Cholesterol: Curse of Modern Society or Misunderstood Scapegoat?

If there is one lab number people know about themselves, it's got to be their blood cholesterol value. This should not be the case. There exists much misinformation when it comes to serum cholesterol, its role in cardiovascular disease and its impact on health. I can't say what single lab value should be "king", but when it comes to cardiovascular disease, high sensitivity C-Reactive Protein (CRP) is a more important risk factor than is cholesterol. CRP was discussed in the last issue of Nutritious Bytes.

For more on cardiovascular risk factors read  The Nutrition Heart Disease Link-More Than Cholesterol. Now, while I believe elevated blood cholesterol is unhealthy, let's look at cholesterol in a more comprehensive way.

What cholesterol value should you be proud of? Most labs seem to report values under 200 mg/dl as normal. If mine is 199 and yours is 180, can you brag? I think so. Now what if we take this to the extreme? Is a cholesterol value of zero the ultimate goal? If you simply look at the reference range reported by many labs, you may think so. Many labs report normal cholesterol as < 200 mg/dl. There is, according to the lab report, no value for cholesterol that is too low. A total serum cholesterol value of 0 is not possible. The lowest value I have seen is about 85. Will your risk of cardiovascular disease continue to fall, the lower you get your cholesterol? To a point. (For example, people over age 80 with the lowest  cholesterol have the highest death rate).

One of the big secrets when it comes to blood cholesterol is that as values drop below 160, there are a variety of adverse health conditions that increase. While you may be reducing your risk for heart disease, you're increasing your risk for other conditions. This is not so surprising when you understand what cholesterol is.  It is essential to human life.

Cholesterol is a vital component of cell membranes. If you think of cells (the microscopic units of structure that make up tissues and organs) as oranges, the membrane is the peel. The membrane governs what passes into and out of the cell: nutrients and waste products. Hormones attach to receptors on cell membranes to direct the activity the cell. The concentration of cholesterol in the cell membrane influences the function and health of the cell.

Cholesterol is a component of the myelin sheath, the insulation on nerve cells, which is essential for their function. Cerebrosterol is a cholesterol-derived substance that is involved in brain function. As a matter of fact, the greatest concentration of cholesterol in the body is found in the brain.

Low serum cholesterol is a very common finding in people with autism. The social-bonding hormone, oxytocin, requires cholesterol for its function. Autistic patients are commonly low in oxytocin.

The "feel-good" neurotransmitter, serotonin, also is dependent on cholesterol. It follows that low blood cholesterol is associated with depression, anxiety, aggression and bipolar disorder.

Cholesterol is also essential as a building block for steroid hormones and vitamin D. Steroid hormones include the sex hormones estrogen, testosterone, progesterone, and adrenal or stress hormones such as cortisol and DHEA. If cholesterol levels are too low, the body may not be able to produce adequate amounts of these. Interestingly, cholesterol-lowering drugs have been associated with reduced sex drive in men, possibly due to low testosterone levels. Vitamin D deficiency is more common than not and is a contributor to many chronic degenerative diseases and unwellness.

Cholesterol likewise serves as a building block for bile acids. Bile acids help the body rid itself of waste products and also help the digestion and absorption of fat-soluble nutrients.

Cholesterol also plays roles in detoxication, inflammation-suppression, and neutralizing free radicals as an antioxidant.

Lower levels of cholesterol are associated with an increased cancer risk. A study published in 2007 in the Journal of the American College of Cardiology looked at the connection between cholesterol reduction by statin drugs and cancer rates. The conclusion was "...the risk of cancer is significantly associated with lower achieved LDL-C [cholesterol] levels... Furthermore, the cardiovascular benefits of low achieved levels of LDL-C may in part be offset by an increased risk of cancer."

Additionally, total serum cholesterol levels below 160 mg/dl have also been associated with:

·         critically ill patients

·         Increased hemorrhagic stroke incidence

·         Increased incidence of chronic heart failure

·         Increased violent behavior and violent death, including suicide

·         Impaired cognition and mental-processing speed, possibly contributing to car accidents

·         Increased rate of school suspension

·         Greater difficulty overcoming drug addiction

·         Increased incidence of Parkinson's disease

·         Increased incidence of cataracts

·         Increased incidence of rheumatoid arthritis

·         Increased incidence of systemic lupus erythematosus

·         Greater incidence of tuberculosis and gastrointestinal infections

People with low cholesterol (below 160 mg/dl) have a 10% to 20% increased mortality rate, with increased death from cancer, violence (including suicide), hemorrhagic stroke, digestive and respiratory conditions.

While drug companies that manufacture cholesterol-lowering medications have advocated everyone use their product, this is clearly a bad idea.

I like to see a total serum cholesterol value between 160 and 180 mg/dl. When cholesterol values are too low, I usually recommend people eat more eggs or take a cholesterol supplement. Imagine that.