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Dear Pharmacist,

I saw Dr. Oz interview a doctor on television about cholesterol. The guest said your total cholesterol doesn't matter and I read that in your book 6 years ago. Suzy, I take a statin, and do a "Lipid Profile" annually. Is this okay?

--M.D., Austin, Texas

Answer: No, it's not okay, and I'm about to shock everyone, unless you've read my books, then this will be review.

Recently I wrote a column about LDL and that we should not necessarily strive to lower it. We need to know the type and number of LDL particles. For example, Lipoprotein A or "Lp(a)" and another called apolipoprotein B or "Apo B" are two subtypes of LDL particles. These particular scores directly affect your cardiovascular risk. Do you have those numbers on your lab test? I bet you don't.

In my first book, The 24-Hour Pharmacist from 2007 and many syndicated columns I've explained that statins are not very effective in reducing LDL particle number or Apo B and usually do not increase the size of your LDL particles, that's why I don't encourage them.

It's confusing for consumers (and physicians who unwittingly accept drug propaganda) because studies conclude statins reduce total LDL. And yes, they do reduce "total" LDL, they are also excellent anti-inflammatories so they are not completely without merit. But I'm bent on you reducing Lp(a) and Apo B, the dangerous subtypes of LDL known to raise risk for heart attack and stroke. One day I'll tell you which vitamin reduces those bad boys, since drugs can't, but now, back to this testing dilemma.

I'll never submit myself for a routine "Lipid Profile" because it would waste my money. Half the people who have heart attacks have normal total cholesterol. If your results shows a low LDL (considered the bad particle), then you may assume you're okay but you see, a low total LDL score doesn't say much. Your triglycerides might be through the roof! You may have a huge concentration of dangerous Lp(a) and Apo B, subtypes of LDL that are never measured in that basic lipid profile.

Likewise, you may be happy with your high HDL cholesterol score, (HDL is considered a good cholesterol), but what if you have the wrong kind of HDL particles? Yeah, some HDL is bad, you didn't know that?! You're still at very high risk. These basic "Lipid Profiles" don't provide the crucial details. It's like a car mechanic who you hire to fix your engine, but you only let him look at the hood of your car, he can't open the hood to see inside!

The better tests, sometimes covered by insurance measure particle size, type and sometimes the actual number of LDL and HDL particles. I urge you to ask your physician to order tests from Berkeley HeartLab, a leader in this field. There's also another one called the "VAP Test" by Atherotec Diagnostics and finally, the "NMR Lipoprofile" by LipoScience.

Suzy Cohen

Suzy Cohen, is known as America’s Pharmacist. She has been a licensed pharmacist for 24 years and is a Functional Medicine practitioner. She’s the author of 6 books, including her most recent Amazon #1 best-seller, “Thyroid Healthy: Lose Weight, Look Beautiful and Live the Life You Imagine.”

She was the host of The Thyroid Summit which broadcast worldwide in June 2014. Suzy has been a syndicated columnist for 19 years reaching 20 million in circulation each week. She is a Huffington Post writer, and also hosts her own syndicated medical minute on TV. Suzy has been featured on The Dr OZ Show 6 times, and has appeared on The View, Good Morning America Health, The Doctors and hundreds of other networks. She is a member of The Institute of Functional Medicine, also the American Academy of Anti-Aging Medicine, The American Pharmacists Association and ILADS, the International Lyme and Associated Diseases Society. You can read free articles and receive your free newsletter by visiting her website, SuzyCohen.com

Books authored by Suzy Cohen include:

  • Thyroid Healthy
  • Headache Free
  • Drug Muggers
  • Diabetes Without Drugs
  • The 24-Hour Pharmacist
  • Eczema: Itchin’ for a Cure (kindle only)
  • Understanding Pancreatitis & Pancreatic Cancer (kindle only)