The Skinny on Cholesterol: The Misleading Narrative Big Pharma Has sold you
Ineffective Treatment, Unimaginable Profits
Introduction
Cholesterol is a substance very misunderstood by the general population, with their understanding of cholesterol, what is does, why it’s vital, lab results, etc. being woefully inadequate. One of the biggest myths people hold is that high-cholesterol is a harbinger foreshadowing one’s demise, and the single most reliable marker for risk of a heart attack or stroke. Nothing could be further from the truth.
Let’s just begin by disclosing, 80% of any individual’s cholesterol levels (whether considered high or low) are predetermined/preset entirely by genetics not by some mysterious cause, although diet can certainly, without debate, have a very negative impact on one’s cholesterol and heart health. Let me be clear. High cholesterol, as determined by standard blood panel, does not by any stretch spell impending doom for the patient with cholesterol elevated above 160 mg/dl.
Every year, millions of patients are placed on statins, not knowing they’re being roped into a unnecessary and almost completely ineffective treatment, that creates a copendendent relationship between the patient and BIG PHARMA, based upon an erroneous narrative that sells countless prescriptions, but does nothing to actually improve/restore the patient’s health.
In this article I aim to clarify what cholesterol is, its importance, and how it functions within the body. We'll also explore the different types of cholesterol vital to understanding what your doctor is telling you, the damage that cholesterol helps repair, and natural ways to manage high cholesterol levels without relying on statins that carry with them a number of unnecessary risks.
Understanding Cholesterol
Cholesterol is a waxy, fat-like substance that's absolutely vital for the proper functioning of the body. It plays a key role in countless functions of the body: building cell membranes, producing hormones, synthesizing vitamin D in response to exposure to sunlight, and creating bile acids necessary for digestion. Despite its bad reputation, which is a misconception based entirely on a medical industry campaign that sells “symptoms” as “diseases” to a very naïve, malleable, and impressionable public, cholesterol is essential for maintaining overall health. But, like so many things in life, the old adage, “too much of a good thing, can be a bad thing” applies here. But how much is too much and what is it telling us about our cardiovascular health?
One way to think of cholesterol, especially high cholesterol levels as they relate to arterial plaque and the hardening of our arteries, as teased out in a blood panel, is as the body's super glue. If we have excessively high cholesterol blood test results, it means the body has sustained damage and is undergoing repair. The most prolific form of damage that sequesters the deposition of cholesterol in a blood panel is arterial wall erosion, created by insulin resistance and brought about by the over consumption of sugar and ultra processed foods that wears away the endothelial lining of blood vessels by way of glycation, requiring the deposition of cholesterol to patch the damage.
When damage occurs to blood vessels, joints, or other tissues, cholesterol rushes to the site to help repair the damage. This repair mechanism is crucial for healing and maintaining the integrity of our tissues and overall health So let’s demystify cholesterol a bit so you really understand what your body is telling you.
Cholesterol is not the “Bad Guy”
As eluded to in the section above, we all need cholesterol to survive. It's so important that if we do not consume cholesterol in our diet, our body makes it - it’s that important! So, let’s explore the myths about cholesterol that physicians have been unwittingly frightening their patients with for decades and ineffectively addressing with an unexamined protocol that only treats high cholesterol as an isolated symptom, as opposed to addressing the actual source of the problem.
The erroneous correlation between high-cholesterol and heart disease came from the Framingham Heart Study (started in 1948), an ongoing observational study that began in Massachusetts after World War II, and identified LDL-C (Low-Density Lipoprotein - Cholesterol) as a significant risk factor for heart attacks, especially at high levels (over 200 mg/dL). However, as mentioned in the opening of this article, detailed analysis revealed that LDL-C levels are largely genetically determined and only pose a significant risk when total cholesterol is extremely high - over 300 mg/dl, a level of cholesterol only 1 in 250 people have - a condition called familial hyperlipidemia. By contrast, individuals with LDL-C levels under 70 mg/dL develop relatively little heart disease, indicating genetic protection at low levels and risk at high levels.
