WELLNESS EDIT | No 31 |

Cholesterol

Understanding Your Numbers, the Hidden Factors That Influence Them, and What You Can Do

Many people are surprised when their cholesterol numbers are elevated despite making healthy choices. They may have changed their diet, started exercising, lost weight, or tried fasting, yet their results do not always change as expected.

The reason? Cholesterol is more complicated than just avoiding saturated fat.

While food choices matter, cholesterol levels are influenced by many factors, including genetics, hormones, thyroid function, medications, sleep, stress, and how your body processes and manages fats.

The human body is complex, and there is rarely one single reason behind a health concern. A cholesterol result is not just a number, it is a clue that can help us understand what may be happening beneath the surface.

This is why looking at the bigger picture matters. No two people are exactly the same, and understanding the factors that influence cholesterol can help create a more personalized approach to health.

Understanding Your Numbers

Understanding your cholesterol numbers is an important first step in taking an active role in your health. Knowledge is power, and your blood work provides valuable information about what is happening inside your body.

Always ask for a copy of your lab results and keep them for your records. You are entitled to access your own health information, and having your results allows you to understand your numbers, track changes over time, and have more informed conversations with your healthcare providers.

Your cholesterol report is not just one number, it is a combination of different measurements, each providing a different piece of the puzzle.

Learning what these numbers mean puts you in the driver’s seat of your health and helps you make more informed decisions. Looking at the complete picture, rather than focusing on a single result, provides a much clearer understanding of your cholesterol profile.

Breaking Down Your Cholesterol Results

Looking at the complete picture, not just one number, can provide a better understanding of what your results may be telling you.

What Do the L’s in HDL and LDL Mean?

Your blood is mostly water, but cholesterol is a type of fat. Because fat and water do not mix, cholesterol needs a carrier to travel through your bloodstream.

That carrier is called a lipoprotein.

Think of lipoproteins as delivery vehicles transporting cholesterol and other fats throughout your body. Different lipoproteins have different roles, which is why your blood work includes different measurements.

The two you will hear about most often are:

HDL — High-Density Lipoprotein
LDL — Low-Density Lipoprotein

Understanding what these cholesterol carriers do can help you make sense of your cholesterol numbers and why each measurement matters.

HDL: The “Happy” Cholesterol

HDL stands for high-density lipoprotein. I like to think of HDL as the “Happy” cholesterol because it helps remove excess cholesterol from the bloodstream.

Think of HDL as a cleanup vehicle. It picks up extra cholesterol and carries it back to the liver, where your body can process and remove it.

This is why HDL is often considered the “good” cholesterol. In general, higher HDL levels are associated with a healthier cholesterol profile.

LDL: The Cholesterol to Watch

LDL stands for low-density lipoprotein.

Think of LDL as a delivery vehicle carrying cholesterol from the liver to the rest of the body. Your body needs cholesterol to build cells, produce hormones, make vitamin D, and support many important functions.

The concern is not LDL itself, your body needs it. The concern is when too many LDL particles are circulating in the bloodstream over time, as they can contribute to plaque buildup in the arteries and increase cardiovascular risk.

Understanding LDL is about balance, not simply labeling it as “bad.”

Triglycerides: Another Piece of the Picture

Triglycerides are not cholesterol, they are another type of fat found in your blood.

Think of triglycerides as your body’s energy storage system. When you consume more calories from food and drinks than your body immediately needs, the excess can be converted into triglycerides and stored for later use.

Higher triglyceride levels can be influenced by factors such as excess calories, added sugars, refined carbohydrates, alcohol intake, insulin resistance, certain medications, and medical conditions.

Looking at triglycerides alongside HDL and LDL provides a more complete picture of how your body is managing fats in the bloodstream.

Total Cholesterol: Looking at the Bigger Picture

Why Total Cholesterol Does Not Tell the Whole Story: Two people can have the exact same total cholesterol number but very different cholesterol profiles.

Person A

LDL: 130 mg/dL
HDL: 85 mg/dL
Triglycerides: 125 mg/dL

Total Cholesterol: Approximately 240 mg/dL

This profile includes a higher HDL level, which is generally associated with a healthier cholesterol pattern.

Person B

LDL: 180 mg/dL
HDL: 35 mg/dL
Triglycerides: 125 mg/dL

Total Cholesterol: Approximately 240 mg/dL

This profile shows a much higher LDL level and lower HDL level, creating a different overall risk picture.

