In this episode, I am doing a deep dive on cholesterol and the many different things it does in the body as well as how it impacts our hormones. I’ll also be covering how certain minerals can impact cholesterol and go through some things to consider when looking at your cholesterol lab test results. 

This podcast episode is for informational purposes only. While I will be discussing lab tests and possible interpretations for results, you can’t interpret a lab completely without having a whole person to compare it to. If you have concerns about your cholesterol, please share them with your doctor or medical provider. 

Links/Resources:
Free thyroid training
Free Training: Optimizing Hormone Health with Mineral Balance
Mineral Imbalance Quiz
Gallbladder episode
Iodine episode
Top 5 Nutrition Myths
Macro Minerals episode
Copper and Iron episode
The Salt Fix by Dr. James DiNicolantonio

References: 
Steroid hormones: https://nutritionandmetabolism.biomedcentral.com/articles/10.1186/1743-7075-7-47
Cell membranes: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6383291/#:~:text=Cholesterol%
20is%20the%20major%20sterol,the%20lipid%20bilayer%20on%20average. 
Myelin: https://www.nature.com/articles/nn1426#:~:text=Myelin%20cannot%
20be%20synthesized%20without,limiting%20factor%20for%20myelin%20growth. 
Bile acids: 
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2712638/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2712638/#:~:text=Bile%
20acids%20are%20synthesized%20from%20cholesterol%20in%20the%20liver

Transcript:
Amanda Montalvo 0:00
Hey, this is Amanda Women’s Health dietitian. And I’m Emily nutritional therapy practitioner. And this is the RU menstrual podcast where we help you navigate the confusing world of women’s hormones in teach you how to have healthy periods. Each week, we will be diving into a different topic on women’s health and sharing our perspective using nutrition, female physiology and metabolic health. Our goal is to help you wade through conflicting health information and empower you on your healing journey. We hope you enjoy it.

Okay, we have another deep dive episode for you. This one is all on cholesterol, and how it can impact our hormones plus a lot of other things. And I’m really going to be focusing on all the different functions of cholesterol in the body, I will cover how it impacts our hormones, how our hormones can impact cholesterol, and then I’m gonna dig into different things that you want to consider when you’re looking at your cholesterol levels. And with that being said, This podcast is for informational purposes only as always, especially when I go into lab test results. I know it can be like a little hairy, because people often think like, oh my isn’t optimal, or my entire minds low. And they want to know exactly what to do. Or if I’m mentioning certain things that could be helpful. They want to know if it applies to them. And you just can’t interpret labs without having a person to compare it to. I think that’s like, the most important thing to always keep in mind. So if something really hits home for you, and you’re like, Yes, I feel like this could potentially be a good fit for me. Talk with your doctor, I am linking a ton of references in the show notes for everything. So you’ll have a lot to work with if they want to see any data or science on it. Hopefully they’re looking at up themselves. But if you want to bring them something and say, Hey, I think XYZ could be a good fit for me. What do you think? Here’s some more information, all that’s going to be available for you in the show notes. So let’s get into this cholesterol Deep Dive. So what exactly is cholesterol? It is a fat like substance that is transported throughout our bodies via the blood. And this transportation is happening through lipoproteins, which are exactly what they sound like lipo like lipid or fat proteins, which are just moving throughout the bloodstream and taking that cholesterol to cells in the body. And when it comes to like how do we discover cholesterol? Where did this all come from? Broda Barnes he’s, I love his work. He really focuses a lot on thyroid. He has an amazing book called hypothyroidism, the unsuspected illness. And I remember when I was reading that book out, they took the talks a lot about cholesterol and heart health in there, because you’ll learn when we cover the thyroid section of this, that our thyroid has a huge impact on our cholesterol levels. But he talks about how one cholesterol was first discovered, it was actually discovered by a French chemist more than 200 years ago, when they were studying gallstones. And we’ll talk about how cholesterol is really important for bile. But I just thought that was really interesting that we didn’t even know what cholesterol was until we discovered gall stones, which is just you know, when we have the thickened bile, that causes a lot of pain in our gallbladder, I did a whole episode on the gallbladder with Olivia Haas who specializes in that. So make sure you listen to that if you’re struggling with that, but that’s how we discovered cholesterol. And I guess it kind of surprises me because it’s so important. And so essential for our health. One of the biggest things it does is it helps make up our cell membranes. So what is surrounding ourselves and keeping ourselves fluid and safe is cholesterol. And it also is really important for the fluidity of that membrane. So how it can move it stiffness, all of that and how permeable it is and permeable, just meaning that like what can get into the cell and out of that cell. And so cholesterol can help reduce the passage of molecules into a cell or out of a cell by increasing the packing of phospho lipids, which are also made up of cholesterol. So really important for cell membranes and cell health. We need it for that it’s also really important for myelin, which is what helps protect our nerve fibers. Cholesterol is a huge part of what makes up myelin. So it is really, really important for our nerves, our brain, health, spine, all of that. And then of course hormones. I feel like a lot of people know cholesterol because it is the precursor to a lot of our hormones. It’s a precursor to all of our steroid hormones. And this includes sex and stress hormones. So if we think about like testosterone, estradiol, progesterone, but then also like cortisol, the stress hormones are glucocorticoids and then mineralocorticoid, like aldosterone. So if we don’t have adequate cholesterol, or if it’s not being utilized properly, then it can trickle down.

had an impact both our sex hormones and stress hormones. It’s also really important for vitamin D, which I, it’s not classified as a hormone, but it acts very similarly, as a hormone in the body, we have vitamin D receptors. So if we don’t have enough cholesterol, we can’t synthesize enough vitamin D, which is just interesting. And Morley Robbins talks about this a lot with how we’re like a vitamin D deficient country. But we have a lot of people struggle with high cholesterol. And it’s kind of like, how do those two things go together. But I think a lot of it’s that we’re not utilizing the cholesterol properly. And then that can lead to low vitamin D levels. And then bile acids, like I mentioned, we discovered cholesterol from looking at gall stones, which bile acids are a big part of that. But our liver makes bile acids out of cholesterol in bile. It’s so so important. We talked about this in that gallbladder episode. But basically, bile acts like a detergent to fat, so it helps to emulsify and break it down. And then that’s how we absorb it properly. So it’s really, really important for digestion. Without adequate cholesterol, we can’t make adequate bile. And then that is just like a huge whole host of issues with nutrient deficiencies. Because we need to break down fat soluble vitamins or fat properly to absorb fat soluble vitamins. And even some minerals like fats really important for copper absorption, too. So that’s big, and then also need to think about what do we eliminate in our bile, right? Estrogen is a huge one. So if you aren’t moving bile, well are producing it, well, then it’s going to be harder to get rid of that estrogen, other toxins we eliminate in the bile. And then copper, I talked about that in the copper deep dive episode. So Bile is huge. We do need cholesterol to make bile acids. And then arterial wall repair. So this is kind of when I think of cholesterol, especially with my traditional, conventional dietetics training that I did first, I think of like heart health and lots of fear around eating too much cholesterol and all that, unfortunately. And when it comes down to it, yes, cholesterol was once thought to build up in our arterial walls, and then cause heart disease. But now we know that this doesn’t happen unless inflammation is present. So it’s not necessarily your cholesterol levels that are the issue. It’s how much inflammation is present in the body, that will then cause the cholesterol to build up. Because there’s a ton of research that goes through people that have high cholesterol and no heart disease issues. And then people that have lower normal cholesterol and have heart disease. And then it’s like, okay, well, what is the defining thing between all these, and it’s really that inflammation, that is the key thing. And that’s the root cause leading to the cholesterol buildup. So it’s not the cholesterol, it’s inflammation. And then, of course, that’s going to open up like a whole rabbit hole of like, well, where’s the inflammation coming from, and that will be unique to each person. And then I just want to wrap up this section was saying like, something that I thought was interesting, at least with just to kind of show like, just how important is cholesterol if you couldn’t grasp it, after going through those important functions. And I think it’s interesting that in all mammals, it’s found in every cell of the body, we have cluster on every cell of the body. And inside those cells, if we don’t have that cholesterol, we actually have enzymes that make that cholesterol. So it just shows you like how important it is that even if we are not getting adequate amounts, or producing adequate amounts, like in our liver, or getting it from our diet, then we can actually make it on a cellular level, because it’s that important for our health. So now you know what cholesterol is, what the different functions of it are in the body. Let’s talk about where it’s made, and where we store it. So we primarily are making cholesterol in the liver 80% is made synthesized by our liver 20% of the cholesterol that you’d see like in your blood work, or that’s in the body we’re getting from food from our diet, and that would be from animal foods. So and then we also make it in ourselves. Like I mentioned previously, every cell has enzymes that can make cholesterol if we need it. So we’re getting it from somewhere, but primarily we’re getting we’re making it within our body. And so this is why when someone is struggling with a higher cholesterol level, and they’re recommended to like cut out animal foods or reduce animal foods, lower fat, it doesn’t really physiologically make sense. Because we’re making most of that cholesterol that’s showing up in their lab. So it’s one of those things where it’s like, should we actually lower in our diet? Or should we get to the root of why it’s high in the first place. So it’s most likely coming from an inside job, right, some sort of dysfunction on a physiological level. And we’ll talk about all the different things and impact those in a bit. But then if we think about okay, so we’re making most of the neuro body we’re getting some from our diet. Where does this cholesterol hang out?

