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All About Cholesterol

Dr Tan Hong Chang, Associate Consultant in the Department of Endocrinology, Singapore General Hospital, explains that the human body is a cholesterol factory as it needs cholesterol to function. “Cholesterol is used by the body to make cell membranes, hormones and vitamin D,” he explains. “It’s also part of the outer covering of nerves, and is a component of bile. As the body is able to make cholesterol in the liver and other organs, there is no minimum requirement for cholesterol intake.”

Good cholesterol (HDL) helps transport cholesterol from the blood to the liver, before excretion in the bile. Bad cholesterol (LDL) is deposited in the blood vessels, forming plaques in the arteries. The relative level of HDL and LDL in your blood is dependent on genetics and diet. When we refer to high cholesterol levels, we predominantly refer to the bad cholesterol, ie high LDL-cholesterol. “High cholesterol increases cardiovascular risk because cholesterol can get deposited in the arterial wall, causing narrowing and hardening of the artery, which leads to atherosclerosis,” reminds Dr Tan. The total cholesterol-to-HDL ratio is an indication of the proportion of good and bad cholesterol, and is a better indicator of cardiovascular risk than total cholesterol.

Dr Peter Eng, Consultant Endocrinologist at Peter Eng Endocrine Clinic in Mount Elizabeth Medical Centre, advises that our body needs to maintain a desirable cholesterol level of no more than 5.2mmol/L (200mg/dl). Total cholesterol levels above 6.2mmol/L (240mg/dl) or LDL-cholesterol levels above 4.1mmol/L (160mg/dl) are considered high for a person without other risks of heart disease. A person with other risk factors for heart disease—such as smoking, hypertension or diabetes—requires a lower target level.


According to Dr Tan, heredity and diet are the most important determinants of your cholesterol level. “Our genes determine the regulation of our blood cholesterol levels. Our diet determines how much saturated and trans fat we consume to aggravate that cholesterol level,” warns Dr Tan.

Chew Siew Tiang, a registered TCM physician with the Eu Yan Sang clinic at East Coast Road, comments, “Males, the aged, and those who overeat and are inactive have a higher risk of getting high cholesterol. Females may face an increased risk after menopause as that is when the yin and yang of the body is highly imbalanced. Look out for signs in your family history—a male family member affected by heart disease before 55, or a female family member before 65.”

According to Physician Chew, symptoms of high cholesterol include:

• phlegm stagnation

qi stagnation

• blood stasis

• deficient yin in liver and kidney

In TCM, a person’s inability to digest efficiently may affect how cholesterol is processed and stored in the body. Similarly with blood and fluid circulation, slower fluid circulation will encourage more or larger deposits of cholesterol, while poor blood circulation is seen in many types of arthritic disorders as well as some types of cardiovascular diseases. Excretory system dysfunction is also a huge indicator, as “the relationship between the liver and bile production is critical to ensure cholesterol is eliminated efficiently when bile is released.”

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