For the majority of the population, LDL-C alone is not a strong predictor at all of heart attack risk nor stroke. Although we’ve been taught in the most generic terms it is and any cholesterol over 160 warrants concern and definitely the consideration of medical intervention, namely statins. Before you become alarmed keep reading.
The problem with this study is it only followed people into their 50s and a few into their 60s. What wasn’t revealed to the public or publicized is that after 50, as your cholesterol drops, your mortality rate actually increases precipitously, and yet the study conveniently omitted this finding and it was never discussed or investigated further. Furthermore, in 1996, Dr. William Castelli, the co-director of the Framingham Study, revisited the study and summarized the study by reframing the discussion on the findings, focusing on LDL’s specifically. He had this to say. Unless your LDL’s are above 7.8moles/dl (roughly equivalent to 300 mg/dl) it has no value whatsoever in evaluating or predicting the risk of heart disease. In other words, the association between cholesterol and heart disease is very weak at best.
To expand upon this, when you try to prove there is a biomarker/causative indicator in predicting heart disease, then obviously you have to demonstrate that lowering the biomarker equates to a reduction in heart disease, heart attack, and strokes. Unfortunately, the study clearly shows the opposite is true.
More recently, in 2019, Dr. Aseem Malhotra, an internationally acclaimed British cardiologist, and his team of 2 other cardiologists published an article in the British Medical Journal (BMJ) that looked at every drug trial claiming to lowering cholesterol. They looked in totality, at randomized control data, (not cherry-picked evidence), for a correlation between lowering cholesterol (via statins) and a lower risk of heart attack and stroke. This is the most robust and convincing evidence medical research can produce. And guess what they found??? There is no correlation whatsoever.
Their research also revealed that it is not statin’s ability to decrease cholesterol that is its main benefit. Statins do have a small benefit, but, it is very small. The small benefit is that they do lower cholesterol ever so slightly, unfortunately it’s not the type of cholesterol with any potential to kill you (more on this further in this article) but it does look good on pathology reports, blood tests, and does sell lots and lots of unnecessary prescriptions.
“Outside of their alleged ability to lower cholesterol, statins possess an anti-inflammatory and an anti-clotting mechanism. Lowering risk of heart attacks and strokes is through that mechanism, if any, not at all by lowering cholesterol. When we look at all the evidence, the benefits/efficacy of statins are less than 1% and only if you're at a low risk of heart disease. But, according to the data, if you’ve had a heart attack and take your statins religiously every day; over the course of 5 years, your benefit is 1 in 83 for saving your life, and only 1 in 39 for preventing another heart attack. A very underwhelming efficacy.” - Dr. Aseem Malhorta (Joe Rogan Podcast)
Looking at this another way; when all the evidenced was poured over in the meta-analysis of the research, the persistent daily taking of statins following a heart attack was only shown to increase one’s longevity . . . brace yourself . . . 4 days. And yet, statins are one of the most prescribed, profitable, moneymaking drugs in all of medicine, producing profits in the hundreds of billions of dollars every year despite the fact that they have virtually no efficacy (effectiveness) whatsoever and by contrast, carry with them countless debilitating side effects including: myopathy, liver damage, elevated blood sugar/insulin resistance predisposing patients to Type 2 diabetes, kidney failure, as well as memory and cognitive issues. So, why are they used. One could argue, sleight of hand in presenting data. Patients participating in clinical trials, if presenting with side effects from the drug are removed from the trials, so as to make the drug appear more efficacious than it actually is. I wish that was the end of the story.
We’ll explore the other false narrative around statins further in the article but before we do I feel it’s important to share with you the Jupiter Study performed in 2008.
The JUPITER Trial (2008):
The JUPITER trial was a landmark study that investigated the effectiveness of the statin drug rosuvastatin in preventing cardiovascular events in individuals with normal LDL cholesterol levels but elevated high-sensitivity C-reactive protein (hsCRP), an inflammation marker. Involving 17,802 participants, the trial's primary focus was on cardiovascular outcomes. However, it also revealed an unexpected finding: a higher incidence of physician-reported diabetes among those treated with rosuvastatin compared to the placebo group. This was particularly significant because the study population was not initially at high risk for diabetes. The U.S. FDA later confirmed a 27% increase in diabetes among rosuvastatin users and noted worsened glycemic control with high-dose atorvastatin.
