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Elevate Your Cholesterol Profile, Elevate Your Health

by Dr. Stephen Gangemi on January 15, 2012

It’s interesting when I see a patient and go over their blood work. They’re always most concerned about one thing – their cholesterol. Other blood levels could be significantly out of normal range, but typically most are worried if their cholesterol level is high, or not. Medical doctors, the media, and of course the pharmaceutical industry has ingrained in each person (including children) the notion that cholesterol is bad and if you don’t lower it, you’re gonna die. Really? I’m doing everything I can to raise mine.

Who is dying from high cholesterol?

Cardiovascular problems, such as heart disease and heart attacks, are a major health problem in today’s societies – they’re the number one cause of death. Cholesterol is often implicated as a major player in these types of problems. High cholesterol may be a factor of an underlying problem, or it may just be a coincidence that one’s cholesterol is elevated due to other health problems, related or unrelated to the cardiovascular system. Typically, due to medical intervention, patients are already on cholesterol lowering medications yet they’re still having health problems, and definitely not living any longer. So if it was just all about high cholesterol causing heart disease and lowering cholesterol resolving these problems then there would be a major improvement in this healthcare crisis.

Cardiovascular disease is caused by a wide range of nutritional, lifestyle and environmental factors that result in inflammation that gets out of control. Sure genetics most likely have some factor, but minimal compared to the rest. The genetic link is typically a cop-out when someone doesn’t take control of their own health. Toxins, infections, excessive stress, lack of proper exercise and diet are far more damaging to the heart than high total cholesterol.

I’m not at all insinuating that high cholesterol is okay, but I am definitely saying that less is not necessarily better. There’s more to it than just that. Cholesterol just doesn’t shift to a dangerous level without other contributing factors. A poor diet and overall health lead to unhealthy cholesterol levels whether that’s low, (as mine were back in the early 1990s), high, or imbalanced. I’ll discuss this more in a bit.

Why do you need cholesterol?

I have been trying for years, decades actually, to raise my cholesterol. Finally after a more significant (call it strict if you like) change in diet, it’s happening and that’s a good thing. You see, low cholesterol is often much more dangerous than high cholesterol even though we’re led to believe that cholesterol is evil. A cholesterol level below 160 mg/dl is said to increase one’s risk of many cancers, stroke, neurological problems such as memory loss and dementia, and many other health problems ranging from digestive to hormonal. I often tell a patient that if they had to pick one, high cholesterol is better than low. Of course, a healthy level is best – which is based off the components that make up cholesterol as discussed below.

Some notable cholesterol functions:

  • It acts as a precursor to vitamin D – low cholesterol means it will be more difficult to absorb this vitamin necessary for a healthy immune system, bones, and DNA. More on vitamin D here.
  • It is the precursor to all steroid hormones such as glucocorticoids which control blood sugar, mineralcorticoids which regulate electrolyte balance and blood pressure, and sex hormones such as progesterone, estrogen, and testosterone.
  • It is used to synthesize bile acids in the liver, which are important for the digestion of fats. These bile salts are then stored in the gallbladder.
  • Cholesterol is found in every cell of your body and is a necessary component of a healthy brain that needs to store and recall memory, process ideas, and function at its highest level.

About 20 years ago my total cholesterol level dropped to 92 mg/dl. I was a student at the University of Miami, well known for its pre-med program. The leading physician at the student health center at that time thought I was extremely healthy; I had the “best” cholesterol level he had ever seen. As nice as he was, this unenlightened doctor did not realize that it was actually perhaps one of the worst he had discovered. I, at the time, knew no better and clearly didn’t know the dangers of such a low level. I was training hard, studying hard, and following the low-fat, high carbohydrate diet of the late 1980s-early 1990s.

Good, bad & ratios

Most of us know that cholesterol is made up of HDLs, LDLs, and VLDLs (which are mostly triglycerides). The HDLs tend to remove cholesterol from tissues so many think of them as the “good” cholesterol whereas the LDLs tend to deposit cholesterol into tissues, so we are told this is the “bad” stuff. In reality it is not that cut and dry, because there are also good and bad LDLs, and good and better HDLs.

Triglycerides are major transporters of dietary fat in the bloodstream – especially fat that has resulted from excess carbohydrates in the diet. On average, a diet consisting of 60% or more of carbohydrates can increase triglyceride levels as can heavy alcohol use. I’ll leave the determination of “heavy” up to you, but typically that means two or more drinks per night, sometimes less.

Your tissues need cholesterol or you will die; so not all LDLs are as bad as they’re made out to be. All cholesterol  particles can be either large or small. Ideally you’d like to have more large, buoyant HDLs and LDLs than small, and more small VLDLs/triglycerides than large. These can be measured through a more thorough lipid analysis, and are readily available today – click here for more info.  One sign that your LDLs are most likely large (good) rather than small (bad) is your HDL to triglyceride ratio. If your HDLs are at least one-half of your triglycerides, then you most likely have large LDLs. So for example, if your HDLs are 40 and your triglycerides are over 80, you have some work to do.

Another good ratio to look at is the total cholesterol to HDL ratio. Most lab reports say this ratio is normal if it is 5:1 or lower. That is still very high, and in my opinion you should shoot for 3:1, if not lower. So if your total cholesterol is 180 and your HDL is 60 that is good. If your total cholesterol is 250 with a  HDL of 100, LDL of 130 and triglyceride of 100 that is also good!

The LDLs really freak people out. I tell patients that it is almost impossible to pass a cholesterol test today. At least one result from the lipid panel is most likely going to be flagged. You’re destined to fail – healthy or not. You see, what has happened is that the LDL upper limit was dropped several years ago by most labs from 138 to 100. So now a LDL of say 125 is considered high, regardless of whether they are the small or large LDLs. Interestingly, around the same time this happened, the pharmaceutical industry was trying to get the upper limit of total cholesterol lowered from 200 to 190. That way, if your cholesterol level was 195, your doctor would recommend a statin medication “for your health.” This never happened, but the LDL was soon lowered – a whopping 38 points. Uncanny coincidence. So now a lipid panel of say 190 total cholesterol, 65 HDL, 105 LDL, and 100 triglycerides, (a triglyceride makes up 1/5 of the total cholesterol, so 100 = 20 of the total points), which is excellent, is flagged as having a high LDL. That’s not cool.

LDLs however are the big issue when it comes to heart health but it is the oxidized LDLs rather than LDLs per se that contributes to atherosclerosis and “cholesterol problems.” What causes LDLs to oxidize? Free radicals, unhealthy fats, and a high carbohydrate diet cause the oxidation.

Free radical damage is often the result of lack of antioxidants in the body, such as vitamins A, C, and E but perhaps more importantly are all the healthy antioxidants found in fruits, vegetables, and herbs. Vitamin D is also a very important antioxidant – and one that won’t be well utilized by a low cholesterol body. Coenzyme Q10 is a very an important antioxidant needed by the heart and for the body to make energy. Statins (cholesterol meds) block CoQ10 from being made naturally in the body, therefore increasing free radical damage and further oxidizing LDLs. The more stress one is under – physical, nutritional, and emotional – the more free radical damage your body will succumb to.

Unhealthy fats mean partially hydrogenated “trans” fats as well as all polyunsaturated vegetable oils – corn, soy, sunflower, safflower, peanut, cottonseed, and yes definitely canola. More on that here.

And yes high carbohydrates (refined sugar especially) will lead to oxidized LDLs. More on cutting the carbs here.

Oxidized LDLs cause the body’s immune system to respond by sending in specialized white blood cells to absorb the oxidized LDLs. This creates what are called foam cells which are not able to process the oxidized LDLs, so they ultimately grow then rupture, depositing a greater amount of oxidized cholesterol into the artery wall. This of course triggers more foam cells, continuing the cycle. Foam cells can accumulate and lead to atherosclerosis (inflammation in the vessel wall), a thrombus or emboli (properties of a stroke), from all the accumulated plaque (fats and cholesterol particles). The occlusion of small vessels results in ischemia and can also result in a stroke and myocardial infarction (heart attack).

The point here – small, dense LDLs are the problem because they’re easily oxidized. Once you get more and more oxidized, you’re in trouble.

Cholesterol and Satan (I Mean Statins)

Statins are known as HMG-CoA reductase inhibitiors – they stop the synthesis of a compound called mevalonate from being formed. Mevalonate is the precursor of cholesterol, but also the precursor of squalene and coenzyme Q10 (ubiquinone), as previously mentioned.

Statins, other than blocking how cholesterol and other compounds are made, are touted as beneficial as some studies show they greatly increase the amount of nitric oxide made by the blood vessel lining which results in stroke reduction and its residual neurological effects.Some also say that statins protect against stroke by increasing the body’s ability to dissolve blood clots independently of both nitric oxide and cholesterol. Of course, as mentioned previously, you can significantly lower your risk of stroke by limiting your number of oxidized LDLs. Additionally, nitric oxide is made naturally in high amounts in healthy individuals with adequate protein intake (via the amino acid arginine) and proper cofactors (primarily manganese and vitamin B6).

