Cholesterol isn't the problem it has been made out to be -- and the drugs your doctor prescribes to lower your cholesterol counts probably won't do much for your health.
Cholesterol is very necessary stuff. It's converted into Vitamin D by sunlight, and it's the precursor for steroid hormones like the testosterone you need to grow, and the estrogen women need to be feminine.
The liver manufactures something like 1,000 mg of cholesterol per day, even if you consume no cholesterol at all. Of that amount, about 800 mg becomes bile salts, which is necessary for the digestion of fats.[Guyton, 885] That leaves about 200 available for other functions.
When your diet contains cholesterol, the liver makes a little less. The typical American diet contains 250-350 grams per day, depending on your sex, but only a third to half of that is absorbed, so out of the 1,000 mg, only 10-15% comes from diet. Even if you eliminate the dietary intake, a healthy liver simply makes more to make up the deficit. Eliminating saturated fat from your diet doesn't help either, because the liver will make cholesterol out of sugar and starch. It's that necessary for life.[Fife, 52-56]
When the liver isn't functioning well, dietary intake of cholesterol is essential. A study at the University of California, Berkeley found that dietary cholesterol improved mental ability in the face of advancing age and declining memory.[Enig, 57]
Clearly, dietary cholesterol is not the cause. So what is? Is the body making too much of it? Unlikely. The body is an extremely intelligent and adaptive organism. Under some conditions, it could conceivably manufacture too much of something, but a more likely cause is that the manufactured cholesterol isn't being used, which leads to an accumulating excess.
It helps to think of the body as a system. In that system, growth hormone release is triggered by the pituitary gland. Since cholesterol is needed to make testosterone, and testosterone functions in conjunction with growth hormone, it is likely that the signal to release growth hormone also triggers the production of cholesterol. If something interferes with the production or use of testosterone or growth hormone, then the body would keep signaling for it, and the liver would keep generating it. The result would be an oversupply of cholesterol.
When you imagine the body's system, think of departments and communication pathways. When the growth department needs more supplies for growth, it generates a cascade of signals that cause the liver to manufacture raw materials and the raw materials to be converted into the substances it needs.
But the liver doesn't do some kind of statistical sampling of the blood stream to see how much of what it has manufactured is already there. It assumes that what it has manufactured has been used. In the past, it never had to worry about a lack of use.
For example, people never lived all their lives in caves like they do now, moving from the home cave to the traveling cave, and from there to the work cave. So the body never evolved the complex mechanisms that would be required to say, "We already have enough cholesterol. We don't need to manufacture more. There's a problem somewhere else in the system. We have to fix that." Even if the body had been able to evolve such a system, that would be a lot of complexity for what should be an extremely simple process. So when the body signals a need for more raw materials, the liver manufactures more cholesterol, even if existing cholesterol is going unused.
Similarly, insulin resistance generated by trans fats[Armstrong, What's Wrong] causes extra insulin to be produced, because the liver isn't monitoring the amount of insulin that is present in the blood. The liver does monitor blood sugar levels, however, at approximately 20-minute intervals after eating. If sugar is present in the blood, the body manufactures more insulin, even if sufficient insulin already exists to handle the sugar. The extra insulin eventually drives all the sugar out of the blood, causing light-headedness, sudden fatigue, and a severe craving for something sweet.
One mechanism that interferes with cholesterol use is a simple lack of sunlight! Lack of sunlight prevents the formation of Vitamin D, and also reduces the production of testosterone.[Kime, 37, 51, 54] People who stay indoors all the time and only go outside using industrial-strength sun block (as opposed to increasing sun exposure gradually and letting it fall on bare skin) are therefore subject to increased cholesterol levels, for that reason.
So getting into the sun is clearly a good idea, if only because it directly lowers cholesterol levels! First, sunlight converts the cholesterol on your skin to hormone precursors (three precursors, in all, including Vitamin D) which are used to make substances like testosterone. The cholesterol in your bloodstream then migrates to the surface of the skin, to replace the cholesterol that was converted.[Kime, 52] In effect, you can think of sunlight as a cholesterol vacuum cleaner -- it sucks the cholesterol right out of your bloodstream!
