Myth: All Cholesterol Is Bad For You
Fact: Some types of cholesterol are essential for good health. Your body needs cholesterol to perform important jobs, such as making hormones and building cells. Cholesterol travels through the blood on proteins called lipoproteins. Two types of lipoproteins carry cholesterol throughout the body:
- LDL , sometimes called bad cholesterol, makes up most of your bodys cholesterol. High levels of LDL cholesterol raise your risk for heart disease and stroke.
- HDL , or good cholesterol, carries cholesterol back to the liver. The liver then flushes it from the body. High levels of HDL cholesterol can lower your risk for heart disease and stroke.
When your body has too much LDL cholesterol, it can build up in the walls of your blood vessels. This buildup is called plaque. As your blood vessels build up plaque over time, the insides of the vessels narrow. This narrowing can restrict and eventually block blood flow to and from your heart and other organs. When blood flow to the heart is blocked, it can cause angina or a heart attack.
Lower Your Cholesterol Without Meds
I had heard from various friends and family members that I should just go on medication for my cholesterol since Im not overweight, go to the gym regularly, and my diet doesnt seem to be a factor . I was told that my cholesterol was high because of my age and my family history. Still, I was determined to give it my best shot.
As you read, keep in mind that Im not a doctor, just a person who did her research and had success. Nothing written here should be construed as medical advice. When in doubt, consult your physician.
Here was my strategy. First, I added:
Rosuvastatin And Atorvastatin Are The Best At Lowering Ldl Cholesterol
Heres the evidence backing this:
A 6-week clinical trial compared rosuvastatin against atorvastatin, pravastatin, and simvastatin and found that it lowered total cholesterol significantly more than all others, and lowered triglycerides significantly more than simvastatin and pravastatin.
A 54-week clinical trial compared atorvastatin with fluvastatin, lovastatin, and simvastatin and found that atorvastatin was better at lowering LDL cholesterol than the other medications.
A systematic review of 75 clinical trials found that rosuvastatin and atorvastatin were the only statins that lowered LDL cholesterol by more than 40% .
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Reducing Heart Disease Naturally
One thing that this study does show is that cardiovascular disease is complicated.
The study also brings to light another fact about cholesterol drugs are not the only way to lower your LDL levels.
Most doctors who prescribe statins for high cholesterol will also recommend that patients exercise more and eat healthier foods.
But more hospitals and doctors offices are starting to promote lifestyle changes as a way for patients to reduce their risk of cardiovascular disease and LDL levels using diet and exercise alone.
Often this approach involves a whole food or plant-based diet rich in vegetables, fruits, whole grains, beans, legumes like chickpeas and lentils, healthy fats like those in olive oil and avocado, and dairy alternatives.
For many, this diet will be a challenge to switch to. But there is a growing body of research on its benefits.
Mechanisms Accounting For Bile Acid Sequestrants Induced Lipid Effects
Bile acid sequestrants bind bile acids in the intestine, preventing their reabsorption in the terminal ileum leading to the increased fecal excretion of bile acids . This decrease in bile acid reabsorption reduces the size of the bile acid pool, which stimulates the conversion of cholesterol into bile acids in the liver . This increase in bile acid synthesis decreases hepatic cholesterol levels leading to the activation of SREBPs that up-regulate the expression of the enzymes required for the synthesis of cholesterol and the expression of LDL receptors . The increase in hepatic LDL receptors results in the increased clearance of LDL from the circulation leading to a decrease in serum LDL-C levels . Thus, similar to statins and ezetimibe, bile acids lower plasma LDL-C levels by decreasing hepatic cholesterol levels, which stimulates LDL receptor production and thereby accelerates the clearance of LDL from the blood.
The mechanism by which treatment with bile acid sequestrants improves glycemic control is unclear .
