Cholesterol – It’s Not the Bad Guy

It’s interesting how something so essential for our overall health (especially hormones) can be thought of as something bad or that needs to be crushed to the lowest level possible.  You probably have guessed (the title gave it away) that I’m talking about cholesterol.

When did cholesterol become the bad guy?  Well, you need to go back to 1950 when Dr. Ancel Keys proposed that heart disease was a result of dietary fats and cholesterol circulating in the blood.  Then, in 1972 Dr. John Yudkin proposed that the over consumption of sugar was the leading cause of heart disease and diabetes.  He wrote the book, “Pure, White and Deadly”.  This was two conflicting ideas and would be contested by the parties involved.  A committee was formed by the US Senate and as a result they published a document called “Dietary Goals for the United States”.  This document sided heavily with Dr. Keys hypothesis about lipids and without scientific proof, cholesterol was now the bad guy.  Ironically, this report went on to suggest that Americans consume more carbohydrates but limit fats, meat, and dairy.  So, began the rise of low fat food that contained added sugar to make it taste better.  This also resulted in the increase of plant based oils – hydrogenated fats.  Remember margarine?  Crisco shortening?  Corn oil and other seed oils?  High fructose corn syrup?  They took the fat out of milk…told you butter was bad for you and the revolution for highly processed food and fast food was on!

This could easily turn into a blog about sugar, obesity, diabetes, and heart disease but let’s get back to cholesterol!

Suffice to say, cholesterol isn’t why there’s heart disease.  Actually, I think we could say it’s trying to save you!  If your arteries are chronically inflamed they will weaken.  As a result, the body will start laying down plaque to keep you from springing a leak.  If that plaque isn’t very strong, kind of like having a weak scab on a wound, it can dislodge and block another area.

In order to avoid heart disease, we need to reduce inflammation and strengthen the vessels.  The truth is that there are plenty of people having heart attacks with perfectly normal cholesterol levels.  Now, that’s not to say elevated cholesterol isn’t a relatively common finding with heart disease…but that doesn’t make it the cause!

So why do we need cholesterol?  I’m going to highlight a few really key areas where cholesterol is important.  It is absolutely essential for a healthy cell membrane.  Our brain needs it to function properly.  In this way, cholesterol that is too low can affect our personality and more significantly our memory. (Check out the book, Lipitor – Thief of Memory by Duane Graveline MD, MPH) And my favorite, we need cholesterol to make our steroid hormones such as estrogen, progesterone, testosterone, cortisol, DHEA and even calcitriol (vitamin D)!  The other thing that I find so fascinating about cholesterol is that it can change so quickly!  We could check it every week or month and see changes.  It is very common for women to see a rise in cholesterol after menopause as the demand for hormone production shifts to the adrenals.

Our primary source of cholesterol is the liver.  Our diet will make up about 50% of our total cholesterol.  To understand your cholesterol numbers, also known as the lipid profile, let us look at their roles.  The first thing that is listed is your total cholesterol.  Then you will have a value for your HDL’s, LDL’s, VLDL’s and triglycerides.  There are no “good” cholesterol  or “bad” cholesterol!  There is balance or imbalances that could indicate deeper problems.  (I really think we need to work on our language when we discuss cholesterol!)

Here is a very simplified way to think about the roles of the lipoproteins: The role of the LDL’s (low density lipoproteins) is to take cholesterol out away from the liver for cell membrane health, hormone production, brain health and anything else the body would use cholesterol for.  It’s like Amazon Prime!  Delivery right away for all the things you can’t wait to have or live without!  But LDL’s can become small, damaged and sticky.  This can be the beginning of atherosclerosis.  (Hint: Sugar is the most damaging substance to the LDL’s>)

The HDL’s (high density lipoproteins) brings back the unused cholesterol to the liver.  If the numbers are low, it’s kind of like the body hoarding the cholesterol and won’t allow very much to return to the liver.  (Which could be sign of increased inflammation or need for cholesterol in other places.)

VLDL’s are very low density lipoproteins and can be up to 60% full of triglycerides.  Then there’s triglycerides, which are undigested sugars stored as fat.

What does trouble look like?  Trouble is showing up if there’s way more cholesterol leaving the liver than coming back and/or there is an excessive amount of triglycerides!  Your cholesterol to HDL ratio should be a 4 or less.  Your LDL’s should be about 100 points less than the total cholesterol if it’s 200 or higher.  And the triglyceride to HDL ratio should be 2 or less.  This would be considered an optimal profile.

    • TC – 225
    • HDL – 65
    • LDL – 125  (LDL’s are a hundred points less than TC)
    • Trig. – 80
    • TC/HDL – 3.46
    • Trig/HDL –  1.2

Don’t shoot the messenger by inhibiting cholesterol.  Instead, correct the problem.  Change the diet by reducing the sugar intake and increase the fiber.  Balance hormones, reduce inflammation…whatever needs to be done!  The body wants to be well.  Help it, don’t hinder it!

I had recent patient come to me complaining of memory issues but also feeling very emotionally unstable. Angry, upset, anxious, paranoid…pretty much all over the place.  About a year ago, her OB/GYN told her that her cholesterol was borderline high and she needed to go on a stain drug.  So she did, she trusted her doctor and what he wanted her to do.  About 3 months later she went back because she was having issues with her memory.  This time she walked out with a prescription for two bio identical hormones.  (She was not through menopause.)  She was becoming more and more undone!  When we had a chance to sit down and talk, I was able to explain what I believed her problems were stemming from. It became apparent that the memory problems started after being on the statin drug for a few months.  Yet, it was decided that she must need more hormones.  THIS IS NOT THE ANSWER OR THE CORRECT APPROACH!  Fast forward just one month under care and she’s doing a hundred times better! Now, I don’t believe the doctor who prescribed the medications was doing anything other than what he thought was best.  Honestly, this isn’t the first time I worked with someone whose memory was affected by a statin.  Some drugs now target just the LDL’s.  That really is like shooting the messenger!

What do you need to do?  If you are on a statin drug or any drug meant to lower/ alter any part of your lipid profile, make sure you are taking CoQ10 at the very least.  Try to look deeper at what is causing your numbers to be out of balance and get to the root cause!  Fixing symptoms with more drugs or the side effects of drugs with more drugs is not healthy nor will is it going to make you well.  It will only cause more problems.  If you would like to come off of these types of medications or avoid going on them altogether, find a doctor/health care practitioner that understands functional physiology and can support you with the right supplements and herbs.  If you cut your sugar down to no more than 20g per day, avoid fried foods and other highly refined carbohydrates, increase your fiber and healthy fats…you will see positive changes.  Herbs like schisandra, globe artichoke, dandelion root, turmeric, and milk thistle can be key to a healthier liver and a better lipid profile.

As always, advocate for yourself and your health!

Be Better.  Feel Better.  Liver Better.
Dr. Annette

P.S.  If you would like to read more about the  role of cholesterol and statins, check out the following books!

  • The Dark Side of Statins by Duane Graveline MD, MPH
  • The Statin Damage Crisis by Duane Graveline MD, MPH
  • Lipitor Thief of Memory by Duane Graveline MD, MPH
  • Statin Drugs Side Effects and the Misguided War on Cholesterol by Duane Graveline MD, MPH
  • The Great Cholesterol Con: The Truth About What Really Causes Heart Disease and How to Avoid It by Malcolm Kendrick
  • The Great Cholesterol Con by Anthony Colpo

This should be enough to get you started down the rabbit hole of statins and cholesterol!

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