Cholesterol
Background
It’s important to recognize that even though cholesterol gets a lot of attention, it’s not necessarily the most important (or even an especially significant) factor in preventing heart disease. Other factors, such as exercise, treating high blood pressure and diabetes, not smoking, healthy diet, nutritional support and optimizing thyroid function, may also decrease the risk of heart attack.
Although the cholesterol-lowering medications in use today can be lifesaving in those who have already had a heart attack or have angina, my impression is that they only decrease heart attack deaths by approximately 2-10% in those without a previous heart attack (called "primary prevention"), and they are not without risks. Some of these include muscle pain, liver inflammation, and depletion of the nutrient coenzyme Q10. This nutritional deficiency can then contribute to fatigue and congestive heart failure, and anybody on statin-family cholesterol-lowering medications (most are) should take 200 mg a day of coenzyme Q10.
To put that 2-10% benefit in perspective, let’s look at other research. Women whose thyroid blood tests show their thyroid function to be on the low vs. high side of normal were at a 69% increased risk of heart attack death. In other studies, non cat owners were 30% more likely than cat owners to die of a heart attack and chocolate eaters were 50% less likely to die from heart disease. This makes owning a cat and eating chocolate (in moderation) much more effective than cholesterol medications for preventing heart attacks (which is the purpose of lowering cholesterol).
So why all the push for using cholesterol medicines? Could it be because they sell well over $25 billion worth yearly?
In the absence of underlying heart disease and if your cholesterol under 250, a good argument could be made to skip the cholesterol lowering medications.
In addition, key causes of an elevated cholesterol include:
- Low thyroid function, even if the tests are normal (see Hypothyroidism). I recommend optimizing thyroid based on symptoms.
- Low testosterone in men. This causes elevated cholesterol, along with diabetes and hypertension. This is so even if the results are normal, but on the low side (see Testosterone Deficiency).
Treating these not only often lowers cholesterol and heart attack risk, but leaves people feeling much better!
Treatments
Diet and Exercise
Start an exercise program
Begin with an exercise program and, if overweight, bring your weight down.
Eggs
Enjoy eating your eggs and cholesterol — study after study shows that eating 6 eggs a day for 6 weeks has no effect on cholesterol blood levels. Yet this myth persists. Avoid saturated fats (hard fats) and margarine (butter is much healthier and tastier than margarine).
Garlic
Eat 1-3 cloves of garlic a day. Crushed into olive oil, it makes a yummy treat that may drop your cholesterol. In addition, have a cereal with oats for breakfast (e.g., Life, Cheerios, Quaker Oats Squares). Simply adding garlic and oats to your diet can lower your cholesterol almost as much as many medications.
Go nuts
Eating 1-2 oz of nuts a day (approximately 1-2 small handfuls) can drop cholesterol about 10% while being heart healthy and also decreasing diabetes risk. Walnuts seem best. Unfortunately, peanuts don’t count (they are actually a legume and not a nut). More good news? Eating the nuts does not seem to cause weight gain.
Recommended Supplements
Herbals that reduce cholesterol
Berberine 500 mg 2-3x a day. Supports overall metabolic health, including healthy blood sugar, cholesterol and triglyceride levels.
Red Rice Yeast
This not only lowers cholesterol, but also decreases heart attacks. I recommend the Red Rice Yeast by Sylvan Wellness as well as the one by Life Extension Foundation. Take 600 mg caps, 2 twice a day.
Coenzyme Q10
If on cholesterol lowering medications (statins), be sure to take coenzyme Q10 (200 mg a day).
Acetyl L-Carnitine
If triglycerides are also elevated, especially be sure to avoid sweets and add acetyl L-carnitine 1,000 mg a day to the above for 3 months to see if it lowers the triglycerides. I do not recommend routinely using it longer than this, as there is a possibility that too much carnitine may increase heart attack risk.
Pantethine
900 mg a day. Takes four months to work and is modestly beneficial.
Niacin
Although natural, this has a minimal benefit at decreasing heart attack deaths, has uncomfortable side effects, and can cause liver inflammation and diabetes. I don’t recommend it. If needed, it’s better to use Inositol hexaniacinate 650 mg 3x day, and avoid the flushing and toxicity (called "Flush Free Niacin").
Medications
Prescription natural testosterone
In men, especially those who are overweight, have high blood pressure, or have diabetes, or are prediabetic (a common mix called "metabolic Syndrome"), cholesterol issues could be coming from too low of a testosterone level. If your total testosterone is under 450 on the blood test, consider using prescription natural testosterone (Androgel or Testim or compounded) to bring your level up to over 700. If you don’t have prescription insurance to cover it, it is important to know that the compounded pharmacy testosterone is just as good at a tiny fraction of the cost. Do not confuse this safe healthy bioidentical testosterone with the toxic steroids that some athletes use.
Armour Thyroid
In both men and women, I recommend considering a trial of prescription natural Armour Thyroid — even if the labs are normal. High cholesterol is often caused by low thyroid and the tests are horribly unreliable (they miss the majority of those who need thyroid hormone).