Understanding Cholesterol: HDL, LDL, Non-HDL, and Triglycerides - What You Need to Know About the Good, the Bad, Risks and Treatment

Cholesterol is a natural component of the blood that functions as a building block for cell membranes. The body needs cholesterol, but elevated levels of bad cholesterol can result in major health risks like a heart attack or stroke.

There are two main types of cholesterol in the body: low-density lipoprotein (LDL) and high-density lipoprotein (HDL). According to the CDC, the combination of low HDL or high LDL cholesterol can also cause health problems ^[1].

The goal of this blog is to help you learn about the different major types of cholesterol, the health risks they may cause, and possible treatment approaches.

What is HDL Cholesterol?

HDL cholesterol is commonly called “good cholesterol” because it helps the body remove bad cholesterol in the blood. This removal lowers the risk of cardiovascular or coronary artery diseases.

What is LDL Cholesterol?

LDL cholesterol is commonly called “bad cholesterol” because elevated levels of LDL cholesterol is associated with an increased risk of cardiovascular disease (heart attacks and stroke).

What are Triglycerides?

Triglycerides are a type of fat lipid in the blood. They come from foods like oils, butter, and other fats. In some cases, triglycerides could also come from extra calories that the body doesn’t need.

When the body needs energy, it releases triglycerides, and a type of LDL cholesterol carries triglycerides to the tissues. Elevated levels of triglycerides can also lead to health problems.

What is Non-HDL Cholesterol?

Your non-HDL is a combination of your LDL cholesterol levels and other bad fats in the blood called atherogenic lipoprotein particles. These particles are associated with a high risk of cardiovascular disease, even when LDL cholesterol levels are low.

Atherogenic lipoprotein particles are typically characterized by (VLDL), intermediate density IDL1, and IDL2. Non-HDL Cholesterol is calculated by subtracting your “good cholesterol” or HDL from your total cholesterol. Unlike HDL cholesterol, it’s advisable to ensure your non-HDL cholesterol range is low.

Symptoms of High Cholesterol

There are typically no symptoms of high cholesterol. Many times, you only discover high levels of cholesterol when you visit the doctor for a lipid panel test.

Symptoms of high cholesterol in young adults and seniors may be visible if they have familial hypercholesterolemia. People with that condition typically have a cholesterol level of 300 mg/dL or more. Some of the visible symptoms of high cholesterol include ^[4]:

Tendon xanthomas: Swellings on the knuckles of the hand, knees, or Achilles due to high cholesterol. People with sitosterolemia and cerebrotendinous xanthomatosis (CTX) may also experience the condition.
Xanthelasmas: Small and yellow lumps of cholesterol near the eyelid skin. It has a soft, chalky, or semi-solid texture and can be removed.
Corneal arcus: A pale white or grey ring around the Iris (colored part of the eye). It often appears denser in superior and inferior eye regions.

Dangers of High Cholesterol

High cholesterol, particularly LDL cholesterol or “bad cholesterol,” can affect proper body functioning for the:

Cardiovascular and circulatory system
Digestive system
Endocrine system
Nervous system

Cardiovascular and Circulatory System

Too much LDL cholesterol can build up in the arteries and clog them. This hardens the arteries, creating a state called atherosclerosis. Blood doesn’t flow properly through the arteries, and your heart needs to work harder to pump.

Too much work by the heart can cause chest pain called angina, which can be a warning sign of a heart attack. The clogging of the arteries leads to the formation of plaques that can also block the blood supply to the intestinal tract, legs, and feet, leading to peripheral arterial disease (PAD).

Digestive System

Cholesterol is essential in the digestive system for the production of bile, which helps your body break down food and absorb nutrients. However, when there’s too much bad cholesterol in the bile, the excess forms crystals and hard stones in the gall bladder.

Gallstones can be painful and may need surgery to remove.

Endocrine System

The endocrine system consists of tissues for creating and releasing hormones like estrogen, testosterone, and cortisol.

As estrogen levels rise during a woman’s menstrual cycle, HDL cholesterol levels begin to rise while LDL declines. This tends to be a reason for a higher risk of heart disease in women after menopause.

Lower production of thyroid hormone may also cause an increase in the total and LDL cholesterol. However, excess amounts of thyroid hormone (hyperthyroidism) cause a reverse effect.

