Understanding Cholesterol: More Than Just a Number

Courtney Thomas
May 5, 2025
5 min read
Cholesterol is likely one of the most feared and misunderstood markers when it comes to our health and lab work.

We see doctors concerned when cholesterol is too high, but never talk about the concerns that can arise if cholesterol is too low. Cholesterol is a good thing and just like many things when it comes to health, we want to see cholesterol in the right ranges. Not too high, and not too low. Cholesterol is crucial for making hormones, creating strong but flexible cell membranes, supporting our neurotransmitters and helps us absorb vitamin D.

Where Does Cholesterol Come From?

Cholesterol comes from two places — exogenous (what we eat) and endogenous (what our bodies manufacture on its own). It is estimated that roughly 80% of cholesterol is manufactured in our liver. The body is always aiming to find balance and is typically really good at doing so. It regulates cholesterol output, meaning, if we are getting more cholesterol from dietary sources, it slows down production of cholesterol from the liver.

However, this feedback loop doesn’t always work the way it should. Situations that could affect this feedback loop usually come down to lifestyle and dietary choices. In the cases of insulin resistance, metabolic syndrome and chronic inflammation and/or adrenal dysfunction (think chronic stress), we can see this feedback loop not working properly, thus, ending up with high blood levels of cholesterol.

What You See in Routine Labs

Most often we see our total cholesterol, HDL, LDL and triglycerides…

  • LDL (Low Density Lipoproteins)
    These are what we think of as the “bad” cholesterol — the LOUSY cholesterol. LDL carries cholesterol to our cells for either our cell membranes or steroid hormone production. LDL cholesterol becomes a problem when the particle size is too small and their ability to be easily oxidized by free radicals can then cause them to stick to arterial walls and cause plaque buildup.
  • HDL (High Density Lipoproteins)
    This is the “good” cholesterol — the HAPPY cholesterol. HDL is the happy helper that collects and brings cholesterol from the bloodstream back to the liver to be excreted through bile. HDL has been shown to be more resistant to oxidation.
  • Triglycerides
    These are essentially unused calories, stored as fat in the blood. Triglycerides can build up from an excess of trans fats and fatty foods, refined sugars and carbohydrates and alcohol.

Knowing these numbers can absolutely give us some insight into our health but they don’t give us the entire picture. What can help us is knowing the particle size of our LDL.

Particle Size: Why It Matters

LDL cholesterol is important but what's more important is your particle size of LDL.

We love a good analogy at LVLTN so here goes:

Think of cholesterol as dirt and your LDL as the vehicle or dump truck that transports the dirt throughout our body. Our total cholesterol is the amount of dirt and our LDL is the number of dump trucks working to transport that dirt. The bigger the dump truck, the more dirt it can transport. If we have too many small dump trucks transporting dirt, that can become problematic as those small dump trucks can more easily get stuck (think traffic jam) and cause plaque build up in the arterial lining. If we have big dump trucks (big, fluffy LDL particles), they can transport more dirt efficiently and flow freely without getting stuck in “traffic”.

Triglyceride to HDL Ratio: A Better Predictor

Another factor to pay attention to is your triglyceride to HDL ratio. This is a better indicator of your risk of cardiovascular disease than just looking at your cholesterol numbers alone.

A ratio above 4:1 (a 2:1 ratio is ideal) can be reason to look into metabolic health and can also be an indicator that you have more low density LDL particles (little dump trucks).

Want to Improve Your Cholesterol?

If you notice your triglyceride to HDL ratio is high, or you are seeing that your LDL is elevated and you test your particle size, there are a few factors that can improve cholesterol outside of just removing healthy eggs, butter and red meat.

  • Watch Refined Sugars and Fats
    Refined sugar, excess fats in processed foods and excess refined carbohydrates play a large role in inflammation which drives up cholesterol levels.
  • Eat More Whole Foods
    Eating more colorful foods, high in fiber and including fruits and veggies with each meal can go a long way to improving your overall cholesterol levels. Make more of your own meals at home by building simple meals with a protein source and plenty of colorful veggies. You have more control over the oils and ingredients used the more you make your own meals.
  • Add Healthy Fats
    Eating more fish and increasing your omega 3 fatty acid consumption, more nuts and seeds, as well as avocados and olive oil can help improve the type and amount of cholesterol in your body.
  • Exercise Regularly
    Studies have shown that regular exercise can optimize cholesterol levels. Even just 30 min of walking can be a great place to start if you are new to exercise.
  • Manage Your Stress
    We know - easier said than done. That said, it should be noted that stress absolutely has a huge impact on our health, including cholesterol. Stress can affect blood sugar regulation and long term blood sugar imbalances can alter the enzymes required for proper fat metabolism.

Be the CEO of Your Health

When we understand how our body works, we can feel empowered to better support our bodies in giving it what it needs to function optimally so we can feel our best and thrive.

Learning about your blood chemistry is no different.

You get to be the CEO of your own health.

Ready to start thriving again? Let us help by putting an expert in your corner to get you there faster and maintain that progress for life! Learn more about our online health coaching by clicking here!

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