 100 mg, and gradually increasing the dose to 1,000 mg daily. I also recommend taking 1–2 grams a day of omega-3 fatty acids and a garlic supplement.

Now it’s your turn: Do you have any cholesterol questions?

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