What Does it Mean to Have High Cholesterol?

What Does it Mean to Have High Cholesterol?

At Sheen Vein (Aesthetics and Functional Medicine) in St. Louis, one of the most common lab results patients bring to us is a report of “high cholesterol.” Many people immediately panic, believing it automatically means clogged arteries or a future heart attack. Others brush it off because they “feel fine.”

The truth is more nuanced. Cholesterol is not inherently bad—it’s an essential molecule your body needs. But when levels rise in certain ways, it can signal underlying metabolic dysfunction and increased cardiovascular risk. In this article, we’ll explore what cholesterol really is, what it means when levels are high, and how we approach it in functional medicine.

What is Cholesterol?

Cholesterol is a fat-like substance found in every cell of your body. It’s critical for:

  • Building cell membranes
  • Producing hormones such as estrogen, testosterone, and cortisol
  • Creating bile acids to help digest fats
  • Supporting brain and nerve function

Your body makes most of its cholesterol in the liver, while the rest comes from your diet.

Understanding Cholesterol Numbers

When you get a cholesterol panel, you’ll typically see several numbers:

  • Total cholesterol: The overall cholesterol in your blood
  • LDL cholesterol (low-density lipoprotein): Often called “bad” cholesterol because it can deposit in artery walls when oxidized or inflamed
  • HDL cholesterol (high-density lipoprotein): Considered “good” cholesterol because it helps transport cholesterol away from arteries and back to the liver for recycling
  • Triglycerides: Another type of fat in the blood that, when elevated, signals insulin resistance and higher cardiovascular risk

Traditionally, high LDL and total cholesterol were seen as direct causes of heart disease. We now know the story is more complex.

What Does High Cholesterol Really Mean?

When your cholesterol is elevated, it doesn’t automatically mean you have blocked arteries. Instead, it signals that your body is under some degree of metabolic or inflammatory stress.

Here are some key considerations:

1. LDL Particle Size and Number Matter

Not all LDL cholesterol is the same. Small, dense LDL particles are more likely to penetrate arterial walls and contribute to plaque. Large, fluffy LDL particles are less harmful. Advanced lipid testing can tell us which type you have.

2. Inflammation is the Real Culprit

High cholesterol by itself does not cause cardiovascular disease—inflammation and oxidative stress do. When LDL becomes oxidized, the immune system reacts, and arterial plaque forms. That’s why measuring markers like C-reactive protein (CRP) is equally important.

3. Triglycerides and Insulin Resistance

High triglycerides and low HDL often point to insulin resistance, which is a major driver of heart disease. This is common in people with prediabetes, diabetes, or metabolic syndrome.

4. Genetics Play a Role

Some people have genetically high cholesterol (familial hypercholesterolemia). For them, risk is higher, and more aggressive interventions may be needed.

5. Hormonal and Thyroid Health

Low thyroid function, menopause, and hormonal imbalances can all elevate cholesterol levels. In functional medicine, we always evaluate these root causes.

Symptoms of High Cholesterol

Here’s the tricky part: high cholesterol has no symptoms. Most people feel perfectly fine, even with very elevated levels. Sometimes, extremely high cholesterol may cause fatty deposits on the skin or around the eyes (xanthomas), but that is rare.

This is why regular screening is important, especially if you have risk factors such as:

  • Family history of heart disease or stroke
  • High blood pressure
  • Diabetes or prediabetes
  • Obesity or metabolic syndrome
  • Smoking history

Risks of Untreated High Cholesterol

Over time, unmanaged high cholesterol can contribute to:

  • Atherosclerosis – buildup of plaque in arteries
  • Heart attack – from blocked coronary arteries
  • Stroke – from blocked blood vessels in the brain
  • Peripheral artery disease – poor circulation in the legs

That said, not everyone with high cholesterol will develop these problems. The context of your overall health, inflammation levels, and lifestyle matter greatly.

Conventional Treatment Approaches

In traditional medicine, treatment often includes:

  • Statins (atorvastatin, rosuvastatin) – lower cholesterol production in the liver
  • Ezetimibe – blocks cholesterol absorption in the gut
  • PCSK9 inhibitors – newer injectable medications for very high cholesterol

Statins are widely prescribed and can save lives in high-risk patients, but they may also cause side effects such as muscle pain, fatigue, or blood sugar changes.

A Functional Medicine Perspective on High Cholesterol

At Sheen Vein (Aesthetics and Functional Medicine), we don’t look at cholesterol in isolation. We ask: Why is your cholesterol high in the first place?

Root-Cause Evaluation

We may order advanced tests to check:

  • LDL particle size and number
  • Inflammatory markers (hs-CRP, homocysteine)
  • Insulin resistance and blood sugar control
  • Thyroid function (TSH, free T3, free T4, antibodies)
  • Nutrient levels (vitamin D, magnesium, omega-3s)

Lifestyle and Nutrition Strategies

  • Anti-inflammatory diet: Emphasizing vegetables, fiber, lean proteins, omega-3 fatty acids, and healthy fats
  • Reducing processed sugars and refined carbs: Helps lower triglycerides and improve insulin sensitivity
  • Increasing fiber intake: Soluble fiber from oats, flaxseed, and legumes binds cholesterol in the gut
  • Exercise: Regular aerobic and strength training improves cholesterol and blood sugar balance
  • Stress management: Chronic stress elevates cortisol, which can worsen lipid metabolism

Targeted Supplements

Depending on individual needs, we may recommend:

  • Omega-3 fatty acids (EPA/DHA): Reduce triglycerides and inflammation
  • Red yeast rice (monacolin K): Natural statin-like effect for some patients
  • Niacin (vitamin B3): Can raise HDL and lower LDL/triglycerides (used cautiously)
  • CoQ10: Supports energy and may counter statin side effects

Advanced Therapies

We also integrate modern therapies like:

  • IV nutrient therapy for patients with deficiencies
  • Red light therapy (PBM) to support circulation and endothelial health
  • Weight optimization programs to reverse metabolic dysfunction

Why Context Matters

Two people can have the exact same total cholesterol number—but their risk is very different depending on inflammation, blood sugar, blood pressure, and lifestyle.

For example:

  • A 45-year-old woman with high LDL but low inflammation, healthy weight, and no insulin resistance may not need medication.
  • A 55-year-old man with moderate LDL elevation but high triglycerides, low HDL, prediabetes, and high CRP may be at much greater risk.

That’s why a personalized approach is essential.

Final Thoughts

High cholesterol is not a diagnosis—it’s a signal. It tells us there may be deeper issues with inflammation, metabolism, or hormone balance. While conventional medicine often focuses on lowering the number at all costs, functional medicine looks at the bigger picture: why the cholesterol is high and how to restore balance naturally when possible.

At Sheen Vein (Aesthetics and Functional Medicine) in St. Louis, we combine advanced testing, lifestyle medicine, and regenerative therapies to address cholesterol in a comprehensive way. Our goal is not just lowering a lab number, but helping you live longer, healthier, and with more vitality.

If you’ve been told you have high cholesterol and want a deeper, root-cause approach, schedule a consultation with us today. Visit our contact page to get started.

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