The Lancet recently published a study saying how safe and effective statins are. These studies often come out to reassure doctors and patients that “all is good.” This one is no different. You can see the study here. The participants in this study either had already had a heart attack or some other form of cardiovascular disease or a condition that would place them at high risk. Also they looked at cancers and non-vascular mortality, not “health.” Oh yeah, it’s worth mentioning that one of the two researches received funding from several drug companies that make statins and has been on drug company advisory boards and even received a honoraria from Pfizer.

How about Pfizer? They make Lipitor, the top-selling drug in history, which lost its patent on November 30, 2011. What a sad day. They pulled in $11 billion worldwide for Lipitor sales last year. Now that some new generics have taken 63% of sales recently they’re down to just a measly $4 billion on the drug, if sales stay up. Speaking of money – here’s an interesting preview of a film called “$29 Billion Reasons to Lie About Cholesterol”. Remember Crestor was pulled off the market (2004 I believe) after being linked to kidney failure. It’s back on the market with that nifty little black box warning. Ever read one of those? Nobody has.

So do you go on a statin if your cholesterol is too high or you’re at some cardiovascular health risk? Personally I think most are putting themselves at more of health risk by doing so, but of course I’m not saying you should stop your medication if you’re on one, but you should understand what they do and really look into why one has been recommended to you. I’ve seen patients on statins for cholesterol levels well below 200, but their doctor thinks “lower is better.” I’ve seen many patients on them who have had pain and fatigue (shoulder pain is very common from statins) yet their doctor tells them to push through it. Many still have pain after they get off the meds.  I even saw a guy who was on a statin to “prevent a heart attack” because his family member, a smoker, had a heart attack. Really. The statin brought his cholesterol down from the 170s to the 120s. These are scary, but true stories. High cholesterol is not the primary cause of heart disease and statins don’t decrease this risk for most people. Statins do however impair vitamin D metabolism and CoQ10 production as previously mentioned, as well as squalene production.

Squalene accumulates at the greatest concentrations in the skin, where it has a vital role as a free radical scavenger, preventing the harmful effects of the degeneration of fats. Adequate concentrations of squalene in the skin prevent oxidative damage from ultraviolet light. Squalene is also a substance that protects people from cancer, so yeah squalene is important. You may have heard of claims that “sharks don’t get cancer.” This is because squalene is super high in shark liver oil. I don’t know if sharks get cancer and I don’t think you should go shark hunting. But you should naturally keep your squalene levels high.

As a sort of side note – I think it’s rather comical that medical doctors think they’re protecting their patient by checking the liver enzymes (AST & ALT) when they prescribe a statin. The liver has to detox these meds and of course cholesterol is made in the liver but there are often functional problems (detoxification impairments) long, long before the enzymes become elevated. I’ve never seen a person taking a statin have elevated liver enzymes yet I’ve seen plenty of them with adverse statin reactions (“side-effects”) – pain, fatigue, and memory problems are the most common.

Less is often not better when it comes to cholesterol

Sure you still need a lot of HDLs and healthy LDLs, but ultimately you need cholesterol. For years after coming off my 92 mg/dl cholesterol plummet, my total cholesterol level hovered between the 130-150 range. My HDLs were always around 50, so that was good, and my triglycerides were always between 70-90 – also good. My LDLs in the 60-80 range – also good. But overall – too low! So back in August 2011 I changed my already very healthy diet to one that was even more healthy for me. I had been eating a diet approximately 55-60% carbohydrate, 20-25% protein, and 20-25% fat. The fat was mostly extra virgin olive oil, butter, nuts, and seeds as well as some fish oil. In August I adjusted to approximately 10-20% carbohydrate, 20-25% protein, 60-70% fat. Additionally, for fats, I significantly reduced my nuts and seeds and added in a lot of coconut oil and coconut milk, more butter, avocados, and a lot of eggs, (pasture raised of course from my 12 hens). In the carbohydrate category I almost completely eliminated all grains with the exception of some corn, rice, and sweet potatoes which I eat on hard intensity or long duration exercise days – this amounts to anywhere from 0-4 times a week. The majority of carbohydrates are from vegetables and some fruit. Oh yeah, 80% dark chocolate too. Did I develop cardiovascular disease? Nope. For the first time ever my total cholesterol hit 170. My HDLs went up over 50% to 78 and my triglycerides dropped even lower to 48 while my LDLs stayed at 82. That’s great to see. And if you’re following, notice that my HDLs, which ideally should be at least one-half of the triglycerides, are actually 1.6X MORE than the triglycerides. What I’ve done is decrease my risk of cancer, stroke, and dementia. Now where was I…

So what’s it all come down to? Diets high in saturated fat and cholesterol don’t cause heart disease. Check out the cool video below to learn even more than what I have here. Actually it’s the high carbohydrate diets and so-called “heart healthy” vegetable oils (corn, soy, canola, safflower, peanut, etc) that are linked to heart disease, cancer and most all diseases. A diet high in carbohydrates and inflammatory oils increase LDLs and oxidize them – and that can cause atherosclerosis.

How to naturally lower or raise cholesterol to a healthy level for you

Are you, “unable to control your cholesterol with diet and exercise”?  What does that even mean? Most doctors don’t exercise or eat well and they sure don’t how to prescribe it. So they fall back on the “diet and exercise alone aren’t enough” motto and recommend a statin. Proper exercise and a healthy diet can do wonders for your health and your cholesterol. That doesn’t mean you cut out all the fat from your diet and get up from your desk a few times a day to walk to the water cooler. Here are some recommendations with the concept that maintaining heart health is about keeping inflammation at bay.

  • Remove all refined sugar (that includes juice) and grains from your diet. Triglyceride levels quickly drop with a low carb diet. Check out the Paleo Diet and Two Week Test here to get started.
  • Oatmeal? What a joke. Does Wilford Brimley look healthy to you?
  • Exercise! Aerobic exercise is a great way to start especially if you’re already on a statin (or any med for that matter). Strength training may be beneficial for you too.  More here. It may be advised for you to have a stress test before engaging in any physical activity. Then again, if you don’t move and engage in some physical activity, isn’t that hazardous to your health?
  • Eat a lot of organic vegetables – the more the better. Sorry, corn and potatoes are not veges.
  • Keep the fruit to 1-2 servings a day; more only if you exercise intensely or for a long duration.
  • Eggs don’t raise cholesterol. Actually, they most likely will lower it. Make sure they’re pasture raised. Butter, heavy cream, avocados, and my favorite – coconut milk & oil. Eat them up, yum.
  • Ditch all the trans fats and polyunsaturated vegetable oils – more here and here.
  • Consider a fish oil supplements too – not a rancid brand from Sam’s Club but one such as Nordic Naturals.
  • More on inflammation here.

Still want to pop that statin pill? Remember that the CoQ10 you’ll deplete prevents atherosclerosis by reducing the accumulation of oxidized fats in blood vessels. It also can lower high blood pressure, regulate the rhythm of your heart, and improve chest pain and exercise toleration if you have angina. You can get CoQ10 naturally from red meat (grass fed), but it’s tough to eat enough. You’ll lose more CoQ10 over the age of 40 and with exercise too so if you take a statin then you’ll quickly become depleted. A general recommendation is 200mg a day. But hey – remember – I’m not your doctor. If your current doctor won’t work with you in your quest to become healthy then go find one who will. It’s your heart and your health.

I'm a board certified chiropractic physician and clinical nutritionist with a passion for true natural health care. I implement dietary & nutritional therapies, exercise & movement practices, and lifestyle changes along with manual therapy techniques to help the body heal and prevent illness and injuries.


Leave a comment
  1. jksnydernc permalink

    I am surprised to read this about low cholesterol. Doctors have never mentioned the dangers of low cholesterol and have never suggested that I try and raise mine.

  2. an incredibly well-researched article Dr – I had no idea about the eggs – so many myths need dispelling. If it’s OK with you, I’ll use this article with my clients…

  3. susan permalink

    a recent profile shows my HDL to be 3x higher than my Triglycerides. This concerns me in light of your own personal experience and guidelines. Is this completely abnormal??? . My chol/hdl ratio is 2.

    • It really needs to be looked at in regards to your total health profile and you can always do the NMR Lipid Profile test to see the particle sizes to confirm those. Though 3X is a lot, I’d be surprised if it was a problem, though I can’t say it isn’t since you’re not a patient and I obviously can’t give you advice over the internet. :)

      Just out of curiosity though – what are the numbers?

      • susan permalink

        total: 221 (she said that was alarmingly high)
        LDL 106
        HDL 109
        TRI 31

        • If I saw a patient in my office with numbers like this I’d say they were lucky to have such an amazing cholesterol level and ratios and they should keep doing what they’re doing.

          I recently saw a guy who had a total around the same as this, but the ratios were not as good, but they were still very good. His MD told him to eat a low fat, low cholesterol diet. I don’t know why they are allowed to give such misinformed and irresponsible information, but they get away with it. At least they have been for some time. “Alarmingly high” is alarmingly ridiculous. But then again, I’m just making a general comment ;)

          • Clay permalink

            My doctor gets it, so he liked my numbers

            total: 235
            LDL 116
            HDL 110
            TRI 46

            This was after experimenting with my already lowish carb diet primal style diet where my previous numbers two years earlier were:

            total: 181
            LDL 77
            HDL 94
            TRI 52

            I was intentionally trying get my HDL as high as possible and my triglycerides as low. So, mission accomplished I suppose.

