Does everyone need to be on statins? Is there an alternative to try? Let's discuss what you should consider before taking statins.
Cholesterol 101.
Cholesterol is a fatty waxy substance produced in the liver, and found in the blood and all of our cells in the body. Cholesterol is also found in certain foods and it's necessary for building cells, digesting foods, making hormones and it contributes to the production of bile and vitamin D.
Cholesterol is a type of lipid that doesn't dissolve in water, but travels throughout the bloodstream to reach different parts of the body. Our liver makes enough cholesterol to support what we need and we can get extra cholesterol from the foods we eat.
Did you know that our body has a system to get rid of excess cholesterol?
HDL [high density lipoprotein] absorbs the cholesterol and delivers it to the liver. Once the liver receives it, it flushes the cholesterol from the body via bile. - Amazing!
Elevated Cholesterol.
Your doctor may recommend taking statins if you've been diagnosed with cardiovascular disease [CVD], a family or personal history that suggests your're likely to develop CVD at some point over the next 10 years and lifestyle corrections that haven't lowered your LDL to <190.
Unfortunately, this is a nuanced conversation that requires more information and most of us aren't given the many important points of how statins may or may not actually support heart health.
High total cholesterol alone isn't a very helful marker of heart disease. We need to know what kind of cholesterol we're talking about.
Simple Question?
Why is this number given so much significance?
Because we have many drugs to treat high cholesterol- whether it's actually effective or not!
Currently worldwide, sales of statins are running at 19 billion yearly and growing quickly.
This is BIG business, representing 14 billion in the US alone.
What is true, is that money is driving the use of statins instead of actual health benefits alone. When incentives are offered through drug reps, free samples, and boatloads of favorable literature pushing the use of statin therapy and most egregious to me - the lack of actual education around cholesterol particle size and risk of cardiac events, doctors continue to prescribe using standard numbers alone.
Of the 2,444 doctors in the Medicare prescribing database, almost 37% received industry payments for prescribing statins.
What You Need to Know.
The number of LDL particles matters more than just the cholesterol amount they carry.
High cholesterol doesn't always reflect the overall health of blood vessels or the presence of inflammation, which are crucial factors in heart disease development.
Dietary and lifestyle factors need to be considered as a first-line therapy and we need to be given information on how effective changing current eating and exercise habits can improve heart health more dramatically than statin therapy.
High cholesterol is a symptom of an underlying problem, rather than a disease to be diagnosed and treated without looking into the actual cause.
High triglycerides levels are much more concerning and carry a greater risk for future heart attacks.
The majority [80%] of circulating LDL-C speices are large, buoyant particles and are cardiovascularly neutral - these partices are not accumulating as plaque in the arterial walls which is the cause of heart attacks.
Less common BLDL-C [20%] are the problematic small, dense particles that statin therapy can help.
Statins have only been shown to extend life in men under 80 years of age with pre existing heart disease.
Statins cause a number of side effects such as muscle pain and cognitive problems.
CoQ10 and vitamin D may decrease the risk of side effects - so supplement if taking statins.
Besides grapefruit, supplementing with seleium is not recommended because it may decrease efficacy of statins.
Testing for particle size is not on a standard lipid panel - what????
If you currently have high LDL-C levels, you will be put on a statin. This treatment will lower your LDL - but only the large buoyant LDL particles, not the dense BLDL-C which is the actual problem!
Unfortunately, as in many cases in convential medicine, the approach to high cholesterol can be oversimplified with possible negative consequences.
A Lifestyle Approach to High Cholesterol Levels.
Remember, the #1 reason our cholesterol is elevated is due to our diet of refined carbohydrates, eating mostly fiberless foods, and especially our high sugar diet.
Prioritze nutrient-rich whole, real foods with a balance of traditional fats and avoid the processed and refined foods.
Most of us with elevated cholesterol are also insulin resistant and have metabolic syndrome.
Eating a low-insulin diet, paying close attention to the foods that spike insulin especially lowering the intake of foods with added sugars that contribute to insulin resistance.
Focus on finding a weight that's realistic for your health, instead of making this a place of either shame or elevated worth.
Familial hypercholesterolemia - an inherited genetic condition that causes high levels LDL [low density lipoprotein] which prevents the body from clearing LDL along with normal triglyceride and HDL levels will do better with moderate carbohydrates, lower saturated fats and higher monosaturated fats, rather than a low carb approach to eating.
Prioritize coldwater fatty fish and shellfish
Include antioxidant foods - vegetables, fruits, nuts & seeds, herbs & spices and even cocoa.
Eat fermented foods - sauerkraut, kefir, greek yogurt, kimchi, apple cider vinegar, miso.
Get more fiber- 30 grams a day is a great goal. Include brocolli, berries, avocados, apples, lentils, not too ripe bananas.
Limit or better yet - eliminate alcohol. This isn't a popular opinion, but for the best health outcomes there is no level of alcohol consumption that improves our health. The "old" message of drinking in moderation as a healthy practice is not true. You decide, but make your choice with good information.
Get moving. A sedentary lifestyle increases our risk of becoming overweight, obese, developing type 2 diabetes, having high blood pressure, heart disease, cancers and experiencing depression and anxiety. We also lose muscle strength and endurance, so exercise is harder, Our bones may get weaker and we lose precious minerals that are the spark plugs for our body. Sitting too much affects our metabolism slowing it further which makes it more difficult for our body to break down fats and sugars.
Manage the Stressors. Find ways to help your body deal with life. Deep breathing, meditation, movement, massage, getting outside, sunlight, and therapy are all effective strategies - if you use them.
Chronic stress is one of the most significant, yet least recognized risk factors for heart disease.
Supplements.
I always encourage you to begin with food and lifestyle practices and get these dialed in first. Then, if you'd like to go a bit deeper, targeted supplements can be another helpful addition.
My Top 5.
High-quality Multivitamin.
Magnesium Glycinate or Citrate if constipation is a concern.
Vitamin D3 +K2
Omega-3
Probiotic
There are many ideas in this post and I've worked hard to condense a complicated topic that sparks a lot of debate within our standard of care. My approach is always begin with what goes in your mouth, as that's something we do many times a day, 365 days a year.
This is an uphill battle to begin to take back your health instead of naively turning over your well-being to a system that's deeply flawed and fraught with conflict of interests - unfortunately your health isn't one of them.
Times Are A-Changin'
Our medical system is a vital important part of maintaining good health. For all the acute problems we face, there's no better place than using the incredible knowledge and expertise of this system. But, for our daily, common chronic issues that plague most of us - there are no good answers within those walls.
A pill, proceedure, surgery or treatment option will only treat the symptom.
Become informed and realize that change begins first at home.
I'm passionate about helping others and I can help you too.
Please reach out and find how using someone to navigate this journey toward better health is so worth it.
You can find me in many ways:
Instagram: janlindquist_ntp
janlindquist@sbcglobal.net /209.484-5999
Thanks for reading,
Jan
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