Both people have the same total cholesterol number, but the individual components tell a very different story.

This is why looking beyond one number is so important. Cholesterol results are not just a score, they are a collection of markers that provide clues about what may be happening inside the body.

Person A: Higher HDL and lower LDL create a different overall picture.
Person B: Higher LDL and lower HDL may represent a different risk profile.

Cholesterol is often blamed on diet alone, but the body is far more complex. Sometimes, factors that seem unrelated to cholesterol can influence your results.

Three Surprising Factors That May Influence Cholesterol Levels

1. Your Coffee Preparation Method

Many people are surprised to learn that it may not be the coffee itself, but how it is prepared that matters.

Unfiltered coffee methods, such as French press, boiled coffee, and some espresso preparations, contain higher amounts of natural compounds called cafestol and kahweol. These compounds can raise LDL cholesterol in some people.

Paper filters remove much of these compounds, which is why filtered coffee may have a different effect.

2. Fasting and Rapid Weight Loss

Many people are surprised when their cholesterol numbers do not look the way they expected after fasting or losing weight.

During fasting or periods of significant calorie restriction, your body shifts from using energy from food to using stored energy. Fat is released from storage and transported through the bloodstream to be used as fuel, which can temporarily influence some blood markers.

This does not mean fasting is unhealthy. It is a reminder that your cholesterol results are a snapshot of what is happening inside your body at that moment.

The timing of your blood work, recent weight changes, and your individual metabolism can all influence how your results appear.

3. Very Low-Carbohydrate Diets

When you eat carbohydrates, your body breaks them down into glucose (sugar) for energy. If there is more glucose available than your body immediately needs, especially from excess calories, your liver can convert some of that excess carbohydrate into fat (triglycerides) through a process called de novo lipogenesis.

Many people assume that cutting carbohydrates will automatically improve every cholesterol marker. While very low-carbohydrate diets can improve triglycerides and blood sugar control for many people, cholesterol responses can vary.

Some individuals may see lower triglycerides and higher HDL levels, while others, particularly lean, active individuals who lose significant weight, may experience a rise in LDL cholesterol.

Researchers are still studying why this occurs, but it is another example of why cholesterol results need to be interpreted in the context of the whole person, not just one dietary pattern.

Health Reminder: Sometimes the answer is not always found where you first expect it.

A powerful reminder of this is a case involving a patient with severe cardiovascular disease. He had already undergone multiple procedures, including angioplasty and bypass surgery, before later suffering a stroke. At the time, homocysteine was not routinely checked. A deeper look revealed significantly elevated levels, and once this was addressed, his levels returned to normal with no further progression of plaque buildup in his arteries.

Another example involved someone who spent years being treated for different concerns, including asthma, digestive issues, high blood pressure, and hair loss. Each issue appeared separate, until a closer look revealed they were connected to undiagnosed celiac disease. After removing gluten, many of his symptoms improved.

Stories like this are a reminder that the body does not always work in separate compartments. Sometimes the missing piece is not where we first expect to find it.

Medicine is always evolving as we continue to learn more about the complexity of the human body. Cholesterol is no different. Your numbers provide important information, but understanding why they are changing often requires looking at the bigger picture.

Bottom Line: What Can You Do?

Start by looking at the bigger picture.

Cholesterol is a complex topic, and there is a lot of conflicting information available. While some argue that elevated cholesterol does not always tell the full story of cardiovascular health, the reality is that one number alone cannot explain everything.

If your cholesterol is elevated, it is worth asking questions, not to judge your choices, but to better understand what may be influencing your health.

What does your overall lifestyle look like? Are your daily habits supporting your health most of the time? Are there areas that may need attention?

Maybe you are fasting, but what does your eating pattern look like during the hours you do eat? Are you nourishing your body with balanced, nutrient-rich meals, or has fasting simply changed the timing of your food?

Maybe you are eating “healthy,” but are you drinking enough water, sleeping well, managing stress, and staying active?

These questions are not about perfection. They are about awareness.

The goal is not simply to chase a number. It is to understand the story behind it. Every result is a piece of information, a clue that can help you better understand what may be influencing your cholesterol and overall health.

If your numbers are higher than expected, do not let one result define your health or leave you feeling overwhelmed. Use it as a starting point, a reason to ask questions, gather information, and better understand what your blood work may be telling you about your health.