            The ridiculous part? According to conventional wisdom my TC is considered borderline high. Maybe even time to prescribe statins. Yet my individual numbers are all considered optimal, even freakishly good in the case of HDL.

            Yep, and eat your eggs. Six a day works for me. I consider them a superfood.

  4. susan permalink

    Thank you Dr. G…truly appreciate your valuable input. may be half genetic predisposition/half my tri lifestyle.

  5. Gina permalink

    I was reading your page on cholesterol. My doc said he is giving me three months to lower my cholesterol, not sure what that means. Here are my numbers~

    Total~ 226
    HDL~ 63
    LDL~ 153
    Triglycerides~ 48

    Is that terrible? Thanks!

    • Yes it is terrible that your doc thinks that :) I would take those 3 months to find a new doctor.

  6. Gina permalink

    I had to laugh out loud at that comment : )
    So, do you think they are normal numbers, or do you see something I need to work on? Thanks!

    • I’m going to ask you to figure that out. There should be no doubt to the answer as I think I’ve covered it well the article. If you really think I missed something let me know.

  7. Laura permalink

    Several years ago, I was told that I have an inherited condition which results in my liver making too much cholesterol and that my LDLs were almost as high as the HDLs. I have been on statins for many years.

    After reading a similar article to yours, I asked my doctor if I could come off them. He agreed, but my cholesterol level shot up to 9.5, with a high number of LDLs.(Sorry, can’t be specific, this all happened a few years ago. )This really scared me. I am now back on 5mg per day of Crestor. I am concerned about the kidney issue as my father died of kidney failure, but I am afraid to come off the tablets. The overall levels diminished, though I haven’t had any tests for a year or so.

    I eat fruit, eggs, vegetables, though only small amounts of chicken, meat and fish. I have been eating more sweet things lately and know I need to cut down!

    I don’t know if there is a connection, but my immune system seems to be weakened and I am prone to viruses and sometimes my legs feel heavy.
    I recently started taking Zinc and Vitamin D and C supplements. At one time I took Q10 but found them really expensive. I am now in my early sixties and retired so I’m on a tight budget these days. I am concerned that cheaper Q10 may not be as effective.

    Please advise.

  8. David @ Normal Cholesterol Levels permalink

    Thank you, thank you, thank you, for posting this. I’m seeing more and more than it’s not just about numbers, and that – as I’ve long suspected – mainstream methodologies for dealing with this situation, as well as many touted dietary suggestions, are incorrect.

  9. Kim permalink

    Hi Doc,
    I know you can’t be very specific online but some of us are VERY math challenged when it comes to ratios and all….yeah…me! Anyway, this is my husbands recent lipid panel. Can you just say yay or nay?
    Total 232
    Tri 80
    HDL 58
    LDL 158
    His doc wanted to put him on statins, we said no and are trying red yeast rice instead. Thanks so much! Kim
    P.s he has never smoked…drinks only red wine and very little….is 6’0″ weighs 186 lbs and is CRAZY about running and strength training.

    • I won’t say yay or nay;

      I think if you’re asking me you already know the answer.

      Red yeast rice is a statin. :)

      • Kim permalink

        Ok, I’ll work on deciphering that. Red yeast rice a statin….geeze! I learn something new every day.

    • Stacey permalink

      My numbers are similar but my triglycerides are a bit higher. This year my HDL is about 10 points lower. Down from the 70″s. My doctor said no problem and I didn’t need to be on a statin. I would tell him forget it anyway as the side effects are many.
      Although my husbands numbers are a bit higher his last doctor put him
      on a statin. Since he changed to my doctor the doctor told him since he
      was already on a statin to keep taking it. I told him to stop and hope the doctor doesn’t give him a hard time.

  10. Kim permalink

    Doctor, could you recommend a good squalene moisturizer/lotion? Thanks!

  11. Dave permalink

    Hey Doc, Nice article! Have you seen the series on cholesterol being done by Dr Peter Attia on his website The Eating Academy?

    • I had not heard of that site and just checked it out. What a great one. I’ll be spending lots of time reading Dr. Attia’s info. Thanks for sharing!

  12. Faith Harper permalink

    I’ve had total cholestorol of over 200 since my 30’s and it has gradually gone up. I was shocked to recently find out the total has jumped to 449 with my HDL at 68, TRIG at 76 and my LDL greater than 350. What shocks me is that I’ve almost completely cut out all forms of sugar (including fruit), starchy vegetables, cheese and dairy due to symptoms of intestinal yeast overgrowth. Because of cutting out cheese I’ve been eating 5-6 eggs a day for protein (I eat cage free, but not organic). My father and brother both died of heart attacks at 61 and 62 (I’m 54). Can you offer any guidance? Thanks.

    • Hi Faith, that’s a tricky one to give on-line advice. I’d need to see labs and see what your eating, taking for supplements, etc. Obviously these things don’t just “happen” for no reason. That is quite a spike especially in the LDL. I’m assuming you re-ran this test in a fasted state a week or so later to verify the results (labs can be, and are know to be wrong); if not, that would be good to do.

      • Faith Harper permalink

        I hadn’t thought of doing a re-run on the test, but that’s a good idea. I got to thinking later that it may be connected with my thyroid since I’ve been using sea salt with iodine for several months. I’m wondering if my system got overloaded, because I’ve been having really bad hot flashes even with taking hormones which usually keeps them under control (I’ve read that thyroid issues can cause hot flashes). I’ve come off the salt with iodine and am hoping the situation reverses but will find out when I get re-tested. Thanks so much for your input.

        • Sure, and yes the thyroid can be an issue. The #1 reason for hypothyroid today is Hashimotos Disease – which is an autoimmune condition. Iodine can make this condition worse. Maybe something to investigate.

  13. Kim permalink

    Hi Doctor Gangemi,
    I have a question about my cholesterol. It was tested a few weeks ago. It was:
    Total -121
    LDL -51
    HDL- 55
    I’m assuming these are a bit too low? They have always been like this. I love red meat and eat it about 3 times a week….avocado’s maybe once a week, olive oil maybe twice a week and full fat cottage cheese 3-4 times a week…..but it still stays low. I was wondering are there cholesterol supplements out there that might be a good idea for me? I suffer from a low level depression that has literally been hanging on for decades so I am thinking this might be causing it. Although, I know my total chol could be tons worse. Any help you could give would be very appreciated. Kim

    • I would call those levels very low. As you have read, I too “always used to have low cholesterol”. I really had to change my diet significantly. I bought into the “it’s genetic” reason too, but I don’t think that’s the case for most. I had to eat a lot of fat every day – egg yolks, cream, coconut – those are the best. I tried cholesterol supplements for a bit but they did nothing for me.

      You have great ratios though. But look at it this way: if you were in the desert and completely dehydrated and came upon a muddy pool of water – that water (any water) – is going to be better for you than no water. So when you have such low cholesterol the ratios don’t matter as much – you just need more of it!

      Check out this series I wrote on SD – especially parts III & IV which discusses how important AA fats are for you.

      • Kim permalink

        Thanks doc…I will read it right now. May I ask, do you feel my low grade depression is likely caused by this low cholesterol I have had for so many years?

        I looked into past cholesterol tests yesterday. I had never done this before because I was always told by my HMO doctors that my levels were “great”. In the last 9 years I have had it tested 6 times and the total chol was never above 165. In the last 2 years it has gone from the 140’s to the 130’s and now the 120’s.

        Also, how long did it take you to get your cholesterol up to good levels? Like I said I already eat good fats but I will increase that. Thanks again : )

        • I too was told my levels were great when my total cholesterol was <100. It's so bad...

          Just by getting off the high-carb diet and adding in some good fats that got me up to the 130-140 range - that didn't take too long. It wasn't until I added in the animal fats and coconut fats and cut the carbs even more that I got my total up to 170. Actually I checked it again just last month - 187 total, with great ratios all around. This is my highest level ever. So that was about 4-5 months to get me out of the mid 140-150 range up to 170 and then 7-8 more months to get me to 187.

          Low cholesterol and depression? Sure I could easily see a link there. Not sure if there are any official studies on that, I'm guessing not since most don't actually study low cholesterol linked with health problems. But there's a huge connection to hormonal problems and neurological problems with low cholesterol, so I'd be surprised if that's just a coincidence.

          I think you're seeing a change in your health for the worst as your numbers have gone from 165 to 120? That is not a coincidence.

  14. Kim permalink

    I stumbled across some info today about how well Krill oil lowers cholesterol…and I’ve been taking it for 6 months. Ooops….I think I better stop.
    Thank you so much for all your help. Your gracious help is valued more than you know.
    God bless,
    Kim : )

  15. Don permalink

    Well written article! I have been looking for information on raising cholesterol, because I have been too low (and congratulated by doctors) for years. Two years ago I had a TC of 95, a month ago, it was 111. I have been eating gluten free for 3 years, and mostly paleo for 2 years. Carbs seem to have minimal impact on my cholesterol numbers. I ham having a hard time finding a way to increase them.

    I have recently started taking a manganese supplement, as I have read manganese deficiency can increase incidence of hypocholesterolemia.

