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Cholesterol Effects and Treatment

            Cholesterol is a flat, waxy molecule that is synthesized by all animals, including humans. It is one of the most misunderstood biochemicals that have been discovered, and the mainstream media is certainly not helping the public to understand what the functions of cholesterol actually are. Cholesterol has two main functions. One is to be the raw material, or building block, for all steroid hormone synthesis in the body. Steroid hormones are very important molecules in the body that help the body deal with stress, bone health, sexual health, salt regulation, and many other functions. The second main function of cholesterol is to provide fluidity for the cell membranes of the body, so that they can function correctly at their surfaces. Most of the body’s cells are not rigid: they are flexible, and their flexibility is often related to their particular function. Without cholesterol to help cell membranes stay fluid, most cells could not perform many of their basic functions, and we would soon die as a consequence.

            Cholesterol is therefore a very important molecule, absolutely crucial to life and health. In fat, too low of a cholesterol level can result in increased suicide and cancer risks (1). On the other hand, although normal levels are cholesterol provide very positive functions in the body, too high of a cholesterol level can be harmful to the heart and the rest of the cardiovascular system. High cholesterol can also contribute to high blood pressure, gallstones, mental problems, and impotence (2). Cholesterol has often been blamed as a main cause of many chronic diseases, such as heart disease. However, cholesterol consumption has remained constant during the last 100 years, but heart disease has increased dramatically (1). Therefore, cholesterol consumption alone cannot be responsible for the increase in heart disease. Much of the reason for this is that, for the average person, only about 20% of their blood cholesterol comes from the animal products that they eat in their diet, and the other 80% is made from their liver (3). Major dietary sources of cholesterol include eggs, meat, and dairy products. According to Dr. Udo Erasmus, a world-renowned expert on fats and their metabolism, almost everyone can control their cholesterol levels by diet alone (1).

            Since cholesterol is a waxy molecule, it cannot be dissolved in blood, which is mostly water. This is similar to oil and vinegar salad dressing: the oil and vinegar don’t mix, because the vinegar is mostly water. This is due to water attracting more charged molecules. Since oils are generally not charged at all, they cannot attract water and can’t enter the bloodstream by themselves. Due to this problem, special proteins are needed to shuttle cholesterol in the bloodstream to its various destinations in the body. The cholesterol, which is a form of lipid, and cholesterol-shuttling proteins are known as lipoproteins. There are different densities of lipoproteins, depending on how much lipid is bound to the proteins. Low density lipoprotein (LDL) transports cholesterol in the bloodstream to where it is needed. High density lipoprotein (HDL) then comes in to clean up any excess cholesterol. HDL is known therefore as the “good” cholesterol because it regulates the levels of LDL cholesterol. Excess cholesterol is taken back to the liver by HDL, then broken down and excreted.

            When HDL levels are too low, LDL levels are too high, or there are not enough antioxidants in the bloodstream to protect the cholesterol, then it may end up sticking on arterial surfaces. In fact, one of the uses for cholesterol by the body is to help repair damage in certain tissues. Unless it has been oxidized, cholesterol is actually more helpful to the body than it is harmful. If the cholesterol does happen to become oxidized and stick on the arterial wall, immune cells called macrophages then come in to clean up the oxidized cholesterol. If there is a large amount of oxidized cholesterol in one area, the macrophages will end up taking in the damaged cholesterol until they die, and actually become part of the arterial deposit, called a plaque. Arterial plaque that builds up can restrict blood flow from the heart, which can result in many serious subsequent illnesses.

            Most health professionals recommend LDL levels to be below 130 mg/dl (milligrams per deciliter). To help visualize an LDL level of 130 mg/dl, you could think of it as 130 parts in 100,000, or 1.3 parts per thousand (0.13% of the bloodstream’s components). HDL levels are recommended to be over 40 mg/dl. Many practitioners feel that the total cholesterol/HDL ratio is more important for gauging overall health than the HDL and LDL numbers alone. The total cholesterol level is generally agreed to be under 200 mg/dl for a healthy person. In general, a total cholesterol/HDL ratio that is considered healthy is under 4 (ex. 160 mg/dl cholesterol and 40 mg/dl HDL).

