I’m a visual learner, and I do best with analogies so that I can grasp onto the images and remember the logic. Please, take a journey with me through my analogies for cardiovascular labs. Modern labs can tell us a lot, but they go far beyond the “bad” LDL and “good” HDL cholesterol of a few years ago.
First off, cholesterol isn’t good or bad, it’s a building material for hormones, cell repair, and stabilizing tissues. What’s really important is how the cholesterol is transported, why it’s being transported, how many particles are carrying it, and how inflamed the “highways” of your arteries are.
We’re going to use a vehicle/cargo/highway analogy to discuss these labs: cholesterol, lipoproteins (LDL, HDL, VLDL, Lp(a)), ApoB, insulin, triglycerides, and hsCRP.
Understanding Cardiovascular Labs
Cholesterol – duct tape
Think of cholesterol as duct tape sealing up minor issues throughout the body. Duct tape isn’t inherently bad, but if you’re using rolls and rolls of it, that signals a deeper problem.
The liver makes the duct tape, and lipoproteins are the vehicles carrying the rolls out where they’re needed. The duct tape is made in the liver and these rolls of duct tape are being transported by the vehicles.
LDL – FedEx/UPS trucks
LDL molecules are the delivery trucks, think the FedEx, UPS, or Amazon trucks. They’re moving the rolls of duct tape from the liver out into the tissues.
Delivery trucks are fine, right? Unless your road is all delivery trucks – they’re double parked, you can’t turn because they’re blocking the view… too many delivery trucks can be bad, but they themselves are not bad.
VLDL – semi trucks
VLDLs are semi-truck sized delivery trucks. They’re big and carry a lot. They primarily haul Triglycerides – big boxes of fat/fuel. (I know, stretching the analogy, but just imagine big boxes of stuff). They are made in the liver and come out fully loaded with their cargo. The more boxes they unload, the smaller they get, eventually shrinking down to delivery truck size.
Small LDLs – beater cars
Small LDLs are the small, beat-up, old cars acting as delivery vehicles. They are more likely to weave off the road and into arterial highway walls. As some of the bigger LDL trucks get older, they remodel into these little clunkers.
They more easily penetrate the arterial walls, are more prone to damage (oxidation), they stick around longer and are strongly linked to insulin resistance (see the traffic control, below). Think of these as tiny, dense, troublemaking cars weaving through traffic, increasing risk.
HDL – city recycling
HDL molecules are the clean up crew and trash collectors! These guys are out there peeling old duct tape off the walls and bundling them back to the liver for recycling. Higher HDL function (not just the number) helps keep the highways clear.
Lp(a) – careening trailers
Lipoprotein(a) aka Lp(a) pronounced “L P little A” – this is a genetic trait where some of your LDL delivery trucks have a sticky, reckless trailer attached. They don’t break down and are on the highway no matter what. It’s a genetic thing so usually only tested once and you either have it, or not.
Ok! That covered the lipoproteins, cholesterol, and triglycerides. You’ll sound like a whiz at your next bookclub meeting. Moving on to ApoB, insulin, and hsCRP.
ApoB – license plates
ApoB stands forApolipoprotein B and it’s basically the license plate on each of these vehicles. Every lipoprotein has only one ApoB tag, so when you get your ApoB levels it’s like you’ve counted the total number of vehicles on the road – helpful to know when you’re predicting risk.
Insulin – warehouse management and traffic lights
Think of insulin as the traffic controller and warehouse manager. When insulin is working well, signals are clear, trucks move efficiently, and packages end up where they’re supposed to go. But when insulin runs high (insulin resistance) it’s like having broken traffic lights and a disorganized warehouse.
Suddenly there are too many oversized VLDL delivery trucks clogging the roads, creating congestion. Those big trucks break down into LDLs and then into even smaller, more problematic LDL particles. Boxes of triglycerides pile up.
The recycling collectors (HDL) become fewer and less effective. All of this unfolds on a highway without functioning traffic signals. It’s metabolic chaos.
hsCRP – road conditions
High-sensitivity C-reactive protein (hsCRP) reveals the road conditions. How many potholes are there? Cracks and heaves of the highway? The worse the road the more likely the vehicles are going to get stuck where the road is damaged.
As naturopathic doctors, we want to look at far more than just your LDL and HDL on a standard lipid panel. My hope is that this analogy helps you picture what we’re assessing when we order deeper, more advanced cardiovascular labs.
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Dr. Jennifer Potter, ND
Naturopathic Doctor San Jose
408-356-1364
Dr. Jennifer Potter, ND provides natural healthcare solutions for families and individuals, focusing on perimenopause/menopause, autoimmune conditions, fatigue, and immune support. She is deeply committed to her patient’s well being, prioritizes patient education and combines natural and conventional therapies to deliver personalized care. Outside of her practice, she enjoys time with her two kids, reading fiction, and crocheting.
