William T Friedewald et al.1 developed a formula for LDL-c estimation using a database of 488 individuals based on fasting plasma measurements of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), and triglycerides (TG): LDL-c = total cholesterol — HDL-c — 0.2 × TG, and it has enjoyed widespread acceptance since that time
The study is titled:
"Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without the use of the preparative ultracentrifuge"
Interesting that back in 1972, the year of the publication, the word "cholesterol" was already associated with LDL. But LDL is a lipoprotein, not the cholesterol molecule, as discussed in blog 1 on this topic.
This excerpt from the paper may confuse you - as it did confuse me.
"An indirect method is presented here for estimating the plasma LDL concentration in terms of the cholesterol contained in this lipoprotein (C LDL). The method requires measurement of the concentration of plasma total cholesterol, triglycerides, and CHDL concentrations.
What they state:
there is cholesterol in the LDL particle (as there is in the HDL particle)
next, they state they calculate LDL based on HDL, "total cholesterol," and triglycerides - ????
My confusion is in this single-line statement that has shaped a $1 trillion industry...
Nowhere in this measurement is the level of the actual cholesterol molecule. Yet, they state they estimate the LDL based on cholesterol contained in LDL. In no way is the amount of actual cholesterol determined in HDL, triglycerides, or "total cholesterol." It simply is NOT measured.
However, from this "cross-eyed speak" we get the famous equation used to harm healthy people.**
Total Cholesterol (TC) = LDL + HDL + 20% of the triglyceride value.
Interestingly, the 20% number - seeming random - was determined this way per the publication.
"Two observations are used in the calculation. One is that the ratio of the mass of triglyceride to that of cholesterol in VLDL is apparently relatively constant and about 5:1 in normal subjects."
Hmmm.....
Where is VLDL in the TC calculation? It is not there! Is there the same ratio of cholesterol in LDL as there is in VLDL?
From Healthline: "Though VLDL and LDL share the same building blocks, these two types of lipoproteins differ in the percentages of the cholesterol, protein, and triglycerides that make them up. VLDL contains more triglycerides, while LDL contains more cholesterol."
What this means to me at 6 am is that.
VLDL carries triglycerides, and you can estimate the free cholesterol in VLDL based on a known ratio - at least in healthy people (what about unhealthy - does one size fit all? Should all our TC be calculated using the "20% triglycerides"?
Does the amount of triglycerides in VLDL predict the amount of cholesterol in LDL? NO SUCH RELATIONSHIP WAS PRESENTED.
CONCLUSION: THE MATH AND RATIONALES DO NOT ADD UP. YET THIS EQUATION IS THE MOST PROLIFIC ONE USED BY DOCTORS TODAY.
The concept of GOOD and BAD
The term "bad" cholesterol emerged in the late 1970's
This concept, and the math applied to "determine your health," is so OBVIOUSLY FLAWED that it is completely overlooked.
Stay with me as we do some simple math. Here is the concept:
If something is good - it is POSITIVE. We add a positive to any other number. POSITIVE = addition.
If something is bad - it is NEGATIVE. We subtract a negative.
Here is a table explaining this. In life, if you have 4 good things and 2 bad things, your net "good" is 2. We subtract the "BAD" from the "GOOD"
But in the cholesterol calculation we ADD the BAD too the GOOD! Does that make sense?
The way doctors calculate TC - The do NOT understand the difference between addition and subtraction. Yet 3rd graders do (at least the used to!)
WRONG PER 3RD GRADE MATH.
RIGHT PER 3RD GRADE MATH
The consequences of the top chart is people with adequate (higher) levels of HDL are punished because in the standard of care, "high" "cholesterol" is bad and a statin script is coming......
Mind boggling.
ALSO, even though the math is technically correct in the bottom chart - the conclusion is dead wrong.
LDL and HDL are soaps that move substances that are not water soluble around through our water-based circulatory systems.
I am not endorsing a change to the equation - the entire thing is a fraud, and the credible data presented earlier supports this conclusion.
If you want a "lipid" value, the best - by far - is the HDL/triglyceride ratio or the log of that called the atherogenic index of plasma.
Earlier in this blog, I stated:
However, from this "cross-eyed speak" we get the famous equation used to harm healthy people.**
Yes, the equation HARMS HEALTHY PEOPLE. This is how it works.
healthy people tend to have high HDL (>70)
healthy people tend to have an LDL of 120 or higher
Even if their triglycerides are low, the total cholesterol calculation will be >200
Their doctor, who cannot perform 3rd grade math, will put them on a statin drug
Lowering LDL and CoQ10 does nothing but cause harm, yet they are pleased when they "lower" your TC - RIGHT INTO A HIGHER ALL-CAUSE MORTALITY ZONE....
SIMPLE MATH - DUMB DOCTORS!
Index & Upcoming (short) blogs
Number 1: Cholesterol fun (true) facts - completed
Number 2: Is the actual cholesterol molecule important? c - completed
Number 3: What is an optimal TC value? Remember, no one knows their actual cholesterol molecule value. - completed
Number 4: Surprising fact about cholesterol as an antibiotic - completed
Number 5: TC simple math - dumb doctors - completed
Number 6: What is LDL really? - Next
Number 7: Statins - do they lower the cholesterol molecule?
Number 8: What did we learn from the new "biologics" to lower "cholesterol"
Number 9: Niacin and other "cholesterol" management treatments
Number 10: What did Natasha Campbell-McBride say about cholesterol/lipids?
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Be Bold - Be Brave - Stay Well
Incredible! You are the expert “fact checker” of the so called “experts”! Our entire educational system is dis functional(K-12…Phd). Only geniuses, like you, see through the (deliberate?) confusion. Who and what is to be believed anymore?