Even from a natural health point of view, there are two different points of view about the validity of lipid or cholesterol testing.
One is that the total cholesterol is meaningless, and we need to look at the breakdown to more accurately determine risk.
The other is that cholesterol readings are ALL completely meaningless and have no relevance to heart disease at all.
I’m inclined towards a combination. Look at the breakdown to get what information you can from it, but use other diagnostic methods to see what your true risk is. And whatever you do, do not take statins under any circumstances. They have been proven beyond doubt to destroy health, sometime beyond repair.
The Saturated Fat & Cholesterol Myths
Uffe Ravnskov wrote about this many years ago, in his books “The Cholesterol Myths” and “Fat and Cholesterol Are Good For You!”
He has a lot of research showing that there are no correlations between:
- consumption of saturated fat and cholesterol levels
- cholesterol levels and heart disease
- or even directly between consumption of saturated fat and heart disease
He explains that the original research by Ancel Keys, which showed a correlation between cholesterol and heart disease, was flawed as the data was “cherry picked” to prove what his employers wanted to prove. Keys later admitted this. At the time, doctors protested his findings, and said they were wrong. But the hypothesis kept being repeated until it became accepted as nutritional truth.
Essentially we have been sold a pack of lies which have been of benefit to:
- the so called vegetable oil industry (they are actually seed oils), who were Keys employers
- the pharmaceutical industry, who have made a fortune from statins
This has been at a double cost to the population. There has been a huge direct cost from the damaging effects of statins. But even if you’ve managed to avoid those, if you fell for the lie about saturated fats and have been avoiding them, you will have been missing out on the essential nutrients that animal foods and saturated fats contain.
This article from Statin Nation shows how cholesterol “guidelines” have changed over time to create more statin customers
Why we need saturated fats in our diet
We need saturated fats for their fat soluble vitamins. For example:
- Vitamin A is only found in animal foods. The carotenes which are often erroneously called Vitamin A can only be converted to usable Vitamin A under certain conditions
- Vitamin D can only be obtained from animal foods or the sun. We can only metabolise D from sun exposure if the sun is high in the sky, we have nothing between the sun and our skin (eg. windows, sunblocks) and there is cholesterol present.
They are also needed for many structural roles in the body, and are a source of energy.
For more information, see this article by Chris Masterjohn
Why we need cholesterol
Cholesterol is an important nutrient used in many of our body’s processes, including:
- Repair of damaged cells
- Manufacturing hormones, including the sex hormones and those needed to manage stress
- Brain function and production of neurotransmitters
- Maintaining the lining of the intestines
- Proper utilisation of vitamin D
- Production of bile salts needed to digest fats
- It is an antioxidant
For more information, see this article on cholesterol
The risks of low cholesterol levels
It has been shown that low levels of cholesterol may:
- Increase the risk of depression
- Increase the risk of commiting suicide
- Lead to violent behavior and aggression
- Increase your risk of cancer and Parkinson’s disease
For more information, see this article by Dr Mercola
Looking at the breakdown
This is a summary of an article by Tom Cowan, from the board of the WAP foundation. For those of you in NZ, I have converted the ranges to the NZ system, which are in [ ], and used a NZ case study.
Dr Cowan feels “it is good to go over the lipid panels with my patients from a conventional point of view, mostly to show them that by assuming the numbers are relevant, we can show that, in fact, their diet is working. What we are taught in the most contemporary school of lipidology is that there are four independent ways of reading these numbers, each with increasing relevance. For each marker you can divide people into no risk, low risk, medium risk, and high risk.”
Total Cholesterol is an extremely insensitive test. US guidelines (at the time Dr Cowan wrote the article):
- No risk: less than 150 mg/dL [NZ = 3.9 mmol/L]
- Low risk: 150 – 200 [3.9 – 5.2]
- Medium risk: 200 – 250 [5.2 – 6.5]
- High risk: greater than 250 [6.5]
In NZ, we are told that we should be aiming for cholesterol of under 4.0. But Dr Cowan reminds that having a total cholesterol of less than 3.9 puts us in the highest risk category for cancer and early death and lots of people with cholesterol levels over 6.5 live long healthy lives.
Using a real world example from my files, a middle aged woman had a total reading of 5.5 and was told statins would be beneficial. But we can straight see that even at this level, the risk is only Medium.
Total Low Density Lipoprotein or LDL, the so-called “bad” cholesterol, is a slightly more specific test is for . This type of lipid is thought to be made in your liver and to contribute to the development of coronary artery disease.
- No risk: less than 100 [2.6]
- Low risk: 100 -130 [2.6 – 3.38]
- Medium risk: 130 – 160 [3.38 – 4.16]
- High risk: greater than 160 [4.16]
In our case study, the LDL was 3.4, still supposedly Medium risk.
From Dr Cowan’s viewpoint, this probably means that her liver senses a need for a lot of this type of lipid in her system. He goes on to say “While I am not convinced this is related to coronary artery disease, very high LDL levels often tell me there is oxidative stress or a liver imbalance in the patient. For this condition I give 1 capsule per day of OPC synergy, a food-based antioxidant, from Standard Process and 1 teaspoon/day of an herbal bitter tonic, the best being Globe Artichoke Extract from MediHerb. This intervention will usually lower the LDL by 10-20 percent.”
