How to Test and Interpret Total Cholesterol Levels: A Functional Medicine Perspective

Welcome to our journey into understanding cholesterol from a whole-person perspective. It's not just about the numbers on a lab report; it's about grasping how cholesterol impacts your body's overall well-being. Whether you're here as a concerned patient or a dedicated healthcare provider, we're all on a quest to unravel the mysteries of cholesterol and its role in our health. 

Together, we'll explore how to make sense of those cholesterol test results in a way that empowers you to take charge of your (or your patient's) health. Join us as we discuss the functional medicine approach, where cholesterol isn't just a statistic but a vital piece in the puzzle of your care.

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What is Total Cholesterol?

Total cholesterol is a comprehensive measure of all the cholesterol in your blood. It encompasses several components, including Low-Density Lipoprotein (LDL) cholesterol, often referred to as "bad" cholesterol due to its association with an increased risk of heart disease; High-Density Lipoprotein (HDL) cholesterol, known as "good" cholesterol because it helps remove other forms of cholesterol from your bloodstream; and triglycerides, which are a type of fat in the blood, often elevated in conditions like obesity and diabetes. These components collectively contribute to your total cholesterol level, each playing a distinct role in your overall health.

Practitioners order this test for various reasons. Primarily, it's a fundamental screening tool for assessing cardiovascular risk. Elevated total cholesterol levels can indicate a higher risk of heart disease and stroke. It is also used to monitor the effectiveness of cholesterol-lowering treatments or lifestyle changes.

Additionally, because cholesterol levels can be influenced by diet, physical activity, age, gender, and genetic factors, this test is often part of a comprehensive evaluation to understand an individual's specific health profile. By monitoring these levels, healthcare providers can offer tailored advice and treatment plans to reduce the risk of heart disease and improve overall health.

How to Test Your Total Cholesterol

The Total Cholesterol Test by Boston Heart Diagnostics is a blood test that measures the amount of cholesterol and other fats in an individual's blood. It is often ordered as part of a routine exam, especially for individuals with certain risk factors like a family history of heart disease, high blood pressure, Type 2 diabetes, smoking, excess weight, lack of physical activity, or a diet high in saturated fat (12).

The Total Cholesterol test assists in determining the risk of developing heart disease and aids practitioners in creating personalized plans to manage and lower high cholesterol levels if necessary.

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How to Calculate Total Cholesterol

Total cholesterol is calculated by adding the values of three biomarkers: Low-Density Lipoprotein (LDL) cholesterol, High-Density Lipoprotein (HDL) cholesterol, and 20% of your triglyceride level. To calculate it, you can use the formula:

Total Cholesterol = LDL cholesterol + HDL cholesterol + (Triglycerides/5)

This formula is based on the understanding that triglycerides are a significant component of the total cholesterol measurement. It is a common method used when only individual lipid panel components are available.

What is the Total Cholesterol Range?

Understanding the range of total cholesterol levels is crucial for assessing cardiovascular risk and overall health. Typically, total cholesterol levels are classified into three categories. A level below 200 milligrams per deciliter (mg/dL) is considered desirable, indicating a lower risk of heart disease. Levels between 200 and 239 mg/dL are deemed borderline high, suggesting a moderate risk. Levels of 240 mg/dL and above are classified as high, indicating a higher risk of heart disease.

The functional medicine approach to total cholesterol ranges can be more individualized to be sure the patient is getting their particular needs met. Functional medicine, which focuses on holistic care and individual variability, might suggest an "optimal" cholesterol range that is more personalized, considering factors such as a person's age, genetics/ family history, lifestyle, and other health conditions.

This optimal range is usually aimed at maintaining cholesterol levels towards the lower end of the standard range, but not too low, as cholesterol is vital for various bodily functions like hormone production and cellular structure. In functional medicine, the emphasis is on achieving a balance that supports overall health and reduces disease risk, rather than strictly adhering to general population-based ranges.

Functional medicine practitioners also place greater emphasis on the ratios of different cholesterol types (like the ratio of total cholesterol to HDL or LDL to HDL) and the levels of other lipid parameters, such as triglycerides and lipid subfractions, in their assessments. This approach reflects the understanding that cardiovascular health and risks are multifactorial and that cholesterol levels are just one part of a larger health picture.

By considering a wider range of factors, functional medicine aims to provide a more comprehensive and tailored approach to cholesterol management, aligning with the unique needs and health goals of each individual.

How to Lower Total Cholesterol

Lowering total cholesterol is a significant health goal for many, especially those at risk for cardiovascular diseases. This section will delve into various strategies and lifestyle modifications that can help in effectively reducing total cholesterol levels.

What is the Conventional Treatment for Lowering Total Cholesterol?

The conventional treatment for lowering total cholesterol typically involves a combination of medication and lifestyle modifications. The primary class of medications prescribed are statins, which work by reducing the liver's production of cholesterol. Examples include atorvastatin, simvastatin, and rosuvastatin. They are effective in lowering LDL and have been shown to reduce the risk of heart attacks and strokes. Other medications might be used in conjunction with or as alternatives to statins. These include cholesterol absorption inhibitors like ezetimibe.

In addition to medication, conventional treatment emphasizes the importance of lifestyle changes. This involves dietary modifications such as reducing the intake of saturated fats and trans fats, and increasing the consumption of fruits, vegetables, whole grains, and lean proteins.

Regular physical activity is also strongly recommended, as it can help to improve cholesterol levels and overall heart health. Maintaining a healthy weight, quitting smoking, and limiting alcohol consumption are other key components of the lifestyle approach to managing cholesterol levels.

What is the Functional Medicine Treatment for Lowering Total Cholesterol?

The Functional Medicine treatment protocol for high cholesterol includes a combination of dietary approaches and natural supplements. Therapeutic diets like the Mediterranean and DASH are recommended for their heart-health benefits and effectiveness in improving lipid profiles.

These diets focus on whole foods, fresh fruits, vegetables, and healthy fats, aiming to reduce unhealthy fats, sodium, and refined carbohydrates while increasing dietary fiber.

Supplement protocols include Red Yeast Rice, which functions similarly to statins; Berberine, known for its ability to reduce total cholesterol (TC) and low-density lipoprotein (LDL-C); Plant Sterols, which help lower cholesterol by competing with its gastrointestinal absorption; and Garlic, which has modest effects in reducing TC and LDL-C.

These supplements are chosen for their specific cholesterol-lowering properties and are typically recommended alongside lifestyle modifications like exercise and stress management for comprehensive cholesterol management (7).

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Total Cholesterol Levels: Key Takeaways

The functional medicine approach to testing and interpreting total cholesterol levels represents a holistic and individualized perspective in healthcare. Understanding total cholesterol, which includes LDL (bad cholesterol), HDL (good cholesterol), and triglycerides, is crucial for assessing cardiovascular risk and overall health.

Understanding and managing total cholesterol levels from a functional medicine perspective involves a comprehensive treatment approach that goes beyond conventional methods. This holistic view emphasizes the importance of individual factors such as diet, lifestyle, and genetics in interpreting cholesterol levels. It advocates for personalized health strategies, considering the unique needs of each individual and their physiology in order to create health in all bodily systems thereby supporting healthy cholesterol levels. Such an approach not only aims to manage cholesterol levels but also contributes to overall well-being, highlighting the intricate connection between cholesterol and broader health aspects.