Why Cholesterol Alone Doesn’t Predict Heart—or Whole-Body—Health

Sonny Wilson
Oct 31
3 min read

For decades, cholesterol has been cast as the villain in the story of heart disease.Doctors measure it. Pharma lowers it. People fear it.

But what if we’ve been asking the wrong question all along?What if cholesterol—by itself—isn’t the health predictor we think it is?

🧪 The Truth About Cholesterol: It’s Not the Whole Picture

Cholesterol numbers are easy to measure, easy to prescribe against, and easy to track.But health is not one-dimensional, and relying on cholesterol alone misses the complexity of how the body actually works.

Here’s what we need to understand:

👉 Not all cholesterol is created equal.

LDL isn’t always “bad.” There are multiple subtypes of LDL, some more atherogenic than others. Basic tests don’t distinguish.
HDL isn’t always “good.” High HDL can be protective in some, but not in all. In some conditions, elevated HDL is dysfunctional.
Triglycerides and inflammation markers (like CRP) often tell you more about cardiovascular risk than LDL alone.

👉 Cholesterol is essential for life.

It’s not just floating around causing trouble—it plays critical roles in:

Hormone production (testosterone, estrogen, cortisol)
Vitamin D synthesis
Cell membrane integrity
Brain function (about 25% of your body’s cholesterol lives in your brain)

🧠 The Brain-Heart Connection: One Size Doesn’t Fit All

In cardiology, lower is better has been the mantra for years. But in neurology and mental health, very low cholesterol can be a red flag:

Low total cholesterol (<160 mg/dL) has been linked to:
- Increased risk of depression and anxiety
- Suicidal ideation
- Slowed cognition
- Impaired serotonin function

A 2020 study in Psychiatry Research even found significantly higher suicide risk in those with low cholesterol—independent of other factors.

🚫 What Cholesterol Can’t Tell You

Even perfect cholesterol numbers can exist alongside:

Chronic stress and inflammation
Insulin resistance or prediabetes
Poor metabolic health
Sedentary lifestyle
Nutrient deficiencies
Smoking, alcohol use, poor sleep

On the flip side, some people with “high” cholesterol have zero markers of inflammation, strong metabolic health, and no evidence of arterial plaque.

So what’s really going on?

🔍 Health Is Contextual—Not Numerical

Cholesterol is one piece of the puzzle, not the entire picture. More accurate assessments of heart and overall health include:

hs-CRP (inflammation marker)
Triglyceride:HDL ratio (better predictor of heart disease than LDL)
Fasting insulin and blood sugar
Coronary artery calcium (CAC) score for actual plaque detection
Lifestyle factors: nutrition, movement, sleep, stress, relationships

These paint a fuller picture of your health than LDL ever could.

💊 The Statin Question

Statins are among the most-prescribed drugs worldwide to reduce LDL cholesterol. They can absolutely be life-saving in certain high-risk individuals.

But here’s the problem:

In some people, they lower cholesterol too far, impacting brain health.
They may be prescribed based on numbers—not personalized risk.
They can sometimes distract from root causes like inflammation, insulin resistance, or lifestyle factors.

We need to shift from “treat the number” to “treat the person.”

🧠 Final Thoughts: Health Isn’t Just About a Lab Result

It’s time to reframe the conversation.

Cholesterol is not a disease—it’s a molecule. It only becomes a problem in the wrong context: when combined with inflammation, oxidative stress, or poor lifestyle choices.

The goal isn’t to “lower cholesterol at all costs.”The goal is metabolic health, cardiovascular resilience, and brain integrity.

And sometimes, that means asking better questions than just:“What’s your LDL?”

🧠💪 Want to support brain and heart health the smart way?

Focus on:

Whole-food nutrition (with quality fats, not low-fat diets)
Strength training and movement
Stress management
Adequate sleep
Regular check-ins with a practitioner who sees the big picture—not just the blood work