2 days ago

Got LDL Cholesterol? Let’s Play Cholesterol Marbles!

Most doctors focus on LDL. But your lipidome holds the real clues to your cardiovascular risk. In this episode, Dr. Regina Druz introduces a tool she uses with patients called “cholesterol marbles,” a hands-on way to see cholesterol not as good vs. bad, but as a complex network of particles with very different roles.

What does it mean if your LDL is high? What’s the role of VLDL or small dense LDL? And why do some people with “great” HDL numbers still end up at risk? Dr. Druz breaks down how these lipoproteins behave, how they form, and how they quietly drive cardiovascular risk. She explains the “40-30-20-10 rule” to help make sense of why LDL still matters, while also showing why markers like ApoB and non-HDL cholesterol may be even more useful. You’ll also hear why high HDL isn’t always protective, why small dense LDL is particularly dangerous, and how metabolic dysfunction, often tied to diet and insulin resistance, can shift your lipid profile in the wrong direction.

Whether you’re managing high cholesterol or simply trying to understand your lab results, Dr. Druz will change the way you think about cholesterol labs, and what you should really be asking for in your bloodwork.

Episode Breakdown:

00:00 What are Cholesterol Marbles?

01:28 The Lipidome and Why It Matters

07:04 How VLDL Becomes LDL

09:02 The “40-30-20-10 Rule” for Lowering Heart Risk

17:02 Small Dense LDL Cholesterol and Cardiovascular Risk

26:00 HDL Cholesterol Functionality

29:04 Genetic Profiles and Lipid Pathways

33:03 Heart Disease as a Fundamental Process of Aging

35:35 Guidelines for Lipid Management

Links

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