Is Cholesterol Bad?

One of the common misconceptions out there is that cholesterol is "bad". The truth is that cholesterol is essential to life.

Each of our cells is surrounded by a cell membrane that is composed of a "lipid bilayer". Cholesterol is a one of the key components of this membrane. 

Cholesterol also serves as a vital component in the production of vitamins and hormones including testosterone, estradiol, cortisol, and aldosterone. These hormones are essential to life. See the figure below for a visual representation of how cholesterol serves as a precursor for these key hormones. 

Because there is poor understanding about the critical role of cholesterol in our bodies we have been led to believe that there is "good" cholesterol and "bad" cholesterol. Nothing is farther from the truth. Cholesterol is good. 

However, cholesterol can lead to "poor" outcomes when it gains access to the wrong places in our body like our arteries. From a clinical perspective this is especially pertinent when we are talking about coronary artery disease (CAD) which is by far and away the leading cause of death in this country. 

Cholesterol, I guess, is much like money. Money has been critical to the development of efficient and effective trade. Without it we would be bartering all day long for what we need. At the same time investment of money in the wrong areas can lead to unfavorable financial conditions. 

Likewise, when cholesterol gains entrance into our arteries it leads to an inflammatory cascade which can lead to narrowing and obstruction. This can eventually lead to heart attacks or strokes. 

So the next logical question is how can we determine if and when cholesterol will invade our arteries?

Since CAD is the number #1 killer in America this question is pertinent to almost everyone. 

The problem lies in the fact that when you get your cholesterol measured we are actually measuring the total cholesterol amount in the blood. This doesn't necessarily tell us if and when these molecules will get into our arteries. 

And that is where I will leave off for now. Stay tuned for the next article in a few days. Also, I would like to acknowledge that I have gotten much of this information from Dr. Attia and his excellent blog. If you would like a personalized assessment of your cardiac risk factors and cholesterol numbers feel free to schedule a consultation. 

Of course, each individual case is different and the advice in this post should not substitute for getting a consultation with your doctor. ​​