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Navigating the world of cholesterol can feel like traversing a maze of conflicting information. Scientific journals and online resources often present contradictory viewpoints, leaving you confused and uncertain. The key to clarity? Breaking down the biological processes. By understanding how cholesterol works within your body, you'll gain the knowledge necessary to cut through the noise and make confident, well-informed health choices.
What is Cholesterol?
Cholesterol is a sterol, a type of lipid that's insoluble in water and structurally very rigid. It's found in every cell membrane and is vital for many processes that occur in the body. The body synthesizes 80% of its cholesterol primarily in the liver, while dietary intake accounts for the remaining 20%. When total body cholesterol is high, liver production decreases. When total body cholesterol is low, liver production will increase, assuming that the body and all its metabolic processes are healthy and functioning properly. This internal production underscores cholesterol's importance - if the body makes the majority of a substance, it's critical for survival.
Functions of Cholesterol
Cholesterol is essential to many critical processes in the body, serving as:
A precursor for steroid hormones such as cortisol, DHEA, testosterone, and estrogen
A key component in vitamin D synthesis
A vital element for reproductive health
A building block for bile production, necessary for fat digestion
An integral part of cellular structure and membrane integrity
An important factor in tissue repair and regeneration
A crucial support for the central nervous system, contributing to neuron health, nerve coatings, and efficient nerve transmission
Cholesterol Synthesis
Cholesterol is synthesized through four main pathways:
Synthesis in the liver
Absorption in the small intestine
Breakdown of sugars, fats, and proteins
Synthesis in adrenal glands, ovaries, intestine, muscle, skin, and placenta (most cells in the body can make their own cholesterol)
Cholesterol synthesis relies on nutrient cofactors such as vitamins B6, B12, and folate. These are essential for facilitating the chemical reactions involved in its production. (There are other coenzymes and cofactors that are needed, but we won't go that deep into the biochemistry here.)
Cholesterol Transport
Being hydrophobic (insoluble in water), cholesterol requires protein transport molecules to move through the bloodstream. These include:
VLDL: Very Low Density Lipoprotein
LDL: Low Density Lipoprotein
HDL: High Density Lipoprotein
The Transport Process:
VLDL binds with cholesterol and triglycerides in the liver
The triglycerides are dropped into fat cells and then VLDL turns into LDL
LDL carries cholesterol to the cells that need it (this can be any cell type from red blood cells to neurons)
HDL picks up the used (oxidized) cholesterol and returns it to the liver where it's converted to bile salts and excreted in the feces
Total Cholesterol
Total cholesterol is a measure of the amount of cholesterol present in the blood. It includes LDL and HDL in the number.
In a normal, healthy person with a balanced cholesterol profile, total cholesterol should be about 100 points higher than LDL.
Low cholesterol can lead to various issues, including:
Weak cellular membranes
Poor quality myelin sheath (the coating of nerves)
Impaired brain function and neurotransmission
Cognitive difficulties and poor memory
Reduced steroid hormone production
Impaired immune system function
Fatty acid deficiency
Uncontrolled inflammation
Many factors can contribute to elevated cholesterol levels, including diets high in refined foods, blood sugar imbalances, cardiovascular disease, chronic inflammation, hormone disruptions, infections, and dysfunction in the liver or bile production. However, the key question to ask is: why are cholesterol levels high? What is damaging the arterial walls or causing injury to cell membranes? It’s important to remember that cholesterol doesn’t accumulate in these areas without an underlying reason. Identifying and addressing the root cause of the damage is essential for resolving the issue and supporting overall health.
Triglycerides
Triglycerides primarily function to store energy and provide fuel for the body. Through a process called lipolysis, triglycerides are broken down into fatty acids and glycerol, which the body uses for energy. Glycerol is converted into glucose, while fatty acids are turned into ketones. Triglycerides can become highly inflammatory when elevated, as they are stored in fat cells—particularly in the abdomen. They can also be stored in the liver, especially when there's an excess; this can lead to the development of non-alcoholic fatty liver disease (NAFLD).
In a healthy individual, triglyceride levels should be about half or less of total cholesterol.
Low triglycerides may indicate issues with liver function, bile production, or insufficient intake of healthy fats or protein.
High triglycerides are often linked to a diet high in refined carbohydrates, unhealthy fats, or excessive fructose consumption, as well as impaired fat metabolism. Elevated levels can increase the risk of atherosclerosis, metabolic syndrome, and insulin resistance.
