Cholesterol is body's attempt to fight inflammation
By Dr. Martin Gleixner, MSc, ND
In my practice, cholesterol is perhaps the most misunderstood topic that can impact one's health.
Generally, cholesterol is viewed as being harmful, especially the 'bad' cholesterol.
How did a useful screening test develop such a bad reputation? Why does the body produce cholesterol? Is high cholesterol the No.1 cause of heart disease? Are there other laboratory markers to evaluate cardiovascular risks? Can cholesterol be lowered naturally?
Whether it's to prevent or treat heart disease or simply to improve health status and preventing future illness, understanding the truths & myths about cholesterol is paramount.
How is it made?
Depending on your diet, up to 80 per cent (although some sources say up to 90 per cent) of your cholesterol is produced inside of your own body, rather than absorbed from food sources. Dr. Guyton MD and Dr. Hall PhD (Medical Physiology, 2000) explain that a diet high in saturated fat can increase blood cholesterol concentration 15-25 per cent. Eating habits therefore can still contribute to increased cholesterol levels.
Since the body produces the majority of cholesterol in the body (mainly via the liver), this compound must serve some function or purpose.
Does cholesterol actually serve a purpose?
Cholesterol serves to:
- build healthy cell membranes (i.e. their outer layer)
- provide the backbone for hormones in our body, such as cortisol, progesterone, estrogen and testosterone
- control inflammation resulting from injury or irritation to body tissues.
The current view is that cholesterol causes plaques in the arteries. But if we consider that cholesterol is a means to keep inflammation under control, we find a different explanation. Inflammation can result from a lack of antioxidant-rich foods, exposure to chemicals, or from imbalances in cortisol, insulin and glucose as may occur with diabetes. As inflammation causes harm to our arterial walls, our body attempts to 'patch' up the problem. Our liver produces more cholesterol so that it can form a band-aid on these irritations. Cholesterol is not in itself the problem, but rather is there to resolve the damage resulting from other causes.
High cholesterol may also occur due to additional underlying imbalances. Daily stress for example pushes our body to produce high levels of cortisol, a hormone that is made from cholesterol. To meet the demands, the body produces more cholesterol to fuel the production of cortisol.
Whether it's a diet high in trans fats, excess blood glucose, or long-term stress due to unrealistic lifestyle demands, looking at the whole picture is always important in addressing cardiovascular risks and disease.
Making sense of your lab values
As part of a general routine screen or to evaluate cardiovascular risks, your doctor will perform a panel for lipids (i.e. fatty substances in your blood). This includes triglycerides (which most closely reflect carbohydrate intake), LDL (the 'bad'), HDL (the 'good'), total cholesterol and total cholesterol/HDL ratio. Keeping each of these parameters in their optimal range is important. The ratio between total cholesterol and HDL is a particularly useful indicator of health status.
Research conducted by Dr. van Lennep indicates that heart attacks can still occur in people with low total cholesterol levels, whether or not they take cholesterol-lowering drugs (article published in Arteriosclerosis, Thrombosis, and Vascular Biology, 2000).
It appears, therefore, that lowering cholesterol to optimal levels reduces risk, but it does not eliminate the risk of heart attacks.
If your total cholesterol numbers do not fall within the ideal range, it is important to work with your medical doctor or naturopathic doctor to investigate why your body is producing more cholesterol than is necessary. It is also important to ensure that total cholesterol doesn't fall too low. Under this circumstance, studies indicate an increased risk of depression and suicide. A possible explanation is that low cholesterol leads to a decline in hormones that can affect our mood.
Promising research is finding that new parameters (although not routinely used yet) can further improve our ability to predict cardiovascular disease, including:
- lipoprotein A
- oxidized LDL
- low HDL along with small LDL particles.
In addition, measuring the degree of inflammation in the body can further improve our predictive ability. Inflammatory markers can be measured in the blood such as C-reactive protein, homocysteine, and fibrinogen.
Speak to your Naturopathic Doctor about conducted diagnostic testing for these additional markers especially if you have an existing cardiovascular disease or if you have a family history that worries you.
Naturopathic treatment plan
As always, a combination of naturopathic approaches tailored to each individual provide the best clinical results. If you are presently taking cholesterol-lowering drugs such as statins or other heart medications, it is important to work with your medical doctor and naturopathic doctor in achieving your health goals.
An effective strategy to prevent or address cardiovascular disease can include some or all of the following:
- Cover the basics: reduce saturated fats, decrease trans fats that cause inflammation of blood vessels, and increase dietary sources of mono- and poly-unsaturated fats.
- An individualized anti-inflammatory eating plan clinically designed to decrease inflammation.
- Exercise, sleep, and deep breathing, which encourages the body to heal.
- Decreasing exposure to chemicals that may cause inflammation in the body.
- Replenish important molecules such as CoQ10 that can become depleted with certain cholesterol-lowering medications.
- Address co-existing chronic inflammatory conditions such as diabetes, osteoarthritis, etc.
- Include specific vitamins or minerals in medicinal doses (niacin for example) and individualized herbal combinations to improve cholesterol metabolism.
Cholesterol therefore can illuminate a lot about a person's overall health and cardiovascular risks. Understanding why it's produced in the body in the first place can go a long way at addressing both the imbalanced lipids and any underlying contributing conditions.
Published by Dr. Gleixner on Wednesday April 29th, 2009 in Times & Transcript.
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