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How To Lower Your Cholesterol Without Statins
Cholesterol is produced in the liver and is required for the production of hormones, vitamin D, and bile acids. Cholesterol doesnt dissolve in blood. To be transported in the bloodstream, cholesterol is packed into two types of carriers: low-density lipoprotein or high-density lipoprotein . LDL cholesterol is necessary in limited quantities, but high LDL cholesterol levels can dramatically increase your risk of heart attack by contributing to atherosclerosis. Although high cholesterol is commonly addressed with statins, it is important for people to understand that lipid abnormalities are not caused by a statin deficiency. Rather, they are usually the result of dietary factors, particularly the inclusion of animal foods and oils and the absence of soluble fiber in the diet. Statins can help lower cholesterol levels however, they can also produce adverse effects in people. Possible side effects include headache, difficulty sleeping, muscle aches and weakness, memory loss, neuropathy, high blood sugar, and an increased risk of developing diabetes. Can diet be just as effective as statins at lowering cholesterol, without the side effects?
What Are Statins Used For
Having high levels of bad cholesterol in the blood can increase the risk of cardiovascular disease, such as heart attack and stroke. Statins are used to lower LDL cholesterol, and this helps lower the risk of cardiovascular disease.
Statins are considered the most effective group of cholesterol-lowering medicines available and work by blocking cholesterol production in the liver.
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Myth #: Taking Statin Drugs Leads To Diabetes Out Of The Blue
Truth: In clinical trials, statins appear to accelerate a diagnosis of adult-onset diabetes because they cause a slight elevation in blood sugar. However, people experiencing this side effect already have higher than normal blood sugar, or prediabetes, explains Martin. For those who are borderline diabetic, the mild increase in blood sugar can lead to a diabetes diagnosis about five weeks earlier than it would be otherwise.
Research indicates that statin drugs do not induce diabetes in someone who isnt already nearing a diabetes diagnosis. Additionally, the benefits of reducing cardiac events in someone who has prediabetes or is diabetic greatly outweigh the mild increase that might occur in their blood sugar, says Martin.
Getting A Cholesterol Test
A blood sample is taken that will be used to determine the amount of bad cholesterol , good cholesterol and other fatty substances in your blood.
You may be asked not to eat for 10-12 hours before the cholesterol test, usually including when you’re asleep at night. This ensures that all food is completely digested and won’t affect the outcome of the test.
Your GP or practice nurse can carry out the cholesterol test and will take a blood sample, either using a needle and a syringe or by pricking your finger.
A newer type of test that measures non-high-density lipoprotein is now sometimes used because it’s thought to be a more accurate way of estimating cardiovascular disease risk than LDL.
Non-HDL cholesterol is total cholesterol minus HDL cholesterol. It’s also not necessary to fast before the test, so it is more convenient.
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Side Effects Of Statins
Many people who take statins experience no or very few side effects.
Your doctor should discuss the risks and benefits of taking statins if they’re offered to you.
The risks of any side effects also have to be balanced against the benefits of preventing serious problems.
A review of scientific studies into the effectiveness of statins found around 1 in every 50 people who take the medicine for 5 years will avoid a serious event, such as a heart attack or stroke, as a result.
Find out more about the side effects of statins.
You Can Begin To Reduce Your Bad Ldl Cholesterol Naturally By Making A Few Simple Changes In Your Diet
If your cholesterol is creeping upward, your doctor has probably told you that diet and exercisethe traditional cornerstones of heart healthcould help to bring it down. And if you’d prefer to make just one change at a time to lower your cholesterol naturally, you might want to begin with your diet. A major analysis of several controlled trials involving hundreds of men and women found that dietary changes reduced LDL and total cholesterol while exercise alone had no effect on either.
The people in the studies followed a variety of diets, from Mediterranean to low-fat to low-calorie. However, the most effective diets substituted foods with the power to lower cholesterol for those that boost cholesterol. According to Kathy McManus, director of the Department of Nutrition at Brigham and Women’s Hospital, eating with your LDL in mind doesn’t have to be an exercise in self-deprivation. While you may have to say goodbye to a few snacks and fast foods, you can replace them with others that are equally satisfying. “You don’t have to follow an all-or-nothing approach. It’s really a matter of common sense,” she says. She suggests a few ways to start getting your cholesterol under control and keep it normal.
