Thread by @DietDrsayajirao

“Your LDL is high. You’ll get a heart attack”.
That’s the fear most people live with.But science says something very different.
Here’s the most important thread you’ll read on LDL cholesterol:
Myths, truths, risks, and what REALLY matters. 🧵👇

1. LDL is not “bad cholesterol.”
LDL (Low-Density Lipoprotein) is not cholesterol.
It’s a carrier vehicle that transports cholesterol from the liver to cells.

Every cell needs cholesterol to:
•Build membranes
•Make sex hormones
•Produce bile & vitamin D

⚠️ LDL is a delivery system, not a toxin.

2. What makes LDL dangerous? Not quantity.But quality.

LDL becomes risky when it’s:
⚠️ Oxidized (damaged)
⚠️ Small & dense (easily trapped in arteries)
⚠️ High in number (ApoB)
⚠️ In an environment of inflammation + insulin resistance

LDL is like a delivery truck. Problem isn’t the truck, it’s damaged trucks in a traffic jam on a broken road.

3. What LDL levels are considered “safe” around the world?

🔻 < 100 mg/dL → general public
🔻 < 70 mg/dL → diabetics or those with heart disease
🔻 < 55 mg/dL → recent heart attack/stroke survivors

But here’s the twist ⤵️

4. Ultra-low LDL isn’t always better.

🧠 Studies show LDL < 70 may be linked to:
Increased hemorrhagic stroke
Higher mortality in elderly
Cognitive decline in some cases

📚 Especially in malnourished, insulin-deficient, or underweight populations.

🔁 So lower is not universally better. Context matters.

5. ApoB is the real silent killer And not LDL-C.

🧪 ApoB = # of atherogenic particles (LDL, VLDL, IDL, Lp(a))
Each particle = 1 ApoB
So it tells you how many particles are roaming your blood

✅ ApoB < 80 mg/dL = safe
⚠️ ApoB > 100 mg/dL = high heart disease risk

📌 Many people with “normal” LDL still have high ApoB → hidden danger.

6. Size matters: Small dense LDL = dangerous.

🔴 Small, dense LDL → enters artery walls → oxidized → triggers plaque
🟢 Large, fluffy LDL → less likely to cause problems

What causes small LDL particles?
❌ High sugar intake
❌ Refined carbs
❌ Low HDL
✅ Fixed by: low-carb diet, exercise, and fixing insulin resistance

7. The #1 enemy of your heart is not LDL . It’s insulin resistance.

High insulin causes:
🔥 Oxidized LDL
🔥 High triglycerides
🔥 Low HDL
🔥 Small LDL particles

LDL is just a messenger. Insulin resistance loads the gun.

8. Your lipid panel is incomplete without these: Marker
Ideal Range
LDL-C < 100 mg/dL
HDL-C > 50 (F), > 40 (M)
Triglycerides < 100–120 mg/dL
ApoB < 80 mg/dL
Non-HDL-C < 130 mg/dL
TG:HDL Ratio < 2.0

📌 Always interpret in combination. One marker ≠ full story.

9. What really improves lipid profile?

And no, it’s not “eat less ghee.”

✅ Reduce seed oils & processed food
✅ Cut sugar, white flour, and excess rice/wheat
✅ Eat enough protein
✅ Lift weights
✅ Sleep well
✅ Correct insulin resistance
✅ Heal your gut

These fix LDL particles, not just numbers.

10. LDL often rises in low-carb or keto diets. Should you panic?

Not necessarily.
🔼 LDL rises
🔽 Triglycerides drop
🔼 HDL improves
🧪 ApoB stays normal
= Metabolic improvement overall

📍This pattern is called Lean Mass Hyper-Responder (LMHR) not high risk unless ApoB and inflammation rise.

11. Statins: Lifesaving or overprescribed?

✅ Beneficial for:
•Heart attack survivors
•Diabetics with high ApoB
•Genetic lipid disorders

⚠️ Not always necessary for:
Metabolically healthy people
Those with good ApoB, HDL, TG, CRP

Statins also lower CoQ10 and may increase diabetes risk in some.

Always ask: Risk vs Benefit.

12. Lp(a): The most ignored risk factor

Lip(a) is a genetically inherited LDL-like particle.
Highly atherogenic.
Normal LDL + high Lp(a) = still high risk.

🧪 Test once in lifetime.
❌ Not fixed by diet.
✔️ Controlled by niacin, diet, emerging therapies.

13. LDL is only a problem in a broken metabolic system.

A healthy person with:
✅ Low triglycerides
✅ High HDL
✅ Normal ApoB
✅ No inflammation
…can have “high” LDL and still be low risk

But a person with insulin resistance + high ApoB + inflammation = ticking time bomb even with normal LDL.

🔚 Final Truths:
🔸LDL is a messenger, not a villain
🔸Focus on ApoB, inflammation, insulin resistance
🔸Don’t treat numbers,treat the terrain
🔸Fix the system, not just the lab report
🔸Context is king