Have you ever wondered why cholesterol levels can change so much person to person? A lot of misinformation has been spread over the last 70 years when analyzing total cholesterol levels, and recent research is proving that we must look beyond the total cholesterol number if we are going to make any meaningful conclusions. 

Beneficial Functions of Cholesterol

Cholesterol is actually a steroid manufactured in the liver or intestines. It is an important component of hormone production and cell membrane structure and is transported through the blood to repair the damage.

Cholesterol has a number of important functions; it is the balance in the body that is important.

• Cholesterol in the cell membrane gives our cells necessary stiffness and stability. When the diet contains an excess of polyunsaturated fatty acids, membrane cell walls actually become flabby.
• Cholesterol acts as a precursor to vital corticosteroids, hormones that help us deal with stress and protect the body against heart disease and cancer; and to the sex hormones like androgen, testosterone, estrogen and progesterone.
• Cholesterol is a precursor to vitamin D, a very important fat-soluble vitamin needed for healthy bones and nervous system, proper growth, mineral metabolism, muscle tone, insulin production, reproduction, and immune system function.
• Cholesterol is needed for the proper function of serotonin receptors in the brain. Serotonin is the body’s natural “feel-good” chemical. Cholesterol levels that are too low have been linked to aggressive and violent behavior, depression and suicidal tendencies.
• Dietary cholesterol plays an important role in maintaining the health of the intestinal wall.

Dietary Cholesterol and Saturated Fat

What about dietary cholesterol? Contrary to popular options, dietary cholesterol only accounts for 15 percent of your total cholesterol number. Your body will make cholesterol out of different macronutrients despite a low-cholesterol diet.

What you do want to avoid is oxidized cholesterol, which is found in powdered eggs and dairy processed at high heat, along with meat and fat cooked at very high temperatures. This damaged cholesterol seems to promote both injuries to the arterial cells as well as a pathological buildup of plaque in the arteries.

There is a common confusion regarding saturated fat. A January 2010 meta-analysis from the American Journal of Clinical Nutrition over 23 years showed no correlations of all saturated fat intake to heart disease and stroke.

However, as we have learned more about genetics, we are starting to see that the response to saturated fat changes person to person, based on ancestral migration routes.

For example, northern Europeans in cold climates often are better equipped for a higher fat diet (especially dairy), while those south of the equator have adapted to more monosaturated and polyunsaturated fats.

Coconut oil is a saturated fat, and studies have shown that people who live in areas that have a diet high in extra-virgin coconut oil have little to no heart disease. This doesn’t mean that all people will respond well to coconut oil. The difference can be seen in fasting glucose levels, very high cholesterol levels, and weight gain. An example can be seen here on how people respond differently to the Ketogenic diet.

Does High Cholesterol Equal A Higher Risk of Cardiovascular Disease?

When I explored the connection to APOE genotypes and cholesterol levels in this article, I discovered the following: While the cholesterol guidelines aim for levels less than 200 mg/dl, a 2019 study of 12.8 million Korean people found the lowest mortality was found in those with cholesterol levels between 210–249 mg/dL. Even levels above 240 mg/dL were associated with a decreased risk in both sexes and each age group except for women aged 18 to 44 years and men aged 18 to 34 years.

Other researchers also found patterns of longevity for those over 60 with higher LDL,^1,2 showing that “LDL reduction may even worsen the health of the elderly because LDL-C contributes to immune functioning, including the elimination of harmful pathogens.” For those under 40, a review of 19 studies in 2020 found that the mortality difference between those with the highest LDL and those with normal LDL was only 0.04%.

Finally, one of the largest longevity studies to date was released in September 2023. Researchers found that “1,224 participants (84.6% females) lived to their 100th birthday. Higher levels of total cholesterol and iron and lower levels of glucose, creatinine, uric acid, aspartate aminotransferase, gamma-glutamyl transferase, alkaline phosphatase, lactate dehydrogenase, and total iron-binding capacity were associated with reaching 100 years.”

When High Cholesterol Levels are a Symptom of other Issues

There are many different reasons that you may have higher than normal cholesterol levels. It is imperative to know why your cholesterol levels are high because cholesterol acts as a protective agent, often acting more as a symptom of something else in the body.