            Although fats such as cholesterol serve important structural and hormonal functions, what about the fats that are used for energy utilization? These are known as triglycerides: they have a different structure and function than cholesterol. They consist of three fatty acid chains linked to a small molecule called glycerol. Gram for gram, fatty acids have more than twice the energy as protein or carbohydrates. A normal triglyceride level in the bloodstream is under 150 mg/dl. There are four main types of fats that come from foods. Saturated fats are most often obtained from animals. They tend to raise LDL levels. Monounsaturated fats are from plants, such as olives and peanuts. They help lower cholesterol levels and also fight oxidation (4). Polyunsaturated fats are mostly derived from plants. They help lower both total cholesterol and LDL levels. Unfortunately, like cholesterol, polyunsaturated fats themselves are easily oxidized. Flaxseed oil is a good example of a polyunsaturated fat. Trans fats are artificially made to help solidify them for convenience. Margerine is a good example of a trans fat. Trans fats not only raise cholesterol and LDL levels, they also lower HDL levels (4). 

            There are many different factors that can influence cholesterol levels. When carbohydrates are ingested, the hormone insulin is released into the bloodstream. Insulin then increases cholesterol production (5). Stress can also increase cholesterol production, since cholesterol makes stress hormones (1). In fact, as mentioned earlier, cholesterol is the building block for all steroid hormones (5). Unfortunately, the level of cholesterol alone is not the only factor that determines how healthy a person’s arteries are. When mineral and vitamin antioxidants are low, cholesterol can be used as an antioxidant in the bloodstream (1). The oxidized cholesterol has sacrificed itself to neutralize a damaging free radical molecule. However, the situation inside the body is now even worse, because the oxidized cholesterol then ends up binding to arterial walls. Immune cells try to clean up the damaged cholesterol, but they end up dying and sticking to the arterial wall too. The above process then progresses to atherosclerosis (heart disease).The above explanation of the danger of oxidized cholesterol is an additional reason to supplement with antioxidants.

            Current medical recommendations are to keep total cholesterol lower than 200 mg/dl. However, the association between high cholesterol and death is not apparent until the level is over 240 mg/dl. Therefore, the level between 200 mg/dl and 240 mg/dl is often termed “borderline high” cholesterol levels (4). There is some controversy about when to use cholesterol-lowering drugs, since cholesterol levels can actually be dangerous if they fall too low (6). Some experts disagree that high cholesterol should be blamed for heart attacks. The average blood cholesterol level of a heart attack patient is 244 mg/dl. This is only 20% greater than the average American’s cholesterol level, which is 205 (7). Also, one out of three heart attack victims have cholesterol levels under 200 mg/dl (8).

            Niacin (vitamin B3) has been used both clinically and holistically to reduce cholesterol levels. The amount of niacin to achieve this is very high, over 1000 mg a day (the average B-complex supplement has only 50 mg). Although niacin is a naturally-occurring vitamin, in very high doses it can have several side effects. These may include: liver damage, skeletal muscle problems, eye problems, heart abnormalities, glucose intolerance, and peptic ulcers (9). Vitamin C can lower cholesterol levels (10). The two-time nobel prizewinning scientist Linus Pauling has also noted that vitamin C can help with heart health in two additional ways: by strengthening arterial walls, and by converting cholesterol into bile acids, which in turn help fat digestion and subsequent metabolism (10). 

            There is currently some controversy about vitamin E supplements. In theory, they should be taken in order for their fat-soluble antioxidant’s ability to protect cholesterol in the bloodstream. In reality, high doses of vitamin E (400 IU/day or more) may actually increase the death rate a small percentage by as yet unknown mechanisms (11). Vitamin E supplements normally come as just one form, alpha-tocopherol. In nature, vitamin E exists as four major forms, alpha, beta, gamma and delta tocopherols. Taking too much alpha-tocopherol may inhibit the assimilation and actions of the other three vitamin E species. If someone decides to supplement with vitamin E, make sure that it is natural and contains all four forms of the vitamin. Also, in the ten studies that showed vitamin E to be harmful (11), five studies were done on patients that already had established diseases that were serious, and may not be helped simply by taking more of one vitamin. Eight out of the ten studies also had the average age of study patients over sixty years, which means that most of them have been accumulating oxidative damage in their bodies for several decades before any antioxidant therapy was initiated. For now, if you choose to supplement with vitamin E, take only 200 IU/day of mixed tocopherols, unless otherwise directed by your physician.

