The first thing to know about cholesterol is it’s not simple. We’ve all heard the mantras, "LDL=bad, HDL=good. High cholesterol = heart disease." Like many evolving views in the medical community, we now know that the human body is way more complicated than those over-simplistic messages. Let’s dig into what’s really going on with high cholesterol.
Cholesterol has a few interesting roles in the body.
It's used in the synthesis of hormones, has a neuroprotective role in the brain, and is an essential component of cell membranes, allowing them to maintain fluidity. Yes, you heard it right. Cholesterol is a protective molecule. It is the single most protective all-purpose molecule. The reason it rises during stress is that it's our defensive molecule and it's the precursor to our anti-stress hormones.
When cholesterol is regulated properly it causes no issues and actually has a protective effect on health.
So is high cholesterol bad?
First off, what is high? The ‘preferred’ level of blood cholesterol has now been taken to a level which makes 90% of the world’s population test over the accepted level, thereby needing medication (statins.)
Studies show these relatively high cholesterol levels are not always a bad thing.
- An inverse trend is found [in Japan] between all-cause mortality and total (or low-density lipoprotein [LDL]) cholesterol levels: mortality is highest in the lowest cholesterol group without exception. Many studies show elderly people with the highest cholesterol levels have the highest survival rates irrespective of where they live in the world.
- Lipophilic statins plus low cholesterol are associated with double the risk of dementia.
- Heart attack patients had LOWER total cholesterol, HDL, and LDL, and higher glucose and HbA1c than in control studies. Low cholesterol in red blood cells contributes to the hardening of the cells, thickening the blood, and causing the cells to break more easily. Red blood cells carry oxygen to all of our tissues, so disrupting their flexibility and strength, in turn, compromises energy production in all cells and tissues in the body.
- Overall there is a lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly.
Are a patient's cholesterol levels actually high or are they high relative to the acceptable measurements?
Cholesterol-lowering statin drugs could be prescribed to an estimated 33 million Americans without cardiovascular disease. That’s according to a new cholesterol guideline from the American Heart Association and American College of Cardiology.
But what if cholesterol is actually high and for the wrong reasons?
Believe it or not but there is no hard evidence that dietary cholesterol is related to blood serum cholesterol. About one-third of cholesterol in the body is derived from diet, while the rest is synthesized in cells through a 30-step energy-intensive process that relies on oxygen, acetyl-coA, and ATP.
Something else is going on.
High cholesterol is linked to low thyroid. Thyroid hormone plays a role in converting cholesterol into sex hormones, adrenal hormones, and vitamin D. As early as the 1930s, researchers found a connection between thyroid deficiency and clogged arteries. When patients had their thyroid gland removed, cholesterol levels would rise and the metabolic rate would drop. In
Hypothyroidism: The Unsuspected Illness, Dr. Broda Barnes stated that increasing cholesterol levels were a better indicator of low thyroid levels than other existing tests for thyroid. If you're lower in the thyroid, your body increases cholesterol to keep up the production of progesterone. Replenishing thyroid may bring cholesterol levels down and increase metabolism.
Why do people say cholesterol is bad?
Back in the 1970's, it was found that polyunsaturated fats (liquid oils like corn, vegetable, canola, seed oils) lowered cholesterol. Americans were told to reduce their saturated fat (whole milk, butter, and coconut oil) and cook everything in cholesterol-lowering unsaturated fats. The seed oil industry loves to tout that their oil will lower your cholesterol; and since you have cholesterol in arteriosclerotic arteries, they say it must be causing the arteriosclerosis. That has never been demonstrated. In advanced cases of arterial blockage, there is a certain amount of migratory adipose cells in and around the scar tissues, these are the source of the idea that fat or cholesterol causes the condition.
The problem is, these polyunsaturated vegetable oils also lower metabolism, interfere with protein digestion, increase the oxidation of cholesterol, inhibit the beta cells of the pancreas, and lower your immune system response.
To sum it all up:
- High cholesterol is not proven to be a cause of heart disease.
- Cholesterol is necessary, protective, and essential for our bodies.
- Dietary cholesterol is not directly linked to serum cholesterol. A recent study from Harvard Medical School showed that dietary cholesterol has little effect on serum cholesterol. Our body self-regulates: if we do not consume cholesterol, our bodies will make it. Therefore, whether the cholesterol comes from our diet or from our own liver, it will rise when we are in a hypothyroid state.
- Elevated triglycerides can occur downstream of insulin resistance, or obesity/visceral fat storage, as well as hypothyroidism.
- A low thyroid may increase your cholesterol levels as a mechanism to maximize progesterone levels.
- The demonization of LDL obscures the larger picture, hiding the studies (like the meta-analyses previously mentioned) that acknowledge that the size of the LDL particles matter and that cholesterol can have profoundly protective effects.
- To get cholesterol working properly, not too high and not too low, the thyroid needs to be functioning correctly. Lifestyle changes including nutrition (avoid industrial vegetable oils) and/or a T3 and T4 supplement may be needed.
This newsletter barely touches the surface of the cholesterol myth. More research is certainly needed on this fascinating topic. It’s important to work with a provider that understands the complexities of the human body. We are an exquisite result of millions of years of evolution. Our systems are not black and white.
If you need more guidance to understand what’s going on with your cholesterol levels, book an appointment with us at 949-680-1880.
Your Partner in Health,
Dr. Leigh Erin Connealy
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