Cholesterol and Statins- Are You Asking The Right Questions?

This blog is dedicated to my mum and sister, who, not being medics, have to decide whether to believe my views on so many medical issues, or to listen to their doctors who practice conventional medicine.

The idea is not to give unsolicited advice to the average person reading this blog as every circumstance is unique; but to encourage you to start asking questions.

We have all heard how bad cholesterol is. Children probably also know this. The average person above 50 is very likely to be on statins or is surrounded by their friends and family who are on the drug. Yet, heart attacks and strokes and other conditions attributable to cardiovascular diseases are not only still present, their numbers are increasing all the time. There is a disconnect somewhere.

More and more information is being released, as recent as a few days ago in http://www.sciencedaily.com/releases/2015/02/150220110850.htm regarding how the efficacy of statins have been exaggerated.

One may argue a few points about why statins are prescribed so much, namely

  • more people are on statins because of better ‘pick up’ rates of high cholesterol by their doctors due to better healthcare
  • people are living longer, hence we are seeing more heart diseases- its a numbers game!

Using this same argument we could then ask the same question about infections as well. Infections were the biggest killer in the at one time. With the advent of antibiotics, infection rates and more importantly mortality and morbidity has decreased greatly. This is with the human race living longer and having better healthcare. Why hasn't this happened with the widespread use of statins, the disconnect still exists.

Lets strip this down to the very basics….

What is cholesterol?

Cholesterol is fatty molecule that is made by all animal cells. It makes up our cell membranes and is essential for cell survival. Cholesterol is also a building block for all steroid hormones, bile acids and Vitamin D. It makes all the important hormones like oestrogen, progesterone, testosterone, DHEA, pregnenolone, cortisol and aldosterone. So in very simple terms- almost all the cholesterol in your bloodstream is produced by the body, rather than being from diet as is widely believed. If we do not have enough cholesterol, we can die- it is essential to survival. Low cholesterol has been linked to cancers, depression and cerebral hemorrhage.

What are statins?

These are drugs that block a very important step in the synthesis of cholesterol. Without this step, cholesterol cannot be formed.

So, how do you read your cholesterol results?

Generally, a regular blood test at your doctor’s will reveal your total cholesterol, HDL and LDL cholesterol. There’s another important marker to look out for and that is your triglycerides. Conventionally, HDL is the “good” cholesterol and you want lots of it. LDL is the “bad” cholesterol and you want very little of it. That brings us to total cholesterol- I’ll discuss this in a while.

HDL is indeed a desirable cholesterol. Its role is to transport the cholesterol back to the liver for excretion or to send the cholesterol to other tissue to make the hormones we need. LDL is the funny one. Its not as clear cut as one would like to think. A high number may not necessarily be a bad thing. If you look at LDL closely, you’ll find that there are a couple distinct subtypes like the large, fluffy cloud type of LDL which is not dangerous, and the small, dense ones which are associated with atheromatous plaques. So if you think that you are doing everything right and you have a high HDL but you can’t understand why your LDL is still high, you may simply have more of the clouds than the dense LDLs. Further testing can be done to determine this. Read up about NMR testing. Unfortunately only one lab does it in the UK and its not available on the NHS.

What about total cholesterol? For a lot of people on “paleo” or caveman type diets (myself included-but I’m not paleo), their total cholesterol is usually in the “red”. This is quite distressing for a lot of people who take a lot of effort with their food. The average doctor may wish to put them on statins. It should be noted that if your HDL is high and your “fluffy” LDLs are high, your total is bound to be high. This is where your own due diligence comes in and you need to make a decision as to how to proceed.

The other necessary parameter to look at is triglycerides. There is a strong correlation between high triglyceride numbers and atherosclerosis. It is usually raised in those eating a high refined carb diet. The idea here is to get a favourable ratio of HDL/triglyceride. So a high HDL and a low triglyceride. In fact, this number, more than anything else (in a simple blood test) can determine your susceptibility to heart disease.

In a nutshell, I believe that our bodies won’t make something that can kill us. Human milk have very high concentrations of cholesterol as babies need it. It is raised if there’s cell healing to do, or more hormones to produce. If its too low, we risk running into trouble. More and more information is coming out regarding the whole cholesterol/statin scenario. I encourage you to read some books on the subject. Some recommendations are:

The Great Cholesterol Con
By Dr Malcolm Kendrick