High Cholesterol – Is your cholesterol too high and should you be on a statin?

• What is cholesterol?
• What are the causes of high cholesterol?
• Treating high cholesterol
• Testing for high cholesterol
• The Functional medicine approach

Cholesterol is essential for the normal functioning of the body. Many Australians have elevated cholesterol and are unsure if they are at risk of artery damage, according to the Health Department of WA, 1 in 3 Perth residents have been told by the doctor they have elevated cholesterol.  Keeping your blood cholesterol at a healthy level can help you reduce your risk of heart disease and other serious conditions.

High cholesterol typically causes no symptoms. That’s why it’s important to get your cholesterol levels checked on a regular basis.

With thorough testing and analysis, a Functional Medicine approach can help you reduce your cholesterol levels and hopefully help you avoid the need to take statins.

What is cholesterol?

Cholesterol is a waxy, fat-like substance that your liver produces naturally. It’s vital for the formation of:

• cell membranes
• certain hormones
• vitamin D

It doesn’t dissolve in water, so it can’t travel through your blood on its own. To help transport cholesterol, your liver produces lipoproteins.

Lipoproteins are particles made from fat and protein. They carry cholesterol and triglycerides (another type of lipid) through your bloodstream. (1)

The two most common types of cholesterol are:   

• Low-density lipoprotein (LDL) – the ‘bad’ cholesterol  

Low-density lipoprotein makes up most cholesterol and is bad because it can stick to the walls of arteries and cause a fatty build-up called plaque. Too much plaque leads to blockages that prevent blood from flowing properly to the heart.  

• High-density lipoprotein (HDL) – the ‘good’ cholesterol

High-density lipoprotein is healthy because it carries LDL away from the arteries and back to the liver to be broken down and then passed as waste. (2)

When testing cholesterol, it’s important to pay attention to:

• HDL versus LDL
• Triglyceride levels
• The ratio of triglycerides to HDL
• The ratio of total cholesterol to HDL

If your blood contains too much LDL cholesterol (cholesterol carried by low-density lipoprotein), it’s known as high cholesterol. When left untreated, high cholesterol can lead to many health problems, including heart attack or stroke. 

Triglycerides

Triglycerides are a type of fat (lipid) found in your blood. When you eat, your body converts any calories it doesn’t need to use right away into triglycerides. The triglycerides are stored in your fat cells. Later, hormones release triglycerides for energy between meals.

These are dangerous in high levels and linked to heart disease and diabetes. 

What are the causes of high cholesterol?

High cholesterol can be inherited, but it’s often the result of unhealthy lifestyle choices, which make it preventable and treatable. A healthy diet, regular exercise and sometimes supplements or medication can help reduce high cholesterol.

In Functional Medicine, we also look for other causes of high cholesterol.

Here are six main causes of high cholesterol we look for:

1. Metabolic dysfunction
2. Chronic infections like H. pylori or even latent viral infections
3. Gut dysbiosis and intestinal permeability 
4. Poor thyroid function
5. Environmental toxins, especially heavy metals. 
6. Genetic disposition (3)

Treating high cholesterol

Conventional medicine treats high cholesterol with statins, but what exactly are they and do they have any side effects?

Statins are among the most commonly prescribed drugs for reducing cholesterol levels. They work by blocking a substance your body needs to make cholesterol and may help stabilise the plaques on blood vessel walls and reduce the risk of certain blood clots.

Statins may lower cholesterol, but they do not address what causes high cholesterol or a cholesterol imbalance in most people. 

Cholesterol is actually beneficial. The body uses it to repair damage in the arteries caused by inflammation. In fact, inflammation, not high cholesterol, is the main cause of heart attacks and strokes.

Side effects can vary between different statins, but common side effects include:

• headache
• dizziness
• feeling sick
• feeling unusually tired or physically weak
• digestive system problems, such as constipation, diarrhoea, indigestion or flatulence 
• muscle pain
• sleep problems
• low blood platelet count

Finding out whether you need to take statins is dependent on the results of your blood tests, although its important to ensure you get the blood test that gives you an overall view of what’s happening.

Testing for high cholesterol

As high cholesterol has no symptoms, a blood test is the only way you can detect it.

But its important you get a test that gives you the full picture. 

Approximately 50% of patients who do not experience heart attacks have higher cholesterol levels while a significant number of heart attack patients have low cholesterol levels.

Researchers think that an increased number of small dense LDL particles could be one of the reasons that some people have heart attacks even though their total cholesterol and LDL cholesterol are not particularly high.  