Low Density Lipoprotein (LDL)
LDL is a protein responsible for transporting cholesterol and other fats from the liver to peripheral tissues. Approximately 60–70% of total blood cholesterol is carried by LDL. However, LDL can deposit cholesterol in artery walls, contributing to plaque buildup and atherosclerosis.
LDL levels respond quickly to lifestyle changes, making them highly modifiable. Elevated LDL can result from a poor diet, such as the standard American diet, as well as insulin resistance and inflammation. When inflammation damages the vascular system, the liver produces more LDL to deliver cholesterol to the damaged area for repair. Unfortunately, when LDL accumulates in the arterial lining, it oxidizes, further driving the atherosclerotic process.
Low LDL levels may suggest a need for more exercise or potential imbalances in steroid hormones.
High LDL levels can stem from several factors, including atherosclerosis, inflammation, excessive consumption of refined carbohydrates and unhealthy fats, metabolic syndrome, insulin resistance, or liver issues such as liver congestion or fatty liver. Hormone replacement therapy and exposure to a partner using testosterone (transferred through skin contact via sweat) can also elevate LDL.
High Density Lipoprotein
HDL is a protein carrier that transports fats and cholesterol from peripheral tissues back to the liver for removal, a process called 'reverse cholesterol transport.' This function helps reduce the risk of cholesterol buildup in the arteries. Essential nutrients for this process include B vitamins, magnesium, and copper.
When evaluating LDL and HDL together, it’s important to ensure that the cholesterol being sent out by LDL is effectively returned by HDL, preventing it from accumulating in peripheral tissues. Ideally, HDL levels should be inversely proportional to LDL. Higher HDL levels indicate lower inflammation, as cells aren’t relying on cholesterol for tissue repair, and HDL is able to carry the used cholesterol back to the liver for elimination.
Factors that negatively influence HDL levels include:
Medications like steroids, diuretics, and beta blockers
Stress
Low-calorie diets
Obesity and a sedentary lifestyle
Low HDL levels may indicate liver congestion or fatty liver, atherosclerosis, metabolic syndrome, oxidative stress, or a lack of physical activity.
Higher than normal HDL levels can result from a family history of high cholesterol, alcohol consumption, hormone replacement therapy, steroid use, or autoimmune conditions.
Very Low Density Lipoprotein (VLDL)
VLDL is a carrier protein that transports triglycerides, fatty acids, and about 10–15% of total cholesterol. Its primary role is to deliver triglycerides from the liver to tissues throughout the body. As it travels through the bloodstream, VLDL releases triglycerides to where they’re needed, gradually shrinking in size. Once depleted of triglycerides, it transforms into intermediate-density lipoprotein (IDL), which can either return to the liver to collect more triglycerides or convert into LDL to transport cholesterol.
Elevated VLDL levels are often linked to diets high in refined sugars and carbohydrates. Like LDL, it can contribute to plaque formation within the arteries and increase the risk of cardiovascular disease.
Cholesterol/HDL Ratio
This ratio is used to determine cardiovascular risk. It’s calculated by dividing total cholesterol by HDL. If the value is greater than 4.8 this can mean there’s a higher risk for cardiovascular disease. The higher the value, the greater the risk.
Managing Your Lipid Profile
Trying to regulate cholesterol levels without first addressing underlying issues such as the microbiome, stress, blood sugar imbalances, the immune system, or hormonal imbalance may not be the best course of action. The key is not just cholesterol levels alone but the overall balance of the lipid profile, as healthy ratios indicate optimal function. The chart below summarizes all the components of the lipid panel, also known as the cholesterol profile.
