My Weirdly High Bad Cholesterol and Why I’m Not Concerned

High Cholesterol

This past week I ran a few blood tests to follow up on the high cholesterol reading my physician identified during a routine annual checkup. This obviously was initially concerning and would have an impact on my diet and health. I wanted to quickly recount my conclusions on this finding based on subsequent personal blood testing.

To clarify, I have high “total cholesterol” (LDL+HDL) and high LDL.

Let me begin by saying I am not a doctor, I’m not even a health expert. Heck, I’m not really even a health blogger. The discussion here is purely speculative in nature. 

My Cholesterol Problem

I have a high total cholesterol count, 204. I have a high LDL (bad) cholesterol count, 136.

The way I understand it, cholesterol is a substance that moves between the liver and the rest of the body. It becomes the biggest issue when it starts building up as hard plaque in the arteries of the heart.

Traditional medical practices had established a standard that total cholesterol and total LDL numbers were the highest indications of cardiac “events” (think heart attacks/angina/acute coronary syndrome.)

High Cholesterol is not dangerous by itself

The goal for a healthy heart is to reduce the amount of plaque being deposited on the arterial walls of the heart. It turns out that a classic cholesterol “count” is not the best way to determine your risk for cardiac events.

Fortunately , there are more detailed and illuminating tests for cholesterol than the simple lipid profile generally ordered as an initial test by physicians (It makes sense the simpler one was initially used for me, especially on a young and relatively healthy 29 year old like myself.)

I ordered this additional test, through, called the “CardioIQ Advanced Lipid Profile”. That gave me something that looked like this:


Yes, it did confirm I do have high cholesterol. However, this test showed a deeper, more promising story.

The test counts the number of the actual LDL particles. The number of particles turns out to be a much better indicator of heart risk than the LDL-count (traditional test.)

When a person, like me, has a “discordance” (different healthy/unhealthy clinical result) in their LDL-Total Count (the kind that I have a problem with) and LDL-Particle number (the kind I’m testing on my own here) it has been found that the particle number is far more indicative of a problem. Thus, LDL-P is a better number to focus on (Otvos et. al.)

This test ran me $109 (it’s on sale this month, no I don’t make any money from this reference.) As with all my self-registered tests, I order them from Direct Labs, go into a Quest Diagnostics lab (the exact same lab I use for my physician) and get a blood draw. Less than a week later I got the results online at the Direct Labs website.

There’s no reason your physician can’t run a test like this for you. It’s not pseudoscience or anything like that. The primary study cited above by Dr. Otvos is widely accepted in the medical community. I just choose to do some of this blood testing on my own because I don’t want to pressure my physician into ordering tests that may not be traditionally insurance agency friendly.

Rioting after the Eagles’ Victory last weekend

My doctor is actually very supportive of this testing and we’ve had chats about it. She loves that I’m taking my preventative health seriously and seeking to understand my body in ways she obviously doesn’t have the time to focus on with hundreds of patients. I want to maintain a friendly relationship as I know ordering the copious tests I want to run on a healthy individual like me is a good way to get flagged by the insurance industry.

If you do have a history of cardiac disease or high cholesterol, I suggest you somehow get this test done. Look specifically at your LDL-particle count. This is the strongest indicator of heart disease prevention. I won’t go into the details of the mechanisms because I am a complete amateur on this topic.

Fortunately, I’ve found here that I don’t have much cause for concern. My LDL-Particle number is healthy and I’ve seen multiple places online that the healthy particle number is associated with a significantly lower risk of heart disease.

Piano we recently had to give away on Craigslist

For a clarification of the concept I recommend this post by Dr. Peter Attia. Dr. Attia was a leading cancer research at Johns Hopkins and now focuses on quality of life extension.  Much of what I said here is articulated by him on that series he wrote.

Also, eating cholesterol doesn’t affect your actual blood levels. Just had to get that out there. (Source)