What is Cholesterol?

When people hear the word “cholesterol,” they usually consider it a negative thing. However, it is important to remember that cholesterol is necessary for human life. Cholesterol molecules help keepcell membranes flexible. Cholesterol also is involved in the production of Vitamin D and also various hormones, including cortisol and the sex hormones.

Cholesterol is a substance similar to fat that is produced by the liver and is also found in animal-derived foods we eat, such as milk, cheese, egg yolks, poultry, pork, and beef. Increased intake of saturated fats and trans fats is linked to higher levels of cholesterol in the bloodstream.

As we all know, cholesterol can also have harmful effects as well as good. High cholesterol levels are associated with Atherosclerosis or hardening of the arteries, which in turn can lead to heart disease, strokes, and other health problems.

What Should My Cholesterol Levels Be?

People often get confused about what their cholesterol levels should be. The experts give us the following guidelines:

• Total cholesterol should be below 200 mg/dL. (It is interesting to note that the level considered “normal” was 250 when I first started practice 54 years ago.)

• LDL or “bad” cholesterol should be below 120 mg/dL. As LDL cholesterol travels through the bloodstream, it can attach to the walls of the blood vessels, contributing to hardening of the arteries.

• HDL or “good” cholesterol should be above 40 mg/dL. HDL cholesterol helps keep LDL cholesterol off the artery walls, carrying it to the liver where it can be recycled or expelled from the body. Thus, HDL helps reduce the risk of heart disease.

• Triglycerides are related to cholesterol and should be below 150 mg/dL. High levels of triglycerides are also linked to heart disease.

What are Statin Drugs?

Statin drugs help lower cholesterol. Examples include Crestor, Lipitor, and Simvastatin (Zocor). Many doctors prescribe these medicines because they help regulate high total and LDL cholesterol, which can contribute to potentially serious health problems, as discussed above. In addition, doctors often recommend that patients who have had bypass surgery or stents put in their heart should be on statin drugs because cholesterol is more likely to build up again on such areas after surgery, possibly necessitating further surgeries if it is not controlled.

What Are the Downsides of Statins?

There are definite upsides of statins, but there are also many concerns about them as well. One is that they simply do not help some people. Other significant concerns include the following:

1. They tend to inhibit coenzyme Q10 (CoQ10), which is one of the major factors that help the immune system as it works to allow you to live better, longer. It is also important in cardiac contractility.

2. Cholesterol is the chief ingredient in making all of the hormones that keep us young, including pituitrin, pitressin, the many adrenal cortical factors, DHEA, the male and female sex hormones, thyroid and thyroxine. Statin drugs are thus inhibiting the raw material out of which these important hormones are made. When we regulate “bad cholesterol” using a healthy, organic diet and exercise, we are allowing necessary cholesterol to perform its needed functions in making us look and feel perhaps 20 years younger than our stated age. We are then allowing the endocrine system to do with the hormones what is necessary to help us be young, vibrant, and full of vitality.

3. Rabdomyalisis, or proximal muscle weakness, is a potential side effect of statin drugs. In certain circumstances not well understood by the medical profession, this situation arises, wherein muscle cells break down and cause people to have trouble walking and climbing stairs. This is a very real problem that we see all too frequently in our patients on statin drugs. Needless to say, we get patients off statin drugs whenever we can and instead put them on something as simple as Vitamin B3, or niacin, to lower their “bad guy” cholesterol and raise their “good guy” cholesterol, which goes around making us younger and more intelligent. Niacin can also improve pain and depression. Too much niacin, however, can affect diabetes, so talk to your doctor about what dosage might be best for you.

4. Statins can contribute to erectile dysfunction in men and reduced sexual function in women. In contrast, niacin often actually helps these problems that statin drugs, including Lipitor, make worse. Niacin is very inexpensive, and you can get it over the counter at any drugstore.

5. Statins lower good cholesterol in addition to bad cholesterol. There is some discussion in medical circles about whether, for some patients, this might actually increase the risk of heart disease.

6. Inflammation causes the degeneration of organs, not cholesterol. Aging people over-express a molecule called Nuclear Factor Kappa Beta (NFkB), which then releases a lethal cascade throughout the body. NFkB acts like a switch to turn on inflammation if you live an unhealthy lifestyle with a poor diet, but it turns off the inflammation switch if you are in good health. It is important to remember that maintaining overall good health is more complex than just taking a medicine to control one potential problem.

So What Are the Alternatives?

We practice Integrative Medicine, which combines the best of natural and preventive medicine with pharmaceutical medicine. Some people may need to be on statin drugs, but it is important to remember that there are other options as well.

Talk to your 21st Century Medicine doctor about a test by Berkeley HeartLab that can check the particle sizes of your cholesterol and other factors that can help to weigh the risks and benefits of statin drugs in your particular case. This test evaluates your genetic tendencies to respond and react to statin drugs, fats, and carbohydrates. It also evaluates inflammation of the blood vessels and body related to atherosclerosis and aging. It also comes with a detailed dietary evaluation from Berkeley HeartLab customized for your personal genetic profile. This test helps us determine the best medicine, supplement, and dietary choices for you.

In addition, there are several supplements that can help lower cholesterol. One of the most important is niacin, as mentioned above. To reduce the “niacin flush,” we recommend slowly working up to the desired dose and also taking niacin in the middle of a meal. No-flush niacin forms are available, but they do not help lower cholesterol.

Red yeast rice is a natural statin that helps reduce cholesterol with fewer side effects than the actual statin drugs. Quality, non-oxidized fish oil supplements have been shown in studies to help reduce the risk of heart disease. Our office provides many of the supplements discussed above, in addition to LipiControl, Triplichol, and other supplements formulated to help lower cholesterol. Talk to your doctor about which supplements might be helpful to you.

Dr. Wolverton likes to say that at 21st Century Medicine our goal is to help you to live to be 130, looking like you’re 60 and thinking like you’re 30, instead of dying at the national average of 77 for men and 83 for women. Remember, your quality of life needs to exceed your quantity of food, as Dr. Johnson likes to say. We would encourage you to learn your options related to cholesterol management. Disease prevention is first about a lifestyle of wellness, less about focusing on one potentially harmful factor. Feel free to talk to your 21st Century Medicine doctor about cholesterol and your options. Though high cholesterol can be a significant problem, we must remember the rest of the story: that statin drugs are not the only answer – there may be better alternatives.