Nervous System

Cholesterol is essential for the human brain, containing 25 percent of the body’s entire supply. This amount of cholesterol is essential to protect the nerve cells and also enables the brain to communicate with the rest of the body.

Even though cholesterol is essential for the brain, too much of it can damage parts of the brain. Symptoms of this damage may include loss of memory and movement, problems swallowing, and speech impediment.

Ideal Cholesterol Range by Age

The chart below shows the ideal approximate range of the different cholesterol types: Total, non-HDL, LDL, HDL, and Triglycerides.

Age	Total Cholesterol	Non-HDL Cholesterol	LDL Cholesterol	HDL Cholesterol	Triglycerides
19 and younger	Below 170	Below 120	Below 110	45 or higher	Below 150
20 and older (male)	125 – 200	Below 130	Below 100	40 or higher	Below 150
20 and older (female)	125 – 200	Below 130	Below 100	50 or higher	Below 150

HDL vs. LDL vs. Triglycerides

High levels of HDL are healthy, but LDL cholesterol combined with high triglycerides is linked to fatty buildups in artery walls.

Causes of High Triglycerides

Some common causes of high triglycerides include:

Being overweight or obese
Smoking cigarettes
Thyroid diseases
Poorly controlled type 2 diabetes
Excessive use of alcohol
Liver or kidney diseases
Certain medications
Genetic disorders
Constantly eating more calories than you burn

High Triglyceride Symptoms

There are usually no symptoms of triglycerides before it gets complicated. So, it’s important to go for regular visits to the doctor to test for high triglycerides.

Risks of High Triglycerides

Some of the major risks of high triglycerides are:

Atherosclerosis
Pancreatitis

Atherosclerosis

Atherosclerosis is the slow buildup of plaque in the artery walls. As plaque builds up, the thickness of the artery wall increases. In the early stages of the condition, the hardening of the arteries is typically unnoticeable.

According to the U.S. National Institutes of Health, 50 percent of people aged 45 to 84 years have atherosclerosis but aren’t aware of the condition ^[6].

Symptoms of atherosclerosis are not notable until the artery walls become very narrow or blocked. Based on body parts blocked, the symptoms of atherosclerosis are:

Heart

Some noticeable symptoms in the heart are:

Shortness of breath during physical activity.
Pain in the back, shoulders, neck, arms, or belly.
Heart palpitations.
Fatigue.
Nausea or vomiting that may feel like indigestion.

Digestive system

Symptoms of atherosclerosis in the digestive system may include:

Bloating
Diarrhea
Pain and cramping in the belly after eating
Unintentional weight loss

Legs and feet

In the legs and feet, some major symptoms are:

Muscle pain
Changes in skin color
Cool skin on your feet
Sores on the feet that don’t heal
Burning or aching pain
Frequent skin and soft tissue infections in the legs or feet

Kidneys

Symptoms of atherosclerosis in the kidney are:

Headaches
Swelling
Unexplained weight loss
Nausea, vomiting, or appetite loss
Feeling drowsy or tired

Brain

In the brain, some of the notable symptoms are:

Loss of muscle strength
Dizziness
Severe headache
Slurred speech or difficulty forming words
Vision loss in one eye

Pancreatitis

Pancreatitis is a condition that causes inflammation and swelling of the pancreas. The condition occurs when enzymes or digestive juices attack the pancreas.

Pancreatitis can be acute or chronic. Symptoms of the condition typically include:

Nausea
Vomiting
Fever
Severe belly pain
Swelling and feeling sore or tender in the upper belly
Lowered blood pressure
Rapid heart rate

How to Lower Bad Cholesterol and Triglycerides

In the United States, close to 25.9 percent of people have elevated blood triglycerides ^[7]. Hence, it’s evident that lowering one’s levels of triglycerides is imperative. Here are some ways to lower triglycerides as well as LDL cholesterol.

Target Attaining a Healthy Weight

Consuming excess calories ends up turning to triglycerides, which get stored as fat in the body. Working towards achieving a moderate body weight by taking in fewer calories may be an effective way out of high triglyceride levels.

Research shows that losing 5 to 10 percent of one’s body weight can significantly reduce triglycerides ^[8].

Reduce Sugar Intake

According to the American Heart Association, it’s advisable to consume no more than 100 – 150 calories of added sugar daily. However, a study showed that the average American consumes up to 308 calories daily ^[9].

