Cholesterol - what it is, types, ideal levels and treatments

Cholesterol, often labeled as unhealthy, actually plays an essential role in a number of bodily functions. Understanding cholesterol is crucial to clearing up many of the misunderstandings surrounding this vital fat in our bodies. This article aims to explain what cholesterol is, its importance for health and discuss the implications of using drugs such as statins to regulate it.

Cholesterol - MY MEDICAL OPINION - Ideal values, Statins and Health - Dr. Icaro Alves Alcântara

Cholesterol - Questions and Answers - May 2018

✅ What is Cholesterol

Cholesterol is a type of fat found in all the cells of the human body. Essential for life, it plays an important role in the formation of cell membranes, the production of hormones, the synthesis of vitamin D, the constitution of nerves, etc. Although some cholesterol comes from food, most of it (up to 80%) is produced by our liver from the carbohydrates we eat. Foods such as pasta, cookies, bread, white rice and potatoes are common sources of sugar, which therefore influence cholesterol levels.

We already understand that cholesterol itself is not harmful, considering its essential role in various processes in our body. With this in mind, we wonder if it really makes sense to believe that nature would have inserted a “time bomb” into us, since we are capable of producing it even without eating fat. Problems arise when there is an excess of cholesterol, often due to high sugar consumption (although there are other causes), or when it oxidizes, forming deposits in the arteries. At the right level, cholesterol is essential for the body to function properly.

✅ Types of “Cholesterol”: HDL and LDL

There is a myth that HDL (High Density Lipoprotein) is the “good cholesterol” and LDL (Low Density Lipoprotein) is the “bad cholesterol”, but in reality there is no such division as “good” and “bad” cholesterol. Firstly, both HDL and LDL are not cholesterol per se, but molecules, specifically lipoproteins - fats combined with proteins, which transport cholesterol around the body, and each performs an important function. LDL takes cholesterol into the cells to be used: to make hormones (the so-called “steroids” such as pregnenolone, DHEA, progesterone, testosterone, estradiol, cortisol, aldosterone, among others), to make up cell membranes, to form nerves, among others, while HDL removes the excess from the blood, transporting it back to the liver to be “recycled” or destroyed/eliminated.

✅ But what are the ideal levels for HDL, LDL and Total Cholesterol? AND WHAT HAPPENS WHEN THEY ARE LOW?

IN GENERAL:

HDL	Over 60.
LDL	More or less double HDL, around 110 to 140.
TOTAL CHOLESTEROL	Around three to four times the value of HDL, somewhere between 180 and 240.

These levels are the ideal “healthy cholesterol” for people who adopt and maintain good lifestyle habits. There is a myth that suggests that cholesterol should always be low; however, the ideal is to maintain a balance, according to the levels mentioned above. If cholesterol is too low, the body may not be able to produce various hormones, recover from injuries, manufacture vitamin D and bile acids, and produce and recover nerves. And because of the lack of these essential processes, health can be compromised, so very low cholesterol can be very dangerous.

✅ I HAVE “HIGH CHOLESTEROL”, WHAT'S GOING ON? DO I NEED TO TAKE MEDICATION TO LOWER IT? Are statins bad?

“High cholesterol” doesn't automatically mean that you need to take medication to lower it.

When cholesterol is high, it is possible that the body is raising these levels as an attempt to correct certain deficiencies. This can include nutrient deficiencies, the need to repair tissues or fight ongoing inflammation. This elevation can be the result of bad lifestyle habits, such as an inadequate diet rich in sugars, vitamin and mineral deficiencies due to poor diet, not drinking enough water, insufficient physical exercise, among many other factors.

Common situation: you have a blood test and, most of the time, it includes a complete lipidogram, or cholesterol measurement. Nowadays, if your total cholesterol is over 180, most doctors tend to prescribe statins, a group of drugs used to “treat” cholesterol (actually reducing its synthesis by the liver), drugs used to lower cholesterol, such as simvastatin, atorvastatin, rosuvastatin, among others. But where's the problem with this approach?