And a lot of it is going to be stored in our adrenal glands that has the highest concentration of cholesterol of any tissue in the body. Which makes sense, because remember, we need cholesterol in order to make steroid hormones, and what corticosteroid hormones are a huge part of that. And then our brain and spinal cord have a ton of cholesterol a quarter of the cholesterol in the body or in the brain and spinal cord. And we also have it in bone marrow. And then of course, there is cholesterol like in our blood. If too much accumulates in our blood, then the liver will actually break down some of that excess cholesterol into bile salts, and those are excreted in our bile. So that’s why they found it in gall stones, because that’s what makes up gallstones. So that’s where cholesterol is made, where we store it in the body, the different functions of it. Now we’re going to get into how it can impact our hormones, thyroid health, gut health, insulin, blood, sugar, all of that.

Now let’s get into cholesterol and hormone production. So I want to talk about how we actually use cholesterol as a precursor to our hormones. And then I’m going to get into how our hormone levels can actually impact our cluster all levels, which I thought was very interesting. So we use cholesterol as the precursor to steroid hormones and like our sex hormones. So what does this mean? cholesterol gets transported into our cells goes into the mitochondria, this the mitochondria, you’ve probably heard me talk about them before. They’re like the powerhouses of our cell. So they’re making energy ATP, the body’s main energy source. Minerals are a huge part of this process. So we the transport proteins, or Trent transport that cholesterol into the mitochondria. From there it is converted to pregnenolone, which is like a parent hormone, because you’ll see that pregnenolone then can get converted to like progesterone DHEA, all that. So cholesterol, an enzyme converts it to pregnenolone, the parent hormone, and then from there, enzymes are either going to convert it to progesterone, which would be the you know that really pro metabolic female hormone, or it’s going to convert it to DHEA. And from DHEA can get turned into testosterone, like androgens, male hormones, or estrogens. So if we think of like, a little pregnenolone, tree, progesterone, and then DHEA, and off that DHEA will be estrogen and testosterone. So that is how we utilize cholesterol on a cellular level to produce sex hormones. And then if we think about, okay, well, how do our sex hormones impact our cholesterol levels, I found some really interesting research on this and one in particular that I wanted to go through for cycling women, because I actually did not know this. And I was like, Oh, this is really cool. I’ve never even considered where I am in my cycle when getting cholesterol levels tested, or interpreting them. So it’s good to know. But it was from the National Institutes of Health. And this is right from the article, researchers have shown that women’s cholesterol levels correspond with monthly changes in estrogen levels, this natural variation, they suggest might indicate a need to take into account the phases of a woman’s monthly cycle, before evaluating her cholesterol measures. On average, the total cholesterol of the women in the study, varied 19% over the course of the menstrual cycle. So 90% is significant. And I think that’s why they like wrote this whole article, because they’re like, Wow, that’s like a pretty big difference. That’s the difference between, you know, someone maybe being recommended medication or not. So I thought that was super interesting. And the major findings were like as estrogen increases, HDL cholesterol also increases which is our good cholesterol, and that peaks around ovulation. And then on the other hand, total cholesterol, LDL cholesterol and triglycerides all declined as estrogen levels increase but not immediate. It was like after estrogen peaked, which is right before ovulation. And then total cholesterol, LDL and triglycerides reached their lowest right before menstruation began. So it’s looking like as estrogen increases and then we ovulate and then we make progesterone. Cholesterol levels were more optimal, which is just really interesting in general. And then it makes you it makes sense in my brain because I’m like, well during menopause when hormone levels drop, high cholesterol is like very, very common, typically, because thyroid health is also declining during that time. And when you look at HRT and studies on using hormone replacement therapy and menopause, a lot of the conclusions are the same. And it shows that hormone therapy and menopause, menopausal women can actually improve cholesterol levels by decreasing the LDL the technically bad cholesterol and increasing HDL which is technically the good one, but it was statistically significant. So overall, typically your that’s like can be one of the benefits.

It’s for heart health using HRT is that it can optimize your cholesterol profile. Again, inflammation is still a very big part of that picture. So we can’t ignore that. But I just think that’s really interesting. And then they did one with birth control, there’s actually quite a few with birth control as well. And oral contraceptives have been shown to increase our LDL cholesterol, so then nothing not good cholesterol, total cholesterol, and then triglycerides, along with insulin levels. And I’ve known that, like I’ve seen in the past that they’ve increased insulin resistance, and CRP, which is like an inflammatory marker, but I didn’t even realize that they increased cholesterol levels. So there’s one study, it’s like meta analysis, it looked at nine different types of oral contraceptives. And they found that the progestin only formulas, or the combination pills that had either DESA, estriol, or low dose norethindrone, those have the best profiles for cholesterol levels, so like cholesterol, triglycerides, all that stuff. So overall, oral contraceptives can lead to higher cholesterol levels. And at certain times in your cycle, as estrogen is increasing, and then progesterone increases that will optimize. So it makes sense, right? Like when you’re on the pill, you’re not ovulating, you’re taking synthetic hormones, and you’re likely having some underlying hormone imbalance that could be impacting your cholesterol levels or lower hormone levels in general, like if someone you know, does a hormone panel while they’re on the pill, it’s like, well, your levels are going to be low. So those low levels could be leading to not so great cholesterol triglycerides in blood sugar profiles, but using things like HRT have actually been shown to improve cholesterol. So I just thought that was really interesting. So we need cholesterol and make sex hormones. Our sex hormones can also impact our cholesterol levels. And if you’re someone if you’re a woman, and maybe you were told you had high cholesterol, I would try to figure out like Where was I in my cycle. And when you retest, I would try to retest like right before your period, or at least during your luteal phase. Because it looks like that’s when you’re going to have the most optimal impact of hormones on your cholesterol levels. And that can make a difference. Now, one of my favorite parts is cholesterol and thyroid hormone. And I would say this is probably one of the most common reasons I see high cholesterol in the women that I work with. It’s not always the sole reason, but it’s something it’s usually the first thing that comes to my mind when someone mentioned that they have high cholesterol, or I look at someone’s labs. And that is because our thyroid hormone is really the main governor of our LDL receptor activity and LDL receptor is just what helps us to clear that cholesterol. So we don’t, we’re not always over producing cholesterol, that’s not always the root cause of why cholesterol can behind the body, it can be part of it. But the other big thing that I think is probably the most important to look at is this LDL receptor activity. And if you have any of these things that could be impacting how that LDL receptor is working. And thyroid hormone plays a huge role in that. So it’s going to impact our cholesterol and inflammation, three different ways. So number one, we need T three, which is our active thyroid hormone, to convert cholesterol into steroid hormones. So if we can’t do that, then that’s cholesterol, it’s not being used properly, right? That’s hanging out. We also need thyroid hormone to clear that cholesterol because that’s what activates this LDL receptor. So if that gets activated, then we’re clearing out any excess cholesterol from the blood. And then finally, T three can help protect LDL cholesterol from free radicals. And that’s that oxidative stress, that inflammation that I was talking about in the beginning, where we can have cholesterol buildup in the blood, but it doesn’t necessarily increase our risk of heart disease until there’s inflammation present. So, basically, the T three helps protect us from free radicals. Free radicals create oxidative stress, oxidative stress is just one we have an abundance of free radicals and not enough of these powerful antioxidants. Like I mean a lot of nutrients, vitamins, but also thyroid hormone. So without adequate thyroid hormone that LDL cholesterol can then get oxidized, and then that creates more inflammation. So those are like the three big ways that thyroids going to thyroid hormone and having enough of it or not enough who’s going to impact our cholesterol status, and how we’re using cholesterol in the body. The other kind of big thing to keep in mind is that with hypothyroidism if someone has an under functioning thyroid, they often will have an elevated lipo Protein A and that does put someone at risk for cardiovascular disease. The other big thing with hypothyroidism is there’s often higher levels of fat