2024 Lancet Meta-Analysis: A 2024 meta-analysis published in The Lancet provided deeper insights into the relationship between statins and diabetes. By analyzing data from 23 large, randomized trials, the study confirmed several key points:
Dose-Dependent Diabetes Risk: The risk of new-onset diabetes increased with statin intensity, with low/moderate-intensity statins linked to a 10% increase and high-intensity statins to a 36% increase.
Glycemic Changes: Statins caused small but significant increases in blood glucose and HbA1c levels, explaining the increased diabetes risk.
High-Risk Individuals: About 62% of new diabetes cases occurred in participants with already high baseline glycemic measures, indicating that those with impaired glucose tolerance are most at risk.
Impact on Existing Diabetes: Statins modestly worsened glycemic control in individuals with pre-existing diabetes, with stronger effects seen with higher doses.
The meta-analysis confirmed that statins increase diabetes risk, particularly with higher doses and in individuals with pre-existing glucose intolerance.
Additional Findings on Statins: The study also highlighted other potential adverse effects of statins, including an increased risk of pancreatic cancer, cataracts, and neurological issues such as hemorrhagic stroke. It noted that long-term statin use has been linked to a higher incidence of pancreatic cancer and cataract surgery, particularly with more potent statins like rosuvastatin.
Further yet, in the article, is the narrative doctor’s are provided to discuss high cholesterol with their patients and the unfounded promise of how statins lower cholesterol. The narrative around statins has been obfuscated and completely adulterated by the way blood panels are presented to the patients, creating unnecessary concern, and false hope regarding their heart health. But, but before we do it’s important to understand better what the different types of cholesterol are. And here all you were taught was “good” cholesterol, “bad” cholesterol.
Distilling Cholesterol Down to understandable terms:
Cholesterol travels through the bloodstream in particles called lipoproteins (lipo, meaning fat - “fat-proteins”). There are several types of lipoproteins, but the two most commonly known by the general public, are High-Density Lipoprotein (HDL) and Low-Density Lipoprotein (LDL). And this is where the obfuscation and public confusion around cholesterol begins and is subsequently compounded by conversations with their physician.
Please understand, I don’t think physicians are nefarious and have malintent. I think most genuinely care, it’s just that they’re on a very short leash tethered to the AMA, and their big brother, the CDC, NIH and therefore, they operate within very strict guidelines that handcuff them in a number of ways. I think most, if they took the Hippocratic Oath seriously, are just trying to do their best for the patients. But, they’re part of a captured/corrupt industry who gets their marching orders from BIG PHARMA and capture agencies of the Federal Government like the CDC, FDA, and NIH (all of whom are largely funded by pharmaceutical companies and in the case of the FDA, drug companies and food conglomerates.
All that said, what’s presented here is an explanation and understanding of cholesterol you won’t have provided to you by your physician.
HDL (High-Density Lipoprotein)
HDL is often referred to as "good" cholesterol because it helps remove excess cholesterol from the bloodstream and transport it to the liver for excretion. Higher levels of HDL are associated with a lower risk of heart disease. HDL acts like a scavenger, patrolling the bloodstream and picking up excess cholesterol to prevent it from accumulating in the arteries.
LDL (Low-Density Lipoprotein)
Low-density lipoproteins (LDL) are a type of cholesterol that transport fats in the bloodstream. LDL is often labeled as "bad" cholesterol (a grossly oversimplified and misguided delineation) because high levels can lead to plaque buildup in arteries, increasing the risk of heart disease and stroke, which they can, but as demonstrated earlier, one’s numbers have to be astronomically out of whack. It’s important to understand not all LDL particles are the same. There are different types of LDL particles, your doctor will not tell you about because these are not separated out and defined in a typical blood panel, so oftentimes your physician can’t tell you, because he simply doesn’t have the data. You’re only told LDL/HDL numbers, which is a very myopic and unreliable data set. LDLs are in fact, categorized by size, density, and total number.
