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The True Facts About Cholesterol

by Leanne J. Sotir, PhD, RNCP

What Is Cholesterol  

The true facts About Cholesterol

Cholesterol is a molecule in the sterol family and found in most of our body tissues. Sterols are waxy insoluble substances that are only soluble in fats and oils. Because the cholesterol molecule is not soluble in watery substances or blood, it needs to be carried through the bloodstream via lipoproteins. Lipoproteins are mixtures of proteins and fat molecules. The two forms of lipoproteins (often referred to as cholesterol) that most people are familiar with are HDL (high-density lipoprotein) and LDL (low-density lipoprotein). These forms are actually not cholesterol but are lipoproteins that carry the cholesterol molecule from the liver, through the bloodstream and back. LDL carries cholesterol from the liver into the blood to the rest of the body. LDL cholesterol is often referred to as “bad” cholesterol by mainstream medicine because it is more prone to oxidation and plaque formation because of its smaller particle size. HDL Cholesterol is often referred to as the “good” cholesterol by mainstream medicine because it carries cholesterol back to the liver where it is recycled for later use. There is no difference between HDL and LDL cholesterol except the density of the molecules.

Cholesterol is found in the bloodstream and in every cell in our bodies and our liver manufactures approximately 70 -80% of it. The liver will produce the amount of cholesterol your body needs to maintain health. If you consume cholesterol from natural food sources, your liver will adjust and make less of it. Ravnskov (2000) states the cholesterol in your food has little or no influence at all on the cholesterol in your blood (p. 110).  Cholesterol is a vital component of the body and has many health benefits; without it we would not be alive.

Health Benefits of Cholesterol

  • It is needed for the healthy function of the body and the brain.
  • It is an essential component of every cell membrane, and helps maintain the health of the cell wall by repairing and replacing damaged cells.
  • It is used to make hormones such as:  Vitamin D, steroids, progesterone, estrogen, and testosterone.
  • It is also needed to make bile and digestive juices to help digest fats.
  • It is needed to maintain healthy neurological function
  • It increases the number of receptors needed in the brain to produce serotonin.
  • It is known to have antioxidant properties which help neutralize toxins in the body that help fight infection.
  • It is a key component of the Myelin Sheath (a white waxy coating that protects and insulates the nerves of the brain and spinal column).

Are High Cholesterol Levels Hereditary?

Most cases of high cholesterol are from poor diet and lifestyle choices. Familial hypercholesterolemia is a rare, genetic defect in a person that inhibits their ability to metabolize cholesterol. This inborn condition is diagnosed by a medical professional when a person has extremely high levels of cholesterol (above 350 dl/mg) and shows severe vascular changes early in life. A little less than 1 % of humanity actually has familial hypercholesterolemia or some other kind of genetic problem that interferes with fat metabolism (Ravnskov, 2000).

Are Cholesterol Levels a Good Indicator of Vascular and Cardiovascular Disease?

High cholesterol levels are a symptom not a disease. The information and education given to the public should not be about if there is a connection between cholesterol and vascular disease but what is the connection.  Cholesterol is necessary for far too many functions in the body to be promoted as something that shouldn’t be there. If a person has increased levels of cholesterol, it is at least in part because of increased inflammation in the body (Mercola, 2010).  This silent inflammatory state in the body can set of a cascade of reactions including free radical damage, LDL oxidation, and chronic systemic inflammation.

What Causes Vascular and Cardiovascular Disease:  The Cycle of Inflammation, Free Radicals and Oxidation