So lipase, a one, this is an it’s an enzyme. So whenever something ends in like the ASC, it’s an enzyme. And those are just things that kick off reactions in the body. Minerals fuel, a lot of enzymes. And a lot of amino acids do as well. So we have higher levels of this phospho lipase, a one it’s very inflammatory. And so that will also impact our LDL particles. And then finally, a lot of the research shows us that C reactive protein that CRP that blood measurement is for inflammation is often found to be elevated, even if someone just has subclinical hypothyroidism, meaning if their labs aren’t necessarily out of range, but they’re close, and a doctor is like, Hey, you don’t have hypothyroidism yet, but you’re kind of heading in that direction, or if they’re just not optimal. So you can see thyroid hormone was really important for how we are able to convert that cholesterol to sex hormones, how we are able to use that LDL receptor, and then protecting the body and cholesterol from inflammation, and the free and free radicals and pro inflammatory enzymes. So basically, we need cholesterol, we need thyroid hormone to make cholesterol to get rid of what the body doesn’t need. It’s really important and I think sometimes people kind of brush this one off, because you’re like, Oh, my thyroid levels are normal, but you don’t have to have very low levels of thyroid hormone in order to see an increase in cholesterol. Even people with mildly low thyroid levels, which is that subclinical hypothyroidism can have higher than normal LDL cholesterol. And there’s a study in 2012 that I’ll link and they found that high TSH levels alone, not even looking at T four and T three can directly raise cholesterol levels. So that’s just good to know, I think because sometimes we can kind of dismiss it, oh, my thyroid is fine. But it’s like your bloodwork might be fine, but then like their basal body temperature may be is very low, or they’re not looking at other markers of thyroid health. That could be an indicator that hey, actually your thyroid is not functioning as optimally. And if you are struggling with high cholesterol, it’s something that you really want to explore. I will link my free thyroid training in the show notes so that anyone that wants to look at okay, what can I do nutrition wise and how can I look at my thyroid labs to understand if I have subclinical hypothyroidism, definitely watch that. The other end of the spectrum is that hyperthyroidism also is not great for cholesterol levels, it can have the opposite effect where we actually have very low cholesterol levels. And it’s because if we are having way too much of that circulating T three levels, and that can impact the LDL receptor activity and we’re clearing it too much, which also is not good. And then if we have too much tea for that can actually promote the oxidation of LDL cholesterol levels. So high TSH, also not great but low TSH, too much thyroid hormone, not great for your thyroid for your cholesterol levels as well. So either way, we just want optimal thyroid so that we can have that great LDL receptor activity clear it but not too much in order to have healthy cholesterol levels. Another important area that we want to dig into if we’re trying to understand imbalances, or sub optimal cholesterol levels, is our ability to manage our blood sugar and our sensitivity to insulin. That is a huge root cause for a lot of people this is often paired with thyroid dysfunction, they’re not always separate. And a lot of that’s because insulin has a huge impact on our thyroid hormone. And then thyroid hormone has a big impact on insulin and how that works in our fat cells. But either way, insulin does impact your LDL receptor and how we uptake that cholesterol into our liver. So if we’re having some imbalances with that, especially if we have insulin resistance, I have a cool study that I’m going to go through in a second. That can lead to higher cholesterol levels. And there was research a research article from Messam me tscm study, I’ve heard people refer to it both ways. That insulin sensitivity regulates cholesterol metabolism to a great extent and an even greater extent than obesity does, because I think we kind of tend to lump high cholesterol in with all the other kind of condition chronic conditions that are we deal with. And we say like okay, well, obesity is the root cause of that. But what they’ve noticed and in this study, particularly they identified was that the disruption in cholesterol metabolism happened regardless of whether someone was obese or not. So they found that cholesterol synthesis is upregulated and absorption downregulated in insulin resistance and type two diabetes, but they did look at people

do not necessarily have a diagnosis which I appreciated. That’s why even though the studies done on men, which, like wah, wah, but it’s, it’s hard to find that it’s hard to find a study that’s not like, okay, these participants have XY and Z diagnosis. I’m like, What about people that are just kind of like on this spectrum of having some blood sugar dysregulation but don’t have a diagnosis yet, because I would say like, that’s most people. And then it just, to me, I was like, Okay, this is actually much more applicable to like the general population. So they looked at people with normal blood glucose levels, they looked at people with impaired but not a diagnosis. And then they did have participants that actually had type two diabetes. And what they found was that that cholesterol metabolism, even in the subjects that had only had minorly, impaired fasting glucose, so they they weren’t type two diabetic, they had no other diagnosis, but maybe their fasting glucose was a little high, there was an upregulation of cholesterol synthesis, so more cholesterol was being made. And that was despite obesity. So like, the insulin, the blood sugar dysregulation had a much greater effect on cholesterol levels than the person’s weight did. And I just think that’s important to highlight. So insulin, huge regulator of that cholesterol metabolism. There’s also a good amount of research on insulin resistance of women with PCOS and elevated cholesterol or triglycerides. There’s a study that I have this quote from in recent meta analysis, triglycerides and low density lipoproteins. So LDL cholesterol levels were 26 milligrams per deciliter and 12 milligrams per deciliter higher and high density lipoprotein cholesterol. So HDL cholesterol, the good cholesterol concentration was six milligrams per deciliter lower and women with PCOS than those of controls that did not have PCOS. So what we’re seeing is that women that have PCOS, that diagnosis that polycystic ovarian syndrome, they have higher levels of cholesterol, and they have higher levels of triglycerides, which is very common when you have blood sugar dysregulation. And a lot of times with PCOS, their insulin resistance is present. It’s not always like a diagnosis. Sometimes women are just kind of like a little on the spectrum. It’s hard to like put people in a perfect box. But I think that most of them in PCOS could benefit from working on blood sugar and insulin balance. I also think it’s important to mention that 25% of women with PCOS also have thyroid dysfunction. And typically, hypothyroidism is the most common one, a large portion of that being autoimmune hypothyroidism, which will also alter cholesterol metabolism and triglycerides. So even if this population, maybe it wasn’t the insulin resistance, for sure, maybe it was also they had some thyroid dysregulation that was contributing. Those are two big things in one population, I think it’s important to consider, if you have PCOS, and high cholesterol, look into thyroid health, I have that free training, talk with your doctor or your practitioner, and then start to dig into like maybe if that looks really good, maybe there is some level of insulin resistance there that isn’t being addressed, because it’s not like blatantly obvious. Again, you don’t have to be overweight, to have insulin resistance, and you don’t have to be overweight to have high cholesterol. And then finally, when I’m kind of digging into the blood sugar piece, of course, the question of like fasting comes up and how fasting affects insulin resistance and carbs? Should we eat carbs? Should we do low carb and how does that affect our insulin resistance and our cholesterol levels? When it comes to insulin resistance, a lot of the times a very common recommendation is to do intermittent fasting, which I have a blog post about that I’ll link in the show notes. I don’t recommend fasting for women, I just don’t think it’s helpful, especially like a longer fasts and going a long period without eating.

