A Word about Cholesterol

Cholesterol and statinsFor some time there has been a big medical drive to bring down everybody’s cholesterol. This lowering of the total cholesterol is driven by antiquated academics and the pharmaceutical companies’ sales propaganda to both the public and physicians. Very often, a doctor looks at the total cholesterol, and if it is above 200 considers it too high and prescribes a cholesterol-lowering drug. This family of drugs are called statin drugs, and include Lipitor, Mevacor, Zocor, and Crestor, to name just a few.

However, when we look only at the total cholesterol number, we fail to take into consideration the fact that there are different kinds of cholesterol, some beneficial and necessary, and some harmful. The facts are these: “good” cholesterol is necessary for the production of a lot of our body’s necessary hormones. It is the basic biochemical configuration from which are made cortisol, aldosterone, testosterone, progesterone, estrogen, and Vitamin D.

 All the emphasis and fear around high cholesterol has eclipsed the dangers of low cholesterol. A person with total cholesterol of less than 180 has a 2.7 times greater chance of being depressed. Suicide rates may also relate to this number as far as having an inverse ratio to low cholesterol (Zubrod 2006, Lee, 2004, and Cousins, 1979). It was not infrequent for a person to come to me with a feeling of malaise, low libido, depression, and fatigue because their cholesterol was so low from being on statin drugs that they could not produce sex hormones, vitamin D (now suspected as necessary as a barrier to depression), cortisol and aldosterone.

 And there are other risks associated with lowering cholesterol. About 60% of the brain is fat, a lot of it from cholesterol, (so actually if someone calls you a fathead it’s a compliment). Fat (cholesterol) also helps form the mylin sheath around the nerves, sort of like the insulation around an electric wire, which protects the nerves and helps with the incredibly fast nerve impulses. Recently there has been scientific evidence indicating that cholesterol plays a role in the synapse between nerves, (the space that lets the nerve impulse jump from one nerve to the next.)

“Good” cholesterol is the high density lipoprotein cholesterol (HDL). This is the cholesterol that is needed for our cell membranes and for other body chemicals. HDL takes cholesterol from the cells and organs back to the liver, which disposes of the excess cholesterol by making it into bile and passing it out of the body via the intestines. The liver also stores what may be used later by the body. When HDL cholesterol is not available, or low, the body uses other types of fats to make the cell membranes and this contributes to hardening of the arterial walls.

“Bad” cholesterol is the low density lipoprotein cholesterol (LDL). It is this cholesterol that is responsible for depositing cholesterol on the walls of the arteries, where over time it builds up and creates blockages, kind of like tartar buildup on your teeth.

 So if we consider only the number that indicates total cholesterol, it can be misleading. If HDLs are high, it makes up a big portion of the total cholesterol, but that is not a bad thing.

 The Cardiac Heart Ratio (CHR) is another index of the heart’s health that can also be a predictor of the heart’s future health. It is found by taking the total cholesterol and dividing it by the HDL. It is not a definitive marker but one factor to be considered in a complete evaluation of the cardiac status.

 Triglycerides are the most abundant fats in the human body, and are found in such foods as seeds, yolks and animal fats. There are very few of them in vegetables. They are used as body insulation since they are found just under the skin, dampening shock waves when we bump into things, and even the fat pad under the heel. But mainly they are the emergency source of energy.

The danger of triglycerides is when they are consumed in excess, by eating too much sugar (which in excess is converted to a large degree into triglycerides), and too much saturated fat. In this case the triglyceride is oxidized, and can damage the interior walls of the arteries and cause red blood cells to clump together.

All the focus on lowering total cholesterol levels has led to high dependence on cholesterol-lowering drugs, known as statins. So let us take a closer look at these. Some physicians believe these to be a magical group of drugs. However, there is now enough evidence that besides sometimes bringing cholesterol levels down to such low levels that the cholesterol base is not available to make other needed substances.

 We already know about the dangerous effects statins can have on the liver; liver function tests need to be done biannually for those taking statin drugs. Statin drugs carry warnings about rhabdomyalysis, which is muscle break-down that gives muscle pain (myalgia). When this occurs, the patient should immediately be taken off the drug, but all too often they are just changed to another statin, or the diagnosis of the causal agent (the statin drug) is missed and the patient is put on a non steroidal anti-inflammatory drug for the pain. These NSAIDs have so many side effects that the FDA had to pull some of them off the market.

 The problem here is that if the rhabdomyalysis persists it may never be cured, even if the drug is stopped. There is a simple blood test that shows if this is happening. Creatine kinase in the blood is elevated. If it is, there is muscle breakdown and the taking of the statin should be stopped.

 In Canada there is also a warning on the statin insert that the Statins will deplete CoQ10. This is because the same pathway the statin is using for lowering cholesterol also stops the production of CoQ10. CoQ10 is produced by the liver, and is used for making energy for muscles, especially needed by the heart muscle. CoQ10 is needed to make ATP (adenosinetriphosphate), used by all cells to make energy. Without ATP we lose or depress functions because we don’t have enough fuel to run the engine. Supplemental CoQ10 is necessary if statin drugs are taken. In the USA pharmaceutical companies, and some physicians, do not find a need to alert the clients taking Statins of this and the necessity of taking CoQ10 if on a Statin. The patient should also be alerted that Statins have been implicated by the FDA as potentially leading to Diabetes Mellitus.

 The statin drugs have been implicated in forgetfulness, and as being one of the co-factors for either causing dementia or being an adjunct to dementia. In fact, cognitive problems are an outstanding complaint with the statin drugs. This is very likely due to the fact that the brain also needs ATP to function. It is usually a temporary condition called transient global amnesia; the patient sometimes cannot even remember their spouse. (This came into view when former astronaut Duane Graveline MD was put on Lipitor and developed TGA. He wrote a book about the statins called Lipitor, Thief of Memory.) As mentioned, this is usually a temporary condition that disappears when the drug is stopped.

 The brain depends on cholesterol, other fatty acids and ATP, to be strong and function properly. When someone gets a “foggy brain” they are still alert enough to know that they are not functioning at their usual level. This leads to stress that only compounds the problem. The Framingham study disclosed that older persons with cholesterol under 200 perform worse on mental function tests than those with higher cholesterol (about 250mg/dl). Numerous articles are available both for and against this theory, but like any of our evidence-based drug studies it is necessary to be careful about who did the study and who paid for it. All too often the drug company producing the pharmaceutical supported the positive studies in one way or another, and may have suppressed any negative studies.

Women taking Lipitor (at one time the best-selling drug in the USA) had 10% more heart attacks then the control group taking a placebo (Whitaker, 2007). For people over 70 years of age there is no research that there is life prolongation by taking statin drugs. The same holds true for young men with high cholesterol without heart disease: Statins do not influence their longevity in any studies (Whitaker, 2007).

 Statin drugs may have their place, but there are many natural ways to take down cholesterol, with botanicals, diet and exercise, and I strongly believe they should be tried first. Statin drugs should have a place only in specific circumstances and after a change of lifestyle is programmed and followed. If statins are used the patient should be followed closely for any signs or symptoms of side effects. The drug should also be stopped when the total cholesterol falls below 160-170, because a sufficient amount of cholesterol is essential for our well-being.

I have found that relying on medications often gives the patient the impression that they can continue to follow an unhealthy lifestyle as long as they are on medication. The drug is a crutch that should be gotten rid of as soon as possible by healthy living habits. Before abrupty stopping a medicine and having studied the medicine for your own knowledge You should discuss your concerns with your physician.

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