How I Finally Got My ApoB Down After Years Of Heart-Healthy Habits

When it comes to heart health, good is not good enough for me. I want GREAT.

Heart disease runs in my family. My father and grandfather never made it to 50, so when it comes to cardiovascular health, I don't mess around. That's why I spent years lowering my ApoB.

I spent years doing everything "right" from a heart health perspective.

Super clean eating. Regular exercise. Not to mention, I've spent over a decade building mindbodygreen and immersing myself in the latest longevity research. I've interviewed hundreds of doctors, scientists, and wellness experts, but despite all my knowledge and hard work, I didn't have the test results I needed to feel at ease.

Here's the thing about standard cholesterol panels: they don't tell the whole story.

Most of us get the basic lipid panel at our annual physical that measures total cholesterol, LDL, HDL, and triglycerides. And for years, that's what I relied on too. My numbers looked fine.

But ApoB is different. It measures the actual number of atherogenic particles in your blood. You can have "normal" LDL cholesterol and still have elevated ApoB, which means you have more of these harmful particles circulating than you'd want.

If you think of your bloodstream like a highway, LDL measures the cholesterol inside the vehicles, whereas ApoB counts the vehicles themselves. And it's the vehicles, not what's inside them, that park in your artery walls and build up as plaque. More particles equal more risk.

Once I found out my ApoB was elevated, I doubled down on lifestyle.

I already ate a healthy, whole foods diet, but I tightened it up even more by cutting back on saturated fat and adding more fiber and omega-3s. I was meticulous about it, shifting from my usual 80/20 diet to 95/5. I was trying so hard to be "perfect" about my diet that food was no longer fun. I had lost the joy and spontaneity around my meals.

I also trained six to eight hours a week and optimized my sleep routine. I focused on stress management, because I know how much cortisol and inflammation can affect cardiovascular markers.

My numbers moved in the right direction, but not enough. Despite months of effort and all that commitment, my ApoB was still above where it needed to be (I got it down to 71) for someone with my family history. I was sacrificing a lot with little payoff, not to mention it simply didn't feel sustainable.

So when my doctor, Frank Lipman, M.D., suggested I consider Ezetimibe, a medication that blocks cholesterol absorption in the gut, I had to ask myself a hard question: Was I willing to consider all the tools available to me?

I had to really think about my goals, my values, and what information I was relying on to make my decision.

Being truly open-minded about health means considering all evidence-based options. Not just the ones that fit a certain narrative.

I had gathered all the information I could for the fullest picture of my heart health:

The research on Ezetimibe is solid. One of the largest studies of its kind3 with over 18,000 patients showed that adding Ezetimibe to statin therapy reduced cardiovascular events. Another study4 of nearly 36,000 patients found that early initiation of combination therapy protects against later cardiovascular outcomes, and that delaying it is associated with "avoidable harm."

I realized that taking medication wasn't a failure of my lifestyle. It was an addition to it. A proactive tool in my toolkit, not a replacement for everything else I was doing. It's a tool for working with my unique physiology.

So, after talking it through with my doctor, I made the decision to start Ezetimibe alongside my continued diet and exercise routine.

The outcome? My ApoB is now at 59, the lowest it's ever been, which most cardiologists would describe as "excellent" rather than just "good" in terms of cardiovascular risk standards.

I'm not sharing this to tell you what to do. This isn't medical advice. It's one person's journey.

But if there's something I've learned, it's this: testing is the foundation. You can't optimize what you don't measure. And ApoB is a test worth asking your doctor about, especially if you're someone who "does everything right" and assumes your heart health is handled. The more information you have, the more confident you can feel about whatever decisions you make.

The other lesson? Stay open. Being proactive about your health sometimes means challenging your own assumptions, even the ones you've held for years.