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Is cholesterol really dangerous? The conviction that cholesterol is the only signal of future serious cardiovascular disease is becoming less of a certainty. Science has turned its attention to other aspects that are more indicative of cardiovascular pathologies than is cholesterol. The possible risks represented by statins are more evident while it has become clear that changes in eating habits and lifestyle are the best remedies for avoiding cardiovascular disease, even if cholesterol values remain high.

In order to really understand whether the cholesterol value given in the tests is actually a problem, you must compare the total cholesterol values to those of "good" cholesterol (HDL) as explained in the article "The correct cholesterol values" (it also includes an easy table for calculating your personal values). If the ratio of these two values it 4,5 or less, the cholesterol value is correct, even if total cholesterol is high.

Cholesterol has the reputation of being one of the great enemies of our health.  It's actually an undeserved reputation, because cholesterol performs some useful functions too. All of our cells contain cholesterol and our brain contains very high quantities of it, without which it could not function; most of the hormones made in our bodies have cholesterol as their basis; cholesterol is also thought to have the function of controlling the production of free radicals and to keep in check the development of degenerative diseases.  Furthermore, HDL Cholesterol (the "good cholesterol") keeps the arteries free and prevents arteriosclerosis.  

Remember, too, that after the age of 65, even a high cholesterol value doesn't justify treatment with drugs. In addition, cholesterol's benefits are often overlooked. For example, after the age of 80, the higher the cholesterol values, the lower the risk of death from tumors or infection Weverling AW et al, Lancet 1997 Oct 18;350(9085):1119-23).

Blood cholesterol values depend on internally produced cholesterol and not on that which is introduced through diet. Therefore, eggs have surely been rehabilitated, and to the contrary, high carbohydrate diets and food regimes rich in hydrogenated vegetable fats are the real culprits.

Statins

Statins, the drugs that theoretically fight the growth of cholesterol levels in the blood, are at the center of huge commercial interests.   Sales of this group of drugs are the highest in the world, which explains why communications on this problem may be biased by interests that are not only scientific but commercial.  Beyond the possible benefit of statins, there are harmful effects that are often not mentioned. The links in the right hand menu contain many articles that explicitly refer to these subjects. It has also been proven that these drugs lead to the consumption of Coenzyme Q10, a substance that is indispensable for muscle functioning (the heart included).

A proper diet that takes insulin and carbohydrates into account

When cholesterol values are higher than normal, diet is the first thing that must be put under control. Intake of all foods that contribute to raising HDL ("good") cholesterol levels should be increased.

Among these we can mention the moderate consumption of red wine (1 glass at dinner), the use of raw garlic and extra virgin olive oil, the use of fruits like grapes, rich in resveratrol , the use of fish that contains EPA and DHA (Omega 3 fatty acids). It's also important to return to one's ideal weight and perform prolonged, light physical activity (walking, bicycling, slow swimming). Exercise must be done on a daily basis to have any effect. The diet must follow guidelines similar to those of the GIFT diet so as to keep insulin peaks in check and formulate a signal diet.

In the past few years we have learned that a harmful rise in cholesterol is almost always related to insulin resistance.  Therefore insulin production must be controlled by way of dietary regimes that resemble that of the GIFT diet and metabolism must be kept active through exercise. Important supplements for cholesterol regulation are: some minerals, such as those contained in Oximix 6+ (1 dose per day), citrus derivatives like those present in Colestrinol (1 tablet per day),  re-balancing supplements for the liver like Inositol (form 2 to 6 tablets per day) and to some extent, Omega 3 fish oil.

Another aid can come from an investigation into possible food intolerances , for instance through a DRIA test .  The stress on the immune system caused by the persistent presence of reactions to food could cause total cholesterol to increase.  A scientific study presented at the Vancouver World Conference on allergology documented this type of effect on people who followed a controlled diet based on their food intolerances. What's more, by following a proper diet for food intolerances, a person can get back to his ideal weight while at the same time reducing the risk of cardiovascular disease.

Hold the margarine

Unfortunately many weight loss or cholesterol control programs start in a tragic way with breakfasts in which "two pieces of toast" stand out. The hydrogenated fats or transesterified fatty acids that defeat the purpose of any anti cholesterol diet are often present in foods where one wouldn't expect them like toasts, crackers, buns, etc. .  An article entitled "Cholesterol, margarine and fatty acids" discusses this subject and contains an interesting comparison table that can help clarify some of the most common errors.

What to do if your cholesterol's high. Gianpiero's and Luisa's stories

Gianpiero is 46 years old. Both his father and maternal grandfather had already had heart attacks. When his cholesterol suddenly leaped to 245 his wife and his doctor were alarmed. However, along with the cholesterol values, his doctor asked for a careful evaluation of the HDL cholesterol (good cholesterol) as well. He also looked at the other risk parameters that today are considered to be most important for heart disease prevention. The tests revealed that the ferritin was normal, the homocysteine was within limits and the C-rP (C-Reactive Protein, inflammation index) was practically unaltered.  However there was a slight alteration in the levels of fasting glycemia (around 97) and in the percentage of fat mass which was rather high (around 30%). Gianpiero only seemed to be thin! The cholesterol HDL value was 48 and so the ratio between total cholesterol and HDL was only slightly altered: just 5.1 for a normality index of between 4,0 and 5,0. His doctor wisely decided not to prescribe drugs, but asked Gianpiero to make some specific changes. He asked him to lose a few kilos of fat (being careful to avoid unbalanced low calorie diets) and he instructed him to eat a nourishing breakfast that would activate his metabolism and reduce the glycemic value. He also ordered him to take his dog out for an hour-long walk at least three times a week. The only remedies that he prescribed were fish oil (Gianpiero didn't like fish) and the minerals Chromium, Manganese, Zinc and Copper. After just 45 days, the cholesterol values were down to 224, but the good cholesterol had risen to 65 lowering the ratio between total cholesterol and HDL to 4,1 which was absolutely normal. Gianpiero had lost 2 kilos, he had modified his fat mass which was now 26% and his dog was pretty pleased, too. There was no longer any need to prescribe anti cholesterol drugs.

