Have you been told that you have high cholesterol levels? Do you know why it is elevated? Or understand how it is affecting your health?
Today we want to share with you the role cholesterol plays in the body, how to properly assess cholesterol levels and its health implications.
So firstly, what actually is cholesterol?
Cholesterol is a type of fat that our bodies cannot live without. Cholesterol is an integral part of every cell, it is within every organ of our body and without it, these structures would start to fail or malfunction. Different kinds of cells in the body need different amounts of cholesterol, depending on their function and purpose. If the cell is part of a protective barrier, it will have a lot of cholesterol in it to make it strong, sturdy and resistant to any invasion. If a cell or an organelle inside the cell needs to be soft and fluid, it will have less cholesterol in its structure.
In particular, the brain (accounts for 25% of our total cholesterol), nervous system, connective tissue, muscles and skin, require the highest levels of cholesterol to function optimally. Cholesterol is also a major building block for many of our hormones, including oestrogen, testosterone, progesterone, aldosterone, cortisol and others. Furthermore, it is also crucial for the synthesis of vitamin D, as well as bile acids which aid in the digestion of fats.
Although we can get cholesterol from the food we eat, this tends to only equate to about 15% of our total cholesterol. while our bodies actually manufacture the remaining 85%. However, when we eat more cholesterol containing foods, our body can compensate using its own regulatory system and reduce its own manufacturing accordingly. What that means is that, even if you follow a strictly low fat diet, you can still have high cholesterol levels!! Bit of a surprise hey!
Cholesterol-lowering drugs are a completely different matter though, as they actually interfere with the body’s ability to produce cholesterol, thus reducing the amount of cholesterol available for the body to use. While these may be necessary in the small portion of people who are genetically prone to having very high cholesterol levels, in our opinion, these are often over-prescribed rather than resolving the underlying cause.
So why does our body sometimes produce more cholesterol?
What might be a surprise to some, is that cholesterol is actually a healing agent. So, when the body has some healing jobs to do, it will signal the liver to produce more cholesterol and then sends it to the site of the damage. Therefore, when cholesterol levels are high, we know that there are problems such as inflammation, stress or hormone imbalances going on in our body. During this time, our liver will make more cholesterol to help deal with these issues.
Keeping this in mind, we can see that high cholesterol levels are not as much a problem in themselves, but rather an indicator or warning of something else going wrong in the body. One of the main triggers for the body to make more cholesterol is inflammation, which in itself is a big cause of heart and vascular disease.
Heart disease is increasing because we are more inflamed, have more oxidation, and have more hormonal imbalances. By simply lowering cholesterol levels, we are treating a symptom rather than dealing with the underlying cause. It’s like blaming the fire fighters for the fire.
‘Good’ and ‘Bad’ Cholesterol…What’s the difference?
You may have heard people or practitioners (even us) talk about so called ‘good cholesterol’ (High Density Lipoprotein -HDL cholesterol) and ‘bad cholesterol’ (types of Low Density Lipoprotein - LDL and Very Low Density Lipoprotein - VLDL cholesterol), or seen these names beneath your total cholesterol on blood tests. So, what do they actually mean?
HDL and LDL aren’t actually types of cholesterol per say, but lipoproteins that help to transport cholesterol around the body to where it is required. These types of lipoproteins have lots of different roles in the body:
Whenever our liver receives a signal that a wound has been inflicted somewhere in our vascular system, or elsewhere in the body, it sends out cholesterol to the site of the damage in its transporter known as called LDL. Because this cholesterol travels from the liver to the wound in the form of LDL, medicine calls this LDL “bad” cholesterol. As the higher the levels of LDL in the blood would suggest that there is more wounds that need healing. The other reason that the body may have higher levels of LDL cholesterol is that it needs the extra for the production of hormones and bile salts. Suggesting that these areas may have unaddressed issues that need to be looked at.
On the other hand, HDL’s role (the ‘good’ form) is to is to carry cholesterol away from the tissues (or site of injury that’s been healed), back to the liver to be broken down and/or excreted. Thus, it is seen as good because it’s done its job of healing and is now heading back to base.
What this tells us, is that the conventional understanding of good and bad cholesterol is forgetting why cholesterol is being produced in the first place and the role of HDL and LDL. As such, conventional treatment is often neglecting to address the underlying causes. For example, cholesterol is often blamed when we talk about the causes of atherosclerosis. Now, from what we have just explained, we know that the cholesterol has been sent out by the body to try and heal an injury. The cholesterol acts as a bandaid over the injury, until the body can heal. This means that although atherosclerosis is linked the elevated levels of cholesterol, cholesterol is a secondary issue to the underlying cause.
The trouble occurs when LDL cholesterol becomes oxidised due to factors such as inflammation in the body, decreased endogenous anti-oxidants (bodies own production of anti-oxidants), high sugar consumption, low consumption of anti-oxidant foods, poor absorption of our protective fat soluble vitamins in particular Vitamin E, too many omega -6- fatty acids (instead of omega-3) or even just extended periods of stress!
When oxidised cholesterol comes into contact with a type of immune cell called macrophages (sent out by the immune system to help kill foreign invaders like bacteria), they can produce harmful cells known as foam cells. It is when these foam cells build up that plaque is formed inside artery walls, thus causing a narrowing of the artery and potentially leading to blood clot formation. This process is also very inflammatory, causing further damage to artery walls and thus signalling the liver to send out more cholesterol... and on the cycle, goes.
Eventually, this cycle results in conditions such as heart disease, peripheral vascular disease and even dementia.
So what does this all mean ?
When looking at a blood test and an elevated cholesterol level is shown, we must immediately look to the LDL and HDL as these will indicate how the increased production of cholesterol in the body is being used. If we have the opportunity to test vLDL, the results give us a deeper understanding of whether the body is performing its repair job well or if oxidation and foam cell formation is occurring. Unfortunately, vLDL testing is not commonly performed in Australia. Therefore, further investigation into whether oxidization/foam cell formation is occurring is highly recommended. Here are some of the things we look at next:
Is there inflammation present?
The following examples may indicate inflammation.
Elevated C-reactive Protein
Elevated Homocysteine
Elevated histamine and/or immune cells
Bacterial or viral infection
Toxins (heavy metals, pesticides, smoking, drugs)
Lack of anti-inflammatory foods in diet
(high in omega 3, vitamin E etc)
Physical injury
Psychological stress or trauma
Pain
Are your levels of antioxidants decreased?
Organic acid test to assess glutathione, catalase and superoxide dismutase levels
Gene test showing a decreased antioxidant production and binding capacity
Testing to check for deficiencies in amino acids, vitamin C, zinc, selenium or magnesium as well as analysing the diet to ensure there is enough consumption of these nutrients.
Over consumption of trans fats and/or omega 6.
Toxins overburdening the system
Elevated blood sugar levels causing oxidation
Liver or kidney damage/overburdened
When it comes to treating high LDL/VLDL levels, nothing beats removing the cause of increased cholesterol production, however increasing HDL levels will help to prevent the oxidation of LDL by mopping up excess cholesterol. There is no conventional medication for increasing HDL however diet and lifestyle changes can help immensely.
As mentioned above, dietary intake of cholesterol only accounts for around 15% of our cholesterol levels.
However, diet is still one of the biggest modifiable factors when it comes to changing our cholesterol levels.
Instead of focusing on how to change the diet to decrease cholesterol, we rather need to focus the diet on decreasing inflammation in the body, increasing our anti-oxidants and increasing our HDL levels.
If your cholesterol levels are elevated or you are concerned that they may be, book in a consultation so that we can help you get to the root of the issue.