Editor’s note: Lisa Tedder is the wife of Dr. Barry Tedder, who practices at St. Bernards Heart and Vascular and specializes in preventative cardiology and lipidology. They reside in Jonesboro and have two adult children.

In April and May, we will do a deep dive into lipids with board certified cardiologist and lipidologist Dr. Barry Tedder. This month, Dr. Tedder explains what lipids are, how they function, the disease process and what a lipid panel is.

“First, we need to understand what happens with the food we eat,” said Tedder. “The body needs energy to move, breathe, think, etc. This energy comes from the food we eat or from stored fat.”

Our food consists of three main nutrients: carbohydrates, fats and proteins. Carbohydrates, the body’s main source of energy, are broken down into glucose and either used immediately or stored for later use. Fats provide energy, help the body store and use vitamins, and are necessary for cell structure and function. Protein can be used for energy but is mainly used to build and repair tissue like muscles. The body converts any calories it doesn’t use right away into fat or stored triglycerides.

So, what are lipids?

“Simply put, lipids are fatty compounds circulating in your blood that are essential for many functions in your body, and those form the building blocks for all living cells,” said Tedder. “Lipids are part of your cell membranes and help regulate what goes in and out of your cells. They help move and store energy, absorb vitamins and make hormones. But, having too much of some lipids in the bloodstream is harmful, so having a lipid panel will tell you if your levels are within a healthy range.”

There are three main types of lipids: Phospholipids, sterols and triglycerides. Phospholipids make up the protective outer layer of cells in animals and humans and rarely cause problems for people.
“Sterols are essential for many important functions within your body,” said Tedder. “The most well-known sterol, cholesterol, is a major component of cell membranes, helps with the production of testosterone and estrogen, helps absorb vitamins and is necessary to produce vitamin D. When too much cholesterol builds up inside your arteries, it’s called plaque and is the beginning of heart disease, as it can eventually restrict or block blood flow.

“The main source of cholesterol in the body is made in our liver, some in our intestines and even in every cell of the body,” he added. “We also get roughly 20% of cholesterol from the food we eat. This is one reason why diet and exercise alone won’t lower your cholesterol enough if it is too high.”

Triglycerides are the most common type of lipid in our body and come from animal and vegetable fats. Triglycerides circulate in the bloodstream to be used as energy by the cells. Any extra is stored in the body as fat to be used later when needed.
“Extremely high levels of triglycerides can also cause an acute inflammation of the pancreas or pancreatitis,” said Tedder. “Having high triglycerides is often a sign of other diseases like obesity, type 2 diabetes, metabolic syndrome or low levels of thyroid hormones, all of which further contribute to heart disease.
He noted that metabolic syndrome refers to having several conditions or risk factors that increase your chances of having heart disease, stroke and diabetes. This includes excessive abdominal fat, low HDL levels, high triglycerides, high blood pressure and high blood sugar.

High triglycerides can contribute to insulin resistance, a condition where cells don’t respond properly to insulin. Insulin regulates your blood sugar and insulin resistance is a step towards developing type 2 diabetes.

“Your body needs both cholesterol and triglycerides for bodily functions, but high levels of in the blood stream represent serious risks to your health,” said Tedder. “High cholesterol can lead to stroke, heart attack, peripheral artery disease or heart failure. High triglycerides can lead to heart failure, stroke, heart attack, pancreatitis, kidney failure, pancreatic cancer, diabetes, metabolic syndrome, thyroid conditions, liver disease or kidney disease. It is possible to have high cholesterol but not high triglycerides, and vice versa.”

To make things even more complex, lipoproteins are also part of the equation.

“Lipoproteins can be thought of as the transportation system for lipids,” he said. “Because fat isn’t soluble in liquids, lipids must be transported through the bloodstream to wherever they are needed by molecules called lipoproteins. While there are several types of lipoproteins that perform different jobs, you may only have heard of HDL and LDL. HDL, high-density lipoproteins, help remove excess cholesterol from your blood and transport it back to the liver for processing. LDL, low density lipoproteins, carry cholesterol to the cells throughout the body. Excess LDL can build up in the arteries, leading to plaque formation. Lesser known, lipoprotein(a) or Lp(a) works similarly to LDL and can contribute to heart disease. Lp(a) levels are determined by genetics. A high level can indicate an increased risk for developing heart disease.”

A lipid panel is a blood test that measures total cholesterol, LDL, HDL and triglycerides. It can predict the risk of developing heart disease and other diseases related to high lipid levels.

“Everyone should have a lipid panel, the earlier the better,” he added. “Even children should have one by age 9, according to the American Academy of Pediatrics, or earlier if there is a strong family history of premature heart disease or high lipids. For the best results, you should fast before having your blood drawn. Lipid levels can be abnormal due to lifestyle, genetics, certain drugs, obesity, diabetes and certain endocrine diseases.”

 In May, we will explore what the lipid panel means, the risks and what to do about it.