Your Liver Makes and Clears Cholesterol: Dr. Jarod's Litmus Test for High Numbers

Most people think of cholesterol as something that comes from food and clogs things up. Your liver sees it differently. It makes cholesterol, sends it out, takes it back and turns the extra into bile. When a lab report flags a high number, Dr. Jarod Ward's first question is how well the liver is keeping up with that loop.

Your body makes all the cholesterol it needs, and your liver ships it out

Cholesterol isn't a villain. MedlinePlus, the National Library of Medicine's health site, puts it simply: "Your body needs some cholesterol to make hormones, vitamin D, and substances that help you digest foods. Your body makes all the cholesterol it needs."

The liver is where much of the shipping happens. After a meal, liver cells turn extra fuel into fat, then package fats, including cholesterol, into particles called very low-density lipoproteins (VLDL) and send them into the blood. That's the outbound trip. Dr. Jarod describes the liver as an organ built for exactly this kind of job:

"The liver is great at converting things into other things, and one of those things is cholesterol."

The number of receptors on your liver cells sets how fast LDL leaves your blood

The return trip matters just as much. LDL, the "bad" cholesterol on your lipid panel, gets pulled out of circulation by LDL receptors. According to the National Library of Medicine, those receptors "are particularly abundant in the liver, which is the organ responsible for removing most excess cholesterol from the body." It goes on: "The number of low-density lipoprotein receptors on the surface of liver cells determines how quickly cholesterol is removed from the bloodstream."

HDL, the "good" cholesterol, runs the same direction. It "carries cholesterol from other parts of your body back to your liver. Your liver then removes the cholesterol from your body."

So a cholesterol number is a snapshot of two things at once: how much is going out, and how fast the liver is bringing it back in.

Bile is how cholesterol leaves for good

Once cholesterol is back in the liver, one of its exits is bile. The liver converts cholesterol into bile acids, which help you digest fat. Most of that bile gets recycled: about 95% of bile acids are reabsorbed in the small intestine and sent back to the liver. About half a gram a day of bile acids made from cholesterol leaves the body in stool.

Dr. Jarod puts the question he asks his patients this way:

"Whenever the cholesterol is high, we have to ask, okay, is the liver not getting rid of the cholesterol and converting it into things I can use? Or am I making a lot of cholesterol because I'm eating a ton of sugar?"

Sugar becomes fat in the liver, and it shows up on a lipid panel

The second half of that question surprises people. The usual advice for high cholesterol is to cut fat. Dr. Jarod looks at sugar first:

"What I do see cause increased cholesterol is actually a lot of refined carbohydrates, so like white sugar, white flour, your favorite sugary Starbucks drink, right? Because sugar overloads the liver and then indirectly causes cholesterol and directly causes triglycerides to go high."

The research on the liver's fat-making backs up the mechanism. In the fed state, the liver uses the products of sugar breakdown "to synthesize fatty acids through de novo lipogenesis," a review of liver energy metabolism explains, and those fats can leave as VLDL. In a 10-week trial, overweight and obese adults drank sweetened beverages for 25% of their daily calories. Fasting triglycerides rose about 10% in the glucose group. In the fructose group, the liver's fat-making went up, along with fasting LDL, apoB and small dense LDL.

Dr. Jarod's picture of why: "Your body takes too much sugar and converts it into fat, because sugar burns quick, fat burns slow." How the liver stores and handles sugar is the topic of Sugar and Your Liver.

"My whole family has high cholesterol" has two possible answers

Genetics are real. Familial hypercholesterolemia, the inherited form of high cholesterol, affects an estimated 1 in 200 to 1 in 250 people in most countries. Many people who mention a family history assume they're in that group. Dr. Jarod uses his cleanse to find out:

"I actually use my liver cleanse as kind of a litmus test for this. They'll come to me and they're like, oh yeah, well, my whole family has high cholesterol. Well, that could be because of two reasons. One, it's truly genetic, or two, families usually eat the same, right?"

Then he looks at the follow-up labs:

"If the numbers come down, okay, it's probably lifestyle and the liver needed a good cleaning. If it doesn't budge at all, all right, fair enough, probably genetic."

Either answer is useful. One tells you your daily habits are a lever you can pull. The other tells you and your doctor what you're working with. For what the three weeks look like day to day, read What to Expect on a Liver Cleanse. The liver's role in turning cholesterol-based building blocks into hormones is covered in Your Liver and Your Hormones.

The full plan comes with the cleanse

Love Your Liver is Dr. Jarod's 21-day guided liver cleanse, and it's self-paced. The full meal plan, supplement schedule, shopping list and daily texts come with the cleanse. Your supplements ship to your door, and Day 1 starts the moment you tap start.

Prefer to start with a conversation? Dr. Jarod runs functional medicine and lab testing at Crown Chiropractic in Fort Myers. Call (239) 441-2275 to book a consultation.

Sources

• Dr. Jarod Ward, Crown Chiropractic. Liver episode on YouTube.
• MedlinePlus, National Library of Medicine. Cholesterol.
• MedlinePlus Genetics, National Library of Medicine. LDLR gene.
• MedlinePlus Genetics, National Library of Medicine. Familial hypercholesterolemia.
• Rui L. Energy metabolism in the liver. Comprehensive Physiology 2014;4(1):177-197.
• Gonzalez FJ. Nuclear receptor control of enterohepatic circulation. Comprehensive Physiology 2012;2(4):2811-2828.
• Stanhope KL, et al. Consuming fructose-sweetened, not glucose-sweetened, beverages increases visceral adiposity and lipids and decreases insulin sensitivity in overweight/obese humans. Journal of Clinical Investigation 2009;119(5):1322-1334.