The research is mostly done on men, there’s very mixed research on women, most especially women that are not on the pill, and are actually cycling and it shows that it can be stressful after a certain period of time. So I would say I don’t recommend fasting. But a lot of that a very common recommendation for insulin resistance is to like hey, do some fasting and that can help speed up your insulin, reducing your insulin resistance, which is controversial in and of itself. I think it’s a little lazy. I think it’s like let’s get to the root of why are you not utilizing those carbohydrates? Well, what’s going on with the insulin? It’s just kind of like leaving so much to be honest, not explored to me like it just doesn’t make sense. But if we think about that recommendation, a lot of the times those people are already struggling with high cholesterol. And then if they add fasting on top of it, it increases their levels more so sometimes their insulin resistance improves but then they’re like, Well, why the heck is my cholesterol going up and a lot of

This is because of how insulin impacts that LDL receptor activity. So if we have enough insulin being secreted because they were eating like a mixed meal, so it’s got protein, fat and carbs, right, and we’re eating regularly throughout the day, our body is getting this consistent message that, hey, we have fats, like lipids circulating in the blood, and nutrients, right, and we have glucose, all that stuff, our bodies, it’s in a Fed state, and it has these fats circulating. Because you have this abundance of fats or lipids, your body then perceives that, okay, I can take some of these fats and clear them from the blood. So it’s going to take those LDL particles into the liver via that LDL receptor. Because we have plenty leftover in the blood, we don’t need to keep these hanging out there. When we are fasting insulin levels are lower. So that’s going to down regulate the LDL receptor already, and then our fat intake or lipid intake is also lower. And so because we have to maintain a certain level of fat supply in our blood, we need enough fat we cholesterol, we need fat soluble vitamins, because we need to make it so that all our tissues are working properly, then what’s going to happen is that LDL receptor activity is going to respond to that, and it’s going to slow down. And so it looks like you have higher cholesterol. But it’s just that you’re not clearing it because your body’s not in that fed state. So it’s like okay, well do I do I want to do fasting for insulin, and for high cholesterol, I mean, always talk with your doctor and your practitioner and do what you think is best for your health. But I would say like physiologically doesn’t really make sense, just because that can actually slow down how quickly we’re obtaining those LDL particles into our liver, it makes more sense to just do regular meals throughout the day, those mixed meals and give your body that consistent flow of fats so that that receptor works better also, that helps support T three levels, that active thyroid hormone and eating frequently throughout the day. So if you are fasting can also lower those T three levels, which can also lower the LDL receptor activity. So that’s kind of like the the take on fasting. And then when it comes to carbohydrates, it’s like do I do low carb, do I not do low carb, low carb and high fat diets, they often mimic fasting, but you’re getting the lipids in, right, so you’re still getting lipids in your system. So you’re going to have less insulin, more fats, and then they’re going to be going toward that circulation, the blood which is going to lead to higher higher cholesterol levels or triglyceride levels as well. And then insulin that can have a positive effect on that thyroid hormone and that LDL receptor activity. So for someone that is insulin sensitive, replacing fat in the diet with carbs could be really powerful for helping them improve their cholesterol levels, and triglyceride levels, lipid levels in general. But if someone is using low carb to improve how their body is utilizing carbs and work on their insulin response, then yes, like that would make sense, like in the short term. But the end goal is always to improve insulin sensitivity. I think that’s like the biggest takeaway is like, yes, like with low carb, you can like kind of mimic the fasting without leading to the high cholesterol levels and slowly improve that insulin sensitivity over time. So gotta get to why it’s there in the first place. Right, you still have to understand like what’s going on, which is gonna be different for each person. But I always think about like, thyroid health, mineral balance, I mean, magnesium and calcium are really important for insulin stress is a huge one, you know, why is your body not utilizing, utilizing that insulin properly? What is your history with food and nutrition? How have you fed yourself the majority of your life, so many things are gonna come into play when it comes to dealing with that? But it’s like, I get it, I get why people are like, Yes, I’m, I’m gonna do reduce my carbohydrates to low carb, increase my fats to like, optimize insulin, but ultimately, what’s really going to optimize insulin. And cholesterol in the long term, is improving the insulin sensitivity and then being able to eat more carbs, that’s what’s going to help support T three, that’s what’s going to help support blood lipids in the long run. And that LDL receptor activity, it’s just a matter of kind of slowly taking the steps to get there. And I think this is where a lot of people kind of get, like, maybe a little stuck on like, what’s the right word? Yeah, I guess like stuck is a good way to put it or just, they’re just totally like lost on their journey when they’re trying to eat more nutrient dense foods. Maybe they’ve been under eating for a long time or they restricted carbs for a long time. And then they’re like, Okay, well, I want to support my metabolism and they are

Add in a ton of carbs, but they don’t have that insulin sensitivity in place their body’s insulin resistant, then that leads to very quick weight gain. And that can lead to changes in cholesterol levels and thyroid hormone and all that stuff. And because their body and their metabolism wasn’t set up to handle those carbohydrates, then they actually can start to feel worse. And that’s why we always want to take things very slowly. And if you are someone that is responding that way, it’s like eating enough protein is always my first question. And then, you know, how are you eating those carbohydrates. The other thing to think about if we’re trying to improve our that consistency of our blood sugar, insulin sensitivity, is if you’re eating your food, your protein foods first, that’s gonna lead to a much lower spike in blood sugar. So if you eat like, say you’re having, I don’t know, just like what I ate for lunch today, I had these like sweet and sour meatballs and sweet potato. If I eat the meatballs first, or even like a few bites of those first, and then I eat the sweet potato, my blood sugar is gonna be a lot more stable than if I eat the sweet potato and then the meatballs or just mix them together. And glucose Goddess has a lot of really great pictures of this, like blood sugar graphs on her Instagram where you can see this. But that could even be to me, I’m like, Well, what’s like a step we can do before all this and without having to go to maybe an extreme of lowering carbohydrates to improve insulin sensitivity. That’s when I will look at the order of your foods. How are you eating? And then of course, like, are you eating enough protein? Can you increase protein fat and slowly increase carbohydrates to eventually improve that insulin sensitivity. And then that will help improve thyroid and your lipid profile?

Hey, Amanda, here, just giving you a quick break, hopefully a break for your brain in the middle of this podcast episode, to remind you that if you haven’t gone through our free training, optimizing hormone health or mineral balance, we really do recommend starting there. And the main reason for that is because you’re going to hear us say things like mineral foundation, having a solid foundation, are you putting the foundations in place, especially when it was we get deeper and deeper into different hormonal topics and specific imbalances in the body, the the mineral foundation is always going to be so essential. So if you haven’t watched the free training, you can find it in our show notes. Or you can go to hormone healing rd.com. And it’s going to be right on that front page there. But we really recommend starting there so you can understand how is your current mineral status? How do you assess this, and how to get started with all that just so you can get as much as you possibly can out of the rest of the podcast episodes. But that’s it, I hope you enjoy the rest of this episode.

