Myths and misunderstandings
Cholesterol is one of the most misunderstood topics in medicine and nutrition. Although much has been learned about cholesterol and its role in disease in the past decades, many people haven’t upgraded their knowledge and beliefs about it accordingly.
Many people believe that:
- Cholesterol is bad
- Cholesterol in the body comes from foods high in cholesterol, which should be restricted
- Fats are bad because they raise cholesterol levels
- The lower your cholesterol level, the better
- Excessive cholesterol in the blood causes heart and blood vessel disease
- All cholesterol is the same, as are cholesterol and triglycerides
- High cholesterol is a disease
Actually, these statements are all false, based on outdated, incomplete, or misunderstood information.
Is cholesterol bad?
Cholesterol in the body is so important that it’s made in the liver. It is the precursor to a number of steroidal hormones such as DHEA, progesterone, and testosterone, and is needed to patch and repair tissues such as those in the blood vessels. Cholesterol reduces the permeability of the cell walls to toxins. It is also used in the manufacture of the adrenal hormone cortisol, which helps us deal with stress, which can in turn raise cholesterol.
It is only recently that it has been known that not all cholesterol is the same. There are high-density lipoproteins (HDLs), and their low (LDL) and very low (VLDL) counterparts. Simplistically, although somewhat accurately, the HDLs are considered to be the good kind, and the LDLs and VLDLs the bad kind. As the subject continues to be studied, it is likely that further categorical divisions will be found.
The heart disease connection
It has been repeatedly noted that many of those with higher cholesterol levels also have higher levels of cardiovascular disease. The erroneous conclusion drawn is that the cholesterol caused the heart and blood vessel problems: cholesterol plus calcium forms plaque, which narrows and blocks blood vessels. This is sort of the case, but there’s more to it. Because of its supposed connection with heart disease, high cholesterol levels are themselves treated as if they were a disease.
Actually, high cholesterol isn’t a disease as such, and so doesn’t need to be treated. It’s simply an indicator, like the oil light in your car. Even more than that, cholesterol in this case is not only not the cause of the damage, but an attempt to cure it by buffering inflammation.
Inflammation in the body can be caused by any number of toxins, metals, allergic reactions, irritants such as smoking or alcohol, sugar, or microorganisms. Cholesterol is manufactured by the body in part to try to buffer the inflammation. If the inflammation is on the arterial walls, the cholesterol acts as kind of a bandage, which, granted, can start to block the blood vessels. Higher cholesterol in the blood, then, is an indicator that the inflammation, which is the actual cause of heart disease, needs to be dealt with, not the cholesterol itself. Some diseases, such as obesity, diabetes, and liver, kidney, and thyroid disease, can cause cholesterol levels to go up.
Not only is the conclusion about how cholesterol causes heart disease erroneous, but the idea that cholesterol is even involved in heart disease is in question. Yes, high cholesterol is associated with an elevated risk of heart disease…for men, and more specifically for men between the ages of 40 and 55. Such a link has not been found for women, or for men outside this relatively narrow age range. About half the people with elevated cholesterol don’t have heart attacks, and about half the people who have heart attacks don’t have elevated cholesterol, so there isn’t as much correlation as previously believed.
Does body cholesterol come from food cholesterol?
For years, doctors have been counseling patients to avoid foods high in cholesterol, such as eggs, red meat, butter, cheese, and shrimp. As it turns out, dietary cholesterol has almost nothing to do with blood cholesterol, which the body makes as needed. The whole fad of eating just the egg whites and tossing out the nutrient- and cholesterol-rich yolks is misguided; the yolks actually contain and benefit the “good” HDL cholesterol levels.
Let’s bust another myth: that cholesterol comes from fats, especially saturated fats. Yes, there is cholesterol in some fats, but only those of animal origin. Plant-based fats and oils, even saturated ones like coconut oil and palm kernel oil, have no cholesterol at all.
The numbers to look for
Although different sources may use slightly different numbers, these are the usual reference ranges given. Total cholesterol, according to popular wisdom, should be no higher than 200 mg/dl, although this applies only to middle-aged men as in the studies noted above. We believe that there’s nothing wrong with higher numbers in themselves, 220 or even 250. What’s more important is the relative levels of HDLs, LDLs, VLDLs, and triglycerides. HDLs should be 40-50 mg/dl or higher, LDLs should be 100 or lower, and triglycerides should be 150 or lower. But this is simplistic and often it’s the ratios and relationships between these numbers that are more significant.
Cholesterol and triglycerides: what’s the difference?
Cholesterol and triglycerides are both blood lipids, or fats, and are often tested for at the same time. But they are different in what they do in the body. Cholesterol is an inflammation buffer; any excess calories that are not immediately needed for energy, primarily those from sugar and other carbohydrates, are converted into triglycerides for storage in fat cells. Decreasing your consumption of sugar can dramatically lower your triglyceride levels, to your benefit.
What about statin drugs?
Statin drugs are often prescribed to lower the “bad” LDL cholesterol numbers, and they have been shown to do so. Less conclusive is any evidence that statins lower the incidence of cholesterol-related heart disease, which is the important part.
If you take statins, nothing has been done to address the causes of the undesirable cholesterol levels. Also, statins are drugs, and like all drugs they have side effects, including liver damage, muscle pain and weakness, digestive problems, memory loss, and an increased incidence of type 2 diabetes.
Yes, there is such a thing as too-low cholesterol
Cholesterol is necessary for a number of necessary bodily functions, and a too-low level, under 160, can compromise these functions. Low levels are correlated with increased risk of cancer, aggression, depression, and suicide.
Since cholesterol is made by the body, one of the main causes of too-low cholesterol is taking long-term or high-dose statins. Other causes are hyperthyroidism, adrenal insufficiency, liver disease, and malnutrition.
What can be done?
If your blood lipids show a problem (not are a problem, show a problem), practitioners at CAM can help sort out what is going on.
