Contrary to common myth, LDL is not “bad” cholesterol. An LDL-C lab measures lipoproteins carrying cholesterol and triglycerides away from the liver for ALL vital functions…including hormone synthesis and cellular repair and regeneration. Check out this clinical tip video to understand what can happen and why when LDL is pushed too low (especially with the use of statin drugs). This is an important concept to be able to explain to your clients, especially given the widespread prescription use of statin drugs today.
Functional medicine teaches that LDL below about 75 mg/dl may even impair steroid hormone synthesis which can cause an array of symptoms including low libido, depression, anxiety, poor stress resiliency, infertility, cardiovascular dysfunction (yes!), and cancer risk. In fact, as we age, we see an inverse relationship between LDL-C and death from all causes (repeatedly). Making this type of connection across body symptoms for a client can be a powerful way to help them understand their body more thoroughly and learn the true root causes of their challenges.
Instead of LDL, one of the most useful markers to assess in conventional lipid labwork is the ratio of Triglycerides: HDL. This should ideally be 2.0 or less, but values of 4.0 or higher are definitely indicative of higher cardiovascular disease risk (and is validated as a better predictor than LDL-C!). This is the best surrogate marker for predicting a patient’s LDL particle count (LDL-P, a much more accurate predictor of CVD risk than LDL-C) where this less common test is not available. You may enjoy reviewing some references to the Trigs:HDL ratio here and here. If you want an article that explores this marker more in-depth, consider this one. Or if you are passionate about helping your clients and patients to avoid heart disease from multiple vantage points, you might want to consider the SAFM’s Cardiovascular Myths and Truths course – one of our student practitioners’ favorites!
P.S. If you know that healthcare must be transformed to be sustainable and effective, and you believe strongly that Functional Medicine is key to making that happen, we urge you to learn about our semester program.
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