Okay, so that kind of wraps up blood sugar, insulin and cholesterol. But hopefully the big takeaway is even some imbalance or dysregulation in blood sugar and insulin can lead to higher cholesterol levels and alteration your lipid metabolism. So that’s not great. And then the biggest concern is like, Okay, well, how is this impacting the rest of my body? Am I able to convert? Is this going to kind of trickled down and lead to more inflammation and then potentially, with heart health issues down the road, I think it’s, it’s just something for you to be aware of, even if you don’t have a diagnosis of like, well, maybe I’m going to explore my blood sugar and insulin a little bit more and look at like how I could optimize these things, in order to optimize the LDL receptor activity, and not just just not go to an extreme, I think that’s hopefully the biggest takeaway is like something like fasting led to actually higher cholesterol levels. Whereas if we do something like maybe moderate low carb and slowly increase our carb that’s actually going to optimize things in the long run. So we’ve talked about hormones and cholesterol, we talked about thyroid and cholesterol, and then we went through insulin and blood sugar and how that can impact cholesterol. Again, a lot of this is happening on the level of the LDL receptor.

The other thing with cholesterol, and another root cause you want to consider is our gut health. And so, I mean, we need a lot more research around this, but I still think it’s really promising and just interesting and a good one to know. But regardless, like there’s certain aspects that we’re very clear, we know in the research, like for example, things like H Pylori, that can raise cholesterol levels. It’s a pathogen. It’s found in our gut primarily hangs out in our stomach throws off stomach acid, that has been shown to increase our cholesterol levels. While on the other hand, we can actually have low cholesterol levels from things like autoimmune conditions. And I mentioned those in this section because most of our immune system lives in the gut and typically someone with an autoimmune condition at some point, they’re going to have to address their gut health. I always recommend doing stool testing when autoimmune condition is present, because there’s often some like whether it’s one infection or many infection

issues are not enough good bacteria, or it’s looking at how your immune system is working in the first place, how your digestion is all those things, that has a huge role in how your body handles an immune condition. A lot of times, it can even be a trigger for autoimmune conditions, it’s kind of like the final straw, gut health are not sub optimal gut health that, especially for a long time, that kind of leads to that diagnosis. But those can really be associated with low cholesterol levels. But even now, we’re discovering certain types of bacteria. And our balance of bacteria in the gut can also contribute to cholesterol levels. And they don’t even know like the type of bacterial yet, bacteria yet they’re calling it microbial dark matter. But I found this article that I’ll link in the show notes. And there’s just a really interesting quote from it that I think sums it up perfectly. the metabolism of cholesterol by these microbes may play an important role in reducing both intestinal and blood serum cholesterol concentrations, directly impacting human health. This was said by Emily Vasquez Professor of Chemistry and Chemical Biology at Harvard University, and then co senior author Remnick Xavier, core member at the Broad Institute. And he’s also the co director of this is at the center for Informatics and therapeutics at MIT. So just really amazing people, professors working on this information and research. But this newly discovered bacteria could one day help people manage their cholesterol levels through diet probiotics, or novel treatments based on individual micro biomes. So do I think gut health is going to be the root cause for everyone and their cholesterol? No, but I do think it is a part of the picture. And especially if we think about, like people that have specific that buildup of cholesterol, and they are struggling with heart disease, we have to address their gut because that’s where a lot of inflammation is coming from for people. So I just thought that was really interesting. And I don’t necessarily think it’s a bad thing. Like if we think of like how H Bhullar causes high cholesterol, it’s not a bad thing, for an infection to raise our cholesterol, it is totally fine. It helps defend our body against that infection. We just don’t want this happening long term. Or especially if you don’t, maybe you don’t have that infection present, or it’s gone now. And your cholesterol is remaining high. It could be it in because of how it impacted the rest of your gut microbiome. So I just thought that was really interesting. And just like a quick summary, age, fluoride, certain types of bacteria can raise cholesterol levels, autoimmune conditions can lower cholesterol levels. And then there’s some bacteria that we don’t even know fully what they are yet, that could be playing a huge role in how we are dealing with cholesterol in the body, on both an intestinal and a blood serum level. So lots of potential there. And even just something that is always worth exploring if you have a concern around inflammation in general. Let’s talk about cholesterol and genetics. I am not going to dive deep into this, because this is not my area of expertise. And it could be its whole own podcast episode. I’m going to link to an article from Chris master John. I think he just speaks about this very beautifully makes it easy to understand. But I will read an excerpt of how he defines familial hypercholesterolemia, which would be when someone it has the genetics for this familial hypercholesterolemia results from a genetic defect in the LDL receptor, which is the receptor required to bring the LDL particles into cells, it can come in two forms. People who inherited only one defective copy of the gene from either their father or mother are heterozygous for the disease, while people who inherited a defective copy from both parents are homozygous for the disease. So if you have one gene from one parent, you could still definitely deal with high cholesterol and no matter what you do with your nutrition and lifestyle, but if you have both, I mean, I think I want to say that that’s pretty rare. Like he goes on in the article, and he talks about how people who are homozygous for familial hypercholesterolemia can develop atherosclerosis and coronary heart attacks in infancy. So I’m going to go ahead and say, I think that’s pretty rare. Regardless, we still want to address all the other things that we’ve talked about in this episode, right? So if you are someone that falls into that heterozygous population, hopefully you’re not homozygous. And you know that this like, in you, I would say, like get tested because you don’t want to assume like if everyone your family has high cholesterol, that’s doesn’t necessarily mean that you have the gene for it. Because you’d also want to look at like nutrition, thyroid health, you know, what is insulin and blood sugar look like for those people in your family? Because it could just be a nutrition and lifestyle thing. It doesn’t necessarily mean it’s familial hypercholesterolemia, and then it’s genetic. But you would still I think everything still applies.

