Cholesterol Particles: Where Size Really Matters

Did you know that the LDL cholesterol on a routine lab test is a calculated value and not really measured? Yet, research has shown that the number, size and type of particle is more predictive of risk than just the calculated value.

If 2 people had an LDL value of 100, one person may have 100 small particles and the other person 50 large particles; there is a big difference in their risk of having a heart attack, stroke or other organ damage. Unstable plaque and clots can break off and block arteries that feed your heart, brain and other organs. They develop as a process of oxidation, inflammation and clotting. You must address all of these factors to decrease cardiovascular disease. The smaller the LDL particle, the more likely it will get oxidized.

  1. Lp (a), IDL (intermediate density lipoprotein) particles, or remnant particle are most likely to oxidize and start the process.
  2. The oxidized particles cause inflammation of the artery wall.
  3. The inflamed cells recruits clotting factors to repair the damage.
  4. Clots form and the pressure from blood flowing through the arteries causes particles to break off.
  5. The particles block flow to vital organs and this results in damage such as a heart attack or stroke.

Size really does matter

So what do you do? Measuring the particle size and type can help you target therapy. Lp (a) does not respond to statin or lifestyle therapy and responds better to niacin, whereas Omega 3 fatty acids can help with IDL or remnant particles.

Measuring C- reactive protein can give you an indication of the amount of inflammation that will keep the process going. High levels of fibrinogen can increase the likelihood of clot formation. Diet, supplements, exercise and nutraceuticals can be used to modify these processes. Knowing your numbers can be critical.

Consult your doctor or a functional medicine or anti aging physician to get the specialized tests that can give you the complete picture of your biomarkers. This may enable you to stop or slow the development of disease. The time to intervene is before something happens.

Lorraine Maita, MD is an award winning physician, speaker and author of Vibrance for Life: How to Live Younger and Healthier” and can make you slim, sharp, sexy and supercharged. She is an expert in anti aging medicine, bioidentical hormone replacement, and weight loss, nutrition, supplements and executive health.  Dr. Maita has a private practice in Anti Aging Medicine in Short Hills, NJ and educates virtually at  You can live younger and healthier; Click Here to Get my Best 7 Tips on How to Live Younger and Healthier!

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