You don't need to worry about skin cancer if you eat well and use coconut oil. In a televised interview, Dr. Lorraine Day, MD, reported that rats fed a healthy diet developed no cases of skin cancer when exposed to the sun, while 25% of those fed the standard american did develop cancerous lesions. The difference between the two diets is likely to be the quality of the fats, as will become apparent shortly. Plus, it turns out that sunlight actually protects against various forms of cancer.[Fife, Eat Fat, 157-158] And even if you don't eat all that well, coconut oil protects you from skin cancer even as it lets the sun through.[Fife, Eat Fat, 216]
In addition to lack of sunlight, there are also dietary factors that prevent cholesterol from being used. You'll learn about those later on. The important message for now is that:
However, even though cholesterol and saturated fat in your diet is not responsible for high cholesterol levels, that doesn't give you a license to go out and eat all the fatty foods you want. As you'll see later on, the quality of the fat is critical to maintaining your cholesterol levels, as well as to overall good health.
And that's the second point: It turns out that only oxidized cholesterol causes coronary heart disease, not normal cholesterol. Cholesterol and fats outside the body are oxidized when they are exposed to sunlight, oxygen, or heat -- as when oils are refined or hydrogenated. (Cholesterol inside your body can also be oxidized by free radical reactions when you consume those rancid oils.)[Fife, 58-63]
Refined and hydrogenated oils have been deodorized to remove the smell, but they're still rancid. For more information, see What's Wrong with Partially Hydrogenated Oils? For a substitute that's actually good for you, see Coconut Oil: Miracle Medicine and Diet Pill.
Medical cholesterol measurements say nothing at all about how much oxidized cholesterol is present. There are people with high cholesterol levels who never have a heart attack, because none of it is oxidized. Others with normal or low levels of cholesterol do have heart attacks, because much of it is oxidized. There is simply no correlation between cholesterol levels and heart attack. After monitoring 5,000 people for several decades, the Framingham Heart Study determined that people who eat more cholesterol have no more tendency to develop coronary heart disease than anyone else.[Fife, 53] Meanwhile, a study at Albany Medical College showed that, "Pure unadulterated cholesterol is not harmful to the arteries and cannot initiate or promote heart disease."[Fife, 59]
Then there is the matter of drugs that are supposed to lower your cholesterol. What if they do? So what? Suppose that 100% of your cholesterol is oxidized, and you lower your cholesterol levels by 50%. How much of the remainder is oxidized? Answer: All of it! Your percentage of oxidized cholesterol remains the same, no matter what you do to your overall cholesterol levels. In other words, you have the same problem you had before. You just have a little less of it.
On the other hand, suppose that none of your cholesterol is oxidized. For the rest of your life, you would be taking expensive drugs to lower your cholesterol when it was entirely unnecessary. (You would make the statistics look good, though: Look! Another person who took the drug that never had any heart problems!)
In short, the effectiveness of such drugs lies somewhere between negligible and an appreciable reduction of risk up to 50%. But they can never be more effective than that, because they leave the real cause of the problem unaddressed.
Were the levels of oxidized cholesterol immediately life-threatening, there might be some justification for taking a drug to immediately lower them -- the good cholesterol along with the bad. But continually taking a drug to keep those levels low is a cruel joke that makes huge profits for drug companies at the expense of patients.
The drugs (statins) lower cholesterol, all right -- temporarily -- but they work against your body to do it. They interfere with cholesterol production so your body can't manufacture it. The moment you stop taking those drugs, your cholesterol levels will shoot right back up, because the drugs haven't addressed the problem that's causing your liver to manufacture the excess. (Notably, the strategy that works to reduce cholesterol -- a healthy diet and exercise -- removes oxidized cholesterol from the diet and tends to increase exposure to sunlight, either because much exercise happens outdoors or because lost weight makes a more person more comfortable being seen in a bathing suit.)
