What Your Cholesterol Numbers Are Really Telling You
As you know, I’m always trying to stress the importance of “owning your health.” It can be an abstract concept at face value.
In the past, when it came to running standard labs during my routine physicals … I didn’t question the doctor at all. Blood was drawn; results came in. The doctor called to say everything looked good. I couldn't even tell you what the labs were measuring, and I just continued on in my usual way.
I certainly wasn’t owning it.
So then the past few years when that call came in, the doctor would say… your cholesterol is creeping up. And I would ask, “what should I do about it?” And he would respond: “just eat healthy and exercise.”
And I would think … Ok … I’m pretty much doing that … but the following year I would still be in the same boat. Cholesterol continuing to creep up.
It's because …
I wasn’t looking closely at how I was eating.
I wasn’t paying attention to how consistently I was moving.
I wasn’t connecting my daily choices to those numbers on the page.
I was participating…
but I wasn’t truly owning it.
It wasn’t until I went to another doctor who ordered a more comprehensive cholesterol test—a particle size test (like a Cardio IQ through Quest or an NMR Lipid Panel through LabCorp)—that things finally made sense.
For the first time, I could actually see what was going on.
And more importantly—I could put a plan in place that started to move my numbers in the right direction.
These tests aren’t always ordered routinely.
But most doctors will run them if you ask.
And they give you a much more complete picture of what’s happening beneath the surface.
A little Cholesterol 101
(just enough to help you ask better questions)
First—cholesterol isn’t just a “bad” thing.
Your body actually makes it in the liver because you need it.
Cholesterol is essential for:
Building cell walls and tissues
Producing hormones
Making Vitamin D
Creating bile acids to help digest fat
So the goal isn’t to eliminate cholesterol.
It’s to understand how your body is using and moving it.
Your standard cholesterol panel gives you:
LDL (Low-Density Lipoprotein)
HDL (High-Density Lipoprotein)
Triglycerides
A simple way to think about them:
LDL → carries cholesterol out to the body
HDL → brings cholesterol back to the liver for removal
Triglycerides → unused energy circulating in the bloodstream
If it helps:
LDL → the one we keep an eye on
HDL → the one we generally want higher
Now, one key piece most people never hear …
Cholesterol can’t move through your bloodstream on its own.
It needs a carrier—something to transport it.
Those carriers are called lipoproteins.
And the easiest way to understand them is this…
Imagine a highway running through your body.
On that highway are trucks.
Those trucks are carrying cholesterol to different parts of your body.
Cholesterol = the cargo
Lipoproteins = the trucks
Now here’s the part most people never hear:
👉 It's not just about how much cholesterol you have.
👉 It’s about how many trucks are on the road.
Two very different situations
You could have:
A small number of large trucks
→ Everything moves smoothly
→ Less chance of buildup
Or:
A large number of smaller trucks
→ More congestion
→ More opportunities for those trucks to get stuck along artery walls
Same amount of cholesterol.
Very different outcome.
Why this matters
When there are too many of these particles:
They interact with artery walls more often
Some get trapped
Over time, that’s how plaque builds
So you can have:
“Normal” cholesterol
“Normal” LDL
…but still have a situation developing beneath the surface.
One more layer (we’ll come back to this)
There’s a marker that helps make this even clearer.
It’s called ApoB.
And what it tells you is simple:
👉 How many cholesterol-carrying particles are in your bloodstream
👉 In other words—how much traffic is on your highway
We’ll come back to this next time, because it’s one of the most useful numbers you can understand when it comes to your heart health.
What your standard labs can still tell you
Even without advanced testing, you can get useful clues.
One of the most helpful:
Your triglyceride to HDL ratio
Think of this as a signal of how well your body is managing energy.
Around 1 → very efficient
Under 2 → things are moving well
Above 3–4 → more congestion building
And what about total cholesterol?
This is where it can get confusing.
You might see:
220 → “high”
180 → “normal”
But total cholesterol alone doesn’t tell you enough.
Because it doesn’t answer:
How many particles there are
How well everything is moving
A better way to think about it:
Total cholesterol is just the headline.
You need the full story to understand what it means.
The shift
This is what changed things for me.
I stopped looking at my labs as something to “pass.”
And started seeing them as feedback.
A way to understand what was actually happening inside my body.
Every choice you make is a signal — adding to the flow … or adding to the traffic.
So I encourage you - get familiar with your numbers. Your actions can influence your cholesterol numbers relatively quickly - so take some time to determine what your best next steps might be.