This is part 2 of my 3-part series about the cholesterol/dietary fat myth. In part 1, which you can view here, I went into some pretty detailed information about how the “cholesterol and dietary fat are bad for you” myths surfaced and I only scratched the surface in regards to elevated cholesterol numbers.
In this article, I am going to cover the common protocol you’ll see at your conventional (i.e. allopathic) doctor’s office, what your doctor will probably tell you if you have elevated cholesterol numbers, and why you should be skeptical about certain advice he or she may give you. In addition, I’ll cover some of the most important biomarkers you should pay attention to and ask your doctor for in your next blood panel.
You should be aware of two approaches to medicine: allopathic and naturopathic. Allopathic medicine attempts to treat disease or health abnormalities by addressing symptoms, often through the use of pharmaceutical drugs. This is the type of medicine you will see your conventional/Western Medicine doctor practice (i.e. the guy or gal that tries to prescribe you statins for your elevated cholesterol levels). Naturopathic medicine, also known as Integrative Medicine or Functional Medicine, is more concerned with prevention of disease and illness through alternative approaches such as diet and lifestyle changes. While allopathic medicine certainly has a place in dire situations where health and wellbeing are truly threatened by disease or injury, the medication-prescribing approach is far too often used to treat symptoms when the root cause of an ailment actually needs to be addressed. More often than not, an allopathic practitioner won’t be able to help you unless you have some sort of serious medical condition. Although I believe all allopathic doctors/physicians have good intentions and want to help people (which is why they got into the field, right?), I would recommend a naturopathic practitioner if you are a generally healthy individual who is free of disease. Naturopathic approaches can even be used to help treat disease! The most common disease that comes to mind is Type II diabetes. This can be managed and even reversed through diet and exercise interventions! To find a naturopathic physician near you, check out this site.
No doubt, you’ve most likely been to your local (allopathic) doctor’s office for a check-up. If you haven’t, you probably should go once a year at a minimum even if you don’t see a naturopathic practitioner; but you should go armed with some knowledge and ready to ask questions. Here’s what you will commonly see…
- Long wait times, just kidding, but seriously, most likely long wait times.
- You will get called in to see the nurse, where he or she will take your weight, blood pressure, and temperature
- You will then see your doctor for your check-up
- He or she may order a basic blood panel to take a look at some biomarkers (i.e. information that gives an insight to your health based on what’s going on inside your body)
- The total time with the doctor will probably take around 10-15 minutes
- Then you will get your bloodwork done and wait a week or two for results to come in
- One of the most common biomarkers that you’ll see, and your doctor will want to talk to you about if it is elevated, is cholesterol
- Your doctor will probably want to set up a follow-up appointment with you to discuss your elevated cholesterol, and most-likely place you on statins (i.e. cholesterol-reducing drugs that have some less-than-desirable side-effects and may end up doing more harm than good)
So, I’ve told you what you may commonly expect when you go see your doctor. Next, I’m going to tell you about statins and why you should be super skeptical about a doctor that wants to put you on them immediately without even considering changing your lifestyle through your nutrition and activity levels.
What are statins?
Statins are pharmaceutical drugs that lower total cholesterol levels. They are prescribed quite often, but have some pretty terrible side effects. Some of these include:
- Extreme fatigue
- Foggy memory
- Joint and muscle pain
- Lack of mental acuity
- Difficulty sleeping
- Flushing of the skin
- Nausea and vomiting
- Abdominal cramping or pain
- And so on…
You can learn more about statins and how much they suck, here. If your doctor tries to put you on these drugs without even considering other lifestyle factors that could be contributing to elevated cholesterol or cardiovascular disease risk, you should first ask why he or she is using the drugs as a first option. You should also ask what other alternatives there are to improve your numbers besides using the drugs. If the doctor tells you that the drugs are the only way, I would start looking for another doctor. He or she is most likely going with the ‘this is how it’s always been done’ or ‘popular thinking’ approach to health and wellness.
Elevated cholesterol numbers alone ARE NOT enough to indicate that you have an elevated risk of cardiovascular disease. Health problems do not surface in a vacuum, and there is rarely a time where only one factor is the sole contributor to an issue. Elevated cholesterol numbers may be pointing to another issue, like chronic, systemic inflammation throughout the body, which is a much bigger issue that needs to be addressed. Lowering cholesterol is often not the solution to the problem, because the true cause of the problem may be something else.
Here are some key biomarkers you should really be paying attention to, in addition to cholesterol numbers:
- Fasting Blood Glucose: This biomarker is usually tested after 12 hours of fasting. It tells you how much sugar (i.e. glucose) is in your blood. Levels that are too high put you at risk for developing diabetes and other cardiovascular issues. Your number should be 92 mg/dL or below for good health. If it’s greater than that or in the 100s, take a good hard look at your nutrition, activity levels, and stress levels, and make some changes.
- hs-CRP (High Sensitivity C-Reactive Protein): hs-CRP is found in the blood and is a marker of inflammation in the body. For whatever reason, I have not seen this marker included in a standard blood test. You generally have to ask for it as an add-on. This is an extremely important marker to keep tabs on, as chronic inflammation is a key contributor to many medical conditions (and way more so than elevated total cholesterol by the way). Your hs-CRP should be between 0-3 mg/dL, with less than 1 being ideal.
- Triglyceride:HDL Ratio: Ah yes, do you remember when I said that good health does not occur in a vacuum? Well, here we are considering the ratio of two numbers instead of considering them individually. In general, we should have a higher HDL number (i.e. above 50, but above 70 is ideal) and a lower triglyceride numer (i.e. below 100, but below 50 is ideal). So, if we consider these two together, your ratio should ideally be as close to 1 as you can get or less than 1 to be ideal. Triglycerides are fats that are stored in the body and can be broken down into free fatty acids and glycerol to be used for energy. Too much of these triglycerides (excess body fat) paired with not enough HDL (to shuttle excess fat and cholesterol to the liver for excretion) is a much better indicator of cardiovascular risk than total cholesterol alone.
- LDL Particle Size (Small LDL-P): You’ve probably heard that LDL cholesterol is the “bad” type of cholesterol and you should keep it low. However, that’s only scratching the surface of the issue. What you should really consider is LDL particle size. There are two types: Large Buoyant LDL (lb LDL) and Small Dense LDL (sd LDL). Think of lb LDL as fluffy, soft, and friendly LDL that indicates good health and sd LDL as hard, sharp, unfriendly LDL which indicates poor health. In addition to your generic LDL number, it’s even more important to look at the proportion of sd LDL particles that you have. Your sd LDL particle count should be around 20% or less of your total LDL particle count, and ideally less than 200 nmol/L. In general, the less the better.
In part 3 of this series, I’ll share some strategies that you can implement to start optimizing your numbers.
Please feel free to leave comments, thoughts, or questions below. I feel very strongly about this issue and want to share this information with as many people as I can.
Moore, J., Westman, E. C. MD. Cholesterol Clarity: what the HDL is wrong with my numbers? Victory Belt Publishing. 2013. ISBN 13: 978-1-936608-38-6.