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Cholesterol Tomfoolery: A Primer

July 2, 2009

How much do you know about your cholesterol? Specifically, how do your doctors get the HDL and LDL numbers that you’re given during your yearly physical? It’s not how you think and it is likely putting you in the “danger” range and allowing the doc to sell you drugs.

When you have a blood test for cholesterol, what is actually being tested is total cholesterol, HDL and triglyceride levels, not LDL levels. Testing for LDL is expensive; what labs do is use the Friedwald Equation, which is this:

LDL (calculated) =  total cholesterol – HDL – (triglycerides/5)

The key point of this equation is that it is crap: because of the division, the last chunk of the equation alters everything. If your triglyerides are high, the number subtracted is higher and your LDL reading is lower. It’s inaccurate at best and it is dangerous at worst.

A more accurate equation for determining LDL (Thanks to the Whole Health Source and Dr. Michael Eades) is this:

LDL (calculated) = total cholesterol/1.19 + triglycerides/1.9 – HDL/1.1 – 38

If you have your numbers handy, run them through this equation and see what spits out; it will be the more accurate of the 2 readings.

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