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Cholesterol: Friend, Foe or SuperHero?

I am still amazed – and concerned – when a patient walks in with blood test results and says “(another) physician  says my cholesterol is too high and I need to be on statins.” Typically the “high” cholesterol is between 200-250 mg/dl.

Multiple studies report that the following effects are associated with higher, rather then lower Total Cholesterol levels :

  • better mental health
  • increased hospitalization survival
  • faster sports injury recovery
  • better coronary heart disease survival

 In the case of coronary heart disease, for which high cholesterol is considered a “high risk” factor, better survival is associated with Total Cholesterol greater than 240. This research, from multiple studies and meta-analyses (studies of multiple studies) started gaining momentum in the late 1990’s – and continues to be replicated in the current scientific press. We have “forgotten” that healthy Total Cholesterol was up to 300 mg/dl before statins were designed and marketed.

Total Cholesterol is not even a meaningful parameter, except as an indicator to examine the subunits of the cholesterol panel. Let’s look at the typical “cholesterol panel/lipid profile” blood test. The value of Total Cholesterol is obtained by a formula of adding 2 different kinds of lipoproteins (fat-proteins) and a lipid (fat) to obtain an estimate of a different kind of substance, neither lipoprotein nor lipid, but cholesterol. That’s somewhat comparable to adding up the orange sections, strawberries, and blue berries in a fruit salad to estimate the number of melon balls. 

Are cholesterol test results useful?  Yes!  Those test results can point to underlying mechanisms or suggest the need for further subunit testing.  How to get useful information for  your health from your lipid profile is another topic.

So who or what is cholesterol and why do relatively “high” levels (by current lab standards) contribute to better health, recovery, and mental and physical survival? Here are some of the reasons why some physicians, myself included, consider cholesterol one of the most important molecules in the body:

  • Cholesterol is produced in the brain, by the brain, for the brain, in the amount of 20-25% of the total amount of cholesterol produced in the body.
  • Cholesterol is the most produced molecule in your body, produced primarily in the liver for distribution throughout the body.
  • Cholesterol is a substance found in every living cell in your body:
    • 1) in the membrane or “skin” that surrounds every cell and defines its function; and
    • 2) internally, in the working of the cells.
  • Cholesterol is the required base to construct every steroid hormone your body produces. Steroid hormones include the reproductive hormones that help define us as male or female, the hormones that regulate the immune response and metabolic activity, that stabilize our blood sugar and mineral concentrations, and that regulate our blood pressure. 
  • Cholesterol is embedded in the protective myelin sheath that surrounds every nerve in your body, and the axons of your brain’s neurons.

I’m not in support of casually depleting such an essential component for brain, hormonal, and immune function and cellular integrity without examining the underlying mechanisms.

The body requires healthy levels of cholesterol. We don’t know precisely what the healthy level of cholesterol is for any particular person, except in the context of the rest of their physiology, function and history.  Decreased cholesterol levels are associated with practically every degenerative human condition including cancers, Alzheimer’s, HIV, death from pneumonia and flu, as well as infertility and erectile dysfunction, and violent crime and suicide. The well-known side effects of statins, including  memory loss, dementia, and muscle pain suggest that lowering cholesterol is not addressing the underlying problems. Proper cholesterol balance, and proper understanding of the roles of its associated lipids and lipoproteins, is central to your physiology and health.

Be mindful that extremely high levels of cholesterol, or any natural body substance, indicates a problem. (Not that it necessarily is the problem, but it indicates a problem.) 

I hope the next time you get test results, you’ll have more questions to ask your physicians.  

There’s lots more to learn. But have you reconsidered your casting of cholesterol as friend, foe or superhero?

Dr M