• Inflammation: Inflammation within the artery wall is the real cause of heart disease. When there is damage to the artery walls, the body produces more cholesterol to repair the damage. This is also true when there is an infection. Without inflammation being present in the body, cholesterol would not accumulate in the wall of the blood vessels and cause heart disease and strokes. Without inflammation, cholesterol would move freely throughout the body. One research team found that low superoxide dismutase (SOD) levels may play a greater role than elevated cholesterol in the development of this atherosclerosis. According to the researchers, diminished levels of SOD and total antioxidant status may well play a larger role in the development of atherosclerosis than isolated elevations in total cholesterol or triglyceride levels.
• Poor thyroid function (hypothyroidism): This will often result in high cholesterol levels because when thyroid function is poor, the body floods the blood with cholesterol as an adaptive and protective mechanism, providing a source of materials needed to heal tissues and produce protective steroids.
• Liver and kidney function: Poor liver and kidney function could also be a cause of higher than normal cholesterol.
• Weight and Exercise: Excess weight and a sedentary lifestyle may increase your LDL levels. Diet and exercise can help boost your HDL, lower triglycerides and lower LDL.
• Stress: Several studies have shown that stress raises blood cholesterol levels over the long term.
• Genetics: Genes may influence how the body metabolizes LDL cholesterol like APOE. Familial hypercholesterolemia is an inherited form of high cholesterol that may lead to early heart disease.
• Menopause: Before menopause, women usually have lower total cholesterol levels than men of the same age. As women and men age, their blood cholesterol levels rise until about 60-65 years of age. After about age 50 years, women often have higher total cholesterol levels than men of the same age.

Traditional Cholesterol Testing vs. Modern Testing

Traditional testing looks at the following:

• LDL cholesterol: Low-density lipoprotein; elevated levels are considered a major indicator of future heart disease in traditional testing.
• HDL cholesterol: High-density lipoprotein; considered protective to the cardiovascular system. A 2012 study in The Lancet has shown that raising HDL levels may not make any difference to heart disease risk, and people who inherit genes that give them naturally higher HDL levels have no less heart disease than those with lower HDL levels. This will undoubtedly change the approach of trying to raise HDL levels as a means of protection.
• Triglycerides: another form of fat in your blood.

Modern cardiovascular testing that gives you much better data regarding your risk:

• LDL-P: LDL particles vary in size. Smaller LDL particles are associated with an increased risk of heart disease. Small, dense LDL is associated with insulin resistance or diabetes.
  Oxidized LDL: Oxidized LDL represents a variety of modification of both lipid and apolipoprotein B (apoB) components by lipid peroxidation. A high BMI creates both higher oxidized LDL and high CRP. Joint high levels have been shown to increase the risk of cardiovascular disease in multiple populations.
  ApoB: ApoB is a protein that is involved in the metabolism of lipids and is the main protein constituent of lipoproteins. High levels of ApoB, especially with the higher LDL particle concentrations, are the primary driver of arterial plaque.
  CRP: C-reactive-protein is a form of inflammation.
  Lp(a): Lipoprotein(a) an inherited risk factor for heart disease. It is more dangerous than other types of cholesterol and does not respond to traditional LDL-lowering drugs.
  Homocysteine: Homocysteine is an amino acid formed by the body as a byproduct of methionine production. A b-vitamin deficiency and stress can contribute to high homocysteine levels which promote free radical damage, causes platelets to stick together, and can attack blood vessel walls. Researchers have estimated that homocysteine is up to forty times more predictive than cholesterol for assessing the risk of cardiovascular disease.

