Introduction: Is Cholesterol Really the Villain?

For decades, high cholesterol has been blamed as the primary culprit in heart disease. Patients are routinely told their cholesterol is “too high” and are placed on statins without deeper investigation. But emerging research shows that cholesterol alone is not the full story—and for many, focusing solely on lowering cholesterol may miss the real threats to cardiovascular health.

In functional medicine, we view high cholesterol as a symptom, not a diagnosis. The goal is to understand why cholesterol is elevated, whether it’s truly harmful, and how to optimize your heart health based on a comprehensive, individualized approach.

What Is Cholesterol, and Why Does Your Body Need It?

Cholesterol is a fat-like substance produced by the liver and also found in certain foods. Despite its bad reputation, cholesterol is essential for survival.

It plays a vital role in:

• Hormone production (testosterone, estrogen, cortisol)
• Cell membrane structure
• Brain and nervous system function
• Vitamin D synthesis
• Bile production (for fat digestion)

Your body produces about 75% of its cholesterol on its own, and only about 25% comes from diet. This means your cholesterol levels are influenced more by internal signals like inflammation, insulin resistance, liver function, and genetics, rather than just eggs or bacon.

Understanding Your Cholesterol Numbers

When your doctor tells you your cholesterol is high, they’re usually referring to a basic lipid panel that includes:

• Total Cholesterol
• LDL (“bad”) Cholesterol
• HDL (“good”) Cholesterol
• Triglycerides

Let’s break them down:

🟥 Total Cholesterol

This number by itself is not meaningful. It includes both LDL and HDL and must be interpreted in context.

🟨 LDL Cholesterol

Often labeled “bad cholesterol,” but not all LDL is created equal. Small, dense LDL particles are more inflammatory than large, buoyant LDL. Standard panels don’t differentiate.

Functional medicine tests for LDL particle size and number (LDL-P) to assess risk more accurately.

🟩 HDL Cholesterol

HDL helps transport excess cholesterol back to the liver, reducing plaque buildup. Higher HDL is generally protective.

🟧 Triglycerides

Elevated triglycerides are often a marker of insulin resistance, metabolic dysfunction, or high carbohydrate intake—not fat consumption.

What Causes High Cholesterol?

Cholesterol levels rise in response to various internal stressors. Key contributors include:

1. Chronic Inflammation

Inflammation damages arterial walls, triggering the body to send cholesterol as a patching agent. If the inflammation persists, plaque forms.

Common causes:

• Poor diet (sugar, processed foods)
• Gut dysbiosis or leaky gut
• Autoimmune conditions
• Chronic infections
• Mold or toxin exposure

2. Insulin Resistance

High insulin promotes increased liver cholesterol production and inhibits the clearance of LDL. It also raises triglycerides and lowers HDL—a dangerous combination.

This is a major driver in:

• Type 2 diabetes
• Fatty liver disease
• Metabolic syndrome

3. Hypothyroidism

Low thyroid function decreases LDL receptor activity, meaning LDL isn’t cleared properly from the blood, resulting in elevated levels.

This is a commonly missed cause of high cholesterol, especially in women.

4. Nutrient Deficiencies

• Low magnesium, vitamin D, or CoQ10 can impair cholesterol metabolism.
• Choline and omega-3s help regulate triglycerides and support liver fat metabolism.

5. Genetic Factors

Familial hypercholesterolemia (FH) causes very high LDL due to receptor mutations, but it’s rare (1 in 200-500 people). Even in FH, lifestyle and inflammation still play a role in risk.

When High Cholesterol Might Not Be Dangerous

High cholesterol doesn’t automatically mean you’re headed for a heart attack. Context matters:

Higher cholesterol is often seen in:

• Older adults with low inflammation
• Those on low-carb or ketogenic diets
• Individuals with high HDL and low triglycerides
• Women with healthy hormones (cholesterol is needed to make estrogen!)

In fact, multiple studies have shown that very low cholesterol may be associated with:

• Depression
• Hormonal imbalance
• Cognitive decline
• Increased mortality in older adults

Functional Medicine Lab Testing for Cardiovascular Risk

Instead of guessing based on a basic lipid panel, functional medicine evaluates the full picture:

Advanced Labs May Include:

• LDL-P (Particle Number) – more predictive than LDL-C
• ApoB – marker of atherogenic particles
• hsCRP – marker of inflammation
• Lp(a) – genetic cholesterol variant linked to clot risk
• Homocysteine – inflammation and methylation status
• Fasting insulin and HOMA-IR – to evaluate metabolic dysfunction
• Omega-3 Index – anti-inflammatory fat levels
• Calcium score (CAC) – visualizes coronary plaque

These provide a deeper understanding of your actual cardiovascular risk.

How Functional Medicine Treats High Cholesterol Naturally

Rather than just lowering cholesterol with a pill, we seek to correct the underlying dysfunction that is driving cholesterol imbalance.

Step 1: Lower Inflammation

• Eliminate processed foods, sugars, and seed oils
• Increase antioxidants (berries, leafy greens, turmeric)
• Heal the gut with targeted probiotics and fiber
• Address infections, mold exposure, or autoimmune triggers

Step 2: Improve Insulin Sensitivity

• Reduce carb intake and processed grains
• Add daily movement (resistance training + walking)
• Intermittent fasting
• Support with nutrients like berberine, chromium, and magnesium‍

Step 3: Optimize Liver and Hormone Health

• Address hypothyroidism
• Ensure adequate vitamin D and B vitamins
• Support bile flow with choline, milk thistle, or dandelion root
• Restore sex hormone balance (testosterone, estrogen)

Step 4: Use Targeted Natural Supplements (if needed)

• Berberine – improves lipids and insulin resistance
• Omega-3s – lower triglycerides and inflammation
• Red yeast rice – natural statin-like effect
• Niacin – raises HDL and lowers Lp(a)
• CoQ10 – supports mitochondrial and cardiovascular health

These may be used alongside or in place of medications, depending on the individual’s risk.

When Statins Are Appropriate

Statins may be appropriate for those with:

• Documented heart disease or stents
• High-risk genetic markers (e.g., Lp(a))
• Very high LDL-P with high inflammation

But they are not always necessary in people with good metabolic health and low inflammation. And they come with side effects:

• Muscle pain
• Memory issues
• Fatigue
• Blood sugar elevation
• Nutrient depletion (CoQ10, vitamin K2)

If prescribed, we often co-manage with nutrient support and close monitoring.

Conclusion: Don’t Fear Cholesterol—Understand It

High cholesterol is not a disease—it’s a clue. When interpreted properly, it can guide us toward better metabolic health, improved inflammation control, and ultimately, a longer, stronger life.

At Sheen Vein & Cosmetics, we don’t just treat lab numbers. We help you understand why your cholesterol is high and how to correct the real issue—without over-reliance on medication alone.

📞 Schedule your functional cardiovascular assessment today and discover how personalized testing and root-cause care can transform your heart health from the inside out.

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