Approximately 45 million Americans take statins daily to manage cholesterol, and the statin pharmaceutical industry is worth billions of dollars. Why has cholesterol become so oversimplified and demonized by conventional medicine? Let’s take a deeper dive into some of the early flawed studies involving cholesterol and mortality risk, as well as examining the many essential roles cholesterol plays in the body. Finally, let’s discuss additional ways to gain insight into cardiovascular risk.
Flawed Studies, Beginning with the “Seven Countries Study”
Ancel Keys led a series of studies from 1958-1970 with the proposition that saturated fat led to higher cholesterol which increased incidence of heart disease. Major flaws with the study include cherry-picked data; Keys had access to data from ~20+ countries but only included the 7 that supported his hypothesis. Secondly, he could not not prove saturated fat caused heart disease, committing a common flaw in research that correlation does not equal causation. He did not adequately control for smoking rates (huge at the time), sugar/refined carbohydrate intake, physical activity, or socioeconomic differences. He ignored contradictory patterns , including that some populations ate high fat but had lower heart disease. Lastly, he did not distinguish LDL subtypes or oxidative and inflammatory status, where modern cardiometabolic science shows matter far more than total cholesterol and LDL. Nonetheless, Keys’ work became a major driver of health policy surrounding cholesterol management.
Why Cholesterol is Essential For Your Body
Cholesterol is essential for:
- Vitamin D synthesis
- Steroid hormone synthesis (testosterone, cortisol, estrogen, progesterone, DHEA-s)
- Bile acid production
- Cell membrane composition and function
- Cognitive health
Is Low-Density Lipoprotein (LDL) Bad? What It Actually Does in the Body
LDL is a transport system that helps deliver cholesterol and fat-soluble nutrients to cells that need it for membranes, hormones, and repair. Cell increase LDL receptor expression when they need more cholesterol for repair during times of inflammation, injury, and cell turnover
Issues arise when the blood vessel lining is damaged, usually secondary to inflammation and oxidative stress. Elevated LDL is not the root of this issue.
Better Ways to Assess Cardiovascular Risk and Root Causes of High LDL
Instead of only focusing on LDL and total cholesterol, I look more deeply into markers of inflammation, insulin resistance, endothelial injury, coagulation status, and oxidative stress, including:
- Oxidized LDL
- Fasting insulin
- Apolipoprotein B
- Lipoprotein A
- hs-CRP
- Fibrinogen, d-dimer, prothrombin
- Hormone status (especially thyroid and estrogen!)
Risks and Side Effects of Conventional Statin Therapy
Muscle-related issues (myalgias)
Secondary to depletion of CoQ10 and impaired muscle energy production. This is especially important to consider for use in aging populations
Fatigue and Cognitive Effects
Brain fog and memory issues have been reported by large numbers of statin users. 25% of the body’s cholesterol goes to supporting the membrane-rich environment of the brain
Hormonal Depletion
Cholesterol is the precursor to steroid hormones including testosterone, cortisol, progesterone, and DHEA-s
Decreased fat-soluble nutrient synthesis (vitamin D) and transport (vitamin D, vitamin E)
Final Remarks
Cholesterol is not the enemy—it’s a vital, life-sustaining molecule. The real issue lies in the environment it operates in: inflammation, oxidative stress, and metabolic dysfunction. When we shift our focus from blaming cholesterol to addressing these root causes, we move closer to true prevention and better health. Find a naturopathic doctor like myself to work with you in assessing and treating underlying drivers of heart disease.