What Is It? | Notes | |
Total Cholesterol | A measure of all cholesterol in the blood, including HDL and LDL | Should be about 100 points higher than LDL. |
Triglycerides | Energy storage and fuel for the body; inflammatory at high levels | Should be half or less of total cholesterol |
VLDL | Transports triglycerides from liver to body tissues | VLDL and LDL together are considered "bad" cholesterol while HDL is considered "good" cholesterol; VLDL and LDL are only bad when their levels are out of balance |
HDL | Carries used cholesterol from body tissues back to liver | HDL and LDL should be inversely proportional: what goes out must come back in for elimination |
LDL | Carries cholesterol from liver to body tissues | Ideally, LDL should be lower than HDL |
Cholesterol/HDL Ratio | Calculates risk for cardiovascular disease | The higher the number, the greater the risk for cardiovascular disease |
The next chart shows the standard reference ranges for the lipid panel and discusses what range may be considered optimal according to functional medicine:
Standard Reference Range | Notes | |
Cholesterol | 100 - 199 | At levels of 100, it's difficult for the body to produce steroid hormones and blood sugar regulation may be disrupted. Numbers between 150 to 180 may be best according to functional medicine. As we age, even higher numbers may be normal and beneficial (closer to 200). |
Triglycerides | 0 - 150 | The optimal range may be somewhere between 50 - 80 since they should be half or less of total cholesterol. |
VLDL | 5 - 40 | Like LDL, we want this number to be on the lower end. |
HDL | > 39 | Optimal levels may be around 60 - 90. We want this number to be higher than LDL since it's considered "good" cholesterol. |
LDL | 0 - 99 | Optimal levels may be around 70 or less. Lower is better since this is considered "bad" cholesterol. Remember that we want this number to be at least 100 points lower than total cholesterol. |
Cholesterol/HDL Ratio | 0 - 4.4 | Numbers between 0 and 3 may be considered optimal. The lower this number is, the lower the risk of cardiovascular disease. |
Improving Your Lipid Panel Naturally
Now that you have a solid understanding of how cholesterol functions in the body, you can take steps to improve your overall lipid profile or maintain it if it's already in a healthy balance. If you’re taking cholesterol medication, do not stop taking it without consulting your primary care physician. Additionally, consult with them before using any of the recommendations below to make sure they are safe for you.
If you have inflammation, heavy exercise can make you feel worse, so it's best to start with activities such as walking, gentle stretching, and using a rebounder.
Aim for walking about 30 minutes per day.
10 minutes on a rebounder per day is a great low impact, moderate intensity workout.
Daily stretching will help your body to feel better overall. I love this morning stretch routine and this evening stretch routine.
Remember to listen to your body - if something hurts or doesn't feel right, don't do it and pick something easier or more gentle.
A good measure of inflammation in the body is high-sensitivity C-reactive protein (hs-CRP), a blood test that provides a measurable value, offering valuable insight into the severity of inflammation. Elevated hs-CRP levels are often linked to increased cardiovascular risk, as chronic inflammation can contribute to the development of plaque in the arteries, potentially raising LDL cholesterol and lowering HDL cholesterol. By monitoring your hs-CRP levels, you can assess how well your body is managing inflammation and address any underlying issues. If your levels are high, adopting an anti-inflammatory diet is essential to help reduce inflammation and restore balance. Focus on incorporating foods rich in antioxidants, healthy fats, and fiber, while avoiding refined sugars, processed foods, and trans fats. Making this diet a lasting part of your lifestyle not only helps reduce inflammation but also supports better cholesterol levels and overall cardiovascular health. You can order your own hs-CRP test here to get a clearer picture of your inflammation status, or you can ask your doctor to order the test.
Chronic stress can significantly impact cholesterol levels by increasing the production of stress hormones like cortisol, which in turn can raise LDL cholesterol and lower HDL cholesterol. Stress also triggers inflammation, which can further contribute to the buildup of plaque in the arteries, increasing cardiovascular risk. Managing stress is essential for maintaining healthy cholesterol levels and supporting heart health. Find an effective stress-management strategy that works for you, whether through mindfulness practices like meditation, physical exercise, deep breathing, or time spent in nature. Reducing stress not only improves cholesterol levels but also promotes overall cardiovascular wellness
Our gut has a profound impact on every process in the body, including cholesterol metabolism. When gut health is compromised by dysbiosis—an imbalance of gut bacteria—it can disrupt cholesterol processing, contribute to systemic inflammation, and impair bile production, which is essential for breaking down and eliminating cholesterol. Addressing dysbiosis and supporting friendly gut bacteria often helps improve cholesterol levels and restore balance across the body. Supporting a healthy gut is a critical step in managing cholesterol and achieving overall health.
Remember, the liver plays a crucial role in the metabolism of cholesterol and all the components of the lipid profile. It produces and regulates cholesterol, helping to maintain a healthy balance between LDL and HDL cholesterol. Additionally, the liver is responsible for bile production, which is essential for the elimination of excess cholesterol. When liver function is compromised, cholesterol metabolism can become disrupted, leading to imbalances in the lipid profile. Supporting liver health through diet, hydration, and proper detoxification can help optimize cholesterol levels and overall cardiovascular health.
