Cholesterol Primer

Cholesterol is an organic molecule. A lipid or fatty acid, it does not dissolve in water. Every one of your cells makes it. In your body, your liver, intestines, and brain make the most. It is essential for synthesizing Vitamin D. It also is essential for making all steroid hormones, including the sex hormones progesterone, estrogens, and testosterone. Gallstones are solid cholesterol. Other cholesterol terms are triglyceride, calcium, high-density lipoprotein, and low-density lipoprotein.

It makes up about 30% of your cell walls, which keeps them flexible, stable, and durable. In the myelin sheath around some nerves, it serves as electrical insulation. This helps make efficient cell signaling and nerve signal conduction.

Your body recycles it, and your liver excretes it into bile, a fluid that aids digestion. In your digestive tract, about 50% is reabsorbed by your body.

Eating cholesterol-rich foods modifies how much your body makes. Because of that, concentrations in the blood can increase. Seven to ten hours after eating it, though, cholesterol in food has little effect on its concentration in your bloodstream. In addition, some people may have a genetic mutation that results in high cholesterol.

It’s not very soluble in water or blood

It dissolves in blood at tiny concentrations and travels through blood via emulsification. LDL (i.e., Lower Density Lipids-transported-within-proteins) particles are the major blood cholesterol carriers. They are lipoproteins whose outward-facing surfaces are water-soluble and inward-facing surfaces are lipid-soluble.

A cell with plentiful cholesterol blocks its LDL receptor synthesis. As a result, this prevents new LDL molecules from being taken up. Conversely, a cell deficient in cholesterol makes new LDL receptors.

Cholesterol plaque buildup

By Blausen.com staff courtesy of Oregon State University – https://commons.wikimedia.org/w/index.php?curid=75022457

When this LDL receptor process gets unregulated

When the process breaks down, LDL molecules without receptors begin to appear in the blood. As a result, that LDL remains in the bloodstream longer than it should. There, LDL molecules oxidize and macrophage white blood cells engulf them. The macrophages swell with fluid and form foam cells. Those cells can get trapped in blood vessel walls and contribute to plaque formation.

Plaque build-ups, or atherosclerosis, are made of cholesterol, fatty substances, cellular waste products, calcium, and fibrin (a clotting material in the blood). These plaques are the main causes of heart attacks, strokes, and other serious medical problems. As a result, we think of so-called LDL cholesterol as “bad” cholesterol that drives arterial disease.

What are HDL particles?

HDL (i.e. Higher Density Lipids-transported-within-proteins) particles take cholesterol back to your liver, either for excretion or for other tissues that make hormones. A large number of HDL particles means better health outcomes, whereas low numbers may mean disease developing in your arteries. We consider HDL as “good” cholesterol that can regress arterial disease.

Food and cholesterol

All animal cells make it, and as a result, all animal-based foods contain it in varying amounts. Major dietary sources include red meat, egg yolks, and whole eggs, liver, kidney, giblets, fish oil, and butter.

Some plant foods, such as avocado, flax seeds, and peanuts, contain phytosterols and compete with cholesterol for absorption in the intestines. Phytosterols reduce the absorption of both dietary and bile cholesterol. However, a typical diet is not enough to have a significant impact on blocking absorption.

In 2016, the USDA* Dietary Guidelines Advisory Committee recommended that Americans eat as little dietary cholesterol as possible. Most foods that are rich in cholesterol are also high in saturated fat, and they may increase the risk of cardiovascular disease.

What are triglycerides?

Triglycerides, fatty acids, are the most common type of fat in your body. They come from foods, especially butter, oils, and other fats you eat, and also come from extra calories. These are the calories your body does not need right away. So your body changes extra calories into triglycerides and stores them in fat cells. Your VLDL (Very Low-Density Lipoprotein) particles carry triglycerides to your tissues. When your body needs energy, it releases triglycerides.

Testing

The American Heart Association recommends testing every 4–6 years for people aged 20 years or older. Patients taking statin medications should be tested 4–12 weeks after their first dose and then every 3–12 months thereafter.

The lab measures a lipid profile or estimate of a person’s lipoproteins from a blood sample after 12-hour fasting.

The lipid profile measures:
(a) total cholesterol
(b) cholesterol associated with HDL particles
(c) triglycerides
(d) (by a calculation and assumptions) cholesterol carried by LDL particles

Vedas and Woodlands Functional Family Medicine are minutes from I-45 (Houston’s North Freeway) in The Woodlands, Texas. Call 281-298-5476 to book your free consultation with Dr. Nangrani. Together, you will discuss testing and a treatment plan. We look forward to seeing you soon!

*USDA: United States Department of Agriculture

If you have atherosclerosis, it’s time to make a plan to slow its progress. Follow the link for tips on eating, exercise, and LDL-reducing statins.

Advanced Lipid Testing at VedasWellness

Primary source: Wikipedia

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