The drugs do produce a slight reduction in your chances of getting coronary heart disease. Between the time that you take the drug and the liver manufactures more, there is a small reduction in the amount of oxidized cholesterol circulating in your blood stream. So there is a fractional reduction in your risk of heart attack for a short period of time. But taking those drugs is a highly expensive way to get woefully inadequate protection, because they haven't addressed the real cause of the health risk -- the ingestion of rancid oils.
Even worse, the drugs can be dangerous. They inhibit cholesterol production (by inhibiting the "mevalonate pathway"). But the consequences of that inhibition can be severe -- insufficient enzymes, Vitamin D, CoQ10, and other substances your body needs for health, all of which have their origins in that process. (For a complete discussion, see How Statins Work and The Dangers of Statin Drugs.)
Finally, those drugs can induce a false sense of security. People who take them think they're doing something good for their health, without necessarily eliminating the processed, refined, hydrogenated, and oxidized fats that are the real source of their health risk. So they may go on poisoning themselves. In that case, taking the drug merely delays the effect of the poison.
There is a marvelously convincing ad on TV these days, for a drug called Crestor. It promises to significantly lower cholesterol levels. Near the end, there is a subtitle with this caveat:
Crestor has NOT been shown to reduce to the incidence of heart disease or heart attacks.
What better admission is there that cholesterol levels are essentially unrelated to coronary artery disease?
Cholesterol-lowering drugs are a scam. There is a measurable quantity (cholesterol levels) that you can be scared about, and wonderfully profitable drugs you can take to make them go down. So you feel like you're making progress, and you feel good beause you're taking care of yourself. You are, right? After all, the doctor you trust said you are. And even though the drugs don't do much good, they don't do anything bad, either. In short, they don't hurt you, and they make you feel better, even though they don don't actually do anything. That, my friends, is the essence of snake oil salesmanship.
You saw that lack of sunlight is one cause of high cholesterol. Another cause of high cholesterol is in the diet, but it doesn't come from high-cholesterol foods. It sneaks up on you from two unexpected directions.
The first direction is indicated in Ray Peat's newsletter, where he says, "Since the 1930's, it has been clearly established that suppression of the thyroid raises serum cholesterol (while increasing mortality from infections, cancer, and heart disease), while restoring (thyroid function) brings cholesterol down to normal."[Peat, 6] Since the thyroid converts cholesterol into hormones, the signals that trigger the need for hormones undoubtedly trigger the production of cholesterol, as well. When the thyroid system isn't functioning optimally, cholesterol levels naturally rise.
It is particularly salient, in that regard, that corn oil and soybean oil suppresses thyroid function.[Fife, 34] That fact is important to know, because soybean oil now predominates in the foods that Americans eat, in the form of partially hydrogenated oils, shortening, and margarine. Not only do those oils provide the oxidized fats that cause heart disease, they're raising cholesterol levels in the process.
The second direction is indicated in the same newsletter, when Peat states that fructose raises cholesterol.[Peat, 6] Since high fructose corn syrup is the number one sweetener in the American food supply, Americans are being deluged with cholesterol-raising fructose and soybean oil.
The key to lowering cholesterol is getting sunlight and raising thyroid activity, so that the cholesterol your liver manufactures is converted into the substances your body needs. Here are the steps:
High cholesterol levels come from the partially hydrogenated oils, shortening, margarine, and high fructose corn syrup that are now ubiquitous in the American diet. Dietary cholesterol is of no consequence. So people are mystified when their efforts to avoid "high cholesterol" foods like meat and dairy products have no effect, and they resort to using drugs to fight the ever-rising tide of cholesterol.
Cholesterol-lowering drugs are a gold mine for drug companies, but they don't address the real problems. They also interfere with important processes that can damage your health, and they can lull you into a false sense of security. But the cholesterol measurements can scare you enough to keep you taking the drugs for life. And since the medical system seems determined to remain oblivious to the nutritional causes of disease, doctors continue to recommend the cholesterol-lowering protocol, along with general admonitions to "eat better", because it's the only approach they know.
I am deeply indebted to Caryn Lipson for pointing out factual errors in the original version of this article regarding the effects of cholesterol-lowering drugs.
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