By Stephen T. Sinatra, M.D., F.A.C.C., F.A.C.N., C.N.S., C.B.T.
Despite decades of public brainwashing about the dangers of cholesterol, I am amazed at how little people actually know about cholesterol…learn more about cholesterol and liberate yourself from unnecessary anxiety.
The word cholesterol remains for most people synonymous with death and disease. It shouldn’t be. It’s a basic, natural substance largely produced in the body that has been wrongfully vilified.
Countless times I have heard worried new patients utter the words: “My cholesterol is high and I’m really scared.” Part of my job has been to defuse their unwarranted dread.
What Your Doctor Isn’t Telling You About Cholesterol
If you are cholesterol-phobic, please review the following information. I hope it will put your fear to rest.
- The fear of cholesterol stems from medical propaganda designed to sell cholesterol-lowering drugs called statins. I strongly urge you to read my bestselling book The Great Cholesterol Myth.
- Half of all heart attacks occur in people with so-called “normal” levels of total cholesterol.
- Most forms of cholesterol are not harmful at all.
- Cholesterol is not your enemy. It is a natural substance made by your body to produce hormones, vitamin D, neurotransmitters, healthy cell membranes, and digestive acids called bile. Your liver and brain make most of it, but almost all the cells in your body synthesize cholesterol. Your body needs it. Life can’t go on without cholesterol.
- The brain is particularly rich in cholesterol and accounts for about a quarter of all the cholesterol you have in your body. The fatty myelin sheath that coats every nerve cell and fiber is about one-fifth cholesterol. Neuronal communication depends on cholesterol. It is not surprising that a connection has been found between naturally occurring cholesterol and mental function. Lower levels are linked to poorer cognitive performance.
- The body makes cholesterol as needed. When you eat more cholesterol (from animal protein) in your diet, the body makes less. If you eat less, the body makes more. On average, 85 percent of blood cholesterol is made in the body, while the rest comes from food.
- You can have different levels of cholesterol at different times of the day.
- Cholesterol goes up in winter and down in the summer. Cholesterol soars after any surgery, and increases when you have an infection or mental stress. It also increases during and after a heart attack. One reason for these variables is that cholesterol serves as a healing agent. The body makes more cholesterol when there is a healing job to do. Thus the level can fluctuate depending on time, weather, the season, exposure to environmental agents and toxins, and what is going on in your life.
- Arterial inflammation is the major cause of heart disease. And yes, cholesterol participates in the inflammatory process, as do many other substances produced in your body. But no, it does not play a major role.
- The liver dispatches cholesterol throughout the circulatory system in the form of protein-wrapped fatty bundles called LDL. As LDL travels through the system, the cholesterol is accessed and used by cells as needed. Similarly, spent and oxidized cholesterol is picked up by HDL particles for return to the liver and subsequent excretion.
- The endothelium is the razor-thin inside lining of blood vessels. Exposure to damaging agents – such as a toxic chemical, a pathogen, free radicals, inflammatory substances − wind up in the blood stream and exert a “ding” or damaging effect someplace along the line. The liver picks up a signal and dispatches LDL − the basic cholesterol in your body − to the site. When the healing process wraps up, the spent LDL particles are carried back to the liver by HDL cholesterol, and then removed from the body. You can see why, for instance, that the amount of cholesterol skyrockets after surgery and heart attacks. The body goes into a repair mode, and needs extra cholesterol to help form and grow new cells.
- The concept of “good” and “bad” cholesterol is utterly outdated, as are the total cholesterol and LDL levels documented on standard lipid tests. They predict heart disease poorly. If, after a standard test, your doctor says your cholesterol is too high and you need to lower it, ask for a follow-up advanced cholesterol particle test that reveals more details. Specifically, such tests reveal the proportion of large vs. small, dense LDL particles, as well as large vs. small HDL particles. The dense particles are much more likely to be involved in the inflammatory process.
- When a doctor finds a high level of cholesterol, instead of automatically reaching for the prescription pad, he or should look for the reason. Why is it high? What’s damaging the body? And he or she should order one of the advanced tests to determine the pattern of your cholesterol particles.
- The number one dietary contributor to heart disease is sugar. It contributes to inflammation in the artery walls. Reduce or eliminate sugar and processed carbohydrates in order to knock down inflammation and triglycerides. High triglycerides are far more of a danger for heart disease than high cholesterol.
- Studies show that the French have the highest cholesterol levels − about 250 − in Europe but also the lowest incidence of heart disease. On the Greek island of Crete, a ten-year-study failed to register a single heart attack despite an average cholesterol well over 200 − a level, by the way, that would prompt most U.S. doctors to prescribe a statin drug.
- What about your total cholesterol? Well, it doesn’t mean much unless you have a level over 320 or so. Above that level you may have an increased risk of thrombotic stroke but also be protected more from the risk of a more serious hemorrhagic stroke. You can readily bring down such an elevated cholesterol level with lifestyle modification, weight reduction, and more fiber (roughage) in your diet. I wouldn’t recommend a statin drug unless you had evidence of arterial disease and were a male. I have been very disappointed with the lack of results among women. And I don’t believe in statins for prevention because of real risks of side effects.
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