Cholesterol - Total

Introduction

As a  functional medicine nurse practitioner in Florida, I emphasize the role of key biomarkers in holistic health. Total Cholesterol reflects the sum of all cholesterol types—LDL, HDL, and VLDL—and is pivotal for evaluating cardiovascular function risk.

What Is Total Cholesterol?

Cholesterol is a structural lipid in every cell, essential for membrane fluidity, steroid hormone synthesis, vitamin D production, myelin sheath integrity, and bile salt formation. Endogenously produced (60–80%) by the liver, intestines, and skin—with dietary intake contributing the rest—its serum total is the aggregate of:

• LDL Cholesterol (“bad” cholesterol)
  
• HDL Cholesterol (“good” cholesterol)
  
• Estimated VLDL Cholesterol (via triglycerides/5)

Clinical Implications of Total Cholesterol Levels

Low Total Cholesterol

• Oxidative Stress & Free Radical Activity: Sudden drops may indicate heightened oxidative stress.
  
• Heavy Metal Vulnerability: Chronically low levels can compromise cell membranes, increasing toxin susceptibility (Heavy Metals).
  
• Liver Function & Biliary Insufficiency: Gallbladder dysfunction and fatty liver can reduce cholesterol synthesis.
  
• Dietary Deficiency: Strict low-fat diets may lead to suboptimal levels; assess Fat Status.
  
• Hyperactive Thyroid: Excess metabolism lowers cholesterol.
  
• Inflammatory States: Low cholesterol with altered lipids suggests inflammation (Inflammation).
  
• Adrenal Stress: Excessive adrenal activity increases lipid utilization.

High Total Cholesterol

• Atherosclerotic Risk: Elevated levels increase atherosclerotic process and coronary artery disease risk.
  
• Primary Hypothyroidism: High cholesterol with elevated triglycerides and TSH.
  
• Adrenal Insufficiency: Increased cholesterol & triglycerides with low potassium.
  
• Secondary Hypothyroidism: Pituitary dysfunction can elevate lipids.
  
• Biliary Stasis: Gallbladder hypomotility thickens bile, raising cholesterol.
  
• Metabolic Syndrome: High triglycerides, LDL, and fasting glucose accompany elevated cholesterol.
  
• Fatty Liver/Steatosis: Early liver congestion often shows high cholesterol with low HDL.
  
• Insulin Resistance: Dysglycemia and elevated cholesterol go hand-in-hand.
  
• Blood Sugar Regulation: Diabetic dyslipidemia typically features high lipids.

Interfering Factors Affecting Total Cholesterol

• Falsely Decreased: Postural changes, acute illnesses (e.g., myocardial infarction, bacterial infection, viral infection), high vitamin C.
  
• Falsely Increased: Thiazide diuretics (+5–8%), seasonal variations (↑ in fall/winter).

Drug Associations

• Decreased Levels: Statins and other lipid-lowering agents.
  
• Increased Levels: Certain antihypertensives (e.g., beta-blockers) and anabolic steroids.

Related Tests

To fully evaluate cardiovascular and metabolic health, consider:

• Apolipoprotein A-1 & Apolipoprotein B
  
• HDL Cholesterol, LDL Cholesterol, VLDL Cholesterol
  
• Triglycerides
  
• Homocysteine
  
• Lipid electrophoresis

Conclusion

Total Cholesterol is a cornerstone biomarker for assessing cardiovascular function and metabolic health. As a functional medicine practitioner in Florida, I integrate Total Cholesterol with personalized nutrition, lifestyle optimization, and advanced therapies like IV Therapy to address root causes and support lasting wellness.

Contact us at 904-799-2531 or schedule online.

Further Reading

• Grundy, S. M., Stone, N. J., Bailey, A. L., Beam, C., Birtcher, K. K., Blumenthal, R. S., … & Yeboah, J. (2019). 2018 Cholesterol Clinical Practice Guidelines: Synopsis of the 2018 American Heart Association/American College of Cardiology Multisociety Guideline. Annals of Internal Medicine, 170(11), 779-783. https://pubmed.ncbi.nlm.nih.gov/31132793/2

• National Cholesterol Education Program Expert Panel. (1988). Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Archives of Internal Medicine, 148(1), 36-69. https://pubmed.ncbi.nlm.nih.gov/3422148/3

• Nayor, M., & Vasan, R. S. (2016). Recent Update to the US Cholesterol Treatment Guidelines: A Comparison with International Guidelines. Korean Circulation Journal, 46(4), 394-406. https://pmc.ncbi.nlm.nih.gov/articles/PMC4857879/4

• Catapano, A. L., & Pirillo, A. (2022). What should be the goal of cholesterol-lowering treatment? European Heart Journal Supplements, 24(Suppl E), E75–E78. https://pubmed.ncbi.nlm.nih.gov/36082945/