Dr. Heidi Yanoti, DC – Life Extension Senior Wellness Specialist
Cholesterol management is a vital part of promoting heart health. But if you are one of the millions of Americans struggling with high cholesterol, you have probably heard and seen conflicting information.1 Is the focus on cholesterol a myth? Or do you need to lower cholesterol to prevent heart attacks? September is Cholesterol Education Month, so it’s a great time to learn the facts!
Are standard cholesterol tests enough?
When doctors first began focusing on cholesterol as a cardiovascular risk factor, their attention was on total cholesterol. We later realized that total cholesterol alone tells us little. We needed to consider its two major components, LDL (low-density lipoprotein or bad cholesterol) and HDL (high-density lipoprotein or good cholesterol), for test results to better reflect cardiovascular risk. While this was a step in the right direction, recent research shows that we need to look even more closely at cholesterol and the particles that carry it through the blood, called lipoproteins, to more fully understand cardiovascular risk.
What is the NMR Test?
NMR (nuclear magnetic resonance) spectroscopy is an advanced lipid-testing method that allows for a more in-depth assessment of the properties of lipoproteins and blood cholesterol than a conventional lipid panel.2 NMR testing goes far beyond the measurements of total cholesterol, HDL cholesterol and LDL cholesterol that standard yearly bloodwork measures. LDL particle size and LDL particle number are both important risk factors and can be used in conjunction with traditional lipid measurements to better estimate CVD (cardiovascular disease) risk.3 The NMR profile assesses LDL particle size and number.
The LDL Paradox
LDL particle number is a powerful tool for predicting heart disease.4LDL stands for low-density lipoprotein. LDL serves as a transport vehicle for cholesterol in the blood because cholesterol by itself doesn’t flow through the blood well. LDL particles can carry varying amounts of cholesterol. Studies indicate that the number of LDL particles, not just the amount of cholesterol in each LDL particle, is an important CVD risk factor.5This means that your typical yearly labs could show high amounts of LDL cholesterol, but if you are maintaining a low particle number, your heart disease risk may not necessarily be high, depending on your other CVD risk factors. The opposite can also apply: if your standard cholesterol test shows a healthy level of LDL cholesterol, you could still have an increased risk of cardiovascular disease if your LDL particle number and/or other CVD risk factors are elevated. And you may not be aware of this without running an NMR test.3
What is LDL particle size?
LDL particle number is not the only important risk factor that the NMR test can detect. LDL particle size is crucial as well. Multiple published medical studies now clearly show that the specific properties of LDL particles in your blood are important factors in your risk for heart disease.6 We now understand that if the majority of your LDL particles are large and buoyant (sometimes referred to as big and fluffy), they may pose less risk to your heart and arteries. If your LDL particles are small and dense, they can much more easily infiltrate the artery wall to cause damage and start the inflammatory process that can lead to the development of arterial plaques.6 Small LDL particles also linger in circulation longer, giving them more time to inflict damage on your arteries.6,7 One study showed that men with the smallest LDL particle size had about three-fold increased risk of ischemic heart disease than men with the largest LDL particle size.8 The NMR test not only measures the average size of your LDL particles, but also offers a count of how many of the small, dense, more-atherogenic particles are circulating.9
What about HDL?
The NMR test also gives us more details about our HDL cholesterol. It has long been known that HDL cholesterol is protective for our heart and arteries, and studies show cardiovascular and even longevity benefits for those with high amounts of HDL.10-13 You can learn even more information about HDL’s protective ability if you utilize an NMR panel. When it comes to good, protective HDL cholesterol, more particles are associated with greater protection.14 The NMR test provides a measurement of HDL particles, and the higher your HDL particle number, the more beneficial your good cholesterol is for your cardiovascular system.15
The Bottom Line
What does this really mean to the average person? If you are relying on standard lipid profiles found in basic yearly blood tests, you may not have an accurate assessment of how your cholesterol impacts your heart disease risk. The information you glean from an NMR profile will provide more robust information and serve as an invaluable tool that your physician can use to decide whether a medication is needed or choosing which nutrients may best promote your cardiovascular health.
To learn more about cholesterol management, listen to the latest episode of the Live Foreverish Podcast as Drs. Mike and Gossard discuss alternative medications and nutrients for lowering cholesterol without all of the side effects.
About the Author: Heidi Yanoti earned her Doctor of Chiropractic degree from Life University. She has been a Senior Wellness Specialist at Life Extension for over 10 years and a lifelong advocate for alternative approaches to optimal health. She enjoys sharing this passion with Life Extension customers, helping them achieve their health goals with a focus on promoting wellness. In her spare time, she enjoys reading, films and desert hikes in her Las Vegas, Nevada, home.
- Centers for Disease Control and Prevention (CDC). High Cholesterol Facts. Accessed 9/11/2019. https://www.cdc.gov/cholesterol/facts.htm
- Am J Cardiol. 2002;90(8a):22i-29i.
- J Clin Lipidol. 2011;5(2):105-13.
- Curr Atheroscler Rep. 2004;6(5):381-7.
- J Clin Lipidol. 2007;1(6):583-92.
- Oxid Med Cell Longev. 2017;2017:1273042.
- Am J Cardiol. 2002;90(8a):30i-47i.
- Circulation. 1997;95(1):69-75.
- Circulation. 2009;119(7):931-9.
- J Gerontol A Biol Sci Med Sci. 2002;57(11):M712-5.
- Atheroscler Suppl. 2004;5(2):25-31.
- Age Ageing. 2007;36(5):514-20.
- Aging (Albany NY). 2018;10(11):3528-3540.
- J Am Coll Cardiol. 2012;60(6):508-16.
- Br J Pharmacol. 2012;167(6):1177-94.