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- Research health conditions
- Prepare for a doctor’s visit or test
- Find the best treatments and procedures for you
- Explore options for better nutrition and exercise
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Understanding Your Cholesterol Results
The results of a cholesterol test can be as confusing as they are important. Learn the difference between LDL and HDL, and how to lower your cholesterol. What do my cholesterol results mean?
Thats because lowering heart attack risk is not just a matter of lowering cholesterol. There are many other factors that damage artery walls and increase the risk of a heart attack or stroke, including:
- High glucose levels
- High blood pressure
Are Statins Really Worth Taking For High Cholesterol
Research has shown that statins are highly effective in reducing the risk of fatal heart attack and stroke. But some people are reluctant to take these life-saving drugs. They worry about taking medicine every day for the rest of their life or have heard that statins have undesirable side effects. What does science have to say about these concerns and others surrounding statins? We talked to UH interventional cardiologist Ian Neeland, MD, Director of the Center of Cardiovascular Prevention at University Hospitals, to learn more.
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Why Should I Lower My Cholesterol
Evidence strongly indicates that high cholesterol can increase the risk of:
- narrowing of the arteries
- transient ischaemic attack often known as a “mini stroke”
- peripheral arterial disease
This is because cholesterol can build up in the artery wall, restricting the blood flow to your heart, brain and the rest of your body. It also increases the risk of a blood clot developing somewhere in your body.
Your risk of developing coronary heart disease also rises as your blood’s cholesterol level increases. This can cause pain in your chest or arm during stress or physical activity .
Mistake : You Forget To Take Your Medication Or Have Stopped Altogether
Drugs to treat high cholesterol, including statins, have a proven impact on cholesterol levels and may prevent heart attack in people with coronary heart disease. But according to an article published in May 2018 in the journal Vascular Health and Risk Management, not taking statins as prescribed was linked to a significantly higher risk of cardiovascular problems and even death.
The article cites reviews showing medication compliance problems worldwide:
- One Italian study examining the effectiveness of statins found that only 61 percent were still taking their meds as prescribed after 3 months.
- A Canadian study found that as many as 60 percent of patients who had experienced acute coronary syndrome, such as a heart attack, stopped taking their statin within 2 years of hospitalization.
- Discontinuing statins is estimated to add a staggering $44 billion to healthcare costs in the U.S.
According to the Vascular Health and Risk Management article, researchers theorize that noncompliance may be due to a combination of factors, including cost, infrequent visits with cardiologists, concerns about side effects, and forgetting to take the medication. They also note that statins may be discontinued at a higher rate than other medications because high cholesterol is a symptomless condition with infrequent tests compared with something like diabetes, which requires constant monitoring of blood sugar levels.
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Can You Lower Bad Cholesterol Too Much
Reviewed byDr. Victor Marchione, MD.Written byMohan GarikiparithiPublished onFebruary 12, 2020
Cholesterol levels are a top concern among Americans focused on heart health. Whether youre using statin medications or lifestyle measures to reduce it, can LDL get too low?
Your body needs cholesterol, even the bad stuff. Low-density lipoprotein, or LDL, is the stuff doctors are concerned about. Small particles can accumulate on arterial walls and cause atherosclerosis, which is the main reason it is such a major risk factor in heart disease.
But you need LDL for healthy hormone levels and cell membranes it allows your cells to communicate with each other. If levels get too low, are these important functions impeded?
That can be controversial.
The American Heart Association and other organizations suggest elevated LDL should be brought down to 70 milligrams per deciliter . Other research, however, has shown it can go much lower without health implications.
On the other hand, there is work to suggest that when LDL gets too low, it may influence how high-lipid organs, like the brain, function. There has also been evidence that aggressive statin treatment can boost the risk of osteoporosis.
But those studies may say more about aggressive statin use than low cholesterol. For example, people with genetic conditions that have very low levels of LDL do not have the same issues.
