7 Things You Need to Know When Your Doc Says Your Cholesterol Is Too High

Cholesterol Test

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.

Resources:

  1. http://jama.jamanetwork.com/article.aspx?articleid=1104631
  2. http://archinte.jamanetwork.com/article.aspx?articleid=617275

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  • Esther

    Great article!
    My current HDL is 57mg/dl and my LDL is 89.9 mg/dl is that a healthy ratio?

    Thank you.

    Best,

    Esther

  • Dana-T

    Cholesterol is required widely in the body including building cell walls, building hormones, brain function, putting out oxidative fires, etc. It is so important that our body makes its own cholesterol all the time. Studies have shown that dietary cholesterol is not responsible for the plaque build up in the arteries. This happens due to inflammatory conditions that the body is producing cholesterol to try and control. A prime example is sugar is know to cause oxidation and inflammation in the arteries (and cells). When the inner lining of the arteries becomes compromised it becomes inflamed. Micro clots can form there. The liver pumps out cholesterol to tame the inflammation and clots develop containing cholesterol, eventually narrowing the artery. So, the problem is more in poor diet choices containing a lot of sugars, chemicals, rancid / oxidized oils, etc .

  • AS

    So much wrong with the first part of this “analysis” I don’t even know what to say….I am incredulous. Articles like this that attempt to take a complex topic like coronary atherosclerosis and “explain it away” simply often do more harm than good. Much of the “7 things” is incorrect analysis, poor use/extrapolation of data, and, in some cases, statements without any scientific basis.

    I will say the second part of the article (10 essential steps) is (mostly) well thought out. And I would agree with the sentiment that one should see an expert in lipids if there is concern regarding CV risk.

  • AS

    So much wrong with the first part of this “analysis” I don’t even know what to say….I am incredulous. Articles like this that attempt to take a complex topic like coronary atherosclerosis and “explain it away” simply often do more harm than good. Much of the “7 things” is incorrect analysis, poor use/extrapolation of data, and, in some cases, statements without any scientific basis.

    I will say the second part of the article (10 essential steps) is (mostly) well thought out. And I would agree with the sentiment that one should see an expert in lipids if there is concern regarding CV risk.

  • Anonymous

    Glad you liked the article – thanks! It is best to talk directly with your doctor about your lab results.
    -Be Well Health coach, Laura

  • Jeff Willits

    I have been researching this a lot this year and I am certain this is an accurate assessment. I’ve taken Essential Step #2 further and have gone to a low-carb, high-fat diet and my lipid metrics are really good. Keeping triglycerides low is critical and, according to Mayo Clinic, that happens with exercise and carbohydrate reduction.

  • docmilo5

    Medicine since the early 2000s understand that inflammation is a larger culprit in arteriosclerosis that cholesterol. Also, if you don’t understand that HDL and LDL are pretty much the same thing but one is “fatter”, then you really shouldn’t be commenting on this subject.
    Processed carbohydrates that aren’t burned are accumulated in the liver and turned into triglycerides for storage. When the liver is full it binds them to lipoproteins to make them water soluble for blood transport so they can be stored in fat cells. When your lipoproteins are fatty, they are less dense, just like a body. Proteins are more dense (HDL). Cholesterol is just a bystander.
    High cholesterol is a misconception and statin prescriptions are such a big money maker the MDs and pharma’s aren’t going to tell us they got it wrong.

  • docmilo5

    Medicine since the early 2000s understand that inflammation is a larger culprit in arteriosclerosis that cholesterol. Also, if you don’t understand that HDL and LDL are pretty much the same thing but one is “fatter”, then you really shouldn’t be commenting on this subject.
    Processed carbohydrates that aren’t burned are accumulated in the liver and turned into triglycerides for storage. When the liver is full it binds them to lipoproteins to make them water soluble for blood transport so they can be stored in fat cells. When your lipoproteins are fatty, they are less dense, just like a body. Proteins are more dense (HDL). Cholesterol is just a bystander.
    High cholesterol is a misconception and statin prescriptions are such a big money maker the MDs and pharma’s aren’t going to tell us they got it wrong.