Many people are experiencing heart attacks despite having lower LDL-C levels because standard lipid profiles do not differentiate between types of LDL particles. The majority (>80%) of circulating LDL cholesterol is large, “buoyant” (Type A LDL), which is increased by dietary intake and reduced by low-fat diets. This type is cardiovascularly neutral and not responsible for plaque buildup in arteries. The smaller portion (<20%) is small, dense (Type B LDL), which in theory, is more predictive of heart attack risk.
Statins primarily lower Type A LDL, the completely benign form found in blood, without significantly impacting or affecting Type B LDL (potential to harm you) in any meaningful capacity. Consequently, reductions in LDL-C seen with statin use only reflect decreases in the non-threatening Type A LDL, giving a false sense of security about heart attack risk. So, in going for a follow up 90 days post initial intake of statins, you and your physician are likely pleased to see you LDL numbers coming down. Unfortunately, it’s not the one’s that matter and is in no way moving you along the continuum towards improved health.
Dr. Robert Lustig, in his book, “METABOLICAL - The Lure And The Lies of Processed Food, Nutrition, and Modern Medicine” states, “Almost assuredly, statins are reducing the large buoyant Type A LDL, but not doing anything to make even a small dent in Type B LDL - therefore the risk of a heart attack remains unchanged [with the use of statins]. [1]
VLDL (Very Low Density Lipoproteins)
VLDL carries triglycerides, another type of fat found in the blood that the body uses for energy. High levels of VLDL can contribute to the buildup of plaque in arteries, similar to LDL. VLDL is converted into LDL in the bloodstream, making it another key player in cholesterol management.
Measuring Cholesterol: An Incomplete Picture
Traditional cholesterol tests measure cholesterol's weight in the blood in milligrams per deciliter (mg/dL). However, that is a very insensitive method of determining cardiac risk. The most important feature of the cholesterol profile is not the total cholesterol, LDL, HDL, or triglycerides measured in an annual cholesterol screening.
For cholesterol, new technology does exist that measures the quality, size, and number of cholesterol particles, but it accounts for less than 1% of all cholesterol tests currently conducted. Yet, it should be the gold standard for understanding your lipid numbers. The test is called “lipoprotein fractionation.” A company called FUNCTION HEALTH with Dr. Mark Hyman as their director, does this, and is where I get my blood testing done. Not covered by insurance but you’ll pay less for 2 full spectrum blood panels with them, than the cost even with insurance. I wouldn’t go anywhere else.
Rather than just measuring the weight of cholesterol, lipoprotein fractionation provides critical insight into the types and numbers of cholesterol particles that comprise a certain weight, such as an LDL of 100 mg/dL. That 100 mg/dL could be comprised of just a few large, fluffy, “buoyant” (harmless) LDL particles or hundreds of small, dense, dangerous LDL particles . Think beach ball versus golf ball. The golf ball hurts if it hits you. The beach ball does not.
The smaller particles are the major cause of cardiovascular disease. Someone could have an LDL of 150 mg/dL but no small particles and less than 1,000 overall particles of LDL and be at low risk. Or that person can have an LDL of 150 mg/dL and have 2,000 small particles and be at serious risk of a heart attack. Same number, very different implications for treatment. The first is benign, and the second requires an aggressive approach in changing one’s dietary habits.
When measuring cholesterol, what matters is the total number of particles of LDL, HDL, and VLDL and their size (small, medium, or large) that are all measured as part of the lipoprotein fractionation test, that unfortunately are not performed in most (99%) medical practices.
Insulin resistance–driven by the large amounts of sugar, starch, and ultra-processed foods in our modern diet–is the primary cause of atherogenic dyslipidemia (hardening of the arteries). Unchecked, this leads to prediabetes and type 2 diabetes. In fact, 75% of all heart attacks are caused by poor metabolic health and insulin resistance, mentioned earlier as causing endothelial vessel lining erosion and therefore the increased deposition of cholesterol - creating hardening of the arteries and plaque in the arterial walls.
A holistic approach to assessing cardiovascular risk (considering one’s dietary and nutritional habits, fitness, sleep, and stress management) is essential and should not be dependent on just one biomarker, such as LDL cholesterol, as is most often the case with a visit to an allopathic (pharmaceutical-based) approach vs. a holistic/naturopathic/functional medicine physician.