Statins And How Statins Work
Doctors also prescribe, usually if lifestyle changes are falling short, drugs like statins. Brand names include Lipitor, Crestor, Mevacor, Pravacol, and Zocor. Statins have been clearly shown to reduce blood cholesterol and prevent atherosclerosis, or heart disease. They work by reducing the livers production of cholesterol. They block an enzyme called HMG CoA Reductase that the liver uses to make cholesterol.
But other things are happening in the liver that statins do not affect. In addition to producing cholesterol, the liver helps clear excess cholesterol from the blood. It has tiny receptors that capture LDL bad cholesterol particles that are floating around. Like vacuum cleaners, these receptors suck this excess cholesterol up and out of the blood, which means theres much less cholesterol seeping into our artery walls, building plaque.
The problem is, a diet full of saturated fats, trans fat, and dietary cholesterol reduces the number and effectiveness of these LDL receptors. And theres nothing statins can do to counteract this process.
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When You Need Themand When You Dont
Your body makes a waxy substance called cholesterol. You also get it from food. Your body needs it, but too much cholesterol in your blood can clog your arteries. This increases your risk of heart disease, heart attack, and death.
Statins are drugs that lower your cholesterol. But if you are age 75 or older and you havent had symptoms of heart disease, statins may be a bad idea. Heres why:
Adults age 75 and older may not need statins.
Many older adults have high cholesterol. Their doctors usually prescribe statins to prevent heart disease.
But for older people, there is no clear evidence that high cholesterol leads to heart disease or death. In fact, some studies show the oppositethat older people with the lowest cholesterol levels actually have the highest risk of death.
Statins have risks.
Compared to younger adults, older adults are more likely to suffer serious side effects from using statins.
Statins can cause muscle problems, such as aches, pains, or weakness. Rarely, there can be a severe form of muscle breakdown.
In older adults, statins can also cause:
- Memory loss and confusion
- Nausea, constipation, or diarrhea.
Often, older adults take many drugs. These can interact with statins and lead to serious problems. Side effects, like muscle pain, may increase. Statins can also cause a fatal reaction when taken with heart-rhythm drugs.
Statins may increase the risk of type-2 diabetes and cataracts, as well as damage to the liver, kidneys, and nerves.
Myth: I Would Be Able To Feel It If I Had High Cholesterol
Fact: High cholesterol usually has no signs or symptoms. You may not know you have unhealthy cholesterol levels until it is too latewhen you have a heart attack or stroke. Thats why its so important to get your cholesterol levels checked at least every 5 years.1,2 Learn more about getting your cholesterol checked.
Occasionally, some people develop yellowish growths on their skin called xanthomas, which are cholesterol-rich deposits. People with xanthomas may have high cholesterol levels.
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Muscle Pain And Weakness
The most common side effect is muscle pain and weakness, a condition called rhabdomyolysis, most likely due to the depletion of Co-Q10, a nutrient that supports muscle function. Dr. Beatrice Golomb of San Diego, California is currently conducting a series of studies on statin side effects. The industry insists that only 2-3 percent of patients get muscle aches and cramps but in one study, Golomb found that 98 percent of patients taking Lipitor and one-third of the patients taking Mevachor suffered from muscle problems.4 A message board devoted to Lipitor at forum.ditonline.com contained more than 800 posts, many detailing severe side effects. The Lipitor board at www.rxlist.com contains more than 2,600 posts .
The test for muscle wasting or rhabdomyolysis is elevated levels of a chemical called creatine kinase . But many people experience pain and fatigue even though they have normal CK levels.5
John Altrocchi took Mevacor for three years without side effects then he developed calf pain so severe he could hardly walk. He also experienced episodes of temporary memory loss.
Active people are much more likely to develop problems from statin use than those who are sedentary. In a study carried out in Austria, only six out of 22 athletes with familial hypercholesterolemia were able to endure statin treatment.9 The others discontinued treatment because of muscle pain.