For a broad picture of heart health, you at least want a standard lipid panel, which is a measure of your HDL (“good”) cholesterol, LDL (“bad”) cholesterol, and triglycerides. But while this is certainly a good baseline test, especially if you have no heart disease risk factors, many functional and integrative doctors don’t believe it goes far enough. That’s because, even though high LDL cholesterol has consistently been linked to heart disease, there are still some people with normal or even low LDL levels that develop heart disease—so there’s more to the story.
Increasingly, integrative doctors, including Gandhi, Amy Shah, M.D., and Kristann Heinz, M.D., R.D., are calling for more advanced lipid panels, like those that include a breakdown of lipoprotein size (cholesterol particle size). Research suggests that looking at numbers of specific particles is more indicative of your risk than simply zeroing in on total or LDL cholesterol. Basically, you want your particles to be big and buoyant, not small and heavy, because then they tend to lodge in the walls of arteries more easily, which can increase your risk of heart attack and stroke.
If your insurance doesn’t cover a more advanced lipid panel, you shouldn’t stress—but you should look at the numbers on your standard lipid panel more closely. “One of the strongest predictors for preventing heart disease is having a good HDL-to-triglycerides ratio,” says Steven Gundry, M.D., cardiologist and functional primary care physician. “So your HDL should be higher than or equal to triglycerides.”
Who should get it? All adults, especially if you have a family history of heart disease or other risk factors.
Coverage: A standard lipid panel is very likely to be covered by insurance as part of your annual physical, while more advanced lipid testing may depend on your risk or family history.