As it turns out, LDL cholesterol is a less predictive risk measure compared to LDL particle number and size, or other biomarkers like ApoB. Measurement and fractionation of the LDL, HDL, and VLDL (a way of looking at the quality of triglyceride particles) cholesterol are critical to understanding your risk.
“In short, DON’T panic when you’re told by your doctor,
your “bad” (LDL) cholesterol is high.
Investigate further!!!”
Ask your doctor to assess cardiometabolic risk, including ApoB, Lp(a), triglyceride to HDL ratio, hemoglobin A1c, insulin, glucose, and hs-CRP and even genetic tests that assess your genetic predispositions for abnormal cholesterol. Medical history, family history, and other potential biomarkers or imaging tests can provide a robust view of your risk. Currently, treatment decisions for lipid disorders mostly rely on measuring only total and LDL cholesterol, an approach that is outdated and inadequate for assessing disease risk and guiding treatment in the 21st century .
Statins: An ineffective treatment with Risks and Side Effects
So, bringing things full circle, statins are a class of drugs sadly, over prescribed to lower cholesterol levels in the blood. They work by inhibiting an enzyme in the liver that's necessary for cholesterol production. While statins can somewhat lower “Bouyant” Type A LDL cholesterol (harmless and completely benign), they come with a range of potential side effects and long-term risks that should be considered.
How Statins Work: Statins block the enzyme HMG-CoA reductase, which the liver uses to produce cholesterol. This reduces the overall level of cholesterol in the bloodstream. This is an entirely symptomatic approach to lowering cholesterol, that can be circumvented completely with a change in diet and nutrition alone with no side effects.
Common Side Effects: Muscle pain and weakness, fatigue, digestive problems, and increased blood sugar levels, liver damage, kidney damage, cognitive and mental issues. These side effects can significantly impact the quality of life for some individuals.
Long-Term Risks: Liver damage, neurological effects (such as memory loss and hemorrhagic stroke particularly with more potent statins like rosuvastatin, and per the Jupiter Study (2008) an increased risk of type 2 diabetes, and increased risk of pancreatic cancer. Statins can also deplete the body of Coenzyme Q10 (CoQ10), an important nutrient for muscle function and energy production.
Ineffectiveness: As explained earlier, the risks of statin use far outweighs the benefit, and therefore should only be used in extreme cases, not to lower cholesterol but as perhaps an anti-inflammatory, anti-clotting mechanism.
Keep in mind, who benefits from the prescription of statins. First, are the pharmaceutical companies who make a fortune peddling their so-called “treatment” for managing cholesterol, which you now know isn’t treating anything really. Next, are the health insurance companies who get to increase your rates for a pre-existing condition that’s being treated, once you begin use of statins. And lastly, influenced by Big Pharma, the government adheres to policies they believe will ensure their voter base lives longer, and of course bow in allegiance to their masters . . . let’s not forget the generous donations from said companies while candidates sequester endorsements along the campaign trail.Reconsidering Statins: Given these potential side effects, statins are targeting the wrong pathology/cause. The use of statins should be carefully considered and only used in extreme cases. It's important to weigh the benefits of lowering cholesterol against the risks of side effects and explore natural alternatives where possible. So, let’s look at some.
Natural Ways to Manage Cholesterol
Managing cholesterol levels naturally is possible through a combination of diet, exercise, and lifestyle changes. Here are some effective strategies:
Diet and Nutrition:
Fiber-Rich Foods: Soluble fiber found in oats, beans, fruits, and vegetables can help reduce LDL cholesterol levels by binding to cholesterol in the digestive system and removing it from the body.
Healthy Fats: Incorporate sources of healthy fats such as avocados, nuts, seeds, and olive oil. These fats can help increase HDL cholesterol and lower LDL cholesterol.
Avoid Trans Fats and Limit Saturated Fats: Trans fats, found in many processed foods, can increase LDL cholesterol and lower HDL cholesterol. Limit saturated fats from red meat and full-fat dairy products, which can also raise LDL levels.
Exercise:
Regular physical activity can help raise HDL cholesterol and lower LDL cholesterol. Aim for at least 30 minutes of moderate exercise, such as brisk walking, cycling, or swimming, most days of the week. Exercise also helps maintain a healthy weight, which is important for managing cholesterol levels.
