Is There Really GOOD Cholesterol?

is there really good cholesterol? continuum internal medicine

Is There Really GOOD Cholesterol?


You are at your doctor’s appointment and your cholesterol panel is reviewed. All you hear is that your LDL and triglycerides are too high and it is recommended that you eat a low-fat diet and have your cholesterol rechecked in a few months. What are LDL and triglycerides, you ask?

Listening to your doctor explain the results can at times seem like you’re listening to a foreign language, but it doesn’t have to feel that way. Let’s go into specifics of a cholesterol panel. The standard cholesterol panel includes total cholesterol, LDL (low-density lipoprotein), triglycerides, and HDL (high-density lipoprotein).

LDL (or what I like to call “lousy” cholesterol) has been studied and confirmed to be a significant player in plaque development in the arterial walls. Plaque propagation contributes to heart attacks and strokes; therefore, it is important to monitor and reduce one’s LDL if it’s elevated. This can be done by changing your lifestyle to include a low-fat diet and exercise, as well as prescription treatment in those patients with cardiac risk factors or those that have persistently elevated LDL levels regardless of lifestyle changes. I describe LDL to patients as being the substance in the blood that acts as concrete within the arterial walls by forming plaques. If the plaque grows, it can narrow the artery, and this can cause an occlusion (or blockage) of an artery resulting in a heart attack. Essentially, a heart attack happens because of decreased or eliminated blood flow from the artery to the heart muscle (think of a clogged pipe). Your physician will discuss your ideal LDL goal depending on your cardiovascular medical history, cardiac risk factors, and diabetic status.

HDL (or what I like to call “heavenly” cholesterol) has a different role. This is what doctors refer to as your good cholesterol. HDL acts as a vacuum to clean up excessive cholesterol in your blood. HDL then transports this excessive cholesterol to the liver to be broken down (i.e., to be disposed of). It is also essential for patients to understand that increasing your HDL is also important, and a desirable goal for HDL would be greater than 60mg/dl. This can be done by exercising and losing weight. Keep in mind that raising your HDL is usually more difficult than lowering your LDL.

Triglycerides are another type of fat in the blood that is associated with atherosclerosis, or plaquing of the arteries. Their exact role still remains unclear. The desirable goal for triglycerides is less than 150 mg/dl. Triglycerides store unused calories and provide your body with energy. High triglycerides can be an early sign of Type 2 diabetes, so a fasting glucose should be checked. Decreasing triglyceride levels can be done by losing weight (are you seeing a theme here?), avoiding sugar, exercising regularly, consuming omega-3 fatty acids, and taking prescription medication.

I hope this has helped you better understand the components of your cholesterol panel, and that the next time you are reviewing your cholesterol with your doctor, you can be an active participant in the discussion.

If you have questions or would like to discuss any concerns you have regarding your cholesterol, you can schedule an appointment with me, Dr. Mai Sharaf, by calling 817-617-8650 or by scheduling online at

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