Before going into menopause , cholesterol had never been a problem for Luisa. The only medicine that she took was one for blood pressure that her doctor had prescribed for a value above the normal limits. However, after menopause her cholesterol went up to 260 and her doctor immediately prescribed statins in order to lower it.  Because of this problem, Luisa had anxiety and wasn't able to sleep well; so her doctor gave her a prescription for sleeping pills. At that point she was taking the typical pharmaceutical triad: statins for cholesterol, psychological drugs for sleeping and anti-hypertensives for pressure. During the summer she went to her doctor's substitute for a case of heartburn and he added a protonic pump inhibitor (lansaprazole) to the list of medicines. She continued in this way until coming to our studio 2 years later due to muscle aches. At that time her cholesterol was at 196 but the HDL at 35. We explained to her that even with her cholesterol below 200, her good cholesterol was low ( Luisa had never practiced sports) and therefore there was no reason for her to take statins, which by the way were the cause of her muscular pains, without even benefiting from them. We started at the foundation: a proper diet that regulated salt intake and allowed her to reduce her blood pressure medicine and even eliminate it after a year . We asked Luisa to start walking for at least 20 minutes per day and to begin eating fruit and vegetables. We also gave her natural remedies that helped increase her HDL values such as Colestrinol and Oximix6+.  We suggested that she supplement her diet with fish and improve the distribution of her meals according to the GIFT diet scheme. Obviously we helped her to bring even eggs back into her diet. When her good cholesterol rose to 5o we suspended the statins in a precautionary way (Luisa had already discontinued Lansaprazole after she discovered its possible side effects). Her next check up showed that, without drugs, her total cholesterol count was 194 with good cholesterol at 65. Since she had stopped taking drugs, she realized that by using natural therapies and especially by changing her lifestyle, she had achieved a state of general well-being. She is now one of our greatest fans.

 Remedies

A rise in cholesterol is to a certain extent the body's attempt to compensate for an increase in oxidizing stress.  In this sense antioxidants can be precious in balancing out the situation.

First of all the minerals that oppose oxidation, such as Zinc, Copper, Chromium, Selenium and Manganese are helpful.  Intake of these minerals reduces the production of free radicals and protects from cardiovascular disease. More specifically, you can take one dose of Selenium Vitamin C and one dose of Manganese Copper Zinc per day. Alternatively, take an equal mix of oxiprolinates like the one in Oximix 6+ (1 measure per day), that rebalances metabolism.  Preparations like Cellfood also provide important anti-oxidant support.

Vitamin E and Vitamin C have the same function.   Even more relevant is the effect of  indispensable vitamins such as B3 or PP (niacin or nicotinic acid); normal daily requirement of this substance is about 20 mg per day, but higher dosages (50-100 mg three times a day) have a very strong effect on HD cholesterol.  However, this increased dosage should be used only when prescribed by a doctor.

It may be wise to improve the functioning of the liver and of biliary drainage, since most of the body's cholesterol transits through there.   Draining remedies like the glycerite extract of Rosmarinus officinalis 1DH (40 drops in the morning in a large glass of warm water):  it's diuretic and it balances out the body's fats, at least partly.   Inositol is also useful to balance out the hepatobiliary function.

Good quality soy lecithin with a high rate of polyunsaturated phosphatidylcholine, associated with a bit of vitamin E in order to avoid the damages of polyunsaturated fats helps to keep cholesterol in check.  (Caution: many people - about 30% -- have become intolerant or allergic to soy and its derivatives, and utilizing it can be counterproductive).  In the same way, Blackcurrant oil seems to act in the same way thanks to its content of special polyunsaturated fats that have a good effect on fat metabolism.   In this case too, it is preferable to take it together with small quantities of vitamin E.  Fish oil, which is rich in EPA and DHA, helps regulate cholesterol.

We wish to point out that there is increasing evidence of the possible damage induced by statins.   It seems they might cause the loss of Co-enzyme Q10, thereby interfering with the heart's ability to contract (see articles on right-hand side). People who use statins should supplement their diet with Coenzyme Q10 (at least 20 mgs. per day) in order to partially compensate for damage caused by statins.

Rather than eating crackers, bread sticks or industrial sweets, go back to whole wheat bread and jam for breakfast and eat homemade cake as a sweet.

Suggested links

If you would like to read more on the subject of hypercholesterolemia and dyslipidemia in general, consult the Merk Manual (Lipoprotein disorders). Also refer to the information given in Wikipedia under Cholesterol .

Another interesting article is printed in the Karolinska Institutet of Stockholm's list of diseases that addresses the effects of statins on muscle (Statins and muscle ). The theme of statins is also discussed in Wikipedia  (Statin ) with an interesting description of the way in which they act upon the metabolic production of cholesterol.

Doctor Attilio Speciani
Clinical Allergist and Immunologist

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