The number of small dense LDL particles you have is determined by a combination of your genetics, your gender, and your lifestyle. Certain diseases and conditions, such as diabetes and high blood pressure are also associated with increased levels of small dense LDL particles. 

So, it is less important how much cholesterol you have but which type of cholesterol is elevated and which size distribution the cholesterol particles have. 

A traditional LDL blood test measures the amount of LDL cholesterol present in the blood but not the number and size of particles. Studies have shown that increased numbers of small dense LDL particles are associated with inflammation and are more likely to cause atherosclerosis than fewer light fluffy LDL particles. 

The standard test we use at Advanced Functional Medicine is the Liposcreen LDL-Subfractions Blood SST.

This test separates and quantifies all lipoprotein sub-fractions including the ‘large’, less atherogenic LDL-1 and LDL-2 and the ‘small’, highly atherogenic LDL-3 to LDL-7. 

It also measures VLDL and IDL cholesterol linked with type III dyslipidaemia and associated hyperlipoproteinaemias. (4)

The Functional medicine approach to high cholesterol

Functional medicine is a highly effective way to lower cholesterol naturally. This is because functional medicine addresses the root causes of cholesterol imbalances and addresses them naturally.

A functional medicine approach includes an anti-inflammatory diet, exercise, nutritional support. Conditions such as hypothyroidism, autoimmune disease, bacterial infections in the digestive tract, poor blood-sugar handling, or other chronic health disorders can impact the cholesterol levels of patients.

Inflammation in the body is a primary link to heart disease. People with systemic inflammation, measured by C-reactive protein (CRP), have a more increased risk for heart disease than those with high cholesterol. Also, normal cholesterol is not protective for those with high CRP.

Inflammation is caused by:

• eating too many sugars and processed carbohydrates
• a sedentary lifestyle
• smoking
• excessive alcohol
• chronic stress
• leaky gut
• autoimmunity
• chronic infections 

There are some simple dietary changes you can make to reduce inflammation:

1. Switch to heart-healthy fats

Certain fats really do harm your health, so you need to be careful about the kinds of fat you consume. Hydrogenated and partially hydrogenated oils, trans fats, and polyunsaturated industrial seed oils such as corn, vegetable, soy and canola oil are all linked to cellular congestion and inflammation, which can lead to chronic diseases like heart disease. (5)

Sources of good fats essential to hormone production, cancer prevention, brain function, weight loss, and heart disease prevention come from coconut oil, local farmed eggs, kefir, ghee, organic butter, grass-fed raw milk, and raw nuts and seeds. Omega-3 fats found in fish and fish oils and monounsaturated fats found in olive oil and avocado facilitate healthy cholesterol. (6)

2. Eat better quality meat

There are many studies that link commercial meat to heart disease. This could be due to grain being fed to these animals, which are supposed to natively eat grass. 

The benefits of eating organic meat are numerous:

• Livestock are given all organic, hormone- and GMO-free feed. Factory farmed cattle are typically given hormones and antibiotics. The inflammatory toxins accumulate in the fat. When you eat grass-fed beef and organic chicken, you avoid this problem.
• Disease is prevented with natural methods such as clean housing, rotational grazing, and healthy diet.
• Livestock must have access to the outdoors.
• The omega 3 to 6 ratio is much higher in organic/grass fed animals.  

3. Avoid processed grains and refined sugars

Sugar, not fat, is more dangerous when it comes to heart attacks. It depletes your body of nutrient stores, elevating glucose levels. This results in insulin spikes that can lead to premature aging and degenerative diseases such as heart disease, diabetes, and cancer.

The genetic modification, refining, hybridization for more starch and sugar content, and all-around defiling of most grains with pesticides and desiccants, makes it difficult to get a good source of grains. As alternatives to products made with industrial wheat and corn, try organic quinoa and wild rice, both good grain options thanks to their high nutrient density and the fact that they don’t typically trigger the inflammatory response that most grains cause. (7)

How we can help

Addressing causes of high cholesterol through functional medicine can help you avoid a statin prescription and, in turn, avoid their risks and side effects.

At Advanced Functional Medicine, we will support you with thorough and accurate testing to assess your cholesterol levels whilst also testing you for the root causes of your high cholesterol. With a tailored dietary and lifestyle plan, supported with supplements if required, means we can give you a better chance of avoiding heart disease.   Our cholesterol liposcreen LDL subfraction testing allows a better understanding of your cholesterol score and the potential risk factors.

Find out more by getting in touch with us or filling out the form below.