 

There are a number of cholesterol-lowering medications on the market. Below are listed the potential side effects of these medications.

Statins (block cholesterol production)

Fluvastatin (Lescol), Simvastatin (Zocor), Pravastatin (Pravachol), Lovastatin (Mevacor)

Muscle and liver problems for all statins. Mevacor also increases inflammatory fatty acids

Fibric Acids (block cholesterol production)

Gemfibrozil (Lopid), Fenofibrate (Tricor)

Gallbladder problems, Liver & kidney toxicity

Bile Acid Sequestrants (lower blood cholesterol)

Cholestyramine (Questran), Colestipol (Colestid), Colesevlam (Welchol)

All sequestrants relatively safe; Questran not as safe for children

 

Here are some potential side effects of natural cholesterol-lowering supplements and herbs:

Herbs

Guggulipids, extract of Commiphora Mukul from the Myrrh herb: May cause hypoglycemia

Garlic: Allergic reactions, bleeding, several drug-garlic interactions

Grains and Yeasts

Red rice yeast extract: Contains the active ingredient Lovastatin, so toxicity the same as Lovastatin above

Minerals

Chromium Picolinate: Possible mild hypoglycemia

Fiber

Guar Gum; Rare hypoglycemia cases 

Oat Bran: Occasionally raises triglyceride levels

Apple Pectin: Relatively safe, may lower some drug levels in the body

Amino Acids

L-Carnitine: Rare seizure cases

 

            There are some additional interesting facts about how to regulate cholesterol levels: High-fiber diets are one of the best ways to help regulate blood cholesterol levels (1). Too much coffee (several cups per day) can raise cholesterol levels. Cooking with extra virgin olive oil is beneficial for people with high cholesterol. There are many different ways to help keep someone’s cholesterol levels in a healthy range by natural means. One can explore several avenues of naturally treating high cholesterol if they do not want to take the pharmaceutical drug path.

References:

1. Erasmus, U. Fats that Heal, Fats that Kill, 14th Ed. Burnaby, BC (Canada): Alive Books, 1993.

2. Balch, P. Prescription for Nutritional Healing, 3rd Ed. Avery Books/Penguin Putnam Inc., 2000.

3. Fleming, R., & Monte, T. Stop Inflammation Now! New York, NY: Putnam, 2004.

4. Litin, S., ed. Mayo Clinic Family Health Book, 3rd Ed. New York, NY: HarperCollins Books, 2003.

5. Sears, B. The Zone. New York, NY: Regan Books / HarperCollins Publishers, 1995.

6. Eades, M., & Eades, M. The Protein Power Life Plan. New York, NY: Warner Books, 2000.

7. Physician’s Committee for Responsible Medicine---(orig. manuscript in Italian), published online 12/17/2000.

8. Feinstein, A. Healing with Vitamins. Emmaus, PA: Rodale Books, Inc., 1996. 

9. PDR Generics, 3rd Ed. Montvale, NJ: Medical Economics Company, Inc., 1997. 

10. Pauling, L. (1974). Are recommended daily allowances for vitamin C adequate? Proceedings of the National Academy of Sciences, 71(11): 4442-4446.

11. Miller, ER, et. al. (2005). Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Annals of Internal Medicine, 142(1): 1-11.

About the Author

Dr. Jensen is both a consultant and author in the BioMedical and Nutrition fields. He has previously written a book on both topics, The Failures of American Medicine, published in 2002. Dr. Jensen has also written a doctoral dissertation on how Vitamin C can reduce stress and allergies via its antihistamine effect. He has worked in a broad range of BioMedical fields, such as gene regulation, cancer research, and HIV vaccine development. However, Dr. Jensen eventually decided that helping people more directly would be more rewarding for everyone involved. He has since helped clients with dozens of different ailments. Dr. Jensen is a practitioner in the field of Metabolic Typing, which characterizes different biochemistries among people based on certain physical and behavioral traits they have.

You can contact Dr. Jensen at 1-800-390-5365, or mail him at drjensen@individualizednutrition.com.