    Recently I have been trying to research other ways to increase my TC by researching the cholesterol pathway. I am now thinking of trying to increase my squalene intake by using more olive oil, and considering shark liver oil supplements instead of the CLO I currently take.

    I would also like to increase the amount of beef liver I eat, which is next to none, because I can’t stand the taste, texture. I am still trying to experiment with different recipes to find one that is palatable.

    The only other idea I have is increasing my intake of vinegar, as acetate is the most basic building block of the cholesterol molecule.

    What have you found that helps? Thanks

    • I think those are all good to try. For me, it was a lot of saturated fat from coconut milk/oil, butter, heavy cream, and egg (yolks). Beef, nuts, and olive oil too. I had to increase my total fat intake to well over 50% as noted in the article.

      Yes, you really need to get those numbers up there – dangerously low!

  16. Kimberly permalink

    Hi Doc, I am wondering if you have heard if there is any link between ADHD in children and low cholesterol? My 9 year old grandson just had his cholesterol checked and they appear very low to me. Here are his results:
    Total 128 (range 121-203)
    Tri 36 (0-200)
    LDL70 (0-100)
    HDL 54 (40-120)
    Ratio 2.4 (6-20)

    If so….would you suggest just increasing his intake of butter, beef, coconut, olive oil, etc?
    Thank you very much!

    • I sure have. I’ve read that the majority of kids on the Autism Spectrum are <160 too.

      If that was my kid (or my patient) I'd be giving him a lot more fat - all those you mention.

      • Kimberly permalink

        Thanks Doc…one last question. Is ADHD considered an Autism Spectrum disorder??…I didn’t realize that.

        • Yes. ADD, ADHD, Dyslexia on one end, Autism on the other. PDD, Aspergers, others in between.

  17. Grant permalink

    Hi Doc,

    Can I get your advice on my cholesterol numbers?

    HDL 47
    LDL 47
    Triglycerides 101

    I’m 25 and my health has seemed to be going downhill over the past few years. I’ve had chronic constipation with constant nagging type pains on my left side. I also have feelings of light-headedness and it seems like i am having trouble just thinking sometimes with funny feelings in my head. I am also extremely tired all the time. My blood work looked good except my cholesterol levels (which are supposedly great). I have had CT scans and MRIs with nothing showing up. I have also had a colonoscopy with stomach and large intestine looking ok. Could my cholesterol levels be related to some other health issue?

    • As you know from reading the article, a low cholesterol is very dangerous and accompanies other health problems, as well can result in other problems.
      Your total is around 115. I’d call that dangerously low.

      • Kimberly permalink

        If I could just add……constipation and fatique are also very common symptoms of low thyroid (which is VERY common now days). Many doctors still think the TSH test is the best to determine this but it’s not. That test result will almost always come back “in range” and the doc will send you off saying you are just fine. It took me many years to find a knowledgable and open minded doctor (to all the newest discoveries) and I now feel better than ever. Insist on having your Free T3 tested and if your doctor refuses then find a doctor who will. Also read this website Its a great place to start.
        Best of luck to you!

  18. Kimberly permalink

    Hi Doc…
    I asked the question above about my 8 years old grandson diagnosed with ADHD. His cholesterol is very low so my daughter and I are trying hard to get it elevated. I suddenly had a thought the other day. Would flax or fish oil actually be good for that…or bad? For unstance,…I know people have used these before to lower their high cholesterol……but I also know good fats are good to take when you have low cholesterol…so this is actually kind of confusing trying to figure out if this would be good for him…or just make his cholesterol even lower? Thanks so much doc…LOVE your articles!

    • Flax and fish can help increase cholesterol if it is low – but only if the person, your grandson, is deficient. I use DHA more too – which is the long chain omega 3 found in fish oil. A lot of people can’t convert flax well to EPA/DHA. But I still say that in kids the most deficient fat I see by far is AA – arachiodonic acid – from eggs, cream, butter, and grass fed meats.

      • Kimberly permalink

        Thanks! Yes…his cholesterol was at 128 in a range of 121-203, so seems pretty low to us. Do you think it would be better to add fish oil to the eggs, cream, butter, and grass fed meats…or just skip the fish oil for now and increase these foods.

        • The fish oil shouldn’t hurt, but I doubt it’s the solution, or any major part of it.

  19. Bert permalink

    Great article thanks for the info. I am eating eggs every other day, cream, whole milk, coconut oil/ milk, olive oil, fruits veggies etc etc… im on board with all I read above thanks to you for sharing.
    I have been on 20mg of lipitor / now generic version and
    20 mg of benicar for about 5 years now. When I started these meds I was 255lbs @6′
    BP 175/95
    total chol. 275
    LDL 200+
    Hdl 26
    Tri 500
    I know i know pretty bad
    Current results 45yrs old @210lbs
    BP 138/82
    total chol. 190
    hdl 40
    tri 80
    Funny thing is I didn’t see huge improvement until I started running and eating more whole foods. Duh…
    My Dr. will not agree to take me off meds and not 100% sure he’s correct. so how do I find a Dr. in my community that agrees with your type of philosophy? I am a runner and currently run 17-25 miles per week with a hr monitor ) and see steady improvements and without major injuries to speak of.

    • The HDL is still too low, as you know. Question is how much of the change in your numbers is from the meds, and how much from the diet and if you say mostly from the diet/exercise then you really should investigate a new doc to work with you. Unfortunately there are plenty of docs out there who think the meds are the only answer – but of course that is not true. The majority of your triglyceride change is most likely from the diet and exercise – hopefully being a little more diligent and consistent there will show more improvement in the HDLs. You have to ask around for a MD who will work with you; they’re out there.

  20. Bob Crason permalink

    My latest numbers are outstanding in my opinion.

    Total Cholesterol is 217
    HDL – 75
    Triglycerides – 56

    When I first started eating a paleo diet, it shot up to over 300 but I stopped “overfatting” it and replaced some of the fat calories with what Paul Jaminet calls “safe starches.” My HDL and triglycerides remained stellar but the LDL really dropped.

  21. Moe permalink

    Can you help me with my readings, please? I’m 56, 130 lbs, F. I just got my health fair results back.


    Everything else in normal

    • The CHOL/HDL RATIO should be <3 and the TRIG/HDL should be <2. Both yours are much higher than this.

  22. Pntnike permalink

    I have been looking for the answers to low cholesterol for about eight years now. Doctors never wanted to hear what I had to say. My son’s total cholesterol was 72 in 2005. Fast forward and here is what. We are looking at…
    Total 91
    HDL 42
    LDL 26

    SGPT 649
    SGOT 333

    Suddenly, the doctor wants him to drop out of college and come home. My son is big like all of my family but knowing about the cholesterol, I have always told him that if he had a taste for steak, then eat the steak. Eggs, hamburger, I was always looking for answers by myself. Seven years it took me to find you. My question, is it too late to fix the damage that has been done?

    • Impossible for me to know w/o seeing him but why are those liver enzymes so high? Hepatitis/cirrhosis?

      • Jeanette permalink

        He has a doctors appointment on Thursday to then, schedule a liver biopsy. With the cholesterol being so low I wish someone would have listened and took more blood tests years ago. He has been seeing a hematologist for six months now and just this past week I was told to get him home. He has one month of school left but the doctor said he isn’t to wait, he needs to come how now. Not sure what to think and even less sure how to proceed.

        • I’d be interested to see what they find and/or other tests they run.

          • Pntnike permalink

            Liver biopsy results are in and he has fatty liver, inflammation, and cirrhosis. He is only 21 and I am scared for him. So, I asked the doctor what else we can do and he stated gastro bypass. Will that help stop or slow down the cirrhosis ? I asked if there were any definite causes or solutions and he just stated gastro. Is it possible the cirrhosis is advanced fatty liver,the fatty liver being a by product of very low cholesterol for years, and if we could find out why the low cholesterol, we could help heal his liver?

          • Look for a naturally-minded doc who can help him. I can’t give specific advice on-line.

      • Jeanette permalink

        He has been checked for HIV and hepatitis. Both are negative.

  23. Jeanette permalink

    I will keep you posted. I do appreciate you sharing your time and knowledge with people that want to know their bodies and how they function. Thank you!

  24. Wojtek Nowakowski permalink

    I recently got my lipids tested. The doctor was concerned with my results. The total cholest. was: 271, which cinsisted of the following: Triglycerides: 56, HDL: 66 and LDL: 194. Should I be concerned? Btw, the number of small and large particles of LDL was unknown in that test.

    • I can’t comment whether you should or shouldn’t be. There’s a lot more than just a number to make up your total health profile. Though I’d say that is a high LDL.

  25. Shadab permalink

    Hi doc,
    I am 29, and recently got a lipid profile done. My LDL was 350 and scared the hell out of me. My doctor wants me to take statins. I dont want to. I have made changes to my unhealthy lifestyle and started exercising and a balanced diet. Stopped sugar altogether.
    I still feel scared. I know my LDL is too high. What can i do to reduce it. I would only try statins if all else fails.
    P.s. I have some cellulite but i am not overweight. Doc thinks its genetic as my dad had a heart attack at 45.

