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Forget everything you have ever heard about cholesterol and let me give you some facts:

Here are some reasons why cholesterol is good:

  • Cholesterol is a building block of every cell in your body.
  • Cholesterol is important for your brain function.
  • Cholesterol is the building block for hormones like estrogen, testosterone, progesterone and DHEA.
  • Vitamin D, a powerful hormone essential to your health, is made from cholesterol.
  • Cholesterol is important for digestion of fats.
  • 80% of your cholesterol is produced by your body because your body needs it.

Here are some important facts that you need to know about cholesterol testing:

  • When it is was discovered in the early 1900’s that plaques in the coronary arteries contained lots of cholesterol, it was assumed that cholesterol was the culprit. We now know that cholesterol is an innocent bystander NOT the villian.
  • You have all heard about “good cholesterol” (HDL) and “bad cholesterol” (LDL). This is actually a misnomer. LDL and HDL are not types of cholesterol but are actually lipoproteins, “vehicles” that transport cholesterol (“passengers”) around the body. A standard lipid panel (Total, LDL, HDL, and Triglycerides) measures the amount of cholesterol carried by these “vehicles”. Although elevated LDL cholesterol is a risk factor for heart disease, there are now even more specific markers to determine risk.
  • The smaller and more dense the “vehicle” (dense LDL), the higher the risk that it can enter the wall of the blood vessel and form plaque. The more inflammation in the body, the more likely that plaque will become unstable, break off and cause a heart attack or stroke. Measuring the size and types of these “vehicles” (advanced cholesterol testing) as well as markers of inflammation, tells you much more about your risk.
  • If you have risk factors for heart disease (high LDL cholesterol, high blood pressure, diabetes, smoking, obesity, family history of heart disease) you should have advanced cholesterol testing.
  • I would not start a patient on cholesterol lowering medication until I have fully evaluated all these markers.
  • I would not start a patient on medication until I have encouraged them to improve their numbers with lifestyle changes such as nutrition, exercise, stress reduction, weight loss, and smoking cessation. I have seen a patient lower their LDL by over 100 points by ONLY changing what they eat (and it was not a low-fat, low-cholesterol diet). Food is a much more powerful medicine than anything a drug company can produce.

Here are some important facts about diet and lifestyle that you need to know in relation to cholesterol:

  • For decades doctors have been recommending a low-fat, low-cholesterol diet as a treatment of high cholesterol; however, there is not strong evidence that the amount of cholesterol or fat in the diet contributes significantly to cholesterol levels or risk of heart disease.
  • There is more and more evidence that the “Standard American Diet” (S.A.D.), high in refined flour, sugar, trans-fats, and additives/preservatives is the culprit in addition to lack of healthy components of the diet including vegetables and fruits, nuts and seeds, fatty fish, and healthy fats (yes FAT).
  • Other contributors to elevated dense LDL and inflammation are chronic stress and lack of exercise.
Here is why I am not quick to prescribe cholesterol lowering statins (Lipitor, Zocor, Crestor, etc…).
  • I am concerned that we are overtreating with these drugs without knowing the long-term consequences and without adequately assessing the patients risk for heart attack and stroke.
  • There is mounting evidence that cholesterol is essential for optimal functioning of the brain. The FDA just added a warning that statins can cause cognitive problems (poor memory and difficulty concentrating). Studies show that higher levels of total cholesterol reduce risk of dementia (by up to 80%), depression, parkinson’s disease, and death from all causes and that those with higher levels of total cholesterol have better memory.
  •  Statins reduce levels of CoQ10 (ubiquinol). CoQ10 is a vital substance that is produced by your body and used by every cell for energy production, cell growth, muscle contraction. Statins can cause fatigue and muscle pain likely due to the interference of your body’s production of CoQ10.
  • Statins increase risk of developing diabetes in women. It is ironic that we are treating one risk factor for heart disease (high cholesterol) and at the same time increasing the risk of another condition (diabetes) that causes the very condition that we are attempting to prevent (heart attack).
  • I am concerned that we are not providing adequate, up-to-date advice on the role of nutrition in treating abnormalities of cholesterol and inflammation.
  • Although statins have been shown to reduce the risk of heart attack, they do not fix the underlying cause of the problem which is usually the everyday personal health choices we are making.
  • Keep in mind that statins are a billion dollar business for the pharmaceutical industry. The majority of studies are funded by this industry and unfortunately, this is where doctors get their information, from studies largely funded by those directly benefitting from the sale of the drugs.
Important note for those taking cholesterol lowering medications.
  • If you are taking a stain drug, DO NOT stop the medication.
  • Talk to your doctor about whether you need it. Ask for advanced cholesterol testing.
  • If your lipid profile is bad, you may need to stay on the medication.
  • Take control of your health and make changes you need to make to improve your health. Once your numbers improve, you can address whether you can discontinue the medication. For more about eating for health, read more
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