When it comes to cholesterol, the message that most of us have been hearing for years is -- "lower your cholesterol, lower your cholesterol." But what happens when cholesterol gets very low? You would think that would be good news -- and good for your health. In fact, the opposite is true. What most people don’t know: Reducing cholesterol levels too much carries its own health risk. Here’s why...
WHAT TOO LOW CAN DO
It is important to remember that some cholesterol is needed by the body -- and that cholesterol, including LDL (so-called "bad") cholesterol -- plays an important role in our health.
Reducing cholesterol too much can impair the body’s immune system response and increase susceptibility to infection and even cancer. This is especially worrisome because target cholesterol levels have been progressively lowered in recent years.
Today, many doctors are encouraging their patients to drive their levels of both total cholesterol and LDL cholesterol lower than ever. People at very high risk for heart disease, including those with diabetes, are being told to lower their total cholesterol to 160 mg/dL or less and their LDL to 70 mg/dL or less. People at lower risk are being told to reduce their LDL to less than 100 mg/dL.
I think it’s unwise to bring cholesterol levels down that far. Based on the research I’ve seen and my own clinical experience, I believe that reducing LDL cholesterol to below 100 mg/dL or total cholesterol to below 160 mg/dL poses a risk to many people. This is especially true for seniors who generally are more susceptible to infection.
WHY YOU NEED SOME CHOLESTEROL
Cholesterol in general (including both LDL and HDL) actually is one of the most important substances in the body. It’s found in every cell membrane and is used by the body to manufacture brain cells and to metabolize vitamin D, sex hormones (including testosterone and estrogen), stress hormones and bile acids used for digestion. It’s involved in conducting nerve impulses and in the healing process, including the repair of damage to the lining of blood vessels.
Even LDL cholesterol plays an important role. It fights infection, binding to and neutralizing various bacteria such as Staphylococcus aureus. It also transports essential fatty acids and fat-soluble vitamins, including A, D, E, K and coenzyme Q10, throughout the body to fuel the cells of the immune system.
In one 2007 study published in Annals of Clinical and Laboratory Science, researchers examined the medical histories of more than 200 patients and found that those with LDL cholesterol levels of 70 mg/dL or lower had significantly increased risk for fever, sepsis (severe infection) and hematologic (blood) cancer. Studies have shown that people whose LDL cholesterol is lower than 70 mg/dL are at increased risk for severe pneumonia and influenza and urinary tract, viral and skin infections. They also are at higher risk for death from respiratory and gastrointestinal infections. There is substantial data linking significantly reduced total cholesterol levels and LDL levels to increased risk for cancer and higher rates of depression, anxiety, suicide and poor memory -- possibly because LDL cholesterol specifically enhances activity of serotonin, the brain neurotransmitter found to play a central role in preventing depression.
ABOUT STATINS LOWERING CHOLESTEROL
As many of you know, I have serious reservations about people taking statin drugs to lower levels of cholesterol. In addition to inhibiting the body’s production of cholesterol, these drugs also affect other important metabolic pathways -- potentially causing such dangerous side effects as joint damage, liver and kidney damage, depression and cognitive deficits.
Given what we know about the body’s need for cholesterol, it isn’t surprising that several large-scale studies have been unable to show any improvement in the life expectancy of people with no history of heart attack who take statins preventively. (Statins have been shown to prevent subsequent heart attacks and strokes in patients who have had heart attacks and strokes.) For example, a meta-analysis of 65,000 people published in 2011 in Evidence-Based Medicine found no link between people with no history of heart attack who take statins preventively and increased life expectancy. In fact, it didn’t find any relationship between cholesterol levels and survival rates.
Even more disturbing, a number of studies have linked lower cholesterol levels in general to higher overall death rates from all causes.
GET IN THE RANGE
If you have no known heart disease and are taking statins or other cholesterol-lowering drugs simply to bring down your cholesterol values preventively, there’s a real concern that you may be putting your health in danger. Other people who may be in danger are those who eat a very low-fat vegan diet.
In my view, an LDL level in the range of 105 mg/dL to 130 mg/dL and total cholesterol between 160 mg/dL and 200 mg/dL are best for most people.
And... as I told readers in the March 2011 issue, research now shows that it’s the size of your cholesterol particles that is the key to your cardiovascular health, not how much total cholesterol you have.
If your total cholesterol and/or LDL are too low, you should talk to your doctor about stopping your statin drug (if you take one). You also can eat healthful foods with saturated fat, such as grass-fed meat, eggs, coconut oil and butter. Be sure to have your cholesterol levels monitored while you do this to ensure that you reach optimal levels without going too high.
If your total cholesterol is above 200 mg/dL, you may want to consider having your LDL particle size tested and, if necessary, working to reduce the size of your LDL particles with natural therapies. I recommend that all my patients have their LDL particle size tested, regardless of their total cholesterol values.
For more information about LDL particle size and how to make your particle size healthier, go to www.BottomLineSecrets.com/More.
The Real Culprit: Inflammation
If high cholesterol is not to blame for heart disease, then what is? Studies have shown that fully half of all heart attacks occur in people whose cholesterol is within "normal" range, which further calls into question the role cholesterol plays in heart disease. Why is this? As much research now shows, other factors play a role -- most notably, inflammation-related damage to the artery walls, which can have a number of underlying causes that have nothing to do with cholesterol. The danger from inflammation is why C-reactive protein (CRP), a sign that inflammation is present, is now (or should be) routinely measured as part of your annual physical exam.
If you have underlying inflammation in your arteries, you can work to reduce that inflammation naturally. To learn how, go to www.BottomLineSecrets.com/More.
Mark A. Stengler, NMD, is a naturopathic medical doctor and leading authority on the practice of alternative and integrated medicine. Dr. Stengler is author of the Bottom Line Natural Healing newsletter, author of The Natural Physician’s Healing Therapies (Bottom Line Books), founder and medical director of the Stengler Center for Integrative Medicine in Encinitas, California, and adjunct associate clinical professor at the National College of Natural Medicine in Portland, Oregon. www.DrStengler.com