Firstly, you may be taking medication unnecessarily. The body, as stated above, naturally increases cholesterol production when it needs to repair injuries, produce vitamin D (which is actually a hormone), produce steroid hormones (such as testosterone, estradiol, cortisol), repair nerves, multiply cells, among other functions. Therefore, cholesterol is not the villain or the “bad” guy. Many people may be damaging these vital processes by using statins: without a detailed medical analysis of lifestyle habits, diet, complementary tests, among others, to identify the cause of the increase in cholesterol, the use of drugs to lower it can be harmful. This deprives the body of essential functions that depend on cholesterol, such as those mentioned above.

In addition, several studies have shown that statins are associated with side effects that can appear shortly after starting treatment and tend to worsen with prolonged use. These effects include tiredness, muscle pain and weakness, headaches, impaired memory, increased risk of diabetes, depression, pancreatitis and even a higher incidence of cancer. These problems occur because statins are cholesterol-lowering drugs, as they block an enzyme called HMG-CoA reductase, which is crucial in the production of cholesterol. This enzyme is part of a process known as the mevalonate pathway, which is essential for a series of chemical reactions that result in the formation of various substances that are important for the functioning of the body. By using statins, as well as reducing the production of cholesterol, we also interfere with the creation of other essential molecules, including the coenzyme Q10, which is essential for energy production and acts as an antioxidant within cells, and dolichol, which ‘directs’ the manufacture of various proteins.

However, there are exceptions: Firstly, if your cholesterol is above 300, you may need to use statins for a short time while you investigate the causes, which are usually related to bad lifestyle habits. The second case is that even after a detailed medical assessment of lifestyle habits, diet, complementary tests, etc., and everything being within ‘normal’ limits, or even after adopting healthy lifestyle habits, eating properly and correcting vitamin deficiencies (I'll explain how this can help below), if the high cholesterol level persists, there may be a genetic problem, such as hereditary dyslipidemia - this condition is characterized by the persistent presence (and refractory to treatment) of high levels of lipids in the blood. In these cases, the use of statins may be necessary, along with Coenzyme Q10 supplementation, as statins can block this substance, as already explained. However, it is essential to discuss this possibility with a doctor you trust and who is well-informed on the subject.

✅ How can I lower high cholesterol or prevent it effectively?

The basis, and what is most effective, is simple: adopting good lifestyle habits, a proper diet and, when necessary, supplementation, can be more beneficial than the use of statins. As mentioned earlier, if cholesterol is high, the body may be reacting to a need to correct something that is lacking, such as vitamins and minerals, repair tissues or fight some ongoing inflammation, and these situations are often the consequence of bad lifestyle habits. Actions such as drinking more than 3 liters of water a day, eating a proper diet with as few sugars as possible, eating more fruit and vegetables, limiting dairy/gluten intake, using appropriate supplements and exercising, among others, are fundamental not only for controlling cholesterol levels, but also for improving health in all aspects.

✅ Is cholesterol linked to heart disease?

I suggest you read the excellent text by Dr. Carlos Braghini, entitled “The Cholesterol Myth and Heart Disease”, which is part of the book “Cell Ecology - The Role of Food and the Environment in Ageing and Longevity”. This text is available on the website and offers a detailed understanding of this subject.

REMEMBER: Cholesterol is not your enemy. When you take a drug to lower your cholesterol without investigating the causes of this increase, you may be blocking your body's own efforts to recover. The most important thing is to investigate the causes, correct the triggering factors, adopt better lifestyle habits (https://icaro.med.br/15habitos/), and seek a balance of vitamins and minerals, hormones and neurotransmitters. This can be much more effective in some cases than the use of medication, which often has side effects. I explain all this in my ninth book, “Master Your Health”, available for free in PDF format at www.dominesuasaude.com.br or on the banner below. The content ensures that you enjoy life with more vitality and less chance of preventable diseases. There are almost 160 pages of knowledge which, if you learn and practice them, will certainly help you to recover, maintain or improve your health, by better understanding what is important and how to apply it to your life in a simple, more natural, yet very effective way.