06/03/2026
Unpopular opinion:
Maybe the most dangerous number in healthcare isn’t cholesterol.
Maybe it’s our obsession with chasing numbers without asking WHY they’re changing.
A patient gets a lab report.
Cholesterol: High.
And almost immediately the conversation becomes:
“How do we lower it?”
But shouldn’t the first question be:
“Why is the body making more of it in the first place?”
Cholesterol isn’t a toxin.
It’s the raw material for:
• Every cell membrane in your body
• Estrogen, progesterone, testosterone, and cortisol
• Vitamin D production
• Bile acids needed for digestion
• Brain structure and function
In other words, cholesterol isn’t the enemy. It’s one of the most important substances in human physiology.
What’s fascinating is that cholesterol can rise in response to:
• Insulin resistance
• Chronic inflammation
• Thyroid dysfunction
• Stress
• Infection
• Active weight loss
• Metabolic dysfunction
Yet many conversations stop at the lab value.
The truth is, insulin resistance and metabolic dysfunction are often stronger predictors of cardiovascular disease than total cholesterol alone.
That’s why modern cardiovascular risk assessment has evolved far beyond simply looking at total cholesterol.
Today, some of the most valuable markers include:
• ApoB
• LDL particle number
• Lipoprotein(a) [Lp(a)]
• hs-CRP (inflammation)
• Fasting insulin
• Triglyceride/HDL ratio
• Blood sugar regulation
• Overall metabolic health
As a Functional Medicine practitioner, I’m less interested in asking:
“How low can we get your cholesterol?”
And more interested in asking:
“Why is your body making it?”
Because cholesterol may not be the root cause.
It may simply be a clue.
The body is always communicating.
Our job is to listen.
Treat the person.
Not just the lab report.