How to Lower Cholesterol Naturally

• Cold exposure recommended for helping maintain lower cholesterol levels for ApoE-e4 carriers.
• Fiber, niacin, anthocyanins and amla have all been studied to be effective at reducing LDL and increasing HDL.
• VLDL and ApoB can be targeted with astaxanthin (high in wild salmon), pterostilbene (blueberries, mulberries, cranberries, raw almonds), genistein (fermented soy), tomatoes, cinnamon, zinc, Lion’s Mane mushroom, Gynostemma tea and L-carnitine.
• Chanterelles, oyster, porcini, and white button mushrooms are a natural source of lovastatin, which belongs to a group of compounds, called statins, commonly used as cholesterol-lowering drugs. Due to the presence of lovastatin, edible mushrooms can be useful in the prevention of hypercholesterolemia. Multiple human trials have shown cholesterol-lowering effects from daily mushroom intake.
• Beta Sitosterol: The FDA has approved beta-sitosterol for the treatment of hyperlipidemia. Found in avocado, fennel, peanuts, edamame, miso, tempeh, and basil.
• Phytosterols are structurally similar to cholesterol, when they are consumed they compete with cholesterol for absorption in the digestive system. An average phytosterol intake of 2 g/day lowers serum LDL-cholesterol by 8%-10%. Found in edamame, tofu, tempeh, peas, sesame oil, tahini sauce, peanut butter, kidney beans, pistachios, lentils, cashews, oranges, macadamia nuts, and olive oil.
• Ellagic Acid: A randomized double‐blind clinical trial using 180mg of ellagic acid daily found that the mean of blood sugar, insulin, insulin resistance, HbA1c, total cholesterol, triglycerides, LDL, malondialdehyde, C-reactive protein, TNF‐α, and IL‐6 were significantly decreased in the intervention group. The antioxidant activity of GPX1 and SOD was also increased. Found in Walnuts, raspberries, strawberries, cranberries, blackberries, cherries, and pomegranates.
• Ghee: Animal studies have demonstrated many beneficial effects of ghee or clarified butter found in Ayurvedic cooking, including dose-dependent decreases in serum total cholesterol, low-density lipoprotein (LDL), very-low-density lipoprotein (VLDL), and triglycerides; decreased liver total cholesterol, triglycerides, and cholesterol esters; and a lower level of nonenzymatic-induced lipid peroxidation in liver homogenate.
• Apples: One study from Florida State University gave 80 women ages 45-65 three-quarters of a cup of dried apples (equal to two fresh apples), while the second group of 80 women had eight to ten prunes. The group that ate apples had an average drop in LDL of 23% and a 4% increase in HDL and lost an average of 3.3 pounds.Another study from Ohio State University found that eating one apple every day for just four weeks can lower blood levels of oxidized LDL (“bad”) cholesterol by 40% in healthy, middle-aged people. In a study published in the British Medical Journal, the researchers constructed a conducted model using statin drugs or a daily apple to all adults in the UK over 50 years old. They found that prescribing an apple a day would prevent or delay around 8,500 vascular deaths such as heart attacks and strokes every year in the UK. While the results were only slightly lower than the projected results of using statins, the risks and side effects of stains including myopathy and Type 2 diabetes made the apple the clear winner.

The Top Recommended Supplementation for Healthy Cholesterol Levels

1. Now Foods Beta Sitosterol

Preventative for different cardiovascular diseases, and the FDA has approved beta-sitosterol for the treatment of hyperlipidemia.

2. Paleovalley Turmeric Complex

There is evidence that curcuminoids modulate the expression of genes and the activity of enzymes involved in lipoprotein metabolism that lead to a reduction in plasma triglycerides and cholesterol and elevate HDL-C concentrations.

3. Kyolic Aged Garlic Extract Cardiovascular Formula

Intake of garlic can prevent diet-induced hypercholesterolemia and vascular alterations in the endothelium-dependent relaxation associated with atherosclerosis using a model study system. Garlic-derived compounds containing an allyl-disulfide or allyl-sulfhydryl group are most likely responsible for decreasing cholesterol synthesis by inhibiting the
sterol 4α-methyl oxidase.

4. Magnesium Citramate by Thorne Research

Like vitamin C, magnesium is a natural HMG-reductase regulator. Unlike statin drugs that inhibit the enzyme leading to the cascade of deficiencies, magnesium makes sure cholesterol is limited to specific necessary functions like hormone production and membrane health without being produced in excess. Magnesium is also required for the enzyme that lowers LDL, triglycerides, and raises HDL.

Like vitamin K, an inadequate supply of magnesium may result in the formation of clots and contribute to calcium deposits in the blood vessels. Magnesium acts as a guardian at calcium channels and allows a small amount in for electrical transmission and then rejects the rest.

Magnesium reduces soft-tissue calcium and calcified plaque, and dilates coronary arteries and peripheral vessels, helps prevent blood clotting, and improves irregular heartbeats.

Epidemiological studies show that death rates from coronary heart disease are higher in areas where the water is low in magnesium. Up to 80 percent of people in the US may be deficient in magnesium due to low levels in water supplies, deficiencies in topsoil, too much calcium supplementation and coffee consumption, and lack of seaweed consumption. Avoid 100 percent magnesium oxide supplements which are very poorly absorbed.

5. Vitamin C with Flavonoids by Thorne Research

Vitamin C is a natural HMG-Reductase regulator – like magnesium – making sure cholesterol is used for specific functions without being overproduced, unlike statin drugs which turn of the switch completely.

Numerous studies have found that arterial blockages start and growth with vitamin C deficiency alone, cholesterol levels increase with vitamin C deficiency and supplementation lowers it, and vitamin C protects arteries from plaque build-up even in the presence of high cholesterol. Vitamin C status could be a better indicator than total cholesterol for determining heart disease risk.

A lack of vitamin C results in tiny cracks in the walls of the blood vessels, which makes the body produce more LDL to fill the cracks. Therefore sufficient vitamin C in the system should lower cholesterol naturally by regulating it.

