Understand Your CHOLESTEROL PANEL & Metabolic Health Tests – The ULTIMATE Guide | Dr. Robert Lustig

Understand Your CHOLESTEROL PANEL & Metabolic Health Tests – The ULTIMATE Guide | Dr. Robert Lustig

A metabolic blood test and cholesterol panel can be confusing, so in this ultimate guide, our Chief Medical Officer and Co-Founder Dr. Casey Means talks with Levels advisor and author of Metabolical, Dr. Robert Lustig, to give you advice on how to interpret your panels to better understand the status of your metabolic health.

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Dr. Robert Lustig walks through what HDL, LDL, triglycerides, and total cholesterol mean, how fasting insulin tests relate to your cholesterol panel, how to improve your cholesterol numbers, and how to interpret ratios of your cholesterol numbers like the triglyceride-to-HDL ratio.

#metabolicHealth #cholesterolPanel #LDL #triglycerides #bloodPanel

📍 What Dr. Robert Lustig and Levels’ Dr. Casey Means discuss:

00:00 – Intro
02:17 – Understanding cholesterol
02:44 – The correlation between LDL and heart disease
05:12 – The connection between LDL and triglycerides
07:14 – Good cholesterol
16:48 – Measuring LDL
30:04 – Portal systems in the body
44:51 – The importance of liver function tests
54:05 – How to reduce liver fat


Levels helps you see how food affects your health. With real-time, personalized data gathered through biosensors like continuous glucose monitors (CGM), you learn which diet and lifestyle choices improve your metabolic health so you can live a longer, fuller, healthier life.


Watch the conversation: https://youtu.be/C3rsNCFNAw8
The ultimate guide to understanding your cholesterol panel and metabolic blood tests: https://levels.link/youtube/blog/the-ultimate-guide-to-understanding-your-cholesterol-panel-and-metabolic-blood-tests
Show notes: https://levels.link/youtube/podcasts/the-ultimate-guide-to-understanding-your-cholesterol-panel-and-metabolic-blood-tests-dr-robert-lustig-dr-casey-means

Subscribe here on YouTube: https://youtube.com/levelshealth?sub_confirmation=1
Connect with Casey on Twitter: https://twitter.com/DrCaseysKitchen
Connect with Casey on Instagram: https://instagram.com/drcaseyskitchen Connect with Rob on Twitter: https://twitter.com/RobertLustigMD
Connect with Rob on Instagram: https://instagram.com/robertlustigmd


  1. In the UK as a patient you are not given your blood results or explained what it all means and your not allowed your blood group unless you donate your blood.

  2. I bought metabolical book thinking it treat cholesterol, but no its talks about everything else except cholesterol.

  3. When you’re explaining all this why don’t you get testimonials and for each thing what to do about diet to fix

  4. Najbardziej wartosciowy wywiad jaki widziałem. Merytoryczny, konkretny i dogłębnie opisujący zależności w tematyce. Świetna robota! Ciesze się, że jeszcze film nie zniknął…

  5. Excellent explanation for us the patients to learn what is causing the health problem and what is the solution.

  6. I actually had heart attack 4 years ago and at the time I was doing the Paleo diet to lose weight. I had lost 30lbs a few years before on paleo but let myself slip and regain 30lbs. So I was back on the diet again and had lost 25 lbs. While riding my bike I had chest pain and long story short, had a heart attack, got a stent and survived the whole thing and now I’m fine. The funniest though is that on the cath lab table, my triglycerides were 70, my cholesterol was 125. My ldl was low, my hdl was high. I was the skinniest person in the room and I was the patient! The nutritionist who saw me saw my labs and couldn’t believe that I had a heart attack. I told her that 3 months before they weren’t the same. The reason is that when my weight was high my triglycerides were 250 and my cholesterol was 190. Every day that you live with your triglycerides up, being over weight, eating a sugary diet, you are doing damage.

  7. Thank you for this very informative video. I have question, I do not not know the ratio of my HDL/TRI My HDL is 80 and my TRI is 70. Can anyone tell my what the ratio is? are these a healthy range? My LDL is 189. thank you for any help.

  8. It is very well explained and I took notes and appreciated it a lot. But there is one thing missing. I think Dr Lustig should have given an example of how to see that LDL -Triglyceride ratio. I´m terrible bad with math and seeing an example would have helped.

  9. So what is a fat bump on skin? What causes it and is there any diet or medication to shrink it without surgery?

  10. I’m still trying to understand my labs… the doctor said this is normal, but based on what you and Dr Casey are saying, I am confused. Can you please give me insight on my results below?

    Triglyceride = 56  
    HDL = 80 
    TG to HDL ratio = 0.7

    My LDL SMALL is above range. The range at Quest diagnostic is 145… my level is 185.

  11. This is a great video. It dives deep into the underlying causes while keeping it simplified for us non-medical people. I have fatty liver, high CAP score on my liver fibroscan but my ALT is 21. I drank for 28 years. Beer only and only on the weekends. But Weekend warrior style. I’m also a marathon runner with high blood pressure and a resting heart rate of 42 from my exercise. I have high 120-150 LDL and tris that bounce from 75-135. I’m a mess but from this video its easy…cut out sugar and alcohol.

