08/29/2026
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Cholesterol Is Not a Disease
For decades, cholesterol has been treated as though it is itself a disease—something that needs to be driven lower and lower. But cholesterol is not a disease. It is an essential molecule required for human life.
Your body needs cholesterol to build cell membranes, produce steroid hormones and bile acids, and support normal cellular and neurologic function. It also participates in immune and inflammatory pathways. In fact, your body considers cholesterol so important that it manufactures much of what it needs.
The problem comes when we reduce cardiovascular health to a single laboratory number.
Cardiovascular disease is far more complex than simply having “high cholesterol.” Insulin resistance, metabolic dysfunction, hypertension, smoking, inflammation, oxidative stress, diabetes, visceral fat, inactivity, genetics, sleep, diet, and other factors all contribute to cardiovascular risk.
Lowering LDL cholesterol can reduce cardiovascular events in appropriately selected higher-risk patients, so cholesterol should not simply be ignored. But lowering a number is not the same thing as correcting the metabolic environment that contributed to disease in the first place.
We need to stop asking only:
“How low can we get the cholesterol?”
And start asking:
“Why is this individual developing cardiovascular disease?”
That means looking at the whole person—metabolic health, insulin resistance, blood pressure, inflammation, smoking status, body composition, nutrition, activity, sleep, genetics, and the broader lipoprotein picture when appropriate.
Treat the patient, understand the risk, and address the root causes—not simply the laboratory number.
— Optimal HealthCare
Integrative & Functional Medicine
