Why a “total cholesterol” score is meaningless

My hubby Greg has just come back from the pathology lab, holding his test results in hand, and with a big smile on his face. If anyone took a closer look at that piece of paper, they would be very worried about his present state of mind. Why? His total cholesterol score was 8 – shock, horror! Are we worried? Absolutely not, and this post will explain why.  For too long we have been taught that cholesterol is bad. That it will clog our arteries, and put us at risk of a heart attack.  Prescriptions for statins are being written, left, right and centre. The pharmaceutical companies are happy. The poor patients – not so much. There can be some very serious side effects to taking statins.  It is important that people understand that high cholesterol does not necessarily mean that you are at risk, and in need of a drug to lower it.

To properly establish your risk for cardiovascular disease, you need more than just a total cholesterol score.  Lets start by looking at what other tests your doctor should be running, and the values you should be aiming for.


Butter is a saturated fat and can raise your good HDL cholesterol.

HDL “good cholesterol”: This number should ideally be greater than 1.7 for men, and women should aim for as close to 2 (or higher) as possible. Greg’s was 2.6 – an excellent score! If yours is on the low side, the best way to get it up to optimal levels is to eat more butter, coconut oil, omega 3 fish oil, eggs and grass-fed meat.  Eliminating junk food, sugars and carbs will also definitely help.

Triglycerides (type of fat found in the blood): An optimum result would be around 0.5, although less than 1.7 is the suggested normal target range. Raised levels puts you at risk for heart disease and diabetes. Greg’s was 0.78 – another excellent, and near perfect score. There is no drug to lower triglycerides, but it does respond exceptionally well to a low carb diet that restricts grains and sugar. Exercise, cutting back on alcohol and not smoking will also help improve the situation too.

Lipoprotein (a): This is your “inherited” or “genetic” cholesterol. Again there is no drug available to lower it, but saturated fat (such as butter and coconut oil) does a pretty god job of it. Elevated levels are a very strong risk factor for heart disease. The range allows for up to 30, although 20 or lower is what one should aim for. Greg’s score was 5.

Ultrasensitive C-Reactive protein: This tests helps to determine whether you have chronic inflammation in your arteries, which is the true cause of heart disease. You would be at a high risk if your result was more than 3. Greg’s score was 1.12 and therefore nothing to be concerned about.

blood vialLets talk briefly about LDL, the so-called “bad cholesterol”. The truth is that not all LDL particles are bad – there are some good ones too. All you need to know is that the small, dense ones are bad, and the large fluffy ones are good.  So how does one determine which ones you have? You can do a particle size test, which is now available in South Africa (but it is rather expensive apparently), or you can use a simple equation to give you an indication whether yours might be the bad or good LDL particles. Simply divide your triglycerides by your HDL reading. A score of under 2 is OK, but the best marker would be under 1. Greg’s score was 0.3. So even though his LDL reading was 5.1 and flagged as high  – we are pretty confident that his LDL particles are all the good,  large and fluffy type.

Based on what we have learned about heart health, and what really causes heart disease, we feel assured that he is at very low risk for heart disease, and that he does not need a statin to lower his total cholesterol score of 8 to the recommended “less than 5” number.  All his other test results were in the excellent range too, i.e. insulin, glucose, HbA1c and his glucose:insulin ratio (which tests for insulin resistance).

Greg is fit, healthy, doesn’t smoke and is lean and strong. He is also a dedicated follower of the LCHF way of eating. With his markers for health and heart disease all being excellent, why would he choose to eat any other way, or take a statin drug? He will discuss these results with a doctor next week. This time he has chosen to make an appointment with a doctor who he knows to be pro-LCHF. Greg actively sought out a health care professional who he knew wouldn’t fall off his chair at a total cholesterol reading of 8. I applaud him for taking control, and making choices that are right for him.


Coconut oil is a saturated fat and healthy for you

Cholesterol is essential for life. Cholesterol does not cause heart disease, inflammation does. Saturated fat will not clog your arteries, but actually helps to raise the good cholesterol. In fact, the majority of people who have heart attacks have normal to low cholesterol. Inflammation is caused by processed junk foods, refined carbohydrates, sugar and vegetable (seed) oils. No wonder heart disease is rampant in today’s modern society. Many people live on these foods to the exclusion of anything else.

Are statins and the current recommended guidelines for cholesterol levels causing more harm than good? Studies done on statins have shown an increased risk for cancer, diabetes, memory loss, osteoporosis, Parkinson’s and  dementia. Not to mention the muscle pain and weakness, dizziness, depression and liver problems experienced by many statin users. Having cholesterol levels that are too low has also been linked to an increased risk for suicide, and violent behaviour.

I believe that as lay-people we have a responsibility to ourselves to be informed, and to ask the right questions of our health care providers. Get the right people in your corner, and your health could be completely revolutionised.



An excellent resource on the topic, is the book Cholesterol Clarity by Jimmy Moore and Dr Eric Westman.  It has been written for the lay-person, to help them make sense of this highly controversial topic.

Also check out this highly entertaining, and very informative video which exposes the truth about cholesterol, saturated fat and what really causes heart disease. (From the movie Fat Head). It brilliantly explains it all.


Please check out my opportunity page of this blog if, like me, your finances took a knock during Covid or if you are keen to earn some passive income. It is definitely worth looking into.




About Nicky Perks

Passionately sharing information about the paleo/primal, high fat/low carb lifestyle that will rock your world! I am on my own journey to good health and a slim body. My goal? To enjoy the ride as life on this beautiful planet is just too short to do it any other way.

Posted on May 29, 2015, in Primal 101 and tagged , , , , , , . Bookmark the permalink. 4 Comments.

  1. Just a question please. How does one know if a person suffers from familial hypercholesterolemia?

  2. Very informative thank you , a great blog post. I will recommend it to others

  3. Very informative article Nicky. With my cholesterol being in the high sevens i will keep this info in mind when i do my next blood tests.



    Sent from my iPhone


  1. Pingback: How to assess your risk for heart disease | Primal Perks

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