It’s just that you would probably want to know if that was the case for you. So that if you’re doing all the things and not seeing a ton of change, it’s like, okay, well is, do I still need to address these things? Or is there a deeper reason? Is it a genetic reason that I’m struggling so much with high cholesterol levels. The last area that we’re going to dig into before I talk about labs, and then ways you can optimize cholesterol, is minerals. Of course, I would never do an episode without talking about minerals wouldn’t be my vodcast. So there are certain minerals that can contribute to high cholesterol levels. And then there’s one mineral in particular that can lead to lower cholesterol levels. So number one is Iodine. Of course, I’m thinking a lot of my longtime listeners would have guessed that one, hopefully, primarily because it’s how it’s impacting your thyroid, if we have an iodine deficiency, we’re going to have a difficult time making adequate thyroid hormone. Remember, t three and T four are made up of iodine molecules. And then that’s gonna lead to hypothyroidism. If we don’t have enough T three, the LDL receptor doesn’t work properly, remember, and then that can lead to high cholesterol. And there are studies that utilize iodine supplementation and how they show how it can actually decrease high cholesterol in women. And I’ll link that in the show notes. So iodine is essential because how it impacts her thyroid, and how that impacts the LDL receptor. And of course, insulin sensitivity, blood sugar, all that stuff. And it is antibacterial impacts the gut. So listen to the iodine episode, if you haven’t, it’s a good one. Iodine is just like a really cool mineral. And then if we think about, okay, iodine is important, but definitely, we don’t want to just go take iodine leaves us with the episode. That’s not what you want to do. But because other minerals impact how we use iodine in the body, so we need enough sodium and magnesium. Really important, there are definitely cofactors. For iodine, you want to take those first. And then selenium is huge, too. We need enough selenium in order to use iodine properly. And if you have selenium deficiency that can lead to increase in thyroid size and goitre. Lower selenium levels are also associated with an increase in third volume and nodule formation. So if you’re dealing with thyroid nodules, like yes, iodine is key. But selenium is also so important for that. So if you’re like, I don’t know if I have these issues, iodine testing, I like to do iodine loading 24 hour urine testing. So you take an iodine tablet before you do the urine test. And then however much leaves your body that’s what is going to be the indicator if you’re deficient or not. If you have the goal is that you want a lot to leave because it means that you have adequate iodine stores. If not, then that shows an iodine deficiency. Hakuba Labs is the one that I use. And then a first selenium you can look at a hair mineral tests on htma you can get that through my master minerals course it allows you to order a hair mineral tests and it teaches you how to interpret it. You can get selenium from supplements but you can also get it from food. Brazil nuts, very easy way to get it six to eight, Brazil nuts has 544 micrograms of selenium. And you don’t want to overdo selenium. So I would say like one to 200 micrograms is the recommended amount for someone with a deficiency. Some people need 300 But that’s like, you know, pretty rare so you you can prioritize foods and not take a supplement 100% Brazilians have a lot. Beef kidney has a lot. One three ounces has 125 micrograms of selenium. Tuna has a lot there’s 92 micrograms, and three ounces of tuna. mussels have a good amount to there’s 76 micrograms in three ounces. So you could do like mineral supplement, you could do food. Always talk with your doctor before we take supplements though or your practitioner and hopefully do lab testing so that you know if you need it or not. But iodine deficiency can lead to high cholesterol. That’s and then it has cofactors so don’t just take the iodine on its own. You got to take the other stuff first. And then copper a copper deficiency can cause high cholesterol and I would even go so far to say is copper imbalance because they talk about how low copper and low super low plasmin they have been shown with coronary artery disease and higher cholesterol levels. atherosclerotic arteries have also been shown with low copper levels. And then if we have as copper status declines, so like blood serum copper, and then Cirilo plasmon, which is the bioavailable form of copper, it’s how we actually use it in the body. I talked about this in the copper deep dive podcast episode. Then, as those decline it can lead to excess iron levels because copper regulates iron and it keeps that whole recycling system moving. It keeps copper fuels, the enzymes that keep that recycling system moving, and then high iron is that as a risk factor for heart disease and high cholesterol levels. So copper is huge copper deficiency copper imbalance and when I think of an imbalance I think of how we can have like excess copper, but it’s an

Not in the bioavailable form. So then we’re not using it. And it’s creating inflammation like that’s like a recipe for disaster when it comes to cholesterol. So we want to have copper in a good place, I talked about how to do that in the copper podcast episode. There was also some pretty interesting information when I was researching of like minerals and high cholesterol levels. And just like the other kind of areas that can trickle down, or minerals can impact that. And that could potentially impact cholesterol, so not like directly but more indirectly, diabetes came up a lot with low cholesterol levels. diabetics have been shown to have a reduction in liver copper content. And diabetes itself can cause an imbalance in copper and loss of copper utilization in the heart. And you know, of course, with cholesterol, we’re thinking about heart health. So I just thought that was interesting. We also have that increase in inflammation when we have high blood sugar levels, or high insulin levels and diabetes, so that paired with high cholesterol is not great. And then inflammation can actually raise our serum copper levels, but there could still be a deficiency present. So if your copper is high in your blood or on your hair test, it doesn’t always mean that you just don’t need any copper or that you have to get rid of all the copper, it could just mean that your copper is not bioavailable in that Cyrillic plasmid form and you can’t use it properly. So then you still can have all the same symptoms of a copper deficiency, including this, these issues with iron, and that excess iron leads to high cholesterol levels. And there is there’s a good amount of research on this iron overload appears to raise blood cholesterol and to contribute to Alzheimer’s disease and possibly Parkinson’s. And because that excess iron can increase oxidative stress, so when we have that imbalance, like too many free radicals, bad guys, not enough antioxidants good guys, then that creates oxidative stress and that increases wear and tear in our tissues increases inflammation, and it increases the deficiencies of other antioxidants. So iron overload equals inflammation and high cholesterol is like the summary there. If we don’t have adequate copper or enough bioavailable copper, then that can increase our risk of iron overload. And then the last mineral that can lead to high cholesterol levels is sodium in it. This is like very common low sodium diets, they increase insulin resistance and lead to higher cholesterol both LDL and triglycerides. So

iodine, we want to have adequate iodine, we want to have adequate bioavailable copper, which includes copper and vitamin A. And then we want to have adequate sodium in our diet. And all those things, especially the iron. The copper specifically helps to regulate iron. Without that regulation of iron, we can lead to high cholesterol when it comes to low cholesterol and what minerals can impact that a manganese deficiency can actually cause low cholesterol. Some of the signs and symptoms of a manganese deficiency are things like getting dermatitis, especially because usually you can’t sweat, like your sweat glands get blocked, so you can get dermatitis, tiny bubbles on the skin. This can also result from excessive sweating, sunburn or fever. So you gotta like rule everything out. Manganese deficiency is pretty rare. Depending on if you supplemented a lot of minerals, those because minerals work together. So you taking one can lead to an imbalance and another one. But manganese deficiency can contribute to it. If you have bone health issues, some dermatitis issues, if you have really low cholesterol levels, all paired with like really poor hair and nail growth in a reddening of your hair, which I thought was interesting, these moderate deficiencies of manganese can accelerate just issues with low cholesterol. So that’s a big one to consider. Some are like risk, some risk factors for manganese deficiency are if you are avoiding like all grains and seeds and things like that, or if you have a diet that’s very low in plant foods that can contribute. But I would say like I have still seen, I have not seen this issue with people that maybe they do like a carnivore diet. I haven’t necessarily seen a manganese deficiency come up. And clinical manganese deficiency, they’re just not well documented in humans outside of like if someone isn’t, is maybe a baby’s getting formula that has no manganese in it like then that could lead to a deficiency. But they’ve really only ever seen it in research like purposely inducing a manganese deficiency. So it’s not super common. But I would still say like, it’s something to consider. If you have very low manganese levels, maybe you do a hair test, you have really low manganese, and then you’re also dealing with like sweating issues, skin issues, bone health issues, low cholesterol, hair, nail growth issues, that sort of thing, then that could fall in line. And then I would say like prioritizing eating more plant foods would be like number one thing digestion

and then look

Yeah, like what supplements are you taking? Are you taking anything that could lead to imbalances in manganese in general, but high cholesterol, low iodine, excess iron, low sodium, low copper, low cholesterol, low manganese.