Eliminating refined sugars and adopting a low-glycemic diet can significantly improve your lipid profile, including lowering LDL (bad) cholesterol and raising HDL (good) cholesterol. Reducing or eliminating fructose and refined carbohydrates helps prevent cholesterol imbalances and supports better heart health. Naturally occurring carbohydrates from whole fruits and vegetables can still be part of a healthy diet, as they provide essential nutrients and fiber. This approach not only improves cholesterol levels but also helps manage high blood glucose and combat early stages of insulin resistance—conditions that directly impact cholesterol metabolism. The good news is that these blood sugar markers can respond quickly to dietary changes.
Getting enough high-quality protein is essential for maintaining healthy cholesterol and triglyceride levels. Protein helps regulate lipid metabolism and supports the production of enzymes that process fats in the body. Including high-quality protein sources like grass fed and pastured meats, fish, eggs, legumes, and plant-based proteins can help stabilize blood sugar, reduce inflammation, and improve lipid profiles. Protein also plays a role in maintaining muscle mass, which is important for overall metabolic health. In particular, omega-3 rich fish such as salmon and mackerel are excellent choices, as they can help lower triglycerides and promote a healthier balance of LDL and HDL cholesterol. Grass-fed, pastured meat is high in omega-3 fatty acids while conventional meat is high in omega-6 fatty acids. By prioritizing nutrient-dense, high-quality protein in your diet, you can support better cholesterol levels and reduce the risk of cardiovascular issues.
Supplements and Herbs that May Help With Cholesterol Levels
These supplements and herbs are excellent options for supporting healthy cholesterol levels. Some, like red yeast rice or fish oil, are widely available in supplement form, making them convenient for daily use. Others, such as holy basil and ginger, can be enjoyed as flavorful teas that provide additional health benefits while promoting relaxation. By incorporating a combination of these into your routine, you can support your cholesterol levels naturally and effectively.
Prickly Pear Juice: may help regulate blood sugar while lowering LDL and total cholesterol. It's loaded with natural minerals and B vitamins, and contains no sugar. Just mix a little with water, and add some monk fruit extract or stevia extract to sweeten to taste.
Black Cumin Seed: may help lower LDL and total cholesterol.
Red Yeast Rice: contains monacolin K, which has a similar chemical signature to certain cholesterol-lowering medications.
Omega 3 Essential Fatty Acids: may lower triglycerides and increase HDL.
Ahiflower oil
Soluble Fiber: may lower LDL.
Flaxseeds: contain omega 3's and fiber
Psyllium: may help clear cholesterol from the bloodstream and eliminate it through digestion (feces)
Herbs that may help lower cholesterol include:
Fenugreek seeds and leaves: may improve the entire lipid profile (lowers LDL and triglycerides while increasing HDL)
Artichoke leaf extract: may lower LDL and triglycerides
Hawthorn: may increase HDL while lowering LDL and triglycerides; may support bile synthesis; may protect the heart from heart disease
Holy Basil: taking 1 gram per day may lower total cholesterol and LDL
Ginger: may lower total cholesterol, LDL and triglycerides; supports digestion
Turmeric: anti-inflammatory and antioxidant properties may help lower cholesterol; may prevent blood clots
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Wrapping Up: Keys To Cholesterol Balance
Cholesterol is far more than just a number on a lab report—it’s a critical component of your body’s overall health and vitality. Understanding how cholesterol functions, the factors that influence its levels, and how it impacts other systems in your body is key to making informed choices about your health. By addressing root causes such as inflammation, stress, gut health, and liver function, while adopting a balanced diet and lifestyle, you can improve your lipid profile naturally and effectively. Remember, your body is a dynamic system, and cholesterol levels are just one piece of the puzzle. When you focus on supporting your overall well-being, cholesterol balance often follows, paving the way for a healthier, more vibrant life.
This post is for educational and informational purposes only and does not constitute medical advice. The natural products and remedies mentioned here are not intended to diagnose, treat, cure, or prevent any disease. Results may vary. Always consult your healthcare provider before trying any new health regimen or natural product, especially if you have a medical condition or take medications. The information provided here does not replace professional medical advice, diagnosis, or treatment.
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