Why Cholesterol Is Not the Root Problem

For decades, cholesterol—especially LDL—has been treated as the problem when it comes to heart health. High LDL? Lower it. End of story.

But from a functional and metabolic perspective, cholesterol is rarely the root issue. More often, it’s a signal—your body’s way of telling you that something deeper is going on.

For many people, especially those dealing with insulin resistance, fatty liver, inflammation, or chronic metabolic stress, elevated cholesterol reflects underlying dysfunction—not a standalone disease.

The goal shouldn’t be just to lower a number. The goal should be to restore metabolic health so cholesterol can regulate itself the way it’s designed to.

What Cholesterol Actually Does (And Why Your Body Needs It)

Cholesterol is not optional. It’s essential.

Your body uses cholesterol to:

• Build and maintain cell membranes

• Produce hormones (estrogen, progesterone, testosterone, cortisol)

• Make vitamin D

• Support brain and nervous system function

• Produce bile for digestion and fat absorption

In fact, your liver makes the majority of your cholesterol because it’s that critical to survival.

If cholesterol were inherently harmful, your body wouldn’t work so hard to make it.

LDL, HDL, and Why Context Matters More Than a Single Number

LDL and HDL are often oversimplified as “bad” and “good” cholesterol, but this framing misses the bigger picture.

• LDL delivers cholesterol to tissues where it’s needed

• HDL helps transport cholesterol back to the liver for recycling or removal

What matters most is why LDL is elevated and how cholesterol is being handled in the body.

When insulin resistance or fatty liver is present, the liver tends to:

• Overproduce LDL

• Release smaller, more inflammatory LDL particles

• Struggle to clear cholesterol efficiently

This is why ratios, trends, particle size, ApoB, triglycerides, and insulin markers provide far more insight than LDL alone.

Fatty Liver & Insulin Resistance: The Missing Link

One of the most overlooked drivers of abnormal cholesterol is fatty liver, which is tightly linked to insulin resistance.

When the liver becomes insulin resistant:

• Fat accumulates in liver cells

• Cholesterol production increases

• Triglycerides rise

• LDL clearance slows

This creates a cycle where cholesterol looks like the problem—but it’s actually the messenger.

Lowering LDL without addressing insulin resistance or liver fat does not resolve the root issue. It just quiets the signal.

Where Statins Fit (and Where They Don’t)

Statins work by blocking cholesterol production in the liver, which lowers LDL numbers. For some people, they are well-tolerated and may play a role—especially in higher-risk situations.

But it’s important to understand what statins do not do:

• They do not improve insulin resistance

• They do not reverse fatty liver

• They do not restore metabolic flexibility

• They do not address why cholesterol was elevated in the first place

Many people also experience side effects such as:

• Muscle or joint pain

• Fatigue

• Reduced exercise tolerance

Lowering a number does not automatically mean better long-term outcomes—especially if the metabolic terrain remains unchanged.

👉 Medication can lower cholesterol. Lifestyle and nutrition improve function.

What Actually Improves Cholesterol Long-Term

A root-cause approach focuses on restoring metabolic health, not chasing numbers.

This includes:

• Improving insulin sensitivity

• Reducing liver fat (by identifying why the liver is under stress)

• Supporting liver detoxification pathways

• Building muscle and metabolic capacity

• Reducing inflammation

• Supporting sleep, stress regulation, and recovery

When these foundations are addressed, cholesterol often improves as a result—not a forced outcome.

Trusted Resources to Learn More

Related Blog Posts

• The Triglyceride-to-HDL Ratio: A Hidden Marker of Metabolic and Heart Health

• The Gut-Liver Connection: How Gut Microbiome Dysbiosis Impacts the Health of the Liver

• Triglycerides: The Overlooked Marker That Tells a Big Story About Your Metabolic Health

• Fatty Liver Is No Longer Rare — It’s a Metabolic Wake-Up Call

• Decoding Ferritin: How Blood Tests Reveal Clues About Iron, Inflammation, and Your Well-Being

👉 You can find more on my blog to learn more about metabolic health, insulin, liver health, gut health, blood sugar, inflammation, just type in a key word

Books

• The Great Cholesterol Myth – Jonny Bowden & Dr. Stephen Sinatra

• The Great Cholesterol Con – Dr. Malcolm Kendrick

Podcasts

• The Drive – Episodes on cholesterol, ApoB, and insulin resistance

• Revolution Health Radio – Cholesterol myths and metabolic health (one of my functional mentors in a 1 year class at the Kresser Institute)

• The Model Health Show – Accessible explanations of cholesterol and liver health

Experts

• Dr. Robert Lustig – Fatty liver and insulin resistance

• Dr. Ben Bikman – Insulin resistance as the root of metabolic disease

Final Thought

Cholesterol is not the enemy—it’s information.

When we take the time to understand what cholesterol is responding to, we uncover far more than a single lab value. By looking at functional blood markers that are often overlooked or never assessed—including insulin signaling, liver enzymes, inflammation, nutrient status, and hormone patterns—we can identify the hidden drivers behind imbalance.

This work goes deeper than standard labs and one-size-fits-all recommendations. It’s a personalized, root-cause approach designed to understand why your numbers look the way they do and what your body actually needs to move toward lasting health.

👉 If you’re ready to dig deeper and uncover the underlying drivers behind your labs, learn more about working together or reach out to get started.