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Small dense LDL (sdLDL) is the most harmful form of “bad cholesterol.” It forms when the liver overproduces VLDL — often driven by visceral fat and high insulin levels. Visceral fat sits deep around the organs and feeds directly into the liver, causing early metabolic disruption long before blood tests detect it.
PCSK9 binds to LDL receptors and directs them to be destroyed within the cell, rather than allowing them to recycle to the surface. When too much PCSK9 is present, fewer LDL receptors remain available to clear LDL from the blood. The result is simple: LDL levels rise. When that happens, the liver compensates by making even more cholesterol internally. This is why around 90% of the cholesterol in your blood is made by your liver, not absorbed from your diet.
Small dense LDL (sdLDL) particles are the most atherogenic type of LDL. They are smaller and heavier, stay in the bloodstream longer and more likely to oxidise and enter artery walls. High sdLDL is typical of metabolic syndrome, diabetes, and high triglyceride states linked to visceral fat.Because sdLDL testing is specialised, the ApoB level and the LDL-C : ApoB ratio can be used to estimate particle size predominance:
Mitochondria are the power stations inside every cell, converting food into energy. But in modern life, with constant carbohydrate intake and low energy demand, they become overwhelmed. Just like solar panels producing too much electricity for full batteries, mitochondria have nowhere to send surplus fuel. This triggers oxidative stress, inflammation, and early ageing. Insulin is meant to divert excess glucose to safe storage — but when that system fails, metabolic chaos follows. In this article, we explore how your mitochondria manage energy, what causes them to overload, and how lifestyle changes can help restore balance and protect long-term health
Carbohydrate Sensitive Phenotype (CSP) is not a diagnosis of diabetes or obesity. Rather, it’s a biologically driven pattern of visceral fat accumulation and carbohydrate intolerance which is highly prevalent in those with a raised waist-to-height ratio (WHtR > 0.5), triggered by aging, Western-style diet and lifestyle. More importantly, CSP gives individuals a name for their experience—one that invites support instead of judgement, and allows them to engage with food and health choices free from social shame.
Troponin-negative presentations are often sent home without a timely work up or prompt imaging tests like a CT angiogram. A delay can be critical. Until these services become widely available, and in good time, patients experiencing unexplained chest symptoms who have not had clinical follow up and diagnosis confirmed are advised to 'vote with their feet'- either head back into hospital in event of further symptoms, or even consider arranging to fund their own urgent CT angiogram from an independent medical provider.
Before birth, the foramen ovale is a vital foetal opening between the right and left atria, allowing oxygen-rich placental blood to bypass the inactive lungs. After the first breath, pressure in the left atrium increases, closing the flap naturally. In around 25% of adults, the flap does not seal fully — this persistent communication is called a Patent Foramen Ovale (PFO) which is an important cause of cryptogenic stroke. All standard tests including an echocardiogram can be normal- it can be only be diagnosed using a bubble contrast study and once diagnosed, treatment with clam shell closure is high effective.
If you have ever found yourself feeling breathless climbing stairs or walking uphill — even though your lung and heart tests are “normal” — you are not alone.Many people attribute it to age or fitness. But recent research has uncovered a powerful hidden cause of breathlessness: visceral fat — the fat stored deep inside your abdomen, around your organs. In this blog, we will explore what visceral fat is, how it affects your breathing, and — most importantly — what you can do about it.
Traditional upper limits for ALT (often ≤55 U/L in UK labs) were derived decades ago, before the epidemic of obesity and steatosis. Current evidence suggests these ranges are too high — and that values above 30 U/L may already indicate liver injury in people with metabolic risk. The British Society of Gastroenterology (BSG) guidelines emphasise that a result within the “normal range” may not be reassuring if the patient is metabolically high-risk
For much of modern cardiology, in its battle against coronary artery disease—one of mankind’s greatest threats—the “enemy” seemed clear. When I trained, the diagnostic armoury was focused on accurately identifying flow-limiting narrowing of one or more coronary arteries. Yet in the last decade, a profound paradigm shift has unsettled these foundations—and in some respects, turned them on their head.
An article written by Dr Edward Leatham, Consultant Cardiologist Tags: Syncope, AFib, NH1, ECG search website using Tags to find related stories. When unexplained fainting episodes (syncope) or certain types of stroke occur, the search for an underlying cause can be […]
In the evolving world of preventative healthcare, one size no longer fits all. We are learning that each person has a unique biological blueprint – shaped by their DNA, lifestyle, and environment – which determines how they respond to food, exercise, and medications. Today, sophisticated tools allow us to uncover this blueprint and personalise health advice in a way never before possible. The goal? Not just to avoid disease, but to extend your healthspan – the number of years you live in good health.