Everyday Wellness: Midlife Hormones, Health, and Science for Women 35+ Ep. 523 This Is Why Your Cholesterol Shifts in Midlife – The Best Strategies to Reduce Risk & Improve Vascular Health with Dr. Thomas Dayspring
Nov 26, 2025
Dr. Thomas Dayspring, a leading clinical lipidologist, returns to discuss the crucial effects of estrogen loss on lipid metabolism during the menopause transition. He highlights the importance of measuring ApoB and Lp(a) for better cardiovascular risk assessment. The conversation digs into how visceral fat impacts lipid levels, why triglycerides are a key marker of metabolic health, and how lifestyle changes can be prioritized over medication in managing lipid disorders. Prepare for a deep dive into the nuances of vascular health in midlife!
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Menopause Raises LDL And ApoB
- LDL and ApoB commonly rise at menopause due to multiple mechanisms tied to estrogen loss.
- HDL changes are variable and HDL-C doesn't reliably reflect HDL function.
Order ApoB And Watch Triglycerides
- Get ApoB and Lp(a) tested; most insurers cover ApoB and it's inexpensive.
- Treat triglycerides above ~70 mg/dL as a sign to address metabolic risk regardless of traditional 'normal' cutoffs.
Triglycerides Drive Small Dense LDL Formation
- Even modest triglyceride rises distort lipoproteins and reduce LDL clearance, driving ApoB up.
- Triglyceride-driven small LDLs persist longer in plasma and increase atherogenic particle number.