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Cholesterol: Friend or Foe from a Functional Medicine Perspective?


Clare Kelway DIHom BCHN®

What is Cholesterol?

Cholesterol is an essential molecule or raw material for the healthy functioning of your body.  Virtually every cell in the human body can make cholesterol, especially your liver and your brain – two areas of health in which we at Metabolix Health are particularly interested.

Cholesterol is a fatty, waxy substance in your body and certain foods. Cholesterol is transported in the blood to carrier proteins called lipoproteins. This is where the markers LDL and HDL come from  – LDL is low-density lipoprotein and HDL is high-density lipoprotein.  HDL, or high-density lipoprotein, is sometimes referred to as “good” cholesterol because it helps lower the risk for health issues by carrying cholesterol away from the arteries and back to the liver.

The liver is a critical player in the health of your cholesterol.

Cholesterol and your Hormones

Cholesterol is critical for bile acids, Vitamin D, and steroid hormones, including sex hormones.  When you think about progesterone, estrogen, testosterone, and those stress hormones pregnenolone and DHEA,  you should think about cholesterol because your hormones depend on it.  So trying to reduce cholesterol levels with drugs that have known side effects is misguided at the minimum when you are not looking at the entire functional picture of your health.  And since our body is an integrated functional system, don’t forget the impact that minerals play on your heart health too.

Dr. George Mann of Vanderbilt University, who participated in the Framingham Heart Study, said, “cholesterol-as-an-indicator-of -heart disease is the greatest scam ever perpetrated on the American public. “

What else is going on? Especially factors such as stress, food intake, movement, social connection, and genetics.  Giving out meds for a high cholesterol reading, without considering all the lifestyle factors, makes me think of the archaic actions of doctors in the 19th Century who used to think blood-letting was a good idea!  

Cholesterol concerns and the effects on your heart health are where functional medicine shines. We take a holistic 20,000-foot view of your health and the functional health of your body’s systems.

LDL as an indicator of Heart Disease – valuable or not?

The medical community considers LDL particles harmful, but like most parts of your health, the story is more complicated than this.  

More recent research discovered that small, dense particles of LDL may, in fact, be a risk factor for heart disease.   These small, dense particles are made worse by a low-fat, high-carb diet, like the one promoted for decades for lowering cholesterol. 

It’s a vital cell wall component and helps your brain and nerves function properly. 

Actually, saturated fats which have been maligned in medical circles can actually reduce these small dense particles of LDL. Saturated fats play a critical role in your lipid community and therefore your health.  The opposite of small dense LDL is large, fluffy LDL particles, which are actually helpful to your health.  Unfortunately, LDL-lowering drugs lower the good LDL particles with the bad LDL particles.

Lab testing for cholesterol

Functional Medicine Perspective, Cholesterol

A standard lipid test while a very inexpensive part of an annual health assessment is a very small part of your cholesterol picture.  There are several sub-types of cholesterol to measure when your standard lipid panel only measures 2 of these. 

Cholesterol has to be contained in a protective structure which is known as lipoproteins. This is where LDL and HDL come from. But the overall amount of cholesterol floating around isn’t the issue. The number of containers ie lipoproteins is the issue. 

e.g. there is HDL2a, HDL2b etc. The size of these containers matters. Some substructures are more likely to promote plaque buildup in your arterial walls. Lipoprotein distribution forms patterns and these patterns are predictive of metabolic health issues such as insulin resistance, metabolic syndrome, and diabetes.  

Our view on this is that high cholesterol on your blood markers is a lab result, not a disease, and should be assessed as such. 

It is far more important to test for inflammation, blood sugar, and blood insulin levels to determine how you are doing along with a more detailed look at your lipids. Today, the standard we recommend with regard to lipid testing is the NMR lipo profile. It tells us what kind of LDL you have.  

Also running inflammatory markers such as C-reactive protein and homocysteine make sense along with fasting insulin, and HbA1C along with your standard panels.

If you have issues with your blood sugar levels, inflammatory markers, and insulin levels, you are clearly on the path to chronic conditions involving the heart, brain, and liver.  It is imperative you work with a clinical nutritionist and a functional medicine practitioner who know what to test for;  how to analyze the labs correctly; and help you get on a program to health and vitality.  There is no time to waste if you have any of these markers out of range. 

Does lowering cholesterol actually lower your heart disease risk?

Study after study has shown that lowering the risk for heart disease has very little to do with lowering cholesterol. The real trouble causes are oxidation and inflammation.   LDL particles aren’t the problem, but where they wind up in the body.  They could get attacked by oxidative stress and inflammatory compounds. This is the problem. 

And sugar is the single leading food (is it really a food) that ages the human body from the inside out. 

Do high levels of total cholesterol really raise your risk of developing heart disease and increase your risk of stroke? 

However, a greater risk for heart disease and stroke is inflammation and oxidation and these factors make your arteries vulnerable to plaque buildup. 

overweight and cholesterol levels

Arterial plaque occurs when cholesterol builds up in the inner lining of the artery. This buildup can happen in any artery in the body, from head to toe, and can develop into a condition called atherosclerosis, which can, in turn, lead to coronary artery disease, angina, heart attack, or potentially heart failure. 

Lifestyle factors to lower lipoproteins running around your body

cholesterol-rich foods including salmon and nuts.
  • Keep alcohol to a minimum. We recommend you stick to a couple of drinks per week if you enjoy sharing a glass with friends and family.
  • Increase your movement. Intense, lengthy strenuous exercise can hurt you rather than help you. We see this with our clients who are in their 40s or early 50s. Suddenly, the intense exercise regime is no longer working for them. Weight is creeping up, and in all the wrong places and even their standard medical blood markers are out of range such as blood sugars, liver enzymes, and lipids (albeit that we don’t rate these). All of this indicates a need for functional testing and a lifestyle intervention plan designed for your specific needs and bio-individuality.  We recommend moving about 30 minutes per day – stretching, yoga, and some short interval training. 
  • Eating a Mediterranean-style food plan that incorporates nutrient-dense foods, and a variety of healthy fats, proteins, and low glycemic foods. We like carbohydrates which can get a bad rap, but not the processed, high trans fat and sugar kinds! No need to count macronutrients – just a balance between these different foods. Variety is key for your microbiome.  Incorporating foods like steel-cut oats, beans, avocado, fatty fish, and walnuts which are high in fiber and antioxidants can really be helpful. 
  • Eat your eggs – you cannot eat your way to a cholesterol problem.  Cholesterol is made from the inside out. Very little actually comes from foods. Your body can’t use esterfied cholesterol which is what is in eggs. So think about this next time a “nutrition expert” tells you to quit eggs or only eat egg whites!
  • Drink sufficient clean water and if you are drinking reverse osmosis water, PLEASE MAKE SURE to be adding minerals to the water. This is often the cause of stomach issues and pH problems with your stomach. 

Conclusion and next steps…

Cholesterol is actually your friend, not your foe. It has been misinterpreted for decades by mainstream medicine. Fortunately, there are now many voices both in mainstream medicine and Functional Medicine leading the way for reducing inflammation and stress rather than cholesterol specifically.

February is American heart month so we have a special focus at Metabolix Health on anti-inflammatory foods and reducing stress this month to help reduce your risks for chronic illnesses related to heart and brain health. 

Schedule a FREE call with a member of our team to discuss your health and learn more about how we can help you restore your health. 

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