Cholesterol: the “Good”, the “Bad” and the Misunderstood

In the last post, “Cholesterol: Building a Foundation for Understanding“, we introduced the concept of the lipid panel and what it consists of: Total Cholesterol, Triglycerides, HDL, LDL and the Cholesterol/HDL ratio. So in this post we are going to combat the hot topic of our “good” and “bad” cholesterol, discussing what they are and what it is that they do.

First off, LDL and HDL, our supposed “bad” and “good” cholesterol, are actually not cholesterol at all. They are protein molecules that transport cholesterol throughout the body. The LDL takes cholesterol from the liver, transports it throughout the body and distributes where needed. The HDL is the molecule that takes excess cholesterol dropped throughout circulation back to the liver. So without LDLs, we wouldn’t be able to transport cholesterol throughout the body to where it is needed.

To murky the waters even more- HDL and LDL are not as simple as they seem. They are not simply “bad” and “good”. They are both broken down into two different categories: LDL-A, LDL-B, HDL-A and HDL-B. The “A” forms are large buoyant molecules that float along through the blood stream like a cloud, and are about as harmless as one. The “B” forms, however, are small, dense little bb pellet type molecules. These ones definitely can be harmful. Again, this is found in both the LDLs AND the HDLs. So neither one is “good” or “bad”, they both have good and bad components.

Now, what makes the small, dense particles bad? The are small enough that they can sneak behind the inner lining of our arteries if there is even the slightest injury there. This is especially problematic because the immune system targets this area as an issue, puts it under quarantine, and begins piling immune fighters along the lining, fighting any bacteria or fat that is accumulated there. All of this commotion in the area narrows the passage way of blood, therefore increasing the blood pressure.

Additionally, it is these small particles that are more likely to be “oxidized”. Oxidation may be a foreign concept to many, so let’s compare it to something we are all familiar with. Think of what happens to an apple that you just slice open. It is nice and white, right? However, as it sits out in open air, it begins to brown – this is called oxidation. Oxygen, the amazing substance that allows us to breathe, is also toxic. That is why it is so vital that we take in “anti-oxidants”.

So when these small particles become oxidized, they become super sharp and begin to start damaging the inner lining of the blood vessel, further increasing the problem that we just talked about. As the oxidized LDLs get stuck in the inner lining they begin to drop all of their cholesterol. This cholesterol is then eaten up by the immune fighters that are on the scene. However, as these immune fighters continue to be present at the scene and clean up all of the excess debris of fat and toxins, they begin to meet their max capacity. Once these immune fighters get full of this fat, they die and remain along the lining of the artery. Once enough of these dead, fat filled cells collect in the inner lining, they will start to be visible by the naked eye. If you wanna make another connection… Guess what color they are? Yellow – these are the yellow streaks that are notoriously present in atherosclerosis.

Defining cholesterol as: “good” or “bad” is not as easy as it would seem. The body is a very complex organism with every structure having a specific design and purpose. Therefore, it is important to understand the underlying function of each structure in the body, to recognize when there is dysfunction.