And 10 Tips to Manage it Better
Getting a blood result with a high total cholesterol, for most people, unfortunately means that their doc’s about to follow it with “Here’s a prescription for Lipitor.” This is because the medical profession is obsessed with lowering your cholesterol because of misguided theories about cholesterol and heart disease. Why would we want to lower it when the research actually shows that three-quarters of people having a first heart attack, have normal cholesterol levels (1), and when data over 30 years from the well-known Framingham Heart Study showed that in most age groups, high cholesterol wasn’t associated with more deaths? In fact, for older people, deaths were more common with low cholesterol (2). Therefore it is very possible that statins are being prescribed based on an incorrect hypothesis, and the problem is, they are not harmless. They can have lots of unpleasant and health-damaging side effects, including muscle pains, increased abdominal fat, mental fogginess and increased diabetes risk. So I encourage you to question the status quo, especially when the statin prescription feels like a doctor’s knee-jerk response. Ask how necessary a statin really is and if perhaps your cholesterol concerns can be addressed in a healthier, drug-free way.
So, here’s what you need to know when your doc sits you down for a cholesterol talk:
1. Your Doctor May be Basing Your Diagnosis on Data That’s a Half-century-old
Hard to believe but today’s mainstream thinking on cholesterol is largely based on an influential but flawed 1960s study which concluded that men who ate a lot of meat and dairy had high levels of cholesterol and of heart disease. This interpretation took root, giving rise to what became the prevailing wisdom of the last 40+ years: lay off saturated fats and your cholesterol levels and heart disease risk will drop. This helped set off the stampede to create low-fat/no-fat Frankenfoods in the lab and launch the multibillion-dollar cholesterol-lowering drug business in hopes of reducing heart disease risk. Did it work? No. Instead of making people healthier, we’ve wound up with an obesity and diabetes epidemic that will wind up driving up rates of heart disease – hardly the result we were hoping for.
2. Pssst. Guess what? You Actually Need Cholesterol
For decades we’ve been sold the story that dietary cholesterol is bad and that it gets into your bloodstream and clogs your arteries. This view has affected what we eat, what we worry about, what drugs we take and it has become the main focus of preventive medicine in Western medicine. The problem is, this depiction of cholesterol as this artery clogging-fat is totally oversimplified and actually false. And the notion that your total cholesterol number needs to be low is not only downright wrong, it’s dangerous too. Cholesterol helps make key hormones, synthesizes vitamin D, it is an essential component of cell membranes and we need it for brain and nerve function. It is needed for many functions in the body and is essential for life! And we now know that elevated cholesterol is not the cause of heart attacks – so don’t fall for that line.
3. Your “Numbers” Don’t Even Measure Cholesterol, Nor How Bad It Is.
The dirty little secret is that what’s measured on your standard cholesterol test or “lipid profile” tells the doc very little about the actual state of your health. And there is no such thing as ‘good’ or ‘bad’ cholesterol…there is just cholesterol. The typical lipid profile test simply estimates how much triglyceride, HDL (high-density lipoprotein) and LDL (low-density lipoprotein) are in the blood. Both HDL and LDL are lipoproteins, which are carriers of cholesterol and triglycerides, as cholesterol and fats are not water soluble and need to be transported in our bloodstream. In addition, the test doesn’t tell us a thing about these lipoprotein’s very important particle size – as in, how much of that LDL number is made up of the more benign “large particle” fluffy kind and how much is the more troublesome small particle kind. Both the OK stuff and the gnarly stuff get lumped in together under a big, old, non-specific LDL umbrella – making the average cholesterol test, at best, woefully inadequate and imprecise. Consequently, you may have blood teeming with the less alarming large particle LDL, and still get signed up for a statin. And with the new controversial – and in my book dangerous – “wider net” guidelines proposed by American College of Cardiology and the American Heart Association, expect that to happen a lot more. The new guidelines will make an estimated additional 15 million more adults (plus a few kids as well) “eligible” to take statins in an effort to drug down their numbers, regardless of what type of LDL they have. Bad news for people, good news if you’re buying drug company stock.
4. Insist That Your Doctor Dig Deeper
If your doc is saying your cholesterol is too high, get a second opinion, not necessarily from another doctor, but from another, more detailed test than the standard lipid profile. If you have a family history of heart disease or other risk factors getting a more complete picture is even more vital. Press your doctor to review and assess the other often overlooked but possibly more important factors that can shed a brighter light on your unique situation – namely tests which look at hs-C-reactive protein, particle sizes of the LDL cholesterol (sometimes called NMR Lipoprofile), Lipoprotein (a) and serum fibrinogen. These measurable physical clues will help fill in a few more pieces of the puzzle, and enable you and your doctor to develop a more customized program to help manage your risk, with or without cholesterol drugs. If your doc’s not interested in looking under the medical hood, then it may be time to switch to a new mechanic.
