(originally posted in January of 2010 and re-posted here)

read order:  cholesterol, research, statin drugs

This will be the first on a series of blogs on Cardiovascular disease (CVD). The first time most people are told they are at risk for CVD is when their cholesterol levels are checked and they come back slightly high (or they have high blood pressure, something I will cover in a future blog). It is for this reason that I will start my series on CVD with a discussion about cholesterol.
First of all, cholesterol is not the cause of CVD. This is a very important concept to understand. There is a correlation (connection) between high cholesterol and CVD, but cholesterol is not the cause of CVD. I have repeated this a couple of times just to emphasize the fact, since the focus on cholesterol (by the media and medical associations) has most people believing that cholesterol is the cause of CVD. Here is another fact. Lowering cholesterol levels with drugs has never been shown to significantly lower the risk of developing heart disease or dying due to heart disease. I will talk more about these drugs in a later blog. For now it is more important to understand that lowering your cholesterol level has not been shown to lower your risk of developing CVD, and for someone that already has CVD, lowering your cholesterol level has not been shown to significantly lower your risk of having future cardiovascular problems (including death). In fact, studies have shown that people with a low cholesterol level have a greater risk of death than those with a high cholesterol level. Remember that I did say that there is a correlation between high cholesterol and CVD, which means that a higher than normal cholesterol level indicates that you are at an increased risk of CVD, but it is probably not the high cholesterol that is the cause for the increased risk. It is more likely that whatever caused the increase in cholesterol is also responsible for the increased risk of CVD. You see, it has been recognized for some time that excess cholesterol is probably being produced by the body in order to repair chronic damage, overcome a hormone deficiency, or for other reasons i will talk about later, and most of these disorders can cause an increased risk of CVD. I will talk more about these processes in a minute.
Cholesterol is necessary for every cell in the body, in fact, human life itself is not possible without it. The integrity of each and every cell membrane in the body is dependent on cholesterol, and it will become rigid and leaky without it. Cholesterol is also needed to produce all of the adrenal hormones. These hormones include DHEA, Progesterone, Cortisol, Testosterone, and Estrogen. Many diseases that we treat are due to deficiencies of these hormones, and these hormones deficiency diseases are devastating to the lives of those who suffer from them. An absence of certain of these hormones would mean death.
Your body does its best to keep these hormones at optimal levels, so when it detects a deficiency it tries to correct it. One of the first things it needs is the precursor for the hormone, and the precursor is cholesterol. The liver will therefore increase its production of cholesterol. If everything is working properly, the adrenal gland will take the extra cholesterol to produce more of the hormone it needs and thus correct the deficiency, and the cholesterol level will drop back to normal levels. If the cholesterol level stays elevated it is a sign that everything is not working properly. You see, this high cholesterol level is a sign of something wrong in the body, so we need to focus on the ‘wrong’ that caused the high cholesterol level, not just lower the cholesterol. Another reason that you might see higher than normal cholesterol levels is when there is damage occurring to the cells in the body. This damage could be due to oxidation by free radicals, inflammation, or a number of other factors. You generally will not detect a rise in cholesterol levels due an acute injury, but a chronic process will frequently cause an increase. In this case the liver is producing larger than normal amounts of cholesterol and circulating it through the blood stream in order to reach the site of injury to repair the damage to the cells (remember cholesterol is used in all the cells membranes). So, if we lower the cholesterol levels in the body using drugs, we do not prevent the chronic damage, we only inhibit the bodies ability to repair that damage. If the damage is occurring to the cells lining the blood vessels then we may slow the formation of plaques, but we inhibit the repair of the blood vessels at the same time. And remember, just lowering cholesterol does not significantly lower the risk of CVD or death. You may have noticed that I used the words “not significantly lower” a couple of times now when referring to lowering cholesterol levels and CVD instead of stating that it “absolutely does not lower” the risk. I am not trying to be sneaky using this phrasing, it just means that there have been studies that showed a very small benefit, but when you look at all the studies on lowering cholesterol this benefit is miniscule at best, and some even show that your risk of death will increase when you use drugs to lower your cholesterol levels. I will talk about this research in another blog on the cholesterol lowering drugs.
Cholesterol is not only important in cell membranes and adrenal hormone production. It is also needed for Vitamin D production, fat and vitamin absorption, optimal neurological function, optimal immune function, and CoQ10 production. Vitamin D is needed to maintain bone strength and immune function and a deficiency of vitamin D is linked to cancer. Cholesterol is the main ingredient in bile salts and bile salts are needed for the digestion of fat and fat soluble vitamins (A, D, E, and K). Cholesterol is part of the sheath that surrounds nerve cells (needed for conduction of nerve signals) and is necessary for neurotransmitter production in the brain (allows transmission of signals from one nerve cell to another). Low cholesterol is associated with low immunity and an increased risk of infection. Cholesterol is needed for CoQ10 production and CoQ10 is a crucial substance in energy production. The heart muscle contains the largest amount of CoQ10 which is needed due to the hearts huge demand for energy. People on cholesterol lowering drugs will become deficient in CoQ10 (unless they supplement) which may eventually lead to congestive heart failure.
Cholesterol is not the villain and is not the cause of CVD. If you look at the volumes of research, not just the abstracts of the research, or the summary that is carefully written by the drug industry and distributed to the media and drug reps, then you will see that cholesterol is a whipping boy of the drug companies, used to sell more cholesterol lowering drugs.
More on the research and the cholesterol lowering drugs in the next blog.
Until then … here’s to your health