And now we can finally go on to understanding your cholesterol bloodwork. Alright, so I’m going to go through the different labs on a lipid panel. And I’m going to go through what’s optimal, and then what’s not. And then what can possibly lead to higher low levels of things. So total cholesterol, that’s the sum of our HDL cholesterol, good cholesterol, LDL cholesterol, bad cholesterol, and then our V LDL cholesterol. So it’s a sum of all those And research shows that values between 170 and 200 milligrams per deciliter is optimal. I will say, I think closer to 200, for my like clinical experience is more optimal. But I mean, do what you want that information. I also think it’s so important with labs to look at your labs and your trends. I so often see women get stuck in this obsession over trying to get to the perfect lab number. And I’m like, does it really matter? You know, like if everything else was going in the right direction, and your cholesterol is 215 or 220. But everything else is perfect. And you’ve reached all your health goals. Do we is 170 200 really optimal for you? Probably not, it’s probably the 220. So don’t obsess over these numbers. And always look at your trends. I’d rather I’d so much rather pay attention to someone’s total cholesterol how it’s changed over time, versus like if it’s optimal or non optimal. But 170 200 technically is optimal for total cholesterol, elevated levels. The cause of that can be everything we just talked about. So like mineral excess or deficiencies in minerals, or insulin resistance or blood sugar imbalances, hypothyroidism, we talked about gut health and having certain infections can raise total cholesterol, PCOS, all those things. So total cholesterol, those are the main root causes low cholesterol, we talked about manganese deficiency. And then if we look at triglycerides, so that’s like measuring actual lipids, and this research shows that the optimal range is 70 to 80 milligrams per deciliter. Again, to do that, what you will when we have I really look at I get mostly concerned when people have very high levels or very low levels, if they’re pretty close to that I’m not super concerned, but high levels are going to be seen with hypothyroidism. Insulin resistance if someone has fatty liver or liver congestion, and that’s not functioning properly poor metabolism and utilization of fats from low bile acids or low lipase enzyme to lipase helps break down fats, and the digestive system. So if we don’t have enough bile, we don’t have enough lipase, that’s going to be a problem can contribute each Flora infections. Again, it’s normal for that to happen during an infection is not necessarily a bad thing. Oral contraceptives like we talked about, and then excessive alcohol intake, all those things can lead to higher triglycerides. I would say I think like liver congestion, and digestion and insulin resistance are usually the top ones I see.

And then for low levels of triglycerides, that’s also a concern. I often see it with really high stress, like overactive adrenals because someone’s been in fight or flight for a long time, or autoimmune disorders. Very, very common again, that can lower cholesterol too. And then hyperthyroidism, so overactive thyroid even if it’s not autoimmune, and liver and biliary dysfunction, so like having some sort of dysfunction in the liver.

And then we look at HDL cholesterol, or the good cholesterol at an optimal is 55 to 85 milligrams per deciliter. Typically, we’re gonna see high levels in autoimmune conditions most often, and then low levels of this would not be great. And we can see that with fatty liver if someone has like, overall just like poor metabolic health, like insulin resistance, they’re struggling with liver function, maybe they also are struggling with their thyroid health, kind of like all compounded together just that poor metabolic function that can lead to low HDL cholesterol levels, heavy metals having an excessive amount of heavy metals. This will probably be linked to minerals for most people, because our mineral status is how we get rid of heavy metals. And then h pylori infection can lead to low good cholesterol and high bad cholesterol. And then overactive thyroid can lead to low HDL and then lack of exercise. So those are going to be like the main root causes with that, and then LDL is optimal is going to be 80 to 100.

If we have high levels that’s going to be from those like metabolic issues fatty liver hypothyroid H. pylori infection

Can oxidative stress or inflammation, and then low, it’s often associated with a higher risk of infection and like chronic inflammation, so having that going on for a long period of time. So you can see that a lot of it’s linked together, right? Whether it’s like your triglycerides, your LDL, your HDL, your total cholesterol, we still want to look at the same root causes. And we still have to take into consideration all the main areas that we’ve gone through, like hormones, like thyroid, like blood, sugar, insulin, gut, health, minerals, all those things.

And then a couple of ratios I wanted to go through these are, sometimes they’re on your lab tests, they’re not always, but there are two that can be helpful, especially because like a lot of those full are like advanced lipid panels, cholesterol panels, they can be very expensive. And you can usually get a lot of that inflammation, information from ratios. So like one of the ratios I really like is triglycerides to HDL ratio, this can be very, very similar, it can be pretty darn close to your LDL particle size, and looking at the number of LDL particles. So you can get those tests done like your LDL P, and then looking at the particle size totally fine, it’s just typically not going to be automatically ordered by your doctor. And it’s often expensive. And they usually don’t know how to read the results. So you could put this ratio together take your triglycerides, divided by your HDL cholesterol, and an ideal ratio is less than two. And if you have a ratio above four, that’s considered high. And above six is like really, really high. And that’s where I got these numbers from different studies. So one study was looking at a triglyceride HDL cholesterol ratio above four. And they found that’s the most powerful independent predictor of developing coronary artery disease. There also was another one where high numbers of small, dense LDL particles are associated with an increased risk of coronary heart disease. And then if you have small dense particles, then that is a higher risk for those with larger, more brilliant particles. Basically, what they found was that if you’re looking at a triglyceride HDL ratio, you can predict that particle size. And one study found that 75% of individuals with a ratio above 3.8 had a preponderance of small LDL dense particles, whereas 81% of those with the ratio below 3.8 had a preponderance of large buoyant particles. So high triglyceride HDL ratio, they typically have higher than average triglycerides, and it that’s going to be like, the biggest concern is going to be that you’re going to struggle with your particle size. If you have very small dense particles, then that can just really increase your risk of coronary artery disease. Whereas the lower the ratio, the larger, more buoyant or particles that’s going to decrease your risk. It’s not perfect, but I mean, that’s a pretty good percentage. And if you don’t have access to that testing, but you do have a lot of concerns with cholesterol and heart health, I think it’s worth just dividing the numbers and doing your ratio for yourself. But yeah, it’s in one of the studies looked at the ratio and how it compared to insulin resistance, I don’t think it’s a perfect marker for that. I think there’s other better markers we can use. But they did see if the ratio is greater than three, then like, if the result was greater than three, then it was a reliable predictor of insulin resistance, I would still look at every I would still look at your fasting insulin, your hemoglobin a one C and your blood sugar levels, I wouldn’t rely solely on that. But it’s just pretty neat that you can take your triglycerides divided by your HDL cholesterol and get some idea of like possible particle size, particles are small, and that good, big good. And then possible insulin resistance. It’s not a perfect measurement, though. And then the other one is looking at total cholesterol divided by your HDL. And for men, you want it to be less than 4.5. For women, you want to be less than four. And this is really just taking a look at like how much of your cholesterol is of the good cholesterol. Most of the research is like HDL cholesterol has the most positive impact on our bodies, whereas LDL can be more problematic, it can oxidize more, which we don’t want because that can lead to the heart health issues. So that’s like your rundown of labs. Again, when you’re looking at your labs, like you have to keep your whole history in mind and like all your main health concerns everything because that’s what’s gonna allow you to know like, okay, maybe I’m not optimal in triglycerides. But if I look at my labs six months ago, from last year, they’re actually way better. So it doesn’t necessarily mean that you need to change everything you’re doing, but I just think it’s helpful to know

Know what could be driving these and then looking at the ratios, if you don’t want to get your particle size tested, but you’re nervous about this is what usually helps most of the people I work with as well look at the ratio, and even though some of their cholesterol is not, the values aren’t as great as they want, the ratios are good. And they’re like, okay, okay, I’m not as worried now.

And then finally, our tangible takeaways, what can we do? If we are concerned with our cholesterol levels? What can we start focusing on? I think just understanding how all those areas that I just went through impact that LDL receptor activity that is going to impact the cholesterol content of the liver, and then our thyroid activity, insulin inflammation, are all responsible for that receptor activity. So it’s not just a one thing. It’s more of like, how’s my body working as a whole? And are there certain areas that I can optimize? I think, if you haven’t looked into thyroid health, get your thyroid tested, do bloodwork, you can do hair, mineral testing, and the iodine test that is the most conclusive and your basal body temperature. Of course, that’s the most conclusive way, I talk about those in the free thyroid training. This is a really good training, I’m just gonna say I think it’s a great training, it should be a paid resource. It’s not because I want people to have access to that information. And it doesn’t teach you how to read your hair test, but it goes through certain markers on the hair tests and thyroid health, all the blood markers and what’s optimal. And then we talk a little bit about the iodine test, but that’s mostly my course.