    • I can’t advise you to take a medication or not take one. Interesting NY Times article this past weekend discussing a study where if you take statins, you’ll pretty much ruin all aerobic gains you attempt to make via exercise.

      • Shadab permalink

        Thanks for the reply Doc. What are the lifestyle changes that have the best effects?
        Also, just to let everyone know. My dad had a heart attack at around 45. Th doctor fears I may have genetically high cholestrol because of this, and my Age of course. My dad was on statins quite a while and became very weak. He tried out a homemade medicine, which worked wonders, and he has been healthy since. Cholestrol always good. Clogs cleared up. I am going to try the same.
        Basically it requires, 1 cup ginger juice, 1 cup garlic juice, 1 cup lemon juice and 1 cup Apple vinegar. Boil these 2 make 3 cups. Add 3 cups of Organic honey. Have 1 tablespoon in the morning without eating anything. I am going to try this along with a healthy diet and exercise. Will update the results in 2 months time.

      • Shadab permalink

        Sorry. I got my readings wrong earlier. Detailed readings are as follows
        Total Cholestrol – 341
        Triglycerides- 137
        HDL – 57
        VLDL(Calculated) – 27
        LDL(Calculated) – 257

  26. Shadab permalink

    Thanks for the response doc. Just 1 question. What are the lifestyle changes that can get me best results?

  27. Jan permalink

    These are the general guidelines in my country… are these compatible with your opinion? I’m asking since I’m not intimate enough with mmol/L to translate it to the values you’re talking about :).

    total cholesterol < 5,5 mmol/L
    LDL-cholesterol 1,55 mmol/L
    triglycerides than 20% of total

  28. Deb P permalink

    Great article. There is so much conflicting info out there, it is hard to sort it out sometimes. Though I am more and more convinced that drug companies dictate the so-called “safe” levels of cholesterol.
    I am a 59 year old healthy, fit, ultramarathon runner. I switched to a whole foods, plant based diet a few years ago, and it works well for me. Recovery is fast, and energy levels are high. We eat no processed foods, no refined sugars, no refined oils, and no wheat. My carbs are starch based , not grain based. In fact, since I grind all grains with a manual hand grinder, thats a pretty good governor not to eat very many – its alot of work! I eat only whole foods, tons of greens and fresh veggies, and raw veggie juices. Small amounts of fruits. I dont use much oil in cooking, prefering to eat the whole food rather than the extracted oil but what we do use is virgin coconut or olive. We do eat nuts and avocados. I make my own coconut milk from fresh coconut, but use that sparingly too. The only animal products I consume are occasional eggs from our own pastured hens, and pastured organic butter, (maybe 1 tbs. a week) we do eat lots of legumes. Very occasional alcohol – perhaps one drink a week.

    So imagine my surprise when a recent lipid profile showed a significant increase in cholesterol over a test a few years ago when I was eating a standard american diet of chicken fried steak and gravy, white flour, coke, pizza, cheese, etc. that t est showed a total of 156, with decent ratios, as I recall. I was so sure it was in error, i asked the doc to re-test. The numbers are consistent.
    March test
    TC. 214
    Triglycerides 67
    HDL 66
    LDL 135
    VLDL (not taken)

    May test
    TC 196
    Triglycerides 112
    HDL 58.2
    LDL 115
    VLDL 22.4

    So the ratios are not horrible, but I just cant figure out how, on a diet of virtually zero saturated fat, they could have gone up a all, and they went up rather significantly. How is this possible? And what can I do to lower that LDL and triglyceride number? I cant see how we could eat any healthier than we do. I am baffled!

    I am taking a thyroid med, the dosage was recently lowered, and levels seem to be right with current dosage.

    • Saturated fat is a big part of a healthy diet as I mention in the article.

      BTW – VLDLs are 1/5 of your triglyceride. They make up 20% of your total cholesterol.

  29. James permalink

    A few years ago. My cholesterol was 275 in which my doctor said it was alarming. Been on Lipitor for three years. 20 mg every day. I am a runner for 8+ years. 30-35 miles per week. I have changed my dietary dramatically. I hate the label stuff but more like flexitarian. I rarely eat red meat. My recent bloodwork:

    Cholesterol: 154
    Tri – 99
    HDL – 77
    VLDL – 19.8
    LDL – 57

    I feel that my doctor tried to keep it low. I do want to get off Lipitor badly. My doctor was against my idea and wants me to stay on it. He said that I have genetic thing in which my liver cannot keep my cholesterol level down but I am a hard-core runner and been eating strictly healthy food.

    What your take?


    • I can’t advise you on whether to take a med or not. Check out my recent FB post on how a statin will pretty much ruin your aerobic system. The cholesterol-statin system is a disaster. Nothing personal but I don’t quite understand why so many people put so much faith in their doctor who often knows nothing about human biochemistry – especially cholesterol. If he says you have a genetic
      “thing” then ask him to run a genetic test to prove it.

      • James permalink

        Thanks for your quick response. Much appreciated ! I will have to check your FB post.

  30. Chris Southby permalink

    Hi Doc
    I recently had a blood test that included cholesterol and these where the results.
    LDL: 117 U/L
    Chol: 5.5 mmol/L
    Trigs: 0.52 mmol/L
    The units are not consistent so I cannot directly compare them with the above article.
    I am wondering if I should change my diet or not.



  31. Andrea permalink

    Total Cholesterol : 181
    Triglycerides: 90
    HDL Cholesterol: 85
    LDL Cholesterol: 78

    I’m 48 years old, female, very active, thin, tall, etc. Am I supposed to get over 200 total cholesterol to prevent stroke, heart attack, etc? I don’t have a family history of stroke, heart attack, etc. I’m deaf, by the way. I’m paranoid because of your article.

    Is this my cholesterol normal?



  32. Pierre H Renevey permalink

    Hi Doc,

    Your text is very interesting. I just have a question about the polyunsaturated fats (omega-6) that don’t have a good reputation. I live half of the year in the US and half of the year in Europe. And reading carefully the labels of those products on both sides of the Atlantic Ocean, I noticed that in the US, the one they called healthy are expelled processed and hexane free but are still heat processed even when it’s written cold processed, it’s heated over or around 120 degrees while the said unhealthy are pressed at around 400 degrees. In Europe, we have really cold processed pressed seeds to get our oils that are much more expensive than the heat processed ones that we also have. The real cold processed are said to be healthy and the literature I’ve read about this (mostly American) claims that if polyunsaturated and omega-6 are unhealthy, it’s because of the heat process that denatures the omega-6 and all the stuffs like salad dressings, dips, mayonnaise, etc are made with adulterated polyunsaturated oils (omega-6). So getting real cold processed oils and raw nuts non roasted would provide healthy polyunsaturated oils and omega-6 (that should be kept in the refrigerator). I’ve also read that some molecules in the unadulterated omega-6 have even more anti inflammatory properties than the omega-3’s. Can you please comment on that ?

    Regarding my diet, I am supplementing every day with a teaspoon of extra virgin olive oil, fish oil, cold processed sunflower seed or walnut oil, and a tablespoon of extra virgin coconut oil.

    • Yes you definitely need some omega-6 oils and most will say more than omega-3 but they’re easily converted to inflammatory fats in the presence of stress, fructose, alcohol, and other stressors, even in an undenatured form. And as you’ve probably read, the omega-3, particularly EPA, can be easily oxidized and become harmful.

  33. Kimberly permalink

    Hi Doctor Gangemi…

    We spoke about a year ago about my low cholesterol and you advised more nuts, butter, avocado, coconut oil, olive oil, etc….
    So I did just that……plus, lots more red meat. I also take 3000 mg of fish oil a day. I got my latest cholesterol results back today and they haven’t budged. Total chol is even a tad lower.
    Total 118
    Tri 51
    HDL 60
    LDL 48

    This is so disappointing….seems like a wasted year. Do you have any idea what might be going on or what else I can do?

    Also….what exactly causes low cholesterol, if anything, other than just not eating enough fat?

    Thanks very much, Kimberly : )

    • Well your ratios are excellent but obviously something going on there. Perhaps you are using up the cholesterol to make hormones (sex & stress hormones).

      • Kim permalink

        Yes, I have high cortisol (all 4 times of the day) and am currently taking 1000 mg phosphorylated serine to lower it. So far no luck. I don’t know about the sex hormones. I guess I will just keep plugging along as I don’t know what else to do.

        • Well there you go. I’ve never seen phos serine to do much of anything; no longer use it with my patients. You should look for a holistic doc to help you out.

          • Kim permalink

            Can I ask what you do recommend for your patients now to lower their cortisol? Thanks!! : )

          • It’s individualized per what is causing their levels to elevate and how to reduce them thru physical treatment, nutrient and dietary changes, exercise and lifestyle changes.

  34. sid permalink

    Doctor. 4 years ago took a medical (30 years) and everything was fine. as part of routine had to take it again now and the results came back as follows:

    LDL: 230
    HDL: 45
    TG: 139
    VLDL: 30

    I was completely shocked (and now worried). i am almost 35. regularly exercising for years. try to watch what i eat (though have a sweet tooth). i go to the gym or for a walk almost everyday of the week. I partly think there is a mistake and should take the test again. if i go to my doc I KNOW i dont want to take meds. please advise!!

