Last week I wrote that I was concerned about more of us menopausal women aging into the common blood pressure/statin drug regimens.
On BP meds, though I didn’t always feel this way, continued research tells me that lowering blood pressure, even if that means using meds, is important. (How low your BP should be day to day is up for discussion.)
Lowering LDL cholesterol however, and putting millions of people on statins, is, with few exceptions, unnecessary and can be dangerous.
Especially for women.
A few years ago I did a 2-part series on the relationship between women and statins and what I learned was not the stuff of hope for better health.
You can read part 1 here.
And part 2, here. This one includes tests I think are as important, or more, than just a lipid panel. I will be updating this list in the coming weeks.
What is cholesterol anyway?
Cholesterol is a waxy, fat-like substance that is carried in the blood in a lipoprotein, fat—lipo—with a protein.
This is true for both LDL, low density lipoprotein, known as the “bad” one, and HDL, high density lipoprotein, loved by all and known as the “good” cholesterol. Neither is good nor bad, they just have different roles in the body.
In Chapter 4 of my book, “Myth: LDL Cholesterol is the Enemy and Statin Drugs are the Answer” I quoted Dr. Ron Rosedale to expand the definition: “First and foremost, cholesterol is a vital component of every cell membrane on Earth. In other words, there is no life on Earth that can live without cholesterol. That will automatically tell you that, in and of itself, it cannot be evil. In fact, it is one of our best friends.”
Here’s a quick summary of how LDL and HDL work.
Think of lipoproteins as submarines doing their job carrying cholesterol around in the body.
LDL submarines deliver cholesterol from the liver out into the body, where it is needed to make new cells and repair damage. Think of it as a sort of spackle patching up a hole or nick. Another kind of submarine, HDL, shuttles around the periphery of the body picking up excess or oxidized LDL returning it to the liver for recycling or moving it into digestion for elimination. In the words of the well-known cholesterol contrarian Dr. Uffe Ravnskof, MD, PhD from his book The Cholesterol Myths, “You may ask why a natural substance in our blood, with important biologic functions, is called ‘bad’ when it is transported from the liver to the peripheral tissues by LDL, but ‘good’ when it is transported the other way by HDL.”[1]
#justsayin’
Thanks to Dr. Rosedale for the submarine analogy.
A few fun facts for your consideration
Your Brain is 25% Cholesterol!
Approximately 25% of the total amount of the cholesterol present in humans is localized to this organ, most of it present in myelin. That’s right—your brain, the organ that makes you who you are, is literally one-quarter cholesterol by content.
Mother’s Milk: Nature’s High-Cholesterol Superfood
Mother Nature clearly didn’t get the memo that cholesterol is “bad.” In fact, she packs breast milk—especially the first few days—with cholesterol:
- Colostrum has nearly twice as much cholesterol as mature milk (31 mgs vs 16 mgs), showing that nature front-loads babies with cholesterol when their brains are developing most rapidly!
Think about it: if cholesterol were truly harmful, would nature design the perfect baby food to be loaded with it?
Your Body MAKES 80% of Your Cholesterol
Here’s a fun fact that might surprise you: cholesterol production is so important that your liver and intestines make about 80% of the cholesterol you need to stay healthy. Only about 20% comes from the foods you eat.
I realize that no matter how many times people hear this they will still shun egg yolks, shrimp and butter.
#sadness
If you eat only 200 to 300 milligrams (mg) of cholesterol a day (one egg yolk has about 200 mg), your liver will produce an additional 800 milligrams per day from raw materials such as fat, sugars, and proteins.
Cholesterol’s Essential Jobs
Cholesterol isn’t just sitting around plotting your demise—it’s working overtime to keep you alive:
Cell Membranes
Cholesterol is a structural component of cell membranes and serves as a building block for synthesizing various steroid hormones, vitamin D, and bile acids. Every single cell in your body needs cholesterol to function properly.
Hormone Factory
All classes of steroid hormones, glucocorticoids, mineralocorticoids, and sex hormones, are derivatives of cholesterol. This includes:
- Testosterone
- Estrogen
- Cortisol
- Progesterone
- Aldosterone
Vitamin D Production
it is the precursor molecule for the synthesis of vitamin D in calcium metabolism
The Brain Connection
The brain-cholesterol connection is particularly fascinating:
- The majority (about 70%–80%) of cholesterol in the adult brain is in myelin sheaths formed by oligodendrocytes to insulate axons
Let me say that in English:
- Myelin sheaths = fatty protective coverings (like insulation)
- Oligodendrocytes = the brain cells that make this insulation
- Axons = the long “wires” that carry electrical signals between brain cells
So basically, cholesterol is a key ingredient in the brain’s electrical insulation system. Without it, your thoughts and nerve signals would move much slower—kind of like trying to use electrical wires without any insulation!
- Without enough cholesterol, your brain cells can’t talk to each other and their connections fall apart.
Some not so fun facts…
Research shows some concerning effects of very low cholesterol:
Several studies show that lowering total cholesterol levels below 160 mg/dL can increase the risk of depression, suicide, and homicide, so 160-200 mg/dL is optimal.
In a recent study available on the NIH Public Access site, researchers showed that in the elderly, the best memory function was observed in those with the highest levels of cholesterol.
Who benefits from statin use the most? Men.
Dr. Lissa Rankin adds this, “The benefits of statin therapy are clear for women with established cardiovascular disease at high risk of heart attack or stroke. But for women looking to prevent disease, the evidence does not show statins are as effective.”
If you want to delve further into the”statins are good/statins are bad” controversy from a balanced doc’s perspective I suggest you read this post from Dr. Chris Kesser.
Here’s an excerpt with possible side effects of these drugs:
“Statins work by inhibiting beta-hydroxy-beta-methylglutaryl-CoA (HMG-CoA) reductase—an enzyme involved in cholesterol synthesis. But this enzyme has other jobs, too, such as aiding in the synthesis of coenzyme Q10 (CoQ10), a key mitochondrial antioxidant needed for cellular energy metabolism. (4) This is why most statin labels will suggest supplementing with CoQ10.
(This note is mine not Chris’s Most people don’t read those big paper inserts tho. If you didn’t know this a thing and you are on a statin, hi thee to a store and buy a good quality CoQ10 supplement.)
Therefore, tinkering with cholesterol synthesis via statins can yield unwanted side effects. The most common statin-related side effects are muscle-related issues, including:
- Pain
- Lethargy
- Weakness
- Myopathy, in rare cases
Muscle problems are reported in 10 to 30 percent of patients from observational studies, and in up to 5 percent in randomized controlled trials (RCTs). (5, 6)
New-onset diabetes while taking statins occurs most often in women and in people who already have some metabolic risk factors. (7, 8
Cholesterol isn’t trying to kill you—it’s trying to keep you alive! The issue isn’t cholesterol itself—it’s when the transport and regulatory systems get disrupted.
What I didn’t cover but is important if only the good news didn’t sit so close to the bad; statins do lower inflammation. At what cost?
In my next newsletter I’ll cover what markers have been proven to be far more representative of heart disease risk than LDL levels alone.
Sources: Multiple peer-reviewed studies from institutions including Johns Hopkins, Harvard, NIH, and Cleveland Clinic