5. For Many Statin Studies, the Fix is Usually in Well Before the Results Are
When you get right down to it, it’s hard to take most of the pro-statin studies seriously when so many of them are either sponsored by the drug companies themselves or done by researchers and universities whose labs are financed by Big Pharma either directly or through “donations.” In fact, the studies were mostly done by drug companies with a history of fraud in reporting results. So naturally, it’s tough to get to the truth of what statins do and don’t do for health. What happens instead is that well-meaning doctors get snowed in by positive statin studies because, as the song goes, they “accentuate the positive, and eliminate the negative, latch on to the affirmative and don’t mess with Mr. In-between!” Making matters worse? It’s also not uncommon for the doctors involved with setting the statin guidelines to have a stake in the companies that produce them, so small wonder the drugs are pushed on the public with such enthusiasm.
6. If Mom and Dad Made It into Their 90s, Think Twice
Unless you’re at high risk for heart problems, have been diagnosed with heart disease, stroke or for instance, have a worrisome family history, particularly of early heart attack and death, it’s more than likely you may not need cholesterol-lowering drugs. If high cholesterol runs in the family as well as longevity, then you too probably have less to worry about too. Regardless, don’t be afraid to push back and tell your doc you’d prefer to avoid drug therapies. Assuming you’re not in a mission critical situation, discuss the possibility of trying a more holistic approach to get your numbers down to what is considered a normal or healthy zone based on all of your specific risk factors, not just your cholesterol numbers. If your risk factors are high and you and your doctor feel you must take a statin, request the lowest dose possible for your situation and take a high-quality CoQ10 supplement to help counteract some of the negative side-effects. Add to that as many lifestyle changes as possible to help cut risk and slow the progression of any heart disease you may already have.
7. Stack the Deck and Play Your Cards Right
Though high levels of small-particle, LDL may be a significant risk factor, it’s one of many that play a role in the progression of heart disease. But the science is imprecise. For example, there are many people with high LDL who are otherwise healthy and millions with so-called “normal” readings who are still at risk for a heart attack. In fact, on the standard cholesterol test usually done, your HDL and triglyceride levels are more important numbers to look at than LDL. Ultimately, the more HDL-boosting steps you take, the better the odds, and if you’re able to do it without medicating the numbers, so much the better.
So what to do next? Here are 10 essential steps to take to help stabilize and improve your situation and reduce risk overall:
1. Eat a Fantastic Diet
Shoot for a diet that consists of whole, organic or locally grown foods, plus some grass-fed, humanely-raised animal products. Avoid factory farmed meats and keep processed foods to a minimum, as they’re anything but whole!
2. Eliminate Sugar and Refined Carbohydrates
They’re no good for your body, brain or heart, and are what increase the more dangerous triglycerides and small LDL particles.
3. Avoid Man-made Fats But Don’t Be Afraid of Good Sources of Fat
There is no good evidence of a link between saturated fat and heart disease. In fact, when we eat good sources of saturated fat, we often increase the large fluffy benign LDL particles. And yes, please eat the whole egg, but make sure they come from pasture-raised chickens, which have been allowed to roam free, eating plants and insects.
4. Bring on the Shrubbery
If you want to improve your lipid profile, eat plants and lots of them!
5. Eliminate No-fat and Low-fat Everything
If the label says no or low-fat, leave it on the shelf. First of all, it’s likely to be a processed food but more importantly, no and low-fat products are usually high in sugars, which actually boost the small more dangerous LDL, the last thing you want to do!
6. Add a Little Sauerkraut
Or for that matter, any fermented veggie to help fortify the resident gut bacteria that play an important role in protecting your arteries against inflammation
7. Go a Bit Nuts
And don’t forget the olives. Aside from being delicious, nuts and olives are thought to have the power to stop LDL from damaging arterial walls.
8. Ditch Your Vices
If you smoke, stop. No exceptions. If you drink, avoid hard liquor. A small glass of red wine with dinner every other day for most people is fine. A bottle every day or two is not.
9. Move Like Your Life Depends On It
Because it does. Better yet, more movement helps boost HDL and flush bad LDL out of your system.
10. Keep Your Mouth Clean
Poor dental health increases instability in the coronary arteries, which in turn boosts the odds of a heart attack.
For more thoughts on the topic, check out this excellent piece by Joseph Hooper on When to Say No to Your Doctor.