Supplements:
A holistic approach to heart health should go beyond traditional cholesterol measures and consider factors like gut microbiome, mitochondrial function, and other health indicators.
Statin drugs, inhibit the production of CoQ10, a vital coenzyme that naturally declines with age. This inhibition can lead to side effects like muscle problems due to reduced CoQ10 levels in the body. For those taking statins, supplementing with CoQ10 or its more bioavailable form, ubiquinol, is recommended. The dosage varies depending on individual health needs, ranging from 100 to 200 mg daily for statin users, with higher doses for others. Consulting with a healthcare provider is advised to determine the right dosage.
Lifestyle Changes:
Quit Smoking: Smoking lowers HDL cholesterol and increases the risk of developing heart disease. Quitting smoking can improve HDL levels and overall cardiovascular health.
Reduce Alcohol Consumption: Excessive alcohol intake can lead to high cholesterol and other health issues. If you drink alcohol, do so in moderation.
Manage Stress: Chronic stress can negatively impact cholesterol levels and overall heart health. Practice stress management techniques such as mindfulness, meditation, yoga, or deep breathing exercises.
Conclusion
Cholesterol is an essential substance in the body, playing a crucial role in various biological processes. Understanding the different types of cholesterol and their functions can help dispel common misconceptions. By focusing on natural ways to manage cholesterol levels, such as diet, exercise/fitness, and lifestyle changes to improve sleep and manage stress, individuals can maintain healthy cholesterol levels and reduce their reliance on statins. Additionally, using advanced testing methods like lipoprotein fractionation can provide a more accurate assessment of cardiovascular risk, leading to better treatment decisions. Empowering yourself with this knowledge is the first step towards making informed decisions about your health.
Sources:
Lustig, R. H. (2021). Metabolical: The Lure and the Lies of Processed Food, Nutrition, and Modern Medicine. Harper Wave. Pages 36-37.
Harvard Health Publishing. (n.d.). Cholesterol: Top foods to improve your numbers. Retrieved from https://www.health.harvard.edu/heart-health/cholesterol-top-foods-to-improve-your-numbers
Mayo Clinic. (n.d.). Cholesterol levels: What numbers should you aim for? Retrieved from https://www.mayoclinic.org/tests-procedures/cholesterol-test/about/pac-20384601
American Heart Association. (n.d.). Understanding cholesterol levels. Retrieved from https://www.heart.org/en/health-topics/cholesterol/about-cholesterol/understanding-cholesterol-levels
National Heart, Lung, and Blood Institute. (n.d.). What is cholesterol? Retrieved from https://www.nhlbi.nih.gov/health-topics/high-blood-cholesterol
National Institute on Aging. (n.d.). High blood cholesterol levels. Retrieved from https://www.nia.nih.gov/health/high-blood-cholesterol-levels
Cleveland Clinic. (n.d.). Statins: Are these cholesterol-lowering drugs right for you? Retrieved from https://my.clevelandclinic.org/health/drugs/17037-statins
WebMD. (n.d.). LDL cholesterol: What it is & how to lower it. Retrieved from https://www.webmd.com/cholesterol-management/ldl-cholesterol-what-is-it
Disclaimer:
I am not a medical doctor or a medical practitioner. I am not legally permitted to claim I treat, cure, or heal disease. I can, however, provide educational content with respect to building/restoring and maintaining optimal health through nutrition, diet, sleep support, and exercise, which can reverse health conditions.Any information provided on this site is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this web site.This website summarizes information on the role of nutrition, diet, and exercise in health, disease and wellness. Readers should be aware that knowledge of nutrition and medicine is constantly evolving. They are encouraged to frequently check the most current information available on preventive and therapeutic measures. It is your designated clinician’s responsibility, relying on their experience and knowledge of the patient, to determine the best course of action in providing care and your choice to follow it or not. The author, editor, and publisher of information on this website accepts no liability for any injury arising out of the use of material contained herein, and makes no warranty, express or implied, with respect to the contents of this online publication, or from the contents of sites or articles we provide links to. 