Sugar-sweetened beverages are likely to contain more sugar and may increase triglyceride levels in the blood. Fortunately, slight changes like staying on a low-carb diet or replacing sugar-sweetened beverages with water can decrease triglycerides.

Exercise Regularly

Regular aerobic exercise, when paired with weight loss, may be effective at decreasing triglycerides. The American Heart Association advises getting a minimum of 30 minutes of aerobic exercise 5 days a week through walking, bicycling, swimming, and jogging ^[10].

All exercises are effective at reducing triglycerides. However, some research shows that exercising at high intensity for a short period is more effective than moderate-intensity exercises for longer periods.

Establish a Regular Meal Pattern

After a meal, insulin gets released into the bloodstream and transports sugar to the cells for energy. When the body has too much insulin, it becomes resistant to it. Insulin resistance causes the body to ineffectively produce insulin, which leads to a build-up of sugar and triglycerides in the blood.

Creating a regular meal pattern can help against insulin resistance and high triglyceride levels. For instance, not eating breakfast can help reduce insulin sensitivity.

So, regardless of how many meals one eats a day, eating regular meals may help improve overall insulin sensitivity and lower blood triglycerides.

Reduce Alcohol Intake

Alcohol contains a lot of sugar and calories. If the body doesn’t use the calories, they become triglycerides and get stored in fat cells.

Alcohol intake may also increase the synthesis of large VLDL lipoproteins in the liver, which is responsible for transporting triglycerides into the system.

It’s important to reduce or stop alcohol because even moderate consumption can increase blood triglycerides by up to 53 percent.

Foods to Lower Triglycerides

Some of the best foods for high triglycerides (foods that help lower triglyceride levels) are:

Avocado

Avocado is a healthy source of monounsaturated fatty acids. When you replace saturated fats, trans fats, and carbohydrates with an avocado, it can significantly reduce triglyceride levels.

The monounsaturated fats from avocado are also better at lowering blood sugar levels than other fat types. They help reduce risk factors for metabolic syndrome, which is a condition that increases the possibility of type 2 diabetes.

Whole Grains

Whole grains like barley, buckwheat, oatmeal, and millet are notable for their potential role in reducing the risk of heart disease. For instance, oatmeal helps reduce total cholesterol and blood sugar levels. Buckwheat and millet have also been shown to reduce triglyceride levels by up to 74 percent ^[11].

Generally, whole grains also provide fiber, vitamins, minerals, and other healthy nutrients that help maintain healthy living.

Garlic

Garlic is commonly known as a seasoning, but it also has therapeutic effects for cardiovascular health conditions. The herb has anti-hyperlipidemic properties, making it effective in reducing triglyceride and cholesterol levels.

Quinoa

Quinoa is derived from the Chenopodium quinoa plant in South America. It contains high protein content and offers antioxidant properties linked to the reduction of heart disease, obesity, and type 2 diabetes.

Soy Protein

Studies show that soy protein helps reduce high levels of triglyceride. Soybeans, edamame, tempeh, and tofu are good sources of isoflavones, a compound that promotes weight management and reduces triglycerides. Fermented soy products contain higher nutritional value than unfermented soy.

Fatty Fish

Fatty fish like mackerel, herring, salmon, and sardines are good sources of omega-3 fats, a type of healthy fat for lowering triglycerides. Besides its importance for healthy cell membranes, fatty fish also help reduce inflammation, lower cholesterol, and support a healthy brain and gut ^[12].

Coconut Oil

Coconut oil is high in saturated fats but also seems to have protective effects against heart disease. It has a mixed fatty acid profile, containing saturated fats and medium-chain triglycerides. A 2018 study revealed that coconut oil helps increase HDL cholesterol and lower LDL cholesterol ^[13].

Conclusion

The combination of high triglycerides and bad cholesterol can cause health problems. However, there are often no visible symptoms of high triglyceride or cholesterol levels. So, it is important to perform a lipid panel test regularly with a licensed medical professional. Also, ensure you have a good diet plan that includes all meals needed for keeping triglyceride and cholesterol levels low.

At Altasciences LA, we conduct studies focused on volunteers with high LDL cholesterol and triglycerides. Explore our current studies to find available opportunities. Take the first step towards finding potential treatment options by signing up today to see if you qualify.