Cholesterol levels are a controversial topic in modern medicine and a source of much confusion by the general public. Cholesterol has been given so much bad press over the last few decades that the word cholesterol is automatically associated with cardiovascular disease. Cholesterol can strike terror in the eyes of even the healthiest patient. If you are concerned about your cholesterol level, we encourage you to meet with your naturopathic doctor to discuss appropriate evaluation and treatment. Our doctors can help you identify potential sources of cardiovascular inflammation, support you with stress reduction, hormone insufficiency or other possible contributing factors.
What is Cholesterol?
Cholesterol is a waxy, fat-like substance that is made in the liver and found in the blood stream and in all body cells. Cholesterol is an important constituent of cell membranes and it helps create steroidal hormones. Cholesterol is carried in the blood by different types of carrier proteins called lipoproteins. We are most familiar with HDL (high-density lipoprotein – the “Good Cholesterol”) and LDL (low-density lipoprotein – the “Bad Cholesterol”). LDL brings fat from the liver to the body cells and HDL returns fats to the liver. Increased LDL levels is associated with an increased risk of heart disease. Your body makes cholesterol because it is the building block for cell membranes and making hormones.We need cholesterol to make hormones including estrogen, progesterone, testosterone, cortisol (our stress hormone) and vitamin D. Bile acids are made from cholesterol which helps with absorption of fats and fat-soluble vitamins. Cholesterol is released on the skin to help protect against dehydration, cracking, sun and wind damage, and prevents infection from foreign organisms.
How is Cholesterol Linked to Cardiovascular Disease?
The role that cholesterol plays in the cause of cardiovascular disease has been changing over time. Research over the past decade has shown that artery problems are caused by a process called oxidation – when free radicals damage the arterial walls. Cholesterol can become oxidized (particularly LDL cholesterol), and then inflammation and plaque build-up in the blood vessel wall occur. This eventually leads to blocked blood flow through the arteries. It’s the oxidation process that leads to cardiovascular inflammation and arteriosclerosis.
High levels of cholesterol can increase the chances of developing heart disease and stroke, however it is only one of many risk factors. Major risk factors include smoking, high blood pressure, diabetes, physical inactivity and elevated blood cholesterol levels. Other important risk factors that often get ignored include low antioxidant status, low levels of essential fatty acids, low levels of magnesium and potassium, increased platelet aggregation, increased fibrinogen, elevated homocysteine, and Type A personality.
With regard to testing cholesterol levels, the traditional cholesterol levels such as total cholesterol, LDL, HDL and triglycerides are becoming outdated. Leading preventative cardiology now utilizes advanced lipid testing. This advanced testing includes lipoprotein sub-fractions and particle sizes. Also inflammatory markers are important for assessing a person’s risk. Most cases of elevated cholesterol are due to dietary and lifestyle although many cases are genetic (familial hypercholesterolemia), menopause, low thyroid, diabetes, and underlying inflammation. It is important to determine the underlying cause of the high cholesterol and appropriately assess the patient’s overall cardiovascular disease risk before determining the best approach to treatment.
Is it dangerous to have low cholesterol?
Yes, it is dangerous to have low cholesterol levels. In fact, rates of suicide and cancer go up as low cholesterol reduces the number of receptors for serotonin in the cell membranes of our brain. Increase in cancer may be due to a decrease in fat-soluble anti-oxidant vitamins such as vitamin E, A and carotene. These antioxidants are transported to cells in the same way that LDL brings fats to cells. Hypolipidemia can lead to anxiety, depression, cancer and pre-term birth in pregnant women. Less than 120mg/dL of total cholesterol is considered very low.
Lowering Cholesterol With Diet and Supplements
Changing your diet can lower your cholesterol and improve your health. Consider a Mediterranean diet which emphasizes plant-based foods and healthy fats. Research shows that a Mediterranean diet can lower your risk of cardiovascular disease and other chronic illness. A Mediterranean diet includes lots of vegetables, fruit, beans, lentils, nuts, olive oil and fish. It limits meats, cheeses, sugars and butter.
One of the benefits of the Mediterranean Diet is its focus on high-fiber foods, especially soluble fiber. This type of fiber does not dissolve in water and binds cholesterol as it passes through your digestive tract and you excrete the cholesterol through your bowels. (Other benefits of this type of fiber)
Consider incorporating the following foods into your diet which can lower your cholesterol by as much as 5%.
– Oats/oatmeal can add 1-2 grams of soluble fiber to your diet.
– Beans & legumes, all types of beans (navy, kidney, garbanzos, etc) lentils, and black-eyed peas can offer a variety of fiber options to lower your cholesterol.
– Nuts and seeds including walnuts, almonds, peanuts chia, and flaxseeds. Use a variety as snacks or on top of meals.
– Fruits such as apples, grapes, strawberries and citrus fruits that are rich in a type of fiber called pectin.
– Soy such as tofu, edamame or soy milk can lower LDL levels.
– Fatty fish are high in omega 3 fatty acids which provide anti-inflammatory effects to the cardiovascular system. Plus eating fish at dinner can take the place of heavy cholesterol-filled meats.
Supplements for Lowering Cholesterol Levels include:
– Niacin – Taking 1,500 – 3,000 mg per day can help reduce total cholesterol and LDL cholesterol and raise the good cholesterol, HDL. The no-flush form is available but not as well studied.
– Red Yeast Rice – Taking 1,200 mg twice per day has been shown to reduce total cholesterol by 11 – 32 percent. Take 25-100mg of CoQ10 with this product to prevent CoQ10 deficiency.
– Plant Sterols – Taking 1,000 – 1,500mg twice per day can inhibit the absorption of cholesterol from food.
– Fish Oil – Taking 2,000 – 3,000mg of combined EPA and DHA can reduce cholesterol and triglyceride levels.
– Garlic – Taking 300mg – 500mg of aged garlic twice per day can reduce cholesterol and increase the good cholesterol, HDL.
