Cholesterol: the Good, the Bad, the Ugly

Q: I have heard about “good” and “bad” cholesterol. What’s the difference and how do I know which one I’m eating?

A: Way to be a buzz kill on Thanksgiving week!  Just kidding – great question.  Let’s begin with a little chemistry lesson.



Fat doesn’t dissolve in water and blood, so it has to get chauffeured around your body by cholesterol.  There are two main types of cholesterol: high density lipoprotein (HDL, “the good guy”) and low density lipoprotein (LDL, “the bad guy”).

HDL acts like a scavenger or vacuum cleaner, picking up cholesterol and transporting it back to the liver, where it is processed and put to many necessary uses like building cell walls and membranes, bile acids and hormones.

On the other hand, LDL picks cholesterol up from the liver and drops it off throughout the body. This is especially problematic in blood vessels where the excess cholesterol can form plaques. The blood vessels around your heart (“coronaries”) are the diameter of spaghetti; a little plaque in them can mean a lot of trouble, like a heart attack. Too much plaque in the vessels supplying your brain can mean a stroke.

How do you know when your LDL is too high? Unfortunately, high cholesterol has no specific symptoms so a blood test is the only way to find out.  While healthy eating and exercise can go a long way towards keeping your cholesterol in check, high cholesterol can have a genetic component so you should talk to your doctor about when you need to start screening.

Certain foods, like trans fats, can actually increase LDL and decrease HDL. On the other hand, fatty fish (like salmon), walnuts and oatmeal can actually decrease LDL.  If you’re a smoker, quitting can also improve the amount of HDL in your blood (among a host of other improvements to your health). To see more tips on cholesterol and what you can do to improve yours, check out the websites below:

American Heart Association

U.S. National Institutes of Health

The Mayo Clinic

Cheryl Czapla, Med IV
College of Medicine
The Ohio State University

Victoria Rentel, MD
Student Health Services
The Ohio State University

Medical Mythbusters: The turkey made me do it!

There are a lot of traditions at Thanksgiving; turkey, pumpkin pie, football games, shopping, and of course “the nap”.   At my house dinner usually begins around two.  After the meal has been blessed, the football fanatics fill their plates and head to the family room to cheer on their favorite teams.  The non-football inclined take their plates to the table and kibitz.  About an hour or so later a quick glance into the family room usually reveals that the football fanatics have transitioned to “the nap”.

The fanatics, of course, would argue that the turkey made them sleepy.  Turkey contains an amino acid called tryptophan.  Tryptophan helps the body produce the B-vitamin niacin which in turn helps the body produce serotonin.  Serotonin acts as a calming agent in the brain and plays a key role in sleep.  Hence the myth that turkey makes you sleepy.

But… tryptophan works best on an empty stomach and let’s face it, at Thanksgiving, no ones’ stomach is empty!  The turkey is competing with the potatoes, veggies, rolls, and deserts and only a small part actually makes it to the brain to produce serotonin.

The more likely culprit for the after dinner nap is a combination of things.  You have on a new fall sweater, dressed up for the relatives, which is making you a bit warm.  It’s the middle of the afternoon and the sun is shining through the windows causing you to squint a bit, i.e. close your eyes.  You’ve just consumed an enormous meal of 3000+ calories with significant carbs, and more than likely you’re a bit sleep deprived.  All of these together have the perfect makings of a nap!

So, don’t blame the turkey for that after dinner rest.  Instead, give thanks this Thanksgiving for the blessings of a wonderful meal eaten with family and friends and for the opportunity to catch up a little bit on your sleep.

Submitted by Tina Comston, M.Ed.

Meningitis B

It seems like every year there are several outbreaks of meningococcal infections on college campuses across the country. This disease is caused by a bacterium called n. meningitides which can infect both the brain and the blood. Although meningococcal infections are rare even with treatment this infection can be deadly in 10-15% of patients. Those who survive can experience permanent disabilities like amputation, hearing loss, brain damage, kidney damage, and scarring from skin grafts. As a student at The Ohio State University you are required to be vaccinated for meningitis before you can live in university housing. This vaccine covers meningitis type A,C,Y, and W-135. It does not cover meningitis B which causes nearly half of meningitis cases in patients aged 17-22. There are currently two vaccines on the market for meningitis B, Trumenba and Bexsero. Both vaccines are approved in the United States for patients aged 10-25 for the prevention of meningococcal type B infection. Although the medication is approved for 10-25 the Advisory Committee on Immunization Practices and the CDC give these recommendations.

These vaccines are recommended for patients ten years and older who:

  • Are at risk due to a type b outbreak
  • Have a damaged or removed spleen
  • Have an immune system condition known as “persistent complement component deficiency.”
  • Are taking eculziumab (Soliris)
  • Routinely work with N. meningitides.

There is an additional recommendation that the vaccine may be given to anyone aged 16-23 with a preferred age of vaccination being 16-18. This allows patients and their healthcare providers to determine if they want the vaccine.

Both vaccines require multiple doses. Bexsero is a two dose series with the doses being administered at least one month apart. Trumenba can be a two or three dose series depending on your risk level for meningococcal B infection.


Michael Kowalczyk

PharmD candidate 2018