  • docmilo5

    Talk to the doctors that aren’t teaching people how to eat right and live well, but instead just drugging them? That’s a wise choice.

  • docmilo5

    Talk to the doctors that aren’t teaching people how to eat right and live well, but instead just drugging them? That’s a wise choice.

  • Mary

    Get the Newsletter from People’s Pharmacy. There are many reports of major problems people have when taking statins.
    Dr. Duane Garveline, MD, is one of the most vocal statin critics and has personally experienced side effects from Lipitor.
    Please think twice, then twice again, before taking any of these drugs.

  • Mary

    P.S. Many, if not most, physicians will deny that statins could possibly have side effects that are being reported. Do your own research at that point.

  • MickJ

    To evaluate your result, check with your doctor, though the first sections of the article discourage us from trusting our docs on their take on how to handle issues concerning cholesterol. Our doctor are still the ones whose been dealing with almost all illness and more verse in telling us what to do base on their expertise when it comes to medicine. When it comes to determining which diet to follow seek help from your dietician…. as they say more heads are better than one or better yet you’ll have someone to point your finger to when all else fail.

    You may also check sources on the internet, but there are a lot of contradicting information about cholesterol and their overall effect in heart health. We can’t play guessing game most especially when our heart health is the ones at stake, don’t hesitate to seek help.

    See below related websites that would also help in your query.
    http://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/cholesterol-levels/art-20048245
    Cholesterol levels: What numbers should you aim for?
    http://tinyurl.com/All-Natural-Supplement – For overall Heart Health

  • MickJ

    To evaluate your result, check with your doctor, though the first sections of the article discourage us from trusting our docs on their take on how to handle issues concerning cholesterol. Our doctor are still the ones whose been dealing with almost all illness and more verse in telling us what to do base on their expertise when it comes to medicine. When it comes to determining which diet to follow seek help from your dietician…. as they say more heads are better than one or better yet you’ll have someone to point your finger to when all else fail.

    You may also check sources on the internet, but there are a lot of contradicting information about cholesterol and their overall effect in heart health. We can’t play guessing game most especially when our heart health is the ones at stake, don’t hesitate to seek help.

    See below related websites that would also help in your query.
    http://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/cholesterol-levels/art-20048245
    Cholesterol levels: What numbers should you aim for?
    http://tinyurl.com/All-Natural-Supplement – For overall Heart Health

  • Sheri Smith

    I had a tooth in infected…which led to me having a root canal (which I now regret) hey…I just wanted the pain to go away NOW ! but the timing of this event was great, I had had just prior to this my cholesterol checked, great by most standards, then the company I work for were having a health check (done voluntary) to qualify for a little discount on health Ins. benefits ( This was done right after my root canal) My Cholesterol was through the ROOF ! with in 2 weeks apart of both tests being done.
    I was so thankful that I didn’t panic ( I had just finished educating myself, by reading the book: @Cholesterol Clarity, by: Jimmy Moore & Eric C. Westman, MD
    The Nurse was VERY concerned about me, but I tried to explained to her what I had learned. The look on her face was priceless when I told what I eat (Healthy Fats

    & don’t eat ( I eliminated ALL GRAINS from my diet) My HDL was 85 – LDL was 174 (LDL test does Not test for particle size) ,Triglycerides were 64- Total Cholesterol 303
    Now prior to this Tooth infection my Total Cholesterol was:215
    also I’d like to add: My HDL prior to reading the book was: 42 then I started eating Healthy Fats, i.e.: Coconut oil, Real Butter (from 100% grass-fed cows, Fat from pastured raised Pigs, (Bacon) and in 2 weeks, my HDL. went from 42 to 85 !
    The BEST Part now…..I feel Amazing,my health has never been better.

  • Harvey Miller

    I do not agree. The statements are generally correct–re statins, cholesterol, and dietary recommendations.

  • Harvey Miller

    I do not agree. The statements are generally correct–re statins, cholesterol, and dietary recommendations.