Follow me on social media, @dr.janine.nd

Welcome to the "Know Your Numbers" series, your go-to guide for understanding the lab results behind your health. In part 6, let’s talk about cholesterol, the bloodwork marker that often gets overlooked because, well... it doesn’t make you feel any different in the short term. But make no mistake: it’s one of the most important numbers to track when it comes to protecting your long-term heart health.

Let’s get into it! 👏

✍️🔍Why Cholesterol Matters

Cholesterol is a silent player. You won’t feel high cholesterol the way you might feel fatigue or joint pain, but over time, elevated cholesterol levels can lead to plaque buildup in your arteries, increasing your risk of heart disease and stroke.

These conditions don’t typically show up in younger adults (under 50), which is exactly why early screening is so crucial. If your cholesterol has been elevated for years by the time you hit midlife, you've already had time for that plaque to accumulate, and that risk is now baked in.

WHAT WE LOOK FOR IN BLOODWORK
When assessing cholesterol, we run a **lipid panel**. This typically includes:
**Total cholesterol**
**LDL ("bad") cholesterol**
**HDL ("good") cholesterol**
**Non-HDL cholesterol**
**Triglycerides**

💡 MY APPROACH TO TESTING

I recommend a one-time screening in your 20s or 30s, even if you feel great. Then, beginning around age 40, screening every 2–3 years is ideal, or more often, depending on your individual risk factors.

Who Should Be Screened More Frequently?

Certain factors significantly increase your risk of high cholesterol and heart disease. You may benefit from earlier or more frequent testing if you have:

Diabetes
High blood pressure
A history of smoking
A family history of premature heart disease or high cholesterol
Are obese
HIV

Inflammatory conditions (like rheumatoid arthritis or lupus)

📊 What Each Marker Tells Us:

Triglycerides: Linked more closely to blood sugar and insulin resistance. Elevated levels may indicate metabolic issues.

LDL, Non-HDL, and Total Cholesterol: These tell us more about your risk for plaque buildup and artery damage, which are the key drivers of heart disease.

Do i need to fast before testing?

Not necessarily, but triglycerides can be elevated if you’ve eaten recently. If your triglycerides come back high or borderline, your provider may ask you to repeat the test while fasting.

Bonus Tests to Understand Your Risk

For a deeper understanding of your cardiovascular risk, consider asking about these two additional tests:

✅ Lipoprotein(a)

Should be tested once in your lifetime
Elevated levels may increase your risk of blood clots and stroke
Note: This test is out of my scope to order

✅ Apolipoprotein B (ApoB)

Tells us how atherogenic your cholesterol is. In other words, how likely it is to contribute to plaque in your arteries
A more precise marker than LDL alone for some people

Why It All Matters

Cholesterol may not be flashy, but knowing your numbers early gives you the power to change your future. The earlier we spot concerns, the more time we have to intervene, often with dietary and lifestyle changes, and sometimes with medication if necessary.

These changes can make a big difference in your risk of heart attack or stroke down the line. And that’s why this number is never boring to me.

Have questions about your cholesterol panel or whether you should be screened?

Reach out! This is exactly the kind of preventive care that saves lives.

book a visit today