Cholesterol: The Myth, The Hero & The Demon

I was sitting around a table with three "lipidologists" (cardiologists who have been declared cholesterol gurus through certification), an invasive cardiologist (stent and cath person), and little old me, the Naturopathic Cardiologist.

There was an intense conversation going on about lipid particles and atherogenicity, specifically about which ones tend to cause heart disease more than others. I chuckled under my breath (to the ire of my colleagues) and said openly that "it is not the particle that's the problem; it's the oxidation of that particle."

In other words, LDL is safe, all of it, unless it becomes oxidized, and when it does, it not only can cause heart disease but probably cancer as well.

Imagine having rancid oil running through your veins all day, that's what causes the problem.

There was a pause, and than one of my lipidologists colleagues said, "That does not fit into this discussion." I answered sternly that you are arguing over which particles do what, but you are not discussing how to stop the disease. He answered, "That is a discussion for a different day." I chimed in, "When are we going to discuss how to stop the disease?"  I received blank looks and the conversation continued.

Here is the problem...

LDL is not a myth as some people are proposing, and it is not a demon as the lipidologists were stating. It is, in fact, like a sober high-functioning addict.

Meaning that when right, LDL coats every cell in the human body, is the precursor (starting material) for all of our hormones, and is key to repairing and maintaining the 100,000 miles of blood vessels the average 154 lb. human has in their body.

However, when wrong it can be devastating. Wrong like an addict with a high, in that the LDL high is to chemically convert into a rancid or oxidized form.

Since there is no 12-step program for LDL, here is what I advise for the prevention of oxidation of LDL in three simple steps:

1. Do regular liver detoxes and consume fiber. LDL becomes oxidized or rancid in the bile of the GI tract and is reabsorbed into the blood stream where it can cause havoc. Liver detoxes and fiber help clear the rancid LDL.
2. Avoid "Oxidizers" like processed foods, white sugar, white flour, white rice, bad water and poor air. Obviously it is hard to avoid bad air, but, as I say to my patients, do your best.
3. Consume antioxidants in food and supplementation. Organic berries, fruits, cold-water fish, and nutritional supplements, to my mind, can prevent LDL from oxidizing. The key with supplements is to use a broad spectrum of fat-soluble antioxidants with alpha lipoic acid. So A, D, D3, K, K2, and at least 600 mgs of alpha lipoic acid daily. Alpha lipoic acid can have a recycling effect on the other antioxidants making them last longer.

Remember, it is medically accepted that if LDL does not oxidize, heart disease does not occur.

Well, no cholesterol discussion would be complete without discussing the use of cholesterol lowering medications.

I will let you know that it is an individual decision, which should be discussed with your cardiologist, internist, or other health care practitioner. But personally, I think the risk outweighs the benefit for the majority of people consuming them.

There is no doubt that since cholesterol is not a myth, that lowering it may have benefit.

However, when we studied the value of lowering cholesterol with medication we found out two things:

1. Unless you have 4 or more risk factors, there is most likely no benefit.
2. There are some potential hefty "now and then" side effects such as muscle aches and kidney damage in the short term, and memory problems, diabetes, and possibly heart failure in the long term. So yes, even if you do not feel the "now" effect, you could get the "then" effect later.

So, if you are a smoking diabetic with hypertension, who is over the age of 65, you may benefit from cholesterol lowering drug therapy.

One neat thing coming out from two companies, Neuroscience and Cleveland Heart Lab (Cleveland Clinic), is the oxidized LDL lab marker. We think it is accurate, and reproducible. In addition, we will be looking at LDL vulnerability (ability to oxidize) rather than just a number.

In conclusion, I wish to tell you that this is my opinion and medical approach that I am discussing with you. I support my opinion with the fact that through 15 years of a very busy practice, I have had just 4 heart attacks and 3 strokes in my patients, most of which were at the end of a much improved and prolonged life.

I dare any conventional cardiologist to match my record, especially since I was mostly seeing patients which they had previously seen, and had a poor result with.