Many people are aware and understand that plaque in the arteries play a major role in vascular and cardiovascular disease. There has been a lot of misinformation as to how someone forms plaque in their arteries. Plaque is not formed from the cholesterol produced by the liver or the amount of cholesterol that is consumed in food.  It is formed in the arteries from Oxidized LDL Cholesterol. This LDL Cholesterol itself does not pose a problem but is a cause for concern when it becomes oxidized. Its smaller molecule size makes LDL more susceptible to the oxidation process. How LDL oxidation occurs is from a cycle of inflammation, free radicals, oxidation, and chronic systemic inflammation. Inflammation in the body, often referred to as “silent Inflammation”, can be from many different factors such as blood sugar abnormalities and obesity (See full list of risk factors below). This can cause and overproduction of free radicals within the body. Free radicals are a by-product of a natural process in the body that happens at a cellular level with such necessary things as digestion, metabolism, breathing, and exercising. They can also be caused by negative lifestyle choices such as a processed food diet and smoking (see full list of risk factors below). These free radicals can cause a problem within the bodywhen we are depleted in antioxidants and other nutrients that are necessary to combat an overproduction of them.  Sinatra (2000) states “without these sufficient antioxidants present to “sponge up” the free radicals, they can run roughshod throughout your cardiovascular system, setting you up for heart disease” (p. 56-57). These free radicals cause the process of Oxidation in the arterial wall, leading to the oxidation of LDL Cholesterol. This continuous cycle of Inflammation, free radicals, oxidation, and chronic systemic inflammation is what causes plaques to form in the vascular wall of the arteries. This may cause your liver to produce more cholesterol to heal the vascular lesions caused by the plaque buildup. Higher cholesterol levels can be a sign of vascular and cardiovascular disease, but testing this number alone cannot predict if a person is laying down plaque. Further investigation by your doctor (see list of additional testing that can be done by your medical professional below) can confirm if this cycle is going on in your body as well as reviewing your risk factors.

Risk Factors That Contribute to the Cycle of Inflammation, Free Radicals and LDL Oxidation

  • Chronically elevated blood sugar and insulin levels. Insulin and blood sugar imbalances such as insulin resistance, pre-diabetes, type 2 diabetes, and metabolic syndrome are strong indicators of vascular and cardiovascular disease.
  • Poor diet of processed foods. Including bad fats and oils such as margarines, trans fats, polyunsaturated oils (corn, soy, and canola), refined carbohydrates, fried foods, all fast foods, and all sugars including fructose and high fructose corn syrup.
  • Smoking (including second hand smoke)
  • Heavy metals such as cadmium, aluminum, mercury and lead.
  • Excessive Alcohol
  • Infections caused by bacteria or fungus
  • High Blood Pressure
  • Physical inactivity
  • Radiation
  • Lack of healthy essential fatty acids such as omega 3’s. This can cause an unhealthy balance between omega 3 fatty acids and omega 6 fatty acids, causing an inflammatory state in the body.
  • Oxidative stress from a deficiency of nutrients and antioxidants
  • Obesity (especially abdominal obesity)
  • Drugs, including prescription, over the counter, and recreational.
  • Environmental chemicals and allergens.

Additional Testing That Can Be Done By Your Medical Professional

A cholesterol number alone cannot successfully predict if a person is laying down plaque in their arteries. Mainstream medicine often uses cholesterol numbers alone to predict vascular and cardiovascular problems.  Listed below is the standard cholesterol test along with some additional tests your medical doctor can take to investigate further if you may be suffering from some form of vascular disease.

  • Total cholesterol- this consists of LDL Cholesterol, HDL cholesterol, VLDL (triglycerides) – standard test performed by your medical doctor.
  • Lipoprotein (a) or Lp (a) – is made up of LDL cholesterol and a protein called apoprotein a. Elevated levels of this protein are associated with a strong risk factor for heart disease. 
  • C-reactive protein– this tests the inflammation level in your body.
  • Glucose Insulin Tolerance Test– this test measures fasting glucose as well as fasting insulin in the body, which is a strong indicator for vascular and cardiovascular disease.
  • Hemoglobin A1c – This test measures your average blood sugar levels over a 6 week period.
  • Fibrinogen – this test looks at how your blood is clotting. Fibrinogen is a protein that is found in the blood that is essential for it to clot. High levels are linked to inflammation and tissue damage. It is also used along with the C-reactive protein test to predict vascular and cardiovascular disease.
  • Homocysteine- High levels of homocysteine have been linked to arterial disease. Homocystein is an amino acid that triggers plaque and blood clot formation when it exceeds normal physiologic levels in the blood (Sinatra, 2007).

