Is Your Cholesterol Test Telling You the Truth? — With Katherine Caris-Harris

What standard GP testing misses, and why it matters more for athletes.

Several months ago I wrote a LinkedIn post about my own decision to start taking statins, after several years of resisting that path. Katherine Caris-Harris, a performance nutritionist and fellow triathlete, reached out afterwards. She felt there were gaps in the conversation, and she was right.

Katherine is a degree-qualified nutritionist who works with what she calls corporate athletes, driven, high-performing people who often push themselves too hard across every area of life. In this episode we dig into the limitations of standard GP cholesterol testing, why LDL alone is a poor predictor of cardiovascular risk, the role of insulin resistance and thyroid function in driving cholesterol up, what the actual numbers needed to treat for statins really look like, and why cholesterol itself is essential, not the villain it's often made out to be.

This isn't an anti-medication conversation. Katherine isn't here to tell you what to do. It's about giving you the fuller picture so you can make an informed decision for yourself, whatever that ends up being.

5 KEY POINTS

LDL alone is a poor predictor of risk. Standard GP testing estimates LDL using a crude calculation, and doesn't account for particle size or how easily those particles are damaged by inflammation.

Better markers exist, but aren't routinely offered. ApoB and Lipoprotein(a) give a far more accurate picture of cardiovascular risk than standard LDL testing, but most GPs don't test for them due to cost.

The number needed to treat varies hugely. For primary prevention in a low risk group, you may need to treat 100 to 200 people with statins to prevent one cardiovascular event. That context rarely makes it into the conversation.

Insulin resistance can quietly drive cholesterol up. Even lean, fit endurance athletes can develop elevated blood sugar and insulin resistance through excessive use of gels, energy drinks and fasted training.

Cholesterol is essential, not the enemy. It's required for hormone production, cell repair, brain health and vitamin D synthesis. The real driver of arterial damage is oxidative stress and inflammation.

3 TAKEAWAYS

Get tested properly before deciding. Standard GP panels are a useful starting point but rarely tell the full story, particularly for athletes.