The Truth about Cholesterol
Friend or Foe?
To understand the truth about cholesterol, we first need to know what Cholesterol is. Cholesterol is “a waxy substance throughout the body (1)” and comes from your liver and from animal products we consume. But wait, I thought cholesterol came from fats such as saturated and trans fats?! Correct! Unclean animal products and by-products, like dairy, can be high in these “bad” fats.
Having healthy cholesterol levels is crucial to many health aspects, not just heart health. Unfortunately, many conventional doctors see “high” cholesterol levels and are quick to prescribe a prescription. However emerging science proposes that high total cholesterol may even be a good thing (2), and preventing your body from naturally producing cholesterol can be a recipe for disaster.
I believe it is important to mention that cholesterol does not dissolve in the blood and requires special proteins (High Density Lipoprotein & Low-Density Lipoprotein) to help move it through the bloodstream to where it is needed within the body.
Healthy Levels
With all that said, let’s look at what “healthy” cholesterol levels actually look like from a functional medicine aspect (I provide the below lab ranges as a reference, not as diagnosis. In my opinion, emerging evidence should make us re-evaluate these levels):
Total cholesterol: Less than 200 mg/dL (may actually need a level of 200 or slightly higher, but that is still up for debate).
LDL (bad) cholesterol: Less than 100 mg/dL
HDL (good) cholesterol: 40 mg/dL or higher (men), 50 mg/dL or higher (women)
Triglycerides: Less than 150 mg/dL
Achieving and maintaining healthy cholesterol levels is important to not just one’s cardiovascular health, but also hormone and thyroid regulation (3-5), among many others.
So, what makes HDL “good,” and LDL “bad”?
HDL helps remove excess cholesterol in the blood and takes it back to the liver so it can be broken down and the excess removed. Meanwhile, LDL does the opposite. LDL can cause build-up of cholesterol within the cell walls. This results in plaque and pathway blockages.
Why is Cholesterol Important?
Cholesterol helps aide the production of hormones like estrogen, testosterone and cortisol. It helps convert T4 to T3 (ironically, the thyroid helps make cholesterol as well and helps our body get rid of what cholesterol it doesn’t need), assists in bile production, assists in converting sunlight into vitamin D, and is a building block of tissue building and repair. These are just some of the main thing’s cholesterol helps our body with.
*If you have high cholesterol, you should probably also get your TSH, FreeT3, FreeT4, and Reverse T3 tested.
There are many ways that we can help support our body and help aide it in maintaining healthy cholesterol levels.
Maintaining Healthy Cholesterol Levels
In order to help achieve and maintain healthy cholesterol levels one should exercise regularly and including some strength training and if possible, high-intensity interval training. In addition to exercise, one can also look at doing the following:
Stop smoking.
Increase fiber-rich foods.
Reduce alcohol intake (studies show that occasional red wine intake can help maintain healthy cholesterol levels. One should look at the source and quality of the red wine).
Reduce your intake of processed foods and sugars.
Increase your intake of healthy fats (within moderation. knowing your Apo-E type can help determine how much healthy fat your diet should consist of). Healthy fats include foods rich in Omega-3’s, avocados, nuts, and flaxseeds.
Using spices like garlic, turmeric, cinnamon, and ginger.
Taking a good activated multi-vitamin.
Supporting your liver. You can read more about liver health here and here.
So, is cholesterol a friend or a foe? Overall, I believe it to be a friend, and a necessary one at that. One large systemic review study that looked at a total of 14 independent reports, including 1,055,309 subjects and 9457 events stated this:
“However, several studies revealed that elevated TC is not associated with CVD, and TC is not the most accurate predictor of future CVD [39,40]. Thus, in recent studies about serum cholesterol, the interest in the role of LDL-C is increasing. There are many studies that show that LDL-C, one of the cholesterols constituting TC, causes atherosclerosis-related disease. However, according to a comprehensive review of the association of LDL-C with atherosclerosis, some studies have shown a lack of an association between LDL-C and severity of atherosclerosis, and in a study of 304 women, there was no association between LDL-C and coronary calcification [41,42].
Despite several conflicting studies, total cholesterol and LDL-C are key components of cardiovascular risk prediction models that are widely used in clinical practice to estimate an individual’s risk of CVD and to guide clinical decision-making regarding the initiation of statin therapy and other lipid-level regulating drugs [43]. In studies of the relationship between cholesterol and CVD occurrence, treatment with TC or LDL-C lowering drugs reduces CVD mortality [44,45]. In our meta-analysis, TC and LDL-C are risk factors for CVD death, which supports previous studies suggesting that maintaining adequate levels of cholesterol is important in lowering CVD death risk [46].
On the contrary, we observed that high levels of HDL-C were significantly associated with decreased risk of CVD mortality. The first compelling study of the inverse association between HDL-C and CHD was from the Framingham Heart Study [47]. This observational study formed the basis for the widely acknowledged concept of HDL-C as the good cholesterol and led to the idea that HDL-C might have properties that protect against atherosclerosis, and intervention to increase HDL-C would reduce CHD risk (the HDL-C hypothesis).” (6).
Achieving and maintaining healthy cholesterol levels is important, and it is possible through lifestyle and dietary changes. If you are on prescription drugs for high cholesterol, it is possible to get off of them. It is important to monitor your levels regularly, and to work with your PCP and other practitioners who can help you achieve your health goals. Remember, cholesterol does not work alone! Looking at the full picture of what is happening within is the best way to understand how to support your body properly and begin rebalancing it.