    • Sorry I can’t give you personal advice on-line. Only for an office visit on consult can I give you more personalized attention.

  35. Linda Smith permalink

    I am a 63 year old female. I am on Atorvastatin 10 MG. My recent lipid panel:
    Triglycerides 116
    Cholesterol 193
    HDL 47
    LDL 123
    Chol/HDL Risk Factor 4.1

    The questions is do I need to up the Atorvastatin to 20 MG or can I lower my numbers naturally. I have started dieting, eating the right foods and exercising daily. I am just not sure if these numbers are dangerously high or if I have time to work on lowering them with diet and exercise. My father died of a heart attack when he was 53 so that is always in the back of my mind.

  36. Tom A. permalink

    Excellent article that I have keep coming back to every time I have a physical and get my cholesterol levels checked (total 208, HDL 55, LDL 139, VLDL 14, Trig 70). What I don’t see mentioned in your article is “Non-HDL Cholesterol”, which I have never seen listed in these standard lab reports until now (mine is 153 and flagged as high). How does non-HDL cholesterol figure into all of this? Thanks.

    • Non-HDL is your LDL plus your VLDL. VLDL is 1/5 of your triglycerides. So, non-HDL is really a useless number.

  37. Daisy Reyna permalink

    I am a 57 year old woman, I am not on any medications at all. My questions is with the numbers I have provided should I be?

    This years Panel from Health Fair

    (2014) (2013)
    Cholesterol Serum – 233 252
    Triglycerides, serum – 130 123
    HDL Cholesterol – 52 50
    LDL Direct Measurement – 151 173
    CHOL/HDL RATIO – 4.5 5.0

    I have lowered my numbers since last year tests (started Jan 1) by watching my diet a little closer and being more mobile. I would appreciate your expert advice on whether or not I should use medication to lower his numbers more so.

    Thank you, Daisy

  38. jack permalink

    TC- 210
    HDL – 39
    LDL – 135
    Tri- 175

    is this values are normal for me (Weight 60 kg, age 26 ,sex- male).
    Please advise me because my doc never concerned about this values.

  39. MittenChick permalink

    What? I’m so confused. I got a postcard, of all things, in the mail from my doc saying Cholesterol Level: 137; Triglyceride Level 128. Uh, does that mean I don’t have any of those other VDL, LDL, HDL or whatever other abbreviations? The only other thing is a hand-written note at the bottom saying “you have very, very little Vitamin D and they sent in a script for me.

    Now, this is the first article I have ever seen which connected Vitamin D with cholesterol. But, in trying to compare my numbers with the article and then other comments, I just got more confused. Nobody else’s trigs are that close to their ‘cholesterol’ level.

    I know you can’t give advice, but is this something I need to investigate further? And, does my “very, very low” levels of vitamin D have anything to do with the above numbers?

  40. Anne permalink

    Love this article. I’ve been eating very low carb Paleo for nearly eight years now and my cholesterol levels have gone from strength to strength. They might scare conventional doctors but they don’t scare me and they don’t scare cholesterol sceptic doctors either:

    Total: 294
    HDL: 140 – yes 140 :)
    Triglycerides: 44 – yes only 44 :)
    LDL: 147 – but remember the LDL is only a calculated value based on the Friedewald formula which is inaccurate when trigs are lower than 100.

    My Total to HDL ratio is 2:1 :)

  41. Issho Genki permalink

    Hey Doc! Thanks for sharing some really interesting insights on the good, bad and ugly side of cholesterol. What interested me the most about your piece was the bit on Squalene.

  42. Patty permalink

    Had my doc for 8 years. Decided to go to his partner for routine labs for refill on my BP meds (10mg lisenpril). He requested an LDL-P and we had no clue. I have health panic disorder and my husband doesn’t but our labs came back with high LDL Particles. My numbers are below
    HDL: 59
    LDL: 131
    Trigs: 135
    Glucose: 100
    Took 2 weeks before he called with our results..In this time I had extreme anxiiety and when he did call I had a major panic attack..I was on Lexapro for 7 years and weaned off, thinking I can handle myself when it comes to certain circumstances..It didn’t work..He requested me to take Simvistatin 20mg and being so undecided and anxious.. I wasn’st able to sleep for 2 nights..Finally went to my shrink and had him put me back on meds. I just don’t know what to do. I’m a mess and don’t want to go on statins. there are too many cons and believe me doctor when I tell you this..I have had WORSE labs and this test was never requested by my DO.
    So why now? I have started a low carb diet, yes I’m overweight and can lose 40lbs but walk 6 out of 7 days over an hour and living in GA, these hills are steep but it looks like I need to do more than walk? Biking outside is dangerous so I may have to bike indoors which I hate. I know weight lifting would help but I also am hearing impaired and it bothers my head when I lift weight..I get dizzy and sometimes sick. I always ate good fats but loved my pasta and bread and have put that behind me now. I don’t eat sweets or sugar in any form except for unsweetened applesauce.
    I dont’ drink sodas, don’t touch HFCS (got rid of all that a while back)
    No trans fats and cook mostly with olive oil and organic coconut oil.I eat good foods and love my beans and greens of all sorts. Love veggies and eat many without added dressings ect..just trying to do it all right and here I am writing to you because I fear statins.. My family said NO! get a new doctor..I know you can’t tell me what to take but I don’t know what to do. Maybe take it for 6 months (he wants me back in 3 to see if they’re working) I want to be cholesterol drug free..I know I will have to take my SSRI’ for got knows how long cuz I have a hard time dealing with bad news..Please tell me what you think. I feel like I’m going to have a heart attack if I say no to statins and if I say yes, I’m going to get diabetes and all the other cons it has to offer too :(

  43. Michelle Muir permalink

    I’m wondering if I should be worried with what nurse says is elevated cholesterol. Here are my numbers: HDL=62, LDL=121, Triglycerides=193, & total cholesterol is 222. Thank you!

  44. bruce krug permalink

    My total cholesterol is 196. LDL is 138, HDL 47 and triglycerides 57.
    My Doc just “strongly” recommended that I go on statins.
    I have been resisting for some time.
    I am being treated for high blood pressure.
    I still am refusing to take statins… what do you think.

  45. Chad Musgrove permalink

    To anyone with cholesterol UNDER 250 that is asking if they should be worried – GO BACK AND READ THE ARTICLE AGAIN (the entire article this time). Calculate your ratio’s and you will know the answers.

    For most of you that posted your numbers and asked the question – the answer is no – nothing to worry about. 200 is a made up number that has been brainwashed into us as being “bad”.

    My Total cholesterol is 384 – but my risks factors are “low” when based on some of the more relevant markers. In some ares – my risks are high, in others they are low.

    I am curious as to what Dr Gangemi thinks about my numbers after 6 months of Low Carb High Fat… I see reduced risk, but think there is still room for improvement. Rather than post them here – you can see my before and after (as well as percent of increase or decrease) on my blog here:

    Thanks for the great right up…

    • Judy permalink

      Thank you for your high cholesterol! I am a 58 year old female and my doctor has been trying to put me on statins for years! My total cholesterol is 271 but my HDL has always been off the charts, this time 86. LDL 164, triglycerides 107.

      I feel fine. Doc is trying to hedge her bets. I’ve made it this far without any major health problems. So just give me this drug that’s bad for my liver just in case? Not happening. Couldn’t see your blog link but would like to read it.

  46. layla permalink

    What do these numbers tell you Doctor?

    HDL 58
    LDL 172
    TRG 86

  47. Matt permalink

    Besides diet changes, is there anywhere else in the body you might look to when explaining low cholesterol and low triglycerides? Is it not necessary to increase animal fats to increase cholesterol or is increasing vegetable fats like coconut oil and avocados sufficient?

  48. Bethany permalink

    How do you bring up treating or looking into low cholesterol with a doctor who is not concerned about numbers like a Total C. of 101? I’m sure this is a totally unique circumstance. But it is affecting me I feel, and I don’t think my dr sees it as a serious problem.

  49. Donna permalink


  50. Why is everyone asking me to assess their numbers? I will not respond as anyone who is able to read this can figure out their own ratios as I teach you in the article. Please read the entire article (as Chad comments) and you will know what I think; but if you’re not currently a patient of mine then I cannot give you any such advice.

  51. Danilo permalink

    I just ck my cholesterol in Italy, I’m italian… I like my red wine.
    My result
    Total 239
    Hdl 53
    Triglycerides is 181
    LDL 149 ( if I calculate correct. 239-53-(181/5))
    I’m 40 and work a lots in construction but no more fitness like when I was young.
    I eat a lotz of vegetables and very little pasta or bread. I’m a great chief on italian cousin. So wine is the answer to all my problems?
    Thanks again.