Regardless, it goes through how to use your basal body temperature to monitor thyroid health. So many different things you can look at at home, you don’t even need to get bloodwork or anything done to look at your thyroid health on a daily basis. So if you haven’t explored that explore thyroid health if you have cholesterol concerns, because remember, even sub optimal subclinical thyroid hypothyroidism, has been shown to increase cholesterol levels. So that’s number one. For nutrition, I would say you want to prioritize adrenal cocktails. I will link to a blog post on those, mainly because we need sodium. Remember, low sodium can lead to issues with high cholesterol. We don’t want to overdo it. But we need like that balance of sodium and potassium, because we need enough sodium but we need to pair that with potassium because they work together in order to utilize it well. So we don’t want to just go crazy and just add salt to every single thing that we’re eating and put it in all of our drinks. I would say you want to ease it in slowly, and you want to pair it with potassium. Fibers foods are another great one. Fiber is great for a few different things. It’s really helpful for bile, especially if you’re maybe struggling with gallstones or some symptoms with bile issues or gallstone issues if fiber can be very, very helpful for that. So things like cooked grains, I love raw carrots, I love high resistant starch foods, like cooked and cooled potatoes, soaked beans if you can sprout them, that’s ideal for all types of beans, rice cooked and cooled rice that’s also going to have resistant starch and then oats and then green plantains. Those are also great for your gut bacteria. So they kind of cover two sections in one but increasing those fibrous foods. If you can tolerate them digestive wise, if you have constipation, and they make it worse, don’t force yourself. But if you can tolerate them, they can be really helpful for that bile. And they’ve also been shown to help with removing cholesterol as well. Certain saturated fats do include increased cholesterol production in the liver, some people can benefit from increasing their mono unsaturated fats in their diet. But I say this is like it’s such a important thing to figure out what’s right for you. Like if you are someone that has the genetic component, I would say like experiment with some mono unsaturated fats and like don’t have saturated fats for everything. But I don’t want anyone to fear them because they are really helpful. And they’re really important for female hormones in particular. So we don’t want to get rid of saturated fats. But if you’re someone that maybe has that family history, then maybe you try to work in more monounsaturated fats like olive oil, avocado, that kind of stuff. But don’t be afraid of those animal foods. And then that’s the other thing is like saturated fats not going to make cholesterol so high that it’s like over 300. So you still want to look at other factors. Remember, only 20% of that cholesterol is coming from our diet, and then balancing protein and carbs to support that insulin and blood sugar. I talked before about like trying to eat your protein foods first because you’re gonna get less of a spike in glucose, that blood sugar, and then that means that you’re going to require less insulin, and it’s going to just help improve insulin sensitivity over time. So that’s a big one. And then if you are one

worried about high cholesterol and heart disease risk? I would really consider lowering your polyunsaturated fat intake those PUFAs because those do increase the risk of heart attack. And I will link research on that. But Chris, Master John talks about that a lot. So, adrenal cocktails, I’ll put a I’ve talked about those a lot. But I’ll put a blog in the show notes with the recipes, eating fibers, foods, getting mono unsaturated fats in as well, especially if you have family history, reducing PUFAs, for sure polyunsaturated fats, those are just going to be things like vegetable oils, not overdoing nuts and seeds. I think they’re fine foods to include in a small amount. But if you are someone who’s eating a lot of those, then I would say you really want to try to prioritize more saturated fats in moto and saturated fats. Saturated fats are going to be anything in animal foods, like dairy, meat, eggs, all that stuff. So if you can just try to balance that out, that’s going to be the most ideal situation. But if you are someone that eats out a lot, or you do have, I mean, any prepackaged food, now it’s a bummer. But a lot of them have those vegetable oils, canola oil, sunflower oil, that kind of stuff in them, the more of that that you’re taking in, that can also increase your risk of heart disease. So it’s one of those things where again, you got to look at your own health history and keep it in context to yourself. But if you have that familial history, you’re struggling with high cholesterol. And then you’re also maybe you are eating more processed foods or foods that contain those poo fuzz and you’re eating lots of nuts and seeds. And maybe you’ve replaced I mean, I remember my paleo days, you replace like everything with almond flour and nuts and seeds. And that’s not great either. So we don’t need to go to extremes, I don’t think we need to never eat a pizza ever in our life. But I think if we balance animal fats, and also like some plant fats from things like olives, and avocado, and then really try to only have nuts and seeds as a condiment and avoid those more processed oils, that’s going to be like the less least stressful and most balanced approach to monitoring those fats to optimize cholesterol levels. And then looking at mental and physical stress. I can’t like express enough how important this is on a healing journey with anything but I would say, especially with high cholesterol as well, just because it’s like looking at your stress is going to impact your mineral status, right? It’s going to impact your thyroid health, your adrenals, your hormone production, your blood sugar, it’s going to also impact your sleep, and that’s going to trickle down and impact everything else. So we can’t ignore that part. So maybe it’s counseling, maybe it is looking into Are you addicted to your phone and technology? Do you always need to be listening to something and stimulated even just slowly trying to detach from that is really helpful. And then sleep in light, like your physical stressors? Are you getting blood exposure late at night? That kind of stuff? Do you have gut infections, I would definitely consider that a stressor. addressing those two is really important. And then supplements, there are certain supplements that I do think can be helpful, but it really depends on the person and your mineral status. Right. I went through all those minerals, but it’s like, well, I mean, there’s no perfect one thing for everyone. I would say that for women with PCOS. inositol can be really helpful. And it has been shown to improve insulin resistance, which could help if someone has high cholesterol in PCOS. And then if someone’s struggling with low cholesterol, and maybe they have an autoimmune condition, I would definitely look into sgot testing, do some stool testing with a practitioner so that you can rule out anything going on in your gut that could be contributing to the autoimmune condition. And then looking at are you getting enough saturated fats in your diet? Right, that’s huge. And then how is your digestion? Are you making enough digestive enzymes like lipase to break down fats? Are you making a file? Other things to consider is like is your thyroid overactive? Do you have a magnesium deficiency? Do you have too much stress? And then is there an issue with heavy metal exposure, you can see that on hair mineral testing, usually on hair testing and showing you how much you’re getting rid of. But if someone has a very high accumulation, because it’s like maybe it’s in their water or something, then that will show up on a hair test. So there’s a lot of areas that you want to consider. But I think like what we can focus on is optimizing things like blood sugar, getting enough fibres in our diet, looking at that fat intake and getting minerals like sodium, potassium, magnesium, adrenal cocktails, all that stuff. Those are going to be like kind of like the biggest like foundational ones. And then from there, it’s like okay, well do I need to do testing? Have I explored thyroid, minerals, and then gut testing. Those are like the the areas that I focused on if someone came to me with either high or low cholesterol concerns. So I know this

This was a lot, this is a big deep dive. But I hope that this is helpful. For those that were struggling with cholesterol and maybe aren’t really sure where it’s coming from, maybe you’re nervous, you’re like, Well, I don’t want to eliminate foods. Hopefully this helps you better understand that there’s so many causes beyond our diet that you’re going to contribute to cholesterol and a lot of it’s coming from within us, it’s just really going to depend on what we have going on. But that’s it. And this is our final episode of season three. And I’m going to take a little break over the next like month, maybe two months, because I have some really fun planning that I’m working on for season four. And just like the next year 2023, and what the podcast will look like, because you guys really liked the deep dives. But I’m just trying to think of like how I can make these even more useful for you. So we will see what comes of all that. But there’s definitely gonna be some changes with the podcasts, but only goods only things that will make it like easier and more tangible takeaways for you in your everyday life. So I hope this is helpful. Please, please, please share this episode with somebody you think it’s going to help. You can send it to someone you could share it in stories. Let me know if you enjoyed this on Instagram. I always do Instagram posts each week for the podcast so you can let me know your biggest takeaway one of those posts. And if you can leave a review, that is one of the biggest ways to say thank you to me for all the free content that I provide. And I read all of them and I appreciate it more than you know. So thank you so much and I will see you and season four.

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