  12. The best thing that we all can do is show this video (or give them the book) to our physicians. If 1 million viewers did this…. It would make an impact. ONE EASY thing for us to do… can make a HUGE impact! Think about that.

  13. When I was a kid in the 70s I’d get side aches.. Right side body abdomen side aches when running around the neighborhood. . Happens the human liver resides on the right side of the abdomen. Love your work Dr. Lustig

  14. Thank you so much for this video, I have been trying to figure out what to say to my doctor about my results. I’m very low triglycerides but because of my total cholesterol the doctor still wants to put me on statins. As a carnivore for quite some time now it’s frustrating in this Canadian health care system.

  15. Apo-B is the current gold standard (along with family history) of predicting when therapy is indicated. If you can get it at or around 70, the plaque build up in your arteries will be halted, and possibly regress.

  16. No reputable lipidologist or cardiologist pays any attention to the ratio of triglycerides to HDL. At least not in the last 15 years. Why? Because we have much better markers for cardiovascular risk. Namely ApoB. Second best would be non-HDL-C. It would be great if you had challenged some of his outlandish and clearly incorrect claims. Large fluffy LDL is also atherogenic. He is a wonderful resource, but when he gets out of his lane, which he clearly is here, he sometimes spreads misinformation.

  17. Amazing … finally after many years of being told my cholesterol levels are too high I understand what is going on. I am endlessly grateful to Dr. Lustig who has an amazing capability to explain this complex matter. It is very unfortunate that almost no medical doctor seems to have this knowledge.

  18. Focus on vitamin C – deficiency !!
    Why do only ARTERIES clog with cholesterol and NOT VEINS or small CAPILLARIES?

    Scurvy = No vitamin C in your diet.
    Symptom: Your blood vessels break and you bleed to death. Think of the sailor of the past.

    Scurvy of the heart = Just enough vitamin C from food.
    Symptom: Arteries around the heart are not strong enough to resist high blood pressure. Damage is repaired with cholesterol to prevent worse. After years of repair, your arteries become clogged.

    Enough vitamin C supplement of at least 3000 mg. per day gives strong and flexible arteries. Cholesterol is not needed as a repair agent. Cholesterol in your coronary arteries is broken down and burned in your liver.

    Google this source: Cardiovascular disease and vitamin C (Dr. Rath Foundation)

  19. Help Tryglicerides 87 HDL 89 LDL 208 204
    Total LDL 304
    This is a huge improvement since 3 nomths low carb 14lb weight lose ALT 19 was (24)

  20. Sha.e on him for using relative risk not absolute risk. THERE IS NOT A 1.3 CORRELLATION BETWEEN LDL AND HEART DISEASE.

  21. This was a fantastic podcast! I didn’t know these specious reasons the ADA uses to oppose testing fasting insulin.
    It’s completely insane that medical doctors are trained so poorly wrt to metabolic health and prevention of chronic conditions. You can literally train a 2 year to pull a lever if they see a light go on and that’s all that most doctors I’ve seen are capable of. The LDL light goes on and they pull the statin lever, or at least they try 🙂
    There is another entire area of what labs look like for low carb of ketogenic diets particularly if you are lean. Dr Casey it would be terrific someday to get Nick Norwitz or Dave Feldman on to talk about LMHR.

  22. Is there a way that I can find a doctor who will analyze the numbers discussed here correctly ?? Thanks 🙏

  23. I feel there are factors as well. My liver enzymes were high and my cholestrol wasnt high. I had not expected to be taking the blood test so my glucose was a bit high. I had high
    c- reactive protein.
    My doctor insisted i had diabetes and gallstones.

    I told him the pain i had was in the wrong area to be gallstones as it was on the left lower side.
    I told him i had diverticulitis and needed an antibiotic.
    He refused to give me any treatment.

    I went to another doctor who agreed with me.
    He gave me antibiotic and i took milk thistle for my liver. He gave me the 3 month glucose test which was normal.

    2 weeks later all my results were normal.

    Why not mention milk thistle for the liver?

  24. My small dende ldl (lab value) 49mg/dl …
    Ldl direct- 96mg/dl
    Total cholesterol -165mg/dl
    Could the measured small dense lldl be wrong?
    I follow low carb diet…

  25. Very helpful info, thank you! I got my lipid panel results back and was really anxious before hearing this. My total cholesterol went up from 150 to 213 in 30 days- but my triglycerides are 58, HDL is 103, and LDL is 100. My total cholesterol/HDL ratio is 2.06 and triglyceride/ HDL ratio is .56. Proof that total cholesterol is an absolute junk number.

  26. Wow ! As a heart disease patient ( 3 heart attacks , 5 stents) who is now self educating as to causation .. and pursuing low carb , intermittent fasting , exercise lifestyle changes ( kudos to Dr Ford Brewer at Prevmed) .. this video has been a total eye opener.. giving the missing pieces … thank you so much!!

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