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What is all the fuss about cholesterol?

By Clifford M. Sonnie, M.D., M.P.H.

Every so often the news gets a hold of this and the advertisers plaster the TV about cholesterol. Seems to me that no one really knows what cholesterol is all about. After all the “normal” level has moved up and down so much since I was in medical school that it looks like a yo-yo. I wonder, did the level go down when a new cholesterol-lowering drug came out? Sorry, I digress.

Well let me try to help you make a little sense of it. Cholesterol is a precursor that your body produces (your liver makes it). That means that your body makes it so that it can be turned into something else that your body needs. That makes sense. In fact cholesterol is one of the first things that your body makes and uses to repair damage anywhere in the body (helping to keep inflammation to a minimum). I won’t get into the different types of cholesterol. Suffice it to say that certain kinds of cholesterol are increased with inflammation. Cholesterol is also the base from which literally every hormone in your body is made. That sounds like it is a pretty important thing to have floating around. Unfortunately it is also found in the plaque that can block your arteries. Now here comes the debate. It is not the only thing found in that plaque. To be truthful it doesn’t even make up a majority of the stuff found in plaque. Many MDs believe that inflammation of the artery’s inside wall starts the formation of plaque. Cholesterol was there trying to help and got caught.

There was a study of Inuit Indians (Eskimos if that is politically correct) done a couple decades ago. Why…to find out why they have very low heart disease. To make a long story short, they found that diet and lifestyle are very strong factors. In addition they found a very interesting fact. Their cholesterol was sky high (due to diet). Wow high cholesterol and low heart disease. To make it even more confusing these same people were watched over the next decade as they relocated to the lower 48 states. A funny thing happened on the way to the lab. Their diets changed, their lifestyles changed, their cholesterols dropped to near normal (no more seal blubber) and their heart disease went sky high. Ok what am I missing? Low cholesterol and more heart disease. Maybe that inflammation thing is not caused by cholesterol. Maybe cholesterol is not only needed to repair the body but also to tell me that inflammation is there. Ok, I know this is confusing. Is cholesterol the cause or a casualty of heart disease? This is still an ongoing debate. Enough of this and on to the drugs.

How do the drugs work? The most popular cholesterol lowering drugs work in the liver by stopping an enzyme that makes cholesterol. Unfortunately that same enzyme helps make Co-Q 10 (real name is too long and has few vowels). Co-Q 10 is vital for the proper function of ALL muscles in the body (one of the side effects of those drugs is muscle pain amongst others). Others work in the intestinal tract by grabbing the cholesterol you eat so it can’t be absorbed. Other drugs work slightly different but aren’t used as much.

Don’t misunderstand. Very high cholesterol is a medical problem. Those levels are usually high because of genetics and you were born that way. For whatever reason very high cholesterol must be appropriately treated. The debate asks two questions. What is the definition of “high” and since cholesterol helps to repair the body, reduce inflammation and is needed to make your body’s hormones, when and how is the best way to treat it?

DO NOT stop any medication that your MD has started. I offer this for you to think about. I do not know the answer to heart disease but it can’t be as simple as taking a drug to lower something that is so important in your body. My cholesterol is 240 and last time I looked, I was ok (at least my heart is).

That’s where the Balance of Life Clinic comes in. When it needs to be treated, we believe that there may be a more natural (less synthetic) way to treat any problem. Many times using natural things we can control not only your cholesterol level, but other things as well. This may result in your needing less of your prescribed medications. No matter what you do, make sure that you discuss this with an appropriately trained health care provider, namely your family MD or DO.

Clifford M. Sonnie, M.D., M.P.H. is a physician at the Balance of Life Clinic.