Total Cholesterol

What is Total Cholesterol?

Cholesterol is a type of lipid (fat) that is an important component of our cell membranes and hormones and contributes to both digestion and metabolism. As Dr. Peter Attia, a leading expert on preventative health, says, “We eat, make, store, and excrete it.” While abnormal cholesterol levels are frequently attributed to diet, only 20-30% of our circulating levels are obtained from food. Most of the cholesterol in our body is synthesized, and although cholesterol is healthy for the body in the right amounts, excessive or insufficient levels can be indicative of critical issues.

Why is it included in the Cardiovascular Axis?

Cholesterol is processed in the liver, but too much (hyperlipidemia) can cause atherosclerosis (plaque buildup within arteries) and eventually lead to cardiovascular events such as heart disease or stroke. On the other hand, the less common but still prevalent hypolipidemia (abnormally low levels of lipids) may indicate the presence of other underlying disorders.

How can I better understand my results?

To better understand your test results, here are some values to reference:

If you are concerned with any of your results, it is important to consult with your physician.

High cholesterol can be lowered with lifestyle changes, including:

  • Exercising regularly
  • Avoiding smoking and tobacco products
  • Maintaining a healthy weight
  • Regulating high blood pressure and high blood sugar
  • Managing stress
  • Reducing dietary cholesterol and saturated fat
  • Increasing fruit and vegetable intake
  • Consuming more soluble fiber (oats, legumes)
  • Limiting alcohol consumption

The Mediterranean diet, as well as heart-healthy plant-based diets, have also been shown to lower cholesterol and cardiovascular risk.

Low cholesterol is typically either caused by a genetic disorder (primary cause) or another peripheral disorder (secondary cause) such as anemia, cancer, hepatitis C, malabsorption, hyperthyroidism, or undernutrition. As a result, hypolipidemia may be more difficult to target through lifestyle interventions.

Where can I learn more?

American Heart Association’s Guide to Cholesterol

Peter Attia’s series with Tom Dayspring, M.D., expert in lipidology

Scientific Literature

Janse Van Rensburg WJ. Lifestyle Change Alone Sufficient to Lower Cholesterol in Male Patient With Moderately Elevated Cholesterol: A Case Report. Am J Lifestyle Med. 2018 Oct 19;13(2):148-155. doi: 10.1177/1559827618806841. PMID: 30800020; PMCID: PMC6378490.

Yi SW, Yi JJ, Ohrr H. Total cholesterol and all-cause mortality by sex and age: a prospective cohort study among 12.8 million adults. Sci Rep. 2019;9(1):1596. Published 2019 Feb 7. doi:10.1038/s41598-018-38461-y