A lot of experts are now viewing high LDL as just an indicator that the body is in healing mode. Think about what healing might be taking place or what stress your body might be under, and look at ways to support the healing.
High Density Lipoproteins or HDLs, the so-called good guys. These compounds are said to direct supposedly atherogenic fats away from the blood vessels and to the liver for processing. It is generally conceded that the HDLs are more specific for risk assessment than the above two values.
- No risk: greater than 75 [>1.95]
- Low risk: 60 -75 [1.56 – 1.95]
- Medium risk: 40 – 60 [1.04 – 1.56]
- High risk: less than 40 [1.04]
In our case study, the level was 1.89, in the Low risk category and not too far off No risk. Dr Cowan says “The most important thing .. is their positive protective HDL levels.”
The ratio of total cholesterol/HDL is considered to be by far the most sensitive way of assessing these numbers is . This gives you a sense of how much of a contribution the good HDL is to the total. This is considered the gold standard of evaluating lipid levels.
- No risk: less than 3.5
- Low risk: 3.5 – 4.5
- Medium risk: 4.5 – 5.5
- High risk: greater than 5.5
In our case study, the ratio was 2.9 ie No Risk.
Dr Cowan says “It is known .. that the HDL level is inversely related to the triglyceride level. For me, the triglyceride level is a key indicator because it is directly related to the amount of carbohydrates consumed as a function of exercise The more carbohydrates, of any kind, the patient consumes, the higher the triglyceride levels and the lower the HDL. So, I use lipid panels to tell me whether my patients are consuming too many carbohydrates for their activity level. If they are, the total cholesterol level will be more than double the triglycerides and the HDL will be low. I vigorously correct this by suggesting lower carbohydrate intake (yes, even grains and fruit) and encouraging more exercise or physical activity.”
In NZ, the guidelines are <1.7 mmol/L and my client’s level was 0.5
And remember that this healthy woman, who went to her doctor just for a check up, was told she needed statins!
What are the real causes of heart disease?
Tim Noakes speculates in this article that high carb diets and the subsequent insulin resistance lead to Non Alcoholic Fatty Liver Disease and then to heart disease.
Dr Tom Cowan has a different theory. While he advises, like Dr Noakes does, a diet low in sugar and liberal in healthy fats, his theory is that heart attacks happen at the level of the autonomic nervous system:
First comes a decrease in the tonic, healing activity of the parasympathetic nervous system—in the vast majority of cases the pathology for a heart attack will not proceed unless this condition is met. Think of those who are always pushing themselves, who never take time out, who have no hobbies, who constantly stimulate the adrenal cortex with caffeine or sugar, who do not nourish themselves with real food and good fats, who do not incorporate a regular pattern of eating and sleeping into their daily lives.
Then comes an increase in the sympathetic nervous system activity, usually a physical or emotional stressor. This increase in sympathetic activity cannot be balanced because of chronic parasympathetic suppression. The result is an uncontrolled increase of adrenaline, which directs the myocardial cells to break down glucose using aerobic glycolysis. Remember that in a heart attack there is no change in blood flow as measured by the pO2 in the cells. This step shunts the metabolism of the heart away from its preferred and most efficient fuel sources, which are ketones and fatty acids. This explains why heart patients often feel tired before their events. This also explains why a diet liberal in fat and low in sugar is crucial for heart health.
Statins, which supposedly help prevent heart attack and stroke, can themselves be direct causes of heart disease, as they deplete the body’s supply of Co-Enzyme Q10, a vital nutrient for the heart.
It seems likely that other nutrient deficiencies could also contribute to less than optimal heart health.
How can we determine true risk of heart (and other) disease
A lot more is now known about different types of LDL particles than when Dr Cowan’s article (above) was written. Large, fluffy LDL particles are benign but the small, dense ones are a risk factor. If your LDL is high, ask for a particle size test.
There are several other blood tests that are more closely correlated with heart disease risk
- C-reactive protein (CRP) is produced by the liver. High levels indicate inflammation in the body.
- Having elevated levels of homocysteine in the blood (hyperhomocysteinemia) is associated with atherosclerosis and blood clots.
- The Lp(a) test is used to identify an elevated level of lipoprotein (a) as a possible risk factor in the development of cardiovascular disease. The Lp(a) level is largely genetically determined but can be affected by factors such as high blood sugar.
Even more important for many aspects of health is to keep an eye on your blood sugar management. Ask your doctor to check:
- Fasting blood glucose
- HbA1c – shows your historical blood glucose (about 3 months)
- Fasting insulin – this is not commonly done and in NZ you will have to pay for it yourself. But this can highlight problems with your blood sugar management long before the blood sugar itself appears high
It may be possible to have your coronary arteries examined by electron beam computed tomography (EBCT). This is a fully evaluated, non-invasive, extremely low radiation, quick, painless technique for precisely detecting and locating any calcified plaque in coronary arteries.