I just completed my 37th trip around the sun. For years, doctors have told me that I may not be able to accomplish 37 trips around the sun unless I go on a statin. I refused. And guess what! I'm still here to tell about it.
What I've learned from my genetic lipid abnormality is that most doctors are clueless when it comes to cholesterol. So are most people. I'll be the first to admit, I may not know it all. But I feel confident about my decision to forego statins and treat myself with diet and lifestyle instead.
My instinct has always told me that statins are not a cure for anything. And I definitely don't have a statin deficiency. My body produces its own cholesterol. Bodies don't produce their own statins. So that Biochemistry 101 fact right there should clue you into why cholesterol > statins.
My ancestors ate a lot of cholesterol-rich foods and they were fine. In fact, statins weren't even introduced to the general public until the 1980s. And prior to the 20th century, doctors weren't running lipid panels on their patients or worrying about cholesterol numbers. So why all of the sudden is there a huge push to put anyone with a total cholesterol of 200+ on a statin?
Our species has been eating cholesterol-rich foods for thousands of millennia. So why all of the sudden are these foods considered "bad"? Because, let me tell you from personal experience, a life without steak is not a life I want to live. Mmmm...steak! This is coming from someone who used to think of veganism as the ultimate healthy diet. I learned real quick that my body disapproves of veganism. Give me all the bacon!
Let's take a deeper dive into the world of cholesterol. I bet most people don't know what their total cholesterol number is. It doesn't matter as this number cannot tell you much. It tells you how much total cholesterol you have in a fasted blood sample. But it's just that: a sample, or a snapshot in time. Your cholesterol fluctuates throughout the day and can change dramatically depending on what you are or are not eating. See Dave Feldman's YouTube channel if you're curious about that.
You may have heard that LDL cholesterol is the "bad guy" and HDL cholesterol is the "good guy". Well, there's more to cholesterol than just this and a total number. Let's go over some sciencey stuff.
LDL is the protein carrier that moves cholesterol from the liver to other parts of your body. Think of it as a raft, and the cholesterol molecules on it are the passengers. Your LDL "rafts" can be full or they can be rather empty. There's further testing you can do to determine this.
HDL does the reverse of what LDL does. It brings cholesterol from peripheral tissues back to the liver when that cholesterol is no longer needed in your body.
Studies have shown that dietary cholesterol doesn't have a huge impact on the amount of cholesterol in your blood. The majority of your cholesterol is made by your body.
Different studies have shown that a reduction in total cholesterol does not mean a reduction in heart attack risk. In fact, there are millions of people who have heart attacks each year who had a total cholesterol lower than 200 (200 is the "magic number" doctors use to determine if you're at risk of heart disease). There are more important risk factors to determine if you're at risk of heart disease. Total cholesterol doesn't tell us much.
The next time your doctor urges you to get on a statin, ask for further testing to be done. I asked for a coronary artery calcium (CAC) score. I told my doctor that if it came back high, I would maybe consider a statin. But guess what! It came back zero!
I should probably tell you that during this visit, my cholesterol was hanging out just around 400 (nearly double that "magic number"). This is due to my genetic lipid disorder called hyperbetalipoproteinemia (they should add that word to the National Spelling Bee!). But I also had the other numbers in my favor. My HDL ("good guy") was 91 and my triglycerides were 52. These are ideal numbers...or at least current science says they're ideal.
Here's what doctors generally look for:
Total cholesterol <200
LDL <150 (<100 is considered ideal)
Doctors will also sometimes check your CRP (a cardio inflammation marker), HBA1C (a blood sugar marker), homocysteine levels, and fibrinogen.
The most likely cause of out of range cholesterol numbers is not the amount of dietary cholesterol you're consuming (Yay! Eat the steak!). Some out of range numbers can be genetic (as is my case). However, they are most likely out of range for other reasons such as your inability to metabolize fats (which probably means you're eating the wrong kinds of fats), a diet high in refined carbohydrates (high triglyceride numbers are a key hint here), excess stress, or gallbladder dysfunction.
Here's something doctors won't tell you: your body needs cholesterol. That's why your body has the ability to make its own in the liver. Cholesterol is the precursor to vitamin D, a hormone necessary for numerous biological processes in the body. It is also a precursor to your sex hormones. Bile salts, which are required for proper fat metabolization, are made of cholesterol. Cholesterol also functions as an important antioxidant, protecting you from cancer and anti-aging. Maybe my high cholesterol is the reason why I sometimes still get carded at 37 years old. Cholesterol is also needed for proper neurological function. It's a key player in the uptake of hormones in your brain such as serotonin. People who have too low of cholesterol (usually <160) may feel depressed because serotonin receptors cannot work properly. In fact, nearly 25% of the body's cholesterol is used by your brain. Our entire nervous system requires cholesterol to function properly.
Choosing healthy fats is crucial. You can't consume trans-fats or rancid and oxidized vegetable oils and expect to have healthy cholesterol. Start cooking with good fats. Throw out your canola oil. There's only one place for that stuff, and it's the garbage. Other vegetable/seed oils such as corn, cottonseed, soy, safflower and sunflower are easily oxidized and often rancid. They should be tossed as well. If you want to dive deeper into the specifics here, I highly suggest reading Dr. Cate Shannahan's book Deep Nutrition. Try cooking with ghee (I love Fourth and Heart!), grass-fed butter, and other animal fats such as lard or tallow. This sounds like bad dietary advice. However, your ancestors cooked with animal fats long before vegetable/seed oils were ever discovered. And they had way less heart disease, cancer, and other chronic illnesses than we have today. Just think about it. If these things were harmful to us, our species would have gone extinct years ago.
Other sources of healthy fats include wild-caught cold water fish such as salmon and sardines, grass-fed red meat, properly raised poultry and pork, and free-range eggs. I don't mess with farmed fish or feed-lot meat if I can help it, and neither should you.
Another thing you can and must do is stop consuming so much refined carbohydrates and processed foods. Our intake of refined carbs and processed foods directly correlates with the rise in degenerative diseases. This could be a coincidence, but probably not.
See your doctor regularly for screenings. I think it's important to know your numbers to know more about yourself. If your lipid panel comes back abnormal, try to get to the root cause of the abnormality. Don't automatically assume statins are a cure-all. They're really just a "band-aid" for your symptoms, but they will not help you to treat the root cause. And in fact, some studies suggest that statins have harmful side effects that are much worse than being at risk for heart disease.
This information is not meant to be taken as medical advice. These views are my own. If you are worried about your cholesterol numbers, please consult a trusted doctor who is willing to treat the root cause of your blood lipid abnormality rather than push a statin on you.