 LDL numbers, if they're high, is that really bad? Watch this. Our next caller is Sean from Minnesota. Sean, what's happening? How can we help you? Hey, how's it going, guys? Thank you, Sal. Thanks for having me on. Yeah, so I have a question about LDL cholesterol. And just to give a little bit of a background, so I'm someone who, I'm a pretty big guy. I work out a lot to the point where I almost overtrain. I'm about six foot two, 200 pounds. I've worked out basically every day since high school, so about 15 years now. And because of that, I eat a lot of calories. I mean, I eat around 4,000 calories a day just to maintain weight. I've also determined that eggs are probably the main source of protein that works best for my digestive system. And in about May of 2021, I started tracking my macros to try to put on some more muscle. And it's worked. I've put on probably about five pounds of muscle. I have not increased my waist circumference. The problem is my LDL cholesterol. So I had labs drawn in July of 2021. And my LDL cholesterol was very good. It was 78 milligrams per deciliter, which is well under the 100, but they recommend you stay under. Then after that, I increased where I was eating a lot of eggs, probably about eight eggs per day with yolks on average and a little bit more red meat throughout the rest of 2021. I had labs drawn again in December. And my LDL was 146, but it shot up. It was pretty high. And then of course, after that, I said, OK, you know, I need to go more either plant-based, whatever. And I guess I heard something. I believe Sal, you said in the episode recently about the eight worst people to take diet advice from. You mentioned something, I think, I'm paraphrasing here about how LDL cholesterol, high LDL cholesterol alone is not necessarily, you know, that much of a big deal if you don't have other risk factors. And so I'm wondering if you can elaborate on that a little bit and kind of what your take is on my situation. Yeah, sure, Sean. So first off, I want to say, obviously, I'm not a doctor. And this is not my field of expertise. So my expertise is in fitness. So what I'm going to comment on now is coming from somebody who's a fitness expert, not a doctor. OK, so I'm not an expert in this. But there's a context that is typically looked at when you're assessing risk. LDL is part of that picture, but you have LDL HDL ratio. You have other lipids that they're looking at in your blood, your blood sugar, body weight. And then LDL can also be broken up into different types of LDL. Some are more damaging. Others now they're talking about being more protective. The total LDL number can also matter. So at some point, if it just gets too high, then that's something that is caused also for concern. And then finally, there's this really interesting variant between people or genetic variant or whatever you want to call or how people react to saturated fat intake. Like I'll use a couple of personal examples. I eat up to 12 egg yolks a day. Most of the meat that I eat is saturated fat. My LDL is always under 100. My total cholesterol is borderline too low. Now, Doug is somebody that, obviously, Doug, our producer, he reacts very differently to saturated fat. And he has to actually control it a little bit because it can have some, what would look like adverse effects on his blood lipids. So it depends on the person as well. Now, my comment on that show was simply this, was when there's one blood marker, unless it's really bad, it doesn't tell you nearly as much as what the whole picture is, right? You got to look at everything to kind of make more of an accurate assessment. And I think really good doctors who are experts in this field will tell you that. So that's what I would look at and I would talk to your doctor about those things. Do you think that Dr. Ran and Dr. Todd would cover a subject like this inside our hormone? Now, they're hormone specialists. Now, they are somewhat knowledgeable about cholesterol because it's something that can get affected with hormones. So you could try asking them. But I would speak specifically to somebody who's an expert in this field because there's a lot we're learning about this. Like what I said earlier about different types of LDL, this was barely discussed just like seven years ago. It was just LDL and then we've discovered, wow, there's smaller denser particle LDL molecules and then there's those that are larger and fluffier and one is more damaging. The other one tends to be more protective. LDL in general is associated with protecting you from infection and illness. So it's also essential. So like having it too low isn't good from what I've read. But there's a lot of complexity to this and I would look at all of these things. So, and I would talk to somebody who's an expert. Well, so that's what I was gonna ask you then. If you were not to just defer to a general practitioner, doctor, who would you defer to that? Maybe who we know that you think could be able to dive into his labs a lot better than, because that's the only, this is the problem with the GP right here, right? They see that and then their first thing right away is, oh, let's fix that, let's get that lower. Dr. Stephen Cabral has got some pretty good takes on cholesterol numbers, blood lipids, the context of the whole thing. Triglycerides, right? That's something else you wanna pay attention to. He's somebody that's really good. But I would bring these exact questions up to your doctor and say, okay, what's the right ratio of HDL to LDL? I would say, can I do a test to determine what kind of LDL particles that I have to see what the difference is? And is my LDL so high that none of that matters? Or am I within the range where I can look at the whole context of things and pay attention? It's a lot less clear, or I should say obvious than it used to be. Used to be, oh, over 200 cholesterol was really bad. And then we saw these long-term studies that showed that people with higher cholesterol in some cases live longer. People with higher LDL tend to get less infections. So my point is with what I said was, we used to look at a single number and be like, oh, good or bad, but it's way more complex than that. Right, it wasn't the fear of potentially that leading to heart attacks and sort of epigenetically unlocking some of these problems down the road. Is that still something that's a very real fear that doctors are afraid of? Yeah, and I know LDL, if it gets too high, everything else, the context of everything else can look whatever it wants and it still might not necessarily be a good thing. But like I said, it's kind of... I've heard conflicting information about it now, so it's tough to answer. It's really weird how some people react to saturated fat in terms of their lipid numbers. And I mean, like I said, I'm a perfect example. I literally eat red meat probably twice a day, three times a day, egg