  52. Total cholesterol 236
    Hdl 43
    Ldl 159
    Trig 172.
    I am an Indian ….age 30…suggest me something…doctor says very alarming numbers..taking ozone medicine and doing exercise and running 2 miles daily

  53. Shawn permalink

    I have extremely low numbers, so this article alarmed me a bit. I was feeling happy that I had low numbers! But the doctor hasn’t said anything, though, so I guess I’ll just keep on eating/living the way I do. I’m a female, 40, 6’2″ and do regular swim training.
    Cholesterol: 121
    HDL: 65
    LDL: 47
    Triglyceride: 45

  54. I recently took my eight year old son for a physical, approx. 58lbs. He was sent for some routine lab work. His doctor advised that his cholesterol was too high considering his age/weight and that his diet would need to change. He is being tested again in six months. His results were as follows:

    Cholesterol, Total: 174 (125-170)
    HDL Cholesterol: 85 (38-76)
    Triglycerides: 53 (30-104)
    LDL Cholesterol: 78 (<110)

    I read that HDL is good cholesterol, and his LDL cholesterol seems normal. Do I need to be concerned and change his diet?

  55. Srinivasan permalink

    Dear Dr,
    today i test my Lipid profile , that details are
    Total cholesterol 198,
    Triglycerides 153
    HDL 40
    LDL 128

    Sir, i have a mild check pain from past 10 days, i have taken ECG , it says normal, my BP also 160/100 for 10 days ago, for that i am taking concor 5 mg morning, i need your advice

  56. treena permalink

    I have been taking statins for around a year now 10mlg a day. I just came off the medication because I have a few side effects and really do not like the idea of taking medication when your not sure weather you should be taking them in the first place or not totally

    Total 253 mg/dL
    Tri 170 mg/dL (seems a little high)
    HDL 59 mg/dL
    LDL 160 mg/dL
    VLDL 34mg/dL

    Any insight would be much appreciated

  57. I just got my lab results and I’m confused. My Cholesterol is 225. My triglycerides are 173, my hdl is 39 and my ldl is 151.
    I work out four times a week. I eat really healthy. I’m 61 years old.
    I’m 5’8 at 160 lbs. I’m strong and feel great. I hardly eat any carbs. I eat lots of vegetables and fish. I eat eggs, almonds, fish, and meat.
    How do I adjust to get to healthy numbers?

  58. okay you won’t comment on levels I get that. How do I get my HDL level up. I’m currently at 39? I also have blood pressure of 127 over 81. I feel great. I know my hdl is too low.

  59. Mario permalink

    I just read your article and it is amazing. My doc tried to push cholesterol drugs on me based upon my test results.
    My numbers are
    LDL: 115
    Tri: 44
    I thought the numbers were fine but she told me a drug for cholesterol for someone who is pre-diabtic would be ideal for me. My A1c was a 6.0. I told her nooooooooooooo!!!!

  60. ragesh permalink

    Please see my Lipid profile


    With out medication am doing regular excersize and reducing my body weight from 95 to 91 kgs now.

    my age is 36 , please suggest i need medication i don’t have sugar, B.P etc all normal

  61. Alan permalink

    Thanks for this article. I’m a 31 y/o male with Low T, chronic heart burn and skin issues (face) the last couple of years. I have been very overweight my entire life. I’m about 375 now. But my cholesterol is always very low. If I’m eating badly, it’s about 120. If I diet, it drops. It’s been as low as 90 before. I truly believe this is the reason for my Low T and other problems. Is it genetics? Why does my body not produce enough cholesterol? I will try this diet again (I tried for a little while, but it’s very hard for me to eat that much good fat..addicted to carbs!) I would love for my total to be 180 or so. I think a lot of my problems would disappear as I approach 200 total.

  62. asraya permalink

    total cholestrol 203,triglycerides-83 HDL 41,LDL 14506
    VLDL 16.6.LDL/HDL ratio 3.55

  63. Gerardo permalink

    Thank you, Doctor, for your article. It has made me think again about my numbers and my doctor’s recommendations.
    My numbers:
    Chol/HDL ratio — 3.8
    CHOL, TOT — 115
    HDL — 30
    LDL — 36
    TRIG — 244

    I am taking Atorvastatin 40mg.

    I’d like to hear your opinion about my numbers and what to do.

    Thank you.

  64. Anuruddha permalink

    dear doctor, my recent profile report is as follows,

    CHOL, TOT — 99
    HDL — 41
    LDL — 48
    TRIG — 47

    Blood sugar 78

    please comment whether these result are normal

  65. Mary permalink

    Just got results of my bloodwork My Total cholesterol is 218
    Triglycerides are 73
    HDL cholesterol is 68
    VLDL cholesterol is 15
    LDL cholesterol is 135
    What does this mean??

  66. Mary permalink

    my bad cholesterol was 275 in scared !

  67. Mary permalink

    Non hdl 294
    Hdl 50
    ldl 271
    Triglycerides 116

  68. Jen B permalink

    Hi, Dr. Gangemi,
    Thank you for writing the above article. That was exactly the information I had been looking for. I am not looking for an analysis of my labs. I used your ratios and know that my levels are very good: total cholesterol: 157. HDL: 106. LDL 44. Triglycerides: 86. I have been an insulin dependent diabetic for almost 25 years. I don’t exercise much anymore and am pregnant with baby number 5. I make everything homemade from scratch and use real butter, cream, eggs, olive oil, etc. even though I was told not to do by the nutritionist. I am curious as to why all of my doctors are “shocked”… They make me feel abnormal because none of my labs are crazy and even wanted to refer me for research blood work. Do diabetics typically have problems here? Thanks in advance for your insight here. :-)

  69. Rolando permalink

    Hi Dr
    Thx for this article. Even though I excercise and try to eat “healthy” I need to change my diet. For some reason I cant increased my HDL. Again, I thought more than 3 eggs was bad :)
    I’m 34 and my last test showed Total Chol=177, Trigly=99 LDL=126 and HDL=31 :( . Last 3 years my 30< HDL <40 .Any suggestions?

  70. Hi Doc,

    Your article on cholesterol came just at the right time. Today I got my blood results and have a cholesterol total of 8.1mmol/l. My HDL is 1.7. My LDL 6.1 and my Trigs 0.64. My Hba1c was 5.3.

    I smssed a doctor friend who said my HDL/Trig ratio was excellent. Through your article, I read that this ratio could mean my LDL particles are nice and big and fluffy! That was the reassurance I needed. It’s tough to get advice from regular medical practitioners who give it from the statin-promoting point of view.

    Any advice, I’d love to hear it.



  71. Sherri permalink

    My levels just came back saying i have low cholesterol. This articl was a couple of years ago since then do recommend any other great supplements to higher it?

  72. Katelyn permalink

    Great article! I am 24 years old and currently 8 weeks pregnant and just got these numbers back from my doctor:

    LDL 100
    HDL 53

    I didn’t get a total cholesterol number….I’m guessing somewhere around 162? Are these good numbers? What can I do to raise my HDL? Thank you.

  73. Lisa permalink

    Hi, I just received my lab results and am confused. I had a couple if “H”s next to numbers. I am concerned, but my doc isn’t. I tried plugging my numbers into your formula, but still don’t understand if the numbers are good or bad? Would love your guidance. Thanks

  74. Lisa permalink

    Hi, I just received my lab results and am confused. I had a couple if “H”s next to numbers. I am concerned, but my doc isn’t. I tried plugging my numbers into your formula, but still don’t understand if the numbers are good or bad? Would love your guidance. Thanks
    Chol 232 H
    HDL. 80
    LDL. 130 H
    Trig. 109

    • I’d agree with your doc as based off those numbers and taking nothing else into consideration they are fine in regards to lipid numbers.

  75. MaegenMarie Jones permalink

    I am a 39 year old female with nothing but minor, more irritating than unbearable, random health issues. My insurance sent me a letter about needing to consult a doctor to further check on my dropping cholesterol numbers that were showing up in my routine physicals. So my lipid screen 1 year ago was Chol-130, Tri-83, HDL-61 , LDL-50 , CH/HDL-2.3 , & VLDL-17.
    6 months ago was Chol-128, Tri-54, HDL-60 , LDL-53 , CH/HDL-2.1 , & VLDL-11.
    Current was Chol-100, Tri-46, HDL-51 , LDL-38 , CH/HDL-2.0 , & VLDL-9.
    I did some research online but I am not really understanding anything! I have not changed my diet or anything else that would account for this and I am actually considered obese for my BMI. Should I be worried and if so where do I need to start?

  76. Trivikram permalink

    Hi Doctor,

    Two months before I had a lipoprotein test done and the reading were 176 total cholesterol, 52 HDL and 91.3 LDL…now from past 2 months I’m on diet consuming more fibre foods like oats, vegetables and fruits and I do cardio exercise daily like jogging and walking. I ear less meat even if i take it’ll be a fish. I weigh 66kgs, height 5’8.
    Your advice on my inputs will help me a lot…:)

  77. Charlotte permalink

    Thank you so much!! After my doctor visit today, I ran to the grocery store and bought a load of fruits and veggies thinking I was a ticking time bomb!! I had no plans of taking the Rx statin I was given, so I was going on a rabbit food diet to stay around for my 7 kiddos!

    My total was 222. I’m not overweight and I’m active, and I love the same diet you eat, so I’ll be making some adjustments using your suggestions ;)

    I’ll ask for the remaining numbers and cross my phalanges they are good like the ones you mentioned! If so, I will let my petrified hubby know I am not having a heart attack tonight as I previously thought! I’m sure he’ll be delighted!! ;)

    Thanks again!!

