Cholesterol is a fatty substance that is absolutely essential for our bodies. It is a part of all cells of the body. The majority of the cholesterol in our body is produced in the liver. That's right, you make most of your own cholesterol. When your liver starts making too much of the wrong kind of cholesterol you can have problems.

What kind of cholesterol is there? When you have a lab test done and get a lipid panel done your doctor gets total cholesterol level, triglyceride level, high-density lipoprotein level and low-density lipoprotein level. Lipid is just a general term for fats and fatty substances. The most important numbers that you get back are the high and low-density lipoprotein levels (or HDL and LDL). Lipoproteins are the way that fats and cholesterol are packaged in the bloodstream.

LDL cholesterol is called “bad” cholesterol and HDL is called “good” cholesterol. The LDL packages are the ones that get stuck in our blood vessels. When too much cholesterol gets layered on the blood vessel it can narrow and lead to angina, heart attacks, strokes and other problems. The HDL packages actually remove cholesterol from the blood vessel and bring it back to the liver to be broken down. These levels are the most important when your doctor discusses your blood work with you. You can see how high total cholesterol and high LDL would be much different than high total cholesterol and high HDL.

Triglycerides are packages of fat that tell us mostly about recent intake of fats and how the body processes these. High levels of triglycerides are often seen in people who have high blood pressure or diabetes and sometimes with other rarer disorders.

What exactly do the numbers mean? This is not a simple question to answer at all. The most important thing for anyone to know though is that the number itself is not very meaningful unless it is taken in context of your overall risk for heart disease. This is after all why your doctor should be checking your cholesterol in the first place to assess your risk for heart disease.

Other risk factors include:

€ Having had a heart attack

€ Having diabetes

€ ANY recent smoking

€ High blood pressure

€ Being male over 45

€ Being female after menopause

€ Having a family member with heart disease

€ Being overweight

€ Not exercising

Ideally you want your total cholesterol less than 200.

Ideally you want your HDL cholesterol greater than 40. If your HDL is greater than 60 you actually have a lower risk for developing heart disease.

Your LDL level is somewhat dependent on your medical condition and risks for heart disease. If you have zero or one risk factors for heart disease you want your LDL lower than 160 and strive for lowering it below 130 with changes to your diet and exercise routine. If you have two or more risk factors for heart disease you should be working to change the ones you can (smoking, overweight, high blood pressure) and your LDL should be lower than 130. If you are a diabetic or have had a heart attack the recommendations are to get your LDL below 100 and some research has shown that getting it below 70 is optimal.

Next month I will address how to lower your cholesterol.

Dr. Davidd Levy is a family

physician practicing in Auburn.

To reach him, call his office at

282-0525