Welcome to the fourth post in our series entitled “Cholesterol: Is it really that bad?”. If you are just joining us, make sure you check out the series introduction, Take Control of Your Health, as well as Part 1 – The Truth About Cholesterol: Where Did We Go Wrong?, Part 2 – Why We Need Cholesterol, and Part 3 – Cholesterol Does Not Cause Heart Disease.

Every day, we are bombarded by messages from our doctors, from billion dollar ad and marketing campaigns, from our government creating guidelines and recommendations, and from the myriad of food items (cheerios, pancake mix, even cookies) that claim to be “heart healthy” and “cholesterol free.” It’s us versus the industry—David versus Goliath.

Luckily, we have the ability to think, investigate, ask and discover the most important thing that can set us free from the overwhelming pressure we receive to lower our cholesterol at all costs: the truth.  For instance, the Framingham Heart Study found the following:

• Older people with the lowest cholesterol have some of the highest death rates.
• Elderly people with low cholesterol die more often from heart attacks than those with high cholesterol.
• People of all ages with low cholesterol have higher death rates from gastrointestinal and respiratory diseases.
• Low cholesterol increases the rate of infection.
• People with cholesterol levels below 160 mg/dL are twice as likely to die than those with levels between 160-250.
• Low cholesterol levels have been associated with higher cancer rates in individuals who use statin drugs.

WHO OR WHAT TO BELIEVE?

So, conventional wisdom and modern medicine tell us two things: that high cholesterol leads to heart disease and that low cholesterol will, therefore, reduce your risk of heart disease.

In 1981, normal cholesterol was considered between 150-310 if you were 50 or older. And in the last 30+ years we have seen those recommendations drop from 300 to 240, to 220, to the current 200 total cholesterol recommendation.

It’s appropriate to reiterate that more than 20 randomized, controlled studies show that people with low cholesterol do NOT live as long as those with high cholesterol.  Not only are mortality rates worse for those with low cholesterol, but there are significant side effects that have proven to negatively impact the quality of life.  Low cholesterol has been linked to violence, aggressive behavior and depression due to low serotonin levels. Further, hemorrhagic strokes are twice as likely to occur in people with cholesterol levels below 180 compared to those with total cholesterol at 230.

The bottom line is that low cholesterol doesn’t necessarily improve our health. So to chase a low cholesterol number does not guarantee improved health, nor will it mean improving the quality of your life.

THE MAGIC PILL

Of course, any conversation on cholesterol needs to include a discussion on cholesterol-lowering medications—statins. The truth is that there are many side effects and adverse health consequences to using statins that some consumers may not know about. The following is taken directly from the Lipitor® web site:

• LIPITOR® (atorvastatin calcium) tablets, along with a low-fat diet, is clinically proven to reduce the risk of heart attack, stroke, certain kinds of heart surgeries, and chest pain in patients with heart disease or several common risk factors for heart disease. Common risk factors include family history of heart disease, high blood pressure, age, low HDL (“good”) cholesterol, and smoking.
• LIPITOR®’s objective is to lower cholesterol.
• LIPITOR® (atorvastatin calcium) tablets are not for everyone, including anyone who has previously had an allergic reaction to LIPITOR®. It is not for those with liver problems. And it is not for women who are nursing, pregnant, or may become pregnant.
• If you take LIPITOR® (atorvastatin calcium) tablets, tell your doctor if you feel any new muscle pain or weakness. This could be a sign of rare but serious muscle side effects. Tell your doctor about all your medical conditions and all medications you take. This may help avoid serious drug interactions. Your doctor should do blood tests to check your liver function before starting LIPITOR® and during your treatment if you have symptoms of liver problems. Tell your doctor if you have diabetes. Elevated blood sugar levels have been reported with statins, including LIPITOR®.
• Common side effects are diarrhea, upset stomach, muscle and joint pain, and changes in some blood tests.

Independent research reported in various publications such as the Archives of Internal Medicine, Annals of Internal Medicine, and the Journal of American Heart Association revealed the following side effects from cholesterol-lowering drugs (otherwise known as statins):

• Increased risk of diabetes by 4%
• Increased risk of impotence by 20%
• Muscle and joint pain in nearly 40% of consumers
• Short term and long term memory loss
• Liver and Stomach problems
• Tingling, burning or numbing sensations in the limbs
• Weight gain, mood swings, protein in the urine, irritability

Please keep in mind that the above is for informational purposes only and in no way constitutes medical advice.  Any topic concerning your personal health should be discussed with your doctor.

WHAT TO KNOW…NOW

So if there’s a wide range of potential “normal” cholesterol numbers, and low cholesterol doesn’t guarantee a reduced risk of heart disease or improved mortality rate, how can we tell if our risk of heart disease decreases, and what should we pay attention to on a typical blood test?

Well, a standard blood test includes the following:

LDL cholesterol – The “bad” cholesterol

HDL cholesterol – The “good” cholesterol

Total cholesterol = LDL + HDL + Triglycerides/5

Triglycerides – Indicates fat accumulation in blood

Fasting Blood Sugar – Indicates sugar accumulation in blood

The truth is, the ratio between Triglycerides to HDL cholesterol has been proven to be the best indicator of heart disease .  Ideally, that ratio should be below 2:1 of triglycerides to HDL, which would give you a better picture of your coronary health.

It is also important to note that triglyceride levels are more related to carbohydrate intake than fat intake. Whatever sugar the body can’t use is taken into the liver and converted into triglycerides, which leads to excess fat on our bodies and in our blood.

To contrast with cholesterol, remember that only 20% of cholesterol is affected by our diet while the remaining 80% is made by our body which is greatly influenced by our genetics.  Furthermore, not only are LDL and HDL cholesterol numbers ‘estimates’ (link to above explanation), but there are actually several different classification or types of LDL cholesterol.  This is a relatively new idea as the recognition of various types of LDL cholesterol, and the testing for it, first began ‘only’ about 30 years ago.  What is known, however, is that there are different types or patterns of LDL particles and these are not differentiated on a typical blood test.  This means one can have a really high LDL number but if those LDL particles are comprised of the benign and harmless Pattern A type there is NO cause for concern.  It is the smaller, denser Pattern B particles that pose the risk to heart health.  [To test for the pattern type of LDL cholesterol you have, ask your doctor for a VAP test or NMR lipoprofile test.]

The purpose of these informational posts is to shine light on information often overlooked or not as well known.  We want to arm people with information to help and improve the quality of their life.  Most people just don’t know the risks with low cholesterol, or better ways to interpret a standard blood test, or that there are even different types of LDL particles.  In the war we wage for health, it becomes increasingly difficult to sift through the barrage of misinformation coming at us from all directions, even from those who are well-intentioned.   But that’s what we will do–provide truthful and factual information to empower our members to improve the quality of their lives.  In essence, we want to give David better chances to defeat Goliath (or at least to know which of Goliath’s nutritional messages we should be listening to

Read the rest of this series:

Take Control of Your Health

Part 2 – The Truth About Cholesterol: Where Did We Go Wrong?

Part 3 – Why We Need Cholesterol

Part 4 – High Cholesterol vs. Low Cholesterol

Part 5 – Cholesterol Does Not Cause Heart Disease.