Wednesday, 1 January 2014

Is Cholesterol Good or Bad?

The cholesterol issue comes home, quite literally, when someone close within the family suddenly finds themselves with blocked coronary arteries and ends up doing a stint on the operating table. Suddenly cholesterol-lowering statins and heart-regulating beta-blockers become de rigueur, and a seriously low-fat diet (except for fish oils) is on the daily menu. This post examines the cholesterol/statin issue. I’ll leave diet for another time.

Anyone who knows me at all knows I’m not one to blindly accept the doctor’s advice without doing my own investigation and research. Although they almost always mean well, doctors promote “best practice” medicine, which usually relies heavily on what they’ve been taught, “conventional wisdom,” and the drug treatments encouraged by pharmaceutical companies anxious to increase sales of their products. Like antidepressants (one of my pet topics, see my post on psychiatric med use), statin drugs are heavily promoted in spite of some rather questionable assumptions about the role of cholesterol in the body.

The standard medical view is based on a [rather shaky] assumption that too much cholesterol causes heart disease. Since statins lower the amount of cholesterol in the body, it is assumed that statins help prevent heart disease.  But what is this stuff called cholesterol anyway? Where does it come from? Does it really cause heart disease? Is it healthy to artificially control your body’s production of cholesterol? And are statins safe?

Cholesterol is a waxy, fat-like substance that is manufactured by the liver. It is essential for the healthy functioning of every single cell in your body. It is so essential that without cholesterol, you would die. Kaput. Nada. End of story. It is also essential for the production of hormones, for digestion, for the healing of injuries, for the distribution of essential vitamins, and for brain function. In fact, the brain contains around 25% of the body’s total cholesterol, which may explain why many folks who take cholesterol-lowering statin drugs complain of brain “fuzziness” and memory loss.

A small portion of the body’s cholesterol may be derived from the saturated fats found in animal products, but the majority is made by the liver. Cholesterol is so essential to life, Mother Nature has ensured the body can produce this essential substance regardless of what a person eats.

Many health practitioners talk about two kinds of cholesterol, one called “good” cholesterol (HDL) and the other “bad” cholesterol (LDL). In fact, HDL and LDL refer to the lipoprotein molecules that transport the cholesterol around the body, not to the cholesterol itself. Cholesterol is just cholesterol. Cholesterol carried by HDL is more tightly bound to the carrier than that carried by LDL and therefore is less likely to be “off-loaded,” and thus is less likely to end up as part of the plaque build-up inside artery walls that is blamed for most heart disease. On the other hand, it is the cholesterol released by the LDL that helps repair and heal injuries that may have occurred to the artery walls. So you do want this stuff helping to heal your injuries or not?

A study begun in the 1940s identified high blood cholesterol levels as one of several factors linked with heart disease. When the pharmaceutical company Merck developed a drug that could block the enzyme responsible for the manufacturing of cholesterol in the liver in 1976, they thought they were on to something that could become a major money-spinner. They got their new drug lovastatin approved by the US FDA in 1987, after clinical trials demonstrated its effectiveness in lowering cholesterol.

Today, there are six statin drugs approved for use within the US, and they are widely prescribed for men and women (and, oddly, even children!) whether or not they have heart disease. However, a meta-analysis of eleven large studies showed no significant difference in mortality rate between people taking a statin and not taking a statin as a heart disease preventative, nor any benefit for women whatsoever, even if they have been diagnosed with heart disease. The benefit for men with diagnosed heart disease is small but statistically significant (a 2-4% decrease in mortality from any cause, depending upon the study and over the time period of the study, 4-6 years in most cases). See Barbara H. Robert's book The Truth about Statins for more details on these studies.

You can actually take this a step further. When Zoe Harcombe analysed the World Health Organisation (WHO) data on a country-by-country basis, it became clear that low cholesterol levels are associated with a HIGHER risk of heart disease, and high cholesterol levels are associated with a LOWER risk of heart disease, and that is a statistically relevant difference. But nobody wants to talk about that.

Clearly, there is good money to be made by the pharmaceutical companies if they can convince you and your doctor that preventative statin treatment IS of value, so they’re hardly going to go out of their way to point out their drugs don’t prevent heart disease.

Furthermore—and they don’t like to talk about this either—statins come with certain side effects and risks. A Dutch survey found 40% of statin users reported muscle pain, 31% reported joint pain, 16% reported digestion problems, and 13% complained of memory loss. The US FDA warns use of the drugs can result in liver damage, muscle damage, the development of diabetes, and brain impairment. A low cholesterol level, drug-induced or not, is also associated with a higher suicide risk.

I’d like to come back to the original supposition made by the medical community, that high cholesterol causes heart disease, and suggest an alternative. I think high cholesterol is a symptom of heart disease, rather than a cause, like a rash is a symptom of measles or bleeding is a symptom of a cut. When you’re immune system is out of whack or there is injury somewhere that needs repair, or you are simply going through a normal aging process (cholesterol levels naturally go up as we age) I think your body increases production of cholesterol to deal with those issues.

I have an enormous amount of faith in Mother Nature. I believe our bodies are intelligent and designed to serve us, and to heal when some damage has been caused. I don’t think a chemical intervention is superior—especially as a “preventative”—to Mother Nature’s own way. Just my thoughts.

If you’d like to know more, follow the links in the post. The  book The Great Cholesterol Con by Malcolm Kendrick and the documentary video Statin Nation are also recommended.

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