Are Statin Drugs The Answer?  Statin Drugs and Their Complications

Approximately 15 to 20 million Americans currently take statin drugs for cholesterol control (Sinatra & Roberts, 2007).  As many doctors continue to prescribe this drug, it is predicted that 36 million Americans will be using it to lower their cholesterol levels in the future. Studies show that lowering levels of LDL with medication can contribute to certain diseases as well as unhealthy conditions in the body such as:

  • The most widely recorded side effect is muscle complications. Muscle weakness can be mild or as severe as developing Rhabdomyolysis, this is the breakdown of skeletal muscle tissue leading to kidney failure. The ability of statins to produce a definite risk for muscle disease (myopathy) is well established in the current literature (Pasternak et al. 2002).
  • Increased rates of depression
  • Elevated Liver Enzymes and pancreatic dysfunction
  • Cancer has been associated with lower levels of LDL cholesterol. The Alsheikh-Ali, Maddukuri, Han & Karas (2007) evaluation of large prospective randomized statin trials show the risk of cancer is significantly associated with lower LDL cholesterol levels. LDL is needed for the body to produce vitamin D, which is a necessary nutrient in cancer prevention.  The latest research in a population based case-control study by Chang, Ho, Chiu, & Yang (2011) showed statins may increase the risk of prostate cancer.
  • Increased risk of cataracts
  • Statin drugs lower levels of CoQ10 in the body.  Co Q10 is an important antioxidant that is needed in the body for healthy cell maintenance, repair, and energy production. It is also plays a key role in protecting cells from free radical damage.  A qualified medical doctor will always recommend a person supplement with CoQ10 when prescribing statins.
  • Current research shows an increased risk of type 2 diabetes in women taking statin drugs.

*More adverse reactions to statins have been shown when someone is also taking additional medications such as anti-fungal drugs, antibiotics, and niacin.

Can Healthy Dietary and Lifestyle Choices Be The Answer?

Yes! Although there may always be particular individuals that may need medication for hypercholesterolemia, many can prevent heart and vascular disease by implementing certain dietary and lifestyle changes. Switching from a processed food diet to a whole food diet that is rich in grass fed meats, wild fish, vegetables, fruits, nuts and seeds can have the biggest impact. This type of diet is void of unhealthy fats and rich in the healthy fats and other nutrients that promote a healthy vascular system. Other lifestyle changes along with a healthy diet that may be beneficial are moderate exercise and healthy weight management, as well as avoiding risk factors that promote vascular disease (see above list of risk factors).

The medical community has caused many people to have an unhealthy obsession with cholesterol. Lowering cholesterol numbers without addressing the underlying causes and contributing factors of the problem may do more harm than good.  Diet and Lifestyle choices can have the greatest impact on the prevention as well as the damaging effects of oxidized LDL cholesterol in the body. Understanding the true facts about what causes vascular and cardiovascular diseases is the first step to prevention.

DISCLAIMER: Always check with your medical doctor before stopping any prescription medications or when implementing any dietary and lifestyle changes.


Alsheikh-Ali, A. A., Maddukuri, P. V., Han, H., Karas, R. H. (2007). Clinical Research: Statins and Toxicity: Effects of the magnitude of lipid lowering on risk of elevated liver enzymes, rhabdomyolysis, and cancer (Electronic version). Journal of American College of Cardiology, 50 409-418.

Chang, C. C., Ho, S. C., Chiu, H. F., & Yang, C. Y. (2011). Statins increase the risk of prostate cancer: A population-based case-control study (electronic version). The Prostate, 71 (16), 1818-1824.

Golomb, B. A. & Evans, M. A. (2008). Statin adverse effects:  A review of the literature and evidence for a mitochondrial mechanism (Electronic version). American Journal of Cardiovascular Drugs. 8 (6): 373-418.

Mercola, (2010). The cholesterol myth that is harming your health. Retrieved September 10, 2010, from http://articles.mercola.com/sites/articles/archives/2010/08/10/making-sense-of-your-cholest…

Pasternak, R. C., Smith, S. C., Bairey-Merz, C. N., Grundy, S. M., Cleeman, J., I., Lenfant, C. (2002). ACC/AHA/NHLBI Clinical Advisory on the use and safety of statins (electronic version).  Journal of the American College of Cardiology, 40 (3), 567-572.

Ravnskov, U. (2000). The cholesterol myths: Exposing the fallacy that cholesterol and saturated fat cause heart disease. Washington, DC: New/Trends Publishing Inc.

Sinatra, S., T. (2000). Heart sense for women: Your plan for natural prevention and treatment. Washington, DC:  LifeLine Press.

Sinatra, S. T., & Roberts, J. C. (2007). Reverse heart disease now: stop deadly cardiovascular plaque before it’s too late. Hoboken, NJ:  John Wiley & Sons, Inc.