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Advanced Cholesterol Testing

  • Writer: Dr. Kate Kresge
    Dr. Kate Kresge
  • Apr 11
  • 2 min read

Why We Can No Longer Rely on Standard Cholesterol Panels


Hi friends,

I wanted to share a recent conversation I had on the podcast that really stuck with me — and I think it’s going to shift how many of us think about cholesterol testing. I sat down with Dr. Eve Henry, a brilliant integrative and internal medicine physician who’s doing some of the most advanced work I’ve seen when it comes to understanding heart disease risk.

We dove into the science behind cholesterol — and why traditional lipid panels just don’t cut it anymore when it comes to assessing cardiovascular risk.

Here’s what I think every practitioner (and client) should know:

Standard cholesterol tests aren’t enough. We’ve relied on total cholesterol, HDL, and LDL for decades, but they often miss the real drivers of risk. Dr. Henry and I talked about why we now look at advanced markers like:

  • ApoB, which tells us the number of atherogenic particles actually damaging the vessels

  • Lp(a), a genetically driven particle that raises risk for early heart disease

  • hsCRP and Lp-PLA2, which show if inflammation is actively fueling plaque formation

This is about particle behavior, not just numbers. It's not “good vs. bad” cholesterol anymore — it’s whether those lipoprotein particles are hanging around too long in the bloodstream, bumping into the arterial wall, and kicking off inflammation.

We can tailor treatment based on how your body works. Some people are “super synthesizers,” meaning they naturally make more cholesterol. Others are “super absorbers” who reabsorb it from bile. These patterns matter — and they change how we use tools like statins, ezetimibe, or PCSK9 inhibitors.

Inflammation, insulin resistance, and metabolic health all play a role. It's not just about cholesterol in isolation. We need to look at triglycerides, blood sugar markers, and inflammation to get the full picture.

And yes — lifestyle still moves the needle.Exercise (especially HIIT), stable blood sugar, great sleep, and an anti-inflammatory diet still make a huge impact. But when you pair that with the right testing and the right treatment? That’s where we see true prevention and transformation.

If you’ve ever felt confused or frustrated by your cholesterol numbers, I hope this episode helps connect the dots.

🎧 You can listen to the full conversation with Dr. Eve Henry here.

With heart, Dr. Kate

 
 
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