LDL Cholesterol (LDL-C)

Routine annual

also "bad" cholesterol, calculated ldl

What it isLDL-C measures the cholesterol cargo carried inside low-density lipoprotein particles. Most labs calculate it from total cholesterol, HDL, and triglycerides; some measure it directly.

DoesLDL particles transport cholesterol from the liver to peripheral tissues. The particles themselves — not the cholesterol they carry — drive atherosclerosis by depositing in arterial walls.

GoodLow LDL-C reduces the substrate available to deposit in vessel walls and is associated with longevity-grade cardiovascular health.

BadElevated LDL-C drives atherosclerosis, heart attack, and stroke. The causal relationship is dose- and time-dependent: lower for longer is better.

Standard

<100 mg/dL optimal; 100–129 near optimal; 130–159 borderline.

Optimal

30–60 mg/dL (lower is good)

Modifiers

Rises with saturated fat, weight gain, hypothyroidism; rises in early ketogenic diet phase; genetics (familial hypercholesterolemia) dominate in some.

How to optimize

Lifestyle: Zone 2 cardio, resistance training, weight loss; avoid trans fats entirely.
Diet: Cut saturated fat sources (full-fat dairy, fatty red meats, butter, coconut oil); add soluble fiber (oats, beans, psyllium 10g/day); olive oil and nuts in place of butter; soy protein.
Supplements: Plant sterols (2g/day), red yeast rice (with monitoring), psyllium fiber (10g/day), bergamot extract (500mg 2×/day), berberine (500mg 3×/day).
Peptides: —
Drugs: Statins (atorvastatin, rosuvastatin), ezetimibe, bempedoic acid, PCSK9 inhibitors (alirocumab, evolocumab), inclisiran.

within Cholesterol & Lipids