    • Charlotte permalink

      Okay, so apparently I am back to dying!! I just got all my numbers and according to my numbers and your statement, I “have some work to do.” I just don’t know what kind of work I need to do. Please help!! Here are my numbers:

      Total 222
      Triglycerides 169
      HDL 29
      LDL 159

      I am 43, 5′ 7″ and, weigh 135 pounds (this is recent weight gain that I tried to gain because I felt I looked too skinny) – I don’t really exercise except chasing children, cleaning my home constantly, and refurbishing furniture. Other than that, I have never exercised a day in my life; just don’t have time. All of my other blood work was fine (CBC, TSH, etc.). I do not have high blood pressure (actually, it’s too low at times, but so are my siblings’ and my father’s), and my sugar levels were “slightly high.” I’ll be honest, I downed two Cokes before doing my blood work…bad, I know, but it was mid afternoon and it was my only chance to get the blood work done. But I know my sugar is normal because my husband is a diabetic and I randomly check mine and it’s always around 110-120 after eating and I feel fine.

      At any rate, should I stock up on avocados?? Please let me know…I’m trippin’! I don’t want to have a stroke and stuff!!

      Thanks so much!!

  78. Grace permalink

    Hi..thanks for this article I’m a little bit worried with the result of my cholesterol it is 121mg/dl and the normal range is 140-199 mg/dl I’m on a diet of juicing I eliminate meat I just eat eggs once in a while for my protein I’m scared because I have lump on my breast and armpit that’s why I do juicing. As of ow I feel weak sometimes.. What do wan with the % of your diet so I can also follow your diet to raise my cholesterol. Thank you so much and God bless!

  79. patty permalink

    just got some of my blood test results
    cholesterol total =232
    chol/hdlc ratio =8.6
    ldl/hdl ratio=6.1
    non hdl cholesterol= 205
    how bad or good are these?

  80. Karen lepik permalink

    I really like your thorogh discussion on cholesterol . Could you read my lipid panel? They are Total – 306.
    HDL 84 Tryglycerides – 111 and LDL-200. Chol/HDL ratio is 3.6 . I have been tracking my numbers for over a decade and this is typical but is a little higher now that I have hit menopause . I am 54. Thank you , karen from Mobile Alabama.

  81. Hello Dr. Gangemi,

    Thank you for sharing your helpful information. I’m going to try to try the diet you recommend to raise my cholesterol (Total Cholesterol-121, HDL-63, LDL-55, Triglycerides-65, Chol/HDLC Ratio 2.1, NON HDL Cholesterol-68). How did you incorporate cream into your diet? Can you share recipe names I can google or do you drink it as is? Will eating coconut help, or is coconut milk and coconut oil better? Do you eat the salted or unsalted butter? Will drinking whole milk vs 1% milk help raise my levels in a good way, or only coconut milk? What does your daily diet look like (specifically what do you eat/recipes for breakfast, lunch, supper, and supplements)? My last and important (to me) question is: although raising your low levels will improve your health, did it effect the way you feel? If so, in what way(s)? I’m wondering if I can raise my levels, maybe my body will make more vitamin D & hormones (including thyroid hormones (currently taking synthroid)) and help me feel even better. I sincerely appreciate you taking the time to write your article to help people, and to read this and any more information you can share. Wishing you good health and happiness:) Thank you, Heidi from KY

  82. Neethi permalink

    Very informative article Doc :)
    Am 28 yr old female and these are the readings.
    Have been getting recurrent sprains on my right scapula immobiliIng my neck and shoulder so was advised to take these. I am 5 8 and weigh 72 kgs.
    Cholesterol- 106 mg/dl
    Triglycerides -50 mg/FL
    VLDL- 10 mg/dl
    HDL – 40 mg/dl
    Ldl/hdl ratio – 1.4
    Vitamin d3 -22.4 ng/dl

    U have mentioned that cholesterol is a precursor to vitamin d absorption. Could that be the reason back pain and sprains?

    Namaste :)

  83. Abid permalink

    Hi doc.
    Currently my lipid profile is
    Chol. 192
    Trig 228
    HDL. 51
    LDL. 95

    While five months before it was as

    Chol. 158
    Trig. 138
    HDL. 52
    LDL. 78

    How are the results. Is it fine.

    • chuck crigger permalink

      Cholesterol total 206, triglyceride 177, Hdl 34, LDL 135. thx doc

  84. Laila permalink

    Hi Doc,
    I am only 41 and my NP has prescribed 20 mg of simvastatin. Total cholesterol is 245
    Triglycerides – 217 HDL – 44 LDL – 158

    Do I need to take it? I prefer to work on it first through diet and exercise. I have seen my mother suffer from pain by taking statin. I cannot function that way as I care for my disabled child and his 2 younger siblings… Please advise… Thank you!

  85. elizabeth permalink

    my dad is 55 and his cholesterol numbers are
    HDL- 27
    LDL- 105
    triglycerides – 130
    what is your suggestion for him ?
    BTW loved your article …..

  86. Virat permalink

    Hi doc..

    I am 36 years old male and I just tested my lipid profile and I have
    Cholesterol -143
    Triglycerides – 65
    HDL Cholesterol – 38
    LDL Chloesterol – 92
    So I was wondering is my level normal or not please give me some advice how to maintain my level thank you😁👍

  87. Paul Torres permalink

    hi Doc, my total cholesterol is 245
    , my triglycerides 196, ldl 164, my ratio is 5:8, hdl 42, I wonder how bad it is

  88. Prabhat permalink

    Hello Doc,

    Very interesting article, loved it for its genuine truth, wanted to know if adding eggs would help my case (specially I try to avoid egg yolk)

    I am 45 years old male and I had my lipid profile tests and I have
    Triglycerides – 99
    HDL Cholesterol – 44
    LDL Chloesterol – 125

    I am worried about these results as they are continuously more or less same from past 4 years, I am already on a very fat deprived vegetarian eating habits and try to use only olive oil from past 7 years, also do aerobic exercise every week (jogging for about 3 miles).

    Any advice would be of great help …

  89. Rosy permalink

    I am worried about my cholesterol
    Cholesterol 220
    HDL 81
    LDL 125
    Triglycerides 71
    Is it too bad?

  90. Lisa permalink

    My Dr put me on simvastatin 10mg…I filled it but do not want to take it
    I also have hep B..any suggestions

    Cholesterol Total 220 (H)
    HDL 80
    Triglycerides 38
    LDL 132 (H)
    Cho/HDLC ratio 2.8
    Non HDL Choles 140

  91. MrA permalink

    I have low cholesterol – after being told to lower it.
    I have never felt worse! How best to increase it safely?
    TC down from 216 to 135! & I have always struggled with HDL (35-39)

  92. Joe permalink

    I’m fighting this now:
    NON Fasting figures:

    Total 202
    HDL 68
    TRI 83
    LDL 117
    Doc wants to put me on atorvastatin 40mg

  93. Sally permalink

    What is your opinion about elderly people taking statins? My Mom is 86 and has always had high cholesterol. She recently starting taking statins and they are making her feel very fatigued and depressed. Her cholesterol was 338, HDL 68, LDL 245, Chol/HDL ratio 5.0, and triglycerides 127. I know this is not great, but I am just wondering if taking statins is worth the lower quality of her everyday life at her age. Her only other health issue is osteoporosis. Her blood pressure is fine and she is active (walks outside 3x per day).

  94. kim Colwell permalink

    Hi, I am 49 and experiencing extreme memory loss and fatigue. My immune system however seems to be working well and overall my health issues seem to be at a minimum, but I am wondering if my low cholesterol or TRIGLYCERIDES could be effecting these issues or if there is something you can think of that I can do. My levels all seem a little low and wondering what your perspective is.


    HDL 2.3
    LDL 104
    HDL 90
    Carbon 26
    Chloride 104
    Protein 7.5
    Calcium 9.5
    Globulin 2.8
    White Blood Count 3.8
    TSH 2.31

  95. Trina permalink

    Hi, my case is a bit different compared to HDL and LDL are both very high. I eat a low carb diet, exercise about 5x a week I’m 26 years old 120lbs BMI 20. My BP is normal as well but my dr said I need to diet and exercise better?

    HDL: 139 (she said this is the highest she has ever seen on a patient)
    LDL: 138
    Triglyceride: 41
    Chol/HDL ratio: 2.05

    I also eat a lot of animal protein not sure if that has to do with a high LDL? She’s giving me 6 months to lower it..

  96. Hi, I am 65 years old, male.
    My Lipid Profile investigation results, carried out on the blood samples taken on 18 April 2016 are:
    Total Cholesterol : 204 mg/dl
    HDL: 47 mg/dl
    LDL: 135 mg/dl
    VLDL: 22 mg/dl
    Triglyceride: 98 mg/dl
    Chol/HDL ratio:4.3
    BP : 70/120
    Sugar (Fasting): 96 mg/dl
    Sugar (PP): 105 mg/dl
    I walk for about 1 hour every morning.

    Kindly advice if I need to take medicine or try to improve the parameters by better diet and continuing with the daily walking

  97. Zach permalink

    Hi, should i be worried as 34yo with 217? I exercise 3-4x’s per day (usually no cardio) but walk a lot daily and drink a lot of beer (lol oops)

    Thank you Dr Gangemi :)

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