yolks up the yin-yang. I eat, I mean, a lot of my fat is saturated and my blood lipid numbers are almost too low. Like my cholesterol is almost too low. So it's very interesting. So that's... So I would, like I said, I would ask an expert those questions specifically. I know the ratio makes a big difference of HDL, LDL. Then there's a ratio of those two, your total, your triglycerides play a role and then the type of LDL that you have. I know all those things now are starting to show that they are important. I would just caution taking the, if it's the general practitioner that he's talking to and referring back to him, I would just caution that I don't know his extent. I think if you ask those questions, you'll know. Like, hey, what are my LDL? Can I get a test that shows me what kind of LDL? Yeah, well, I don't know. I don't think there is one. Like then you know, okay, I might need to find someone that, really looks a little deeper. Yeah, if I was, back when I was trained, I always had like a doctor that I knew because I had trained one and then I'd keep them on tabs because this is something I would defer, right? I would, this is not my level of expertise, but I know enough and experienced enough where I've had healthy, really healthy clients still test high like this. So finding somebody that is more, or that's well versed in this besides just their, because a lot of times they would come with their, from their recommendation from their doctor saying, hey, my doctor says my cholesterol's too high and they would just give me some number and say that's all you were told, nothing else. What about all these other markers? Well, okay, let me refer you over to my buddy over here. Go get it ran and ask these questions and see. Yeah, well, part of the problem, Sean, it was that, and this was from doctors that I trained. They actually told me this, that they said, you know, one of the issues is we invented a pharmaceutical drug that was so effective at lowering cholesterol. Like you take a statin and it will lower your cholesterol. Yeah. And so what happened was because we had something that was really effective, that was easy, you just take a pill, that they focused really hard on that because it was something so easy to treat. Yeah, everything became a nail. Yes, and so that was, I guess, part of the issue, but we know now that it's a little bit more complex than that, so, and again, the genetic factor's huge, man. Some people are very, they have to really reduce saturated fat intake and even have to reduce total fat intake. There's a small percentage of people that still have to do that, so it depends. So again, I would go to your doctor and ask all these specific questions and see if you get the answers you're looking for and if not, then find somebody who has a say. And if you're not following already Dr. Steven Cabral, I think that's his Instagram too, right? Yeah, S-T-E-P-H, I think, Steven with a P-H. Yeah, Cabral. Okay, you said, I'm sorry, Steven, is it Cabral? Yeah, Steven Cabral. C-A-B-R-A-L. You could actually go back. Okay, Cabral. We did an interview with him on here, so it was a really good interview. We might have actually touched on cholesterol with him. I think we did. I think we did touch on cholesterol with him, so that'd be a good episode to listen to anyways. He's actually got a podcast, too, that it does really, really well, and I think he does like we do where we field questions. He would be a great follow in general, I think, for these types of questions. Okay, perfect. And what were the names of the other? There was a couple other doctors you guys had mentioned. Yeah, I don't know. Did we mention more right now? For right now. Dr. Ruscio, maybe? No, no, no, no, no, we didn't write anything. Yeah, that's okay. Maybe it was just Cabral. Yeah, I mean, we have Dr. Friends for specific things, like Jolene Brighton and also Dr. Ruscio and... But Stephen, Dr. Cabral would probably be... Yeah, we have like that, we recommend for like gut health, functional medicine, so it kind of depends, but Cabral is up your alley for what you're asking. Oh, Dr. Allo, he's also, he's a... Yeah, he's a cardiovascular specialist, so he was on a podcast as well. Dr. A-L-O. I was trying to think of him. Yeah, he's also something that might run. Okay, perfect, yeah. Yeah, when I listen to this, I'll remember what we said and then look those doctors up. So yeah, if we've got just a couple more minutes here, I was just gonna say, yeah, I kind of actually heard the same type of thing when I was reading in Ben Greenfield's book, Boundless. He actually had a section about that where he talked about some of the same thing, how it really comes down to the different types of LDL particles. And so there's a lot more to it than just HDL, LDL. And then I guess just one last question. So with the testing, you've talked about Sal a lot about how different body types, different genetic types, we react differently to saturated fats. So can they test for that at a typical clinical setting? I don't think so. I think the way you know is you... By teasing it out. Yeah, you tease it out. Like I use Doug as an example. Him and I, if we ate the same diet, our blood lipids would look very different. So I think that's really the only way at this point. Okay. All right, thanks for calling, Sean. Yeah, I appreciate it very much, guys. Thank you. No problem. Thank you. Yeah, gone are the days of just, ah, cholesterol over 200 is bad for you. And LDL is always bad. Well, I mean... It's way more lower. Here's the medicine. Yeah, it's way more... The unfortunate part though is gone, the days are not gone. They're still getting general practitioners that still talk like this. But that's all they say. Oh, it's high. Let's get it down. Here, take the statin. Or we need to change your diet up right away versus looking at all the factors. So I find that I still get stuff like this, but I know damn well that I'm not an expert in this. Like, this is not my field of expertise and I know there's such a... Bio-individuality. Yeah, that's hard to say. I have a lot of fun with this because when I get my blood work, when I used to, I don't do this anymore, but I used to have fun with it. And before I would get the results, doctor would test my blood and I'd say, yeah, I'm interested in seeing my numbers look like. I eat about 12 eggs a day and I eat probably one to two pounds of red meat every day. And the look on their face is always like... I suck on butter cubes. Yeah, they're always like, oh my God. Like, oh, this is gonna be really bad. And then they get the numbers and they're like, oh, your cholesterol, your total. Do you sweat mayonnaise? Your total cholesterol is 163 or whatever. Like, oh, this doesn't make any sense, you know. Hey, if you enjoyed that clip, you can find the full episode here or you can find other clips over here. And be sure to subscribe.