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Cholesterol 101 - good cholesterol & bad cholesterol

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 4 minutes read

Lipids are fat compounds found in the body that include cholesterol and triglycerides. They are used for many important functions, but sometimes there is too much of a good thing! Here we dive into a bit more detail on what exactly is good and bad cholesterol.

Cholesterol is a waxy, fatlike substance we all have in our blood, and it’s essential for good health, helping to store energy and with other vital body functions such as creating healthy cell membranes. However, too much of the ‘bad’ kind of cholesterol can increase your risk of conditions such as heart disease or stroke. There are two main ways we make cholesterol – from our body and from what we eat. Body-generated cholesterol is made in our liver and it helps your body build cells and make vitamins and certain hormones. We make all the cholesterol we need through this process. Dietary cholesterol comes from the food we eat, particularly products like meat, eggs, cheese and milk.

HDL is good cholesterol

High-density lipoprotein (HDL) cholesterol is known as 'good cholesterol' because it carries non-HDL cholesterol (bad cholesterol) away from your arteries to be broken down by your liver and eliminated from your body.

LDL (low-density lipoprotein) or non-HDL cholesterol is bad cholesterol

High levels of non-HDL cholesterol and triglycerides can lead to the build-up of fatty deposits in your arteries (atherosclerosis), increasing your risk of developing cardiovascular problems such as coronary heart disease, angina, or a heart attack or stroke.

What should your cholesterol levels be?

There are usually 4 different measures for the cholesterol level. Total cholesterol is the overall amount of cholesterol in your blood. This should be below 200 mg/dL. HDL (good cholesterol) lowers your risk of a heart attack or stroke. This should be above 60 mg/dL. LDL (bad cholesterol) increases your risk of heart problems or stroke and should be below 100 mg/dL. Triglycerides are similar to bad cholesterol and should be below 150 mg/dL.

What are the warning signs of high cholesterol?

High cholesterol usually doesn't have any symptoms until it reaches a critical stage and becomes an emergency. A blood test is the only way to find out if you have a high level of LDL cholesterol. If left untreated, a build-up of 'bad cholesterol' can occur in the arteries where a layer of plaque forms, blocking blood flow. This can lead to coronary artery disease (CAD), a heart attack or stroke, so it's vital to keep an eye on your cholesterol levels. We at Healthwords recommend you have a regular blood test if you are at risk or have a family history of cardiovascular events. You can also keep an eye out for the following symptoms:

  • Nausea
  • Numbness
  • Slurred speech
  • Extreme fatigue
  • Chest pain or angina
  • Shortness of breath
  • Numbness or coldness in extremities
  • High blood pressure

What are lipids?

You may hear the term "lipids" when talking about cholesterol. This is because they are closely connected as cholesterol is actually part lipid.

Lipids are fat-like molecules that can be found circulating through your bloodstream and also in cells and tissues throughout your body.

Different types of cholesterol are known as lipoproteins, taking the name from lipid and protein, of which they are made up of. Cholesterol is one of the several types of fats (lipids) and they are a vital part of a balanced diet. They are used as a store of energy, and in vital body functions such as creating cell membranes.

How about statins?

Statins reduce the production of 'bad cholesterol' (non-HDL cholesterol) from your liver. They can also lower triglyceride levels and increase 'good cholesterol' (HDL cholesterol) levels in your body. Statins work by inhibiting an enzyme in your body called HMG-CoA reductase.

There are seven statins available on prescription in the US. They are:

  • atorvastatin
  • simvastatin
  • rosuvastatin
  • pravastatin
  • lovastatin
  • pitavastatin
  • fluvastatin

Statins are for people who have high levels of non-HDL cholesterol and triglycerides in their blood. Lifestyle factors and genetics can both play a part in this. People with normal lipid levels may also be prescribed a statin if they are at a high risk of developing cardiovascular problems.

How do I reduce my cholesterol?

If you have high cholesterol, the best way to reduce it is through a healthy lifestyle. Your doctor may also prescribe medications if needed.

Here are some of the best ways to help reduce your bad cholesterol:

  • Reduce the amount of saturated fats you eat found in butter, fatty meats and cheese.
  • Add more fiber to your diet.
  • Limit the amount of processed foods, fatty red meats, egg yolk, and high-fat dairy products in your diet.
  • Have two oily fish meals a week.
  • Maintain a healthy weight.
  • Avoid alcohol and tobacco use.
  • Regular exercise is important. Do at least 30 minutes of exercise five times a week or vigorous aerobic activity for 20 minutes three times a week. Some of the best exercises for lowering cholesterol include walking, running, cycling, swimming and yoga.

If you have any questions for Healthwords, please reach out to our team.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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