Vitamin C keeps the blood vessels strong, lowers blood pressure, promotes vasodilation, reduces circulating cholesterol, while also clearing the inner walls of fat deposits. It is easily depleted by stress, pollution, illness, exercise, and sugar.

Vitamin C also promotes the production of coenzyme Q10 along with b-vitamins and may lower the harmful Lp(a). Vitamin C has also been shown to protect HDL cholesterol from lipid oxidation and lower triglycerides.

Epidemiological studies demonstrate that people with the highest blood levels and daily intakes of vitamin C are at as much as a 50% reduced risk of developing or dying from cardiovascular diseases. 2-9

Ninety-nine percent of animals do not get heart attacks. Why is this? The majority produce their own vitamin C – carnivores in particular – whereas herbivores obtain it from their diet. Herbivores and omnivores, however, do get atherosclerosis, and it has been postulated that it is due to vitamin C.

Linus Pauling found that guinea pigs get atherosclerosis by depleting their bodies of vitamin C, and caused Lipoprotein (a) to appear in the plaque.

Once upon the evolutionary timeline roughly 40 million years ago, our ancestors produced their own vitamin C, and most likely lost this ability when the climate changed and we increased our plant intake in tropical environments.

This has made vitamin C unlike any other dietary requirement in our body, creating the need for much higher levels to meet the physiological needs of the body in the modern world.

Two-time Nobel Prize winner and holder of 48 honorary Ph.D.’s, Linus Pauling at the age of 92 said “I think we can get almost complete control of cardiovascular disease, heart attacks and strokes by the proper use of vitamin C and lysine, even cure it. Knowing that lysyl residues are what causes Lp(a) to stick to the wall of the artery and form atherosclerotic plaques, any physical chemist would say at once that to prevent that put the amino acid lysine in the blood to a greater extent than it is normally.”

Lysine is an Lp(a) binding inhibitor, meaning at sufficient dosage it can reverse atherosclerotic plaques. Meat and fish are excellent sources of lysine.

6. Biotics Research Bio-B 100 or Pure Encapsulations B-Complex

Studies have found a positive relationship between deficiencies in folate, B6 and B12 and severity of hardening or stiffness of the arteries, as well as the buildup of pathogenic plaque. Elevated homocysteine – an inflammatory marker – is also connected to low intake of folate, B6 and B12.

Patients treated with simvastatin and niacin had a 26 % increase in HDL-C as well as substantial reductions in LDL-C and triglycerides, leading to a significant decrease in angiographic atherosclerosis compared to those in the control arm and up to 90 % decrease in coronary events compared to placebo

7. Ultimate Omega by Nordic Naturals

A double-blind placebo study found that fish oil decreased triglycerides, but increased LDL. Triglycerides are part of a total cholesterol panel, but technically are different from HDL and LDL cholesterol. Fish oil is best used to target high triglycerides and HDL, but be aware that it may also increase LDL.

Researchers admit that the slight increase in LDL from fish oil does not have any evidence in more adverse outcomes, but simply gets in the way of fixed number targets.

Sources

1. The Truth about Saturated Fats by Mary Enig, PhD, and Sally Fallon
2. Superko HR. Did grandma give you heart disease? The new battle against coronary artery disease. Am J Cardiol. 1998 Nov 5:82 (9A);34Q-46Q.
3. Rolfs, Pinna, Whitney. Understanding Normal and Clinical Nutrition. 7^th Edition.
4. Arjmandi, Bahram, PhD, RD. Center for Advancing Exercise and Nutrition Research on Aging.
5. Ishikawa, T, Fujiyama Y, Igarashi O, et al. Effects of gammalinolenic acid on plasma lipoproteins and apolipoproteins. Atheroslcerosis. 1989 Feb; 75 (2-3): 95-104
6. Guivernau M, Meza N, Barja P, Roman O. Clinical and experimental study on the long-term effect of dietary gamma-linolenic acid on plasma lipds, platelet aggregation, thromboxane formation, and prostacyclin production. Prostaglandins Leukot Essent Fatty Acids. 1994 Nov;51(5):311-6.
7. Shi LM, Ge HT, Kong XQ, et al. Effects of gamma linolenic acid on atherosclerosis induced by cholesterol-rich diet in rats. Zhongguo Zhong Yao Za Zhi. 2008 Dec;33(23):2808-12.
8. Cullen, Ellie. Normal Blood Test Scores Aren’t Good Enough! YFH Press 2002.
9. Lundell, Dwight MD. Heart Surgeon Speaks Out On What Really Causes Heart Disease. http://www.sott.net/articles/show/242516-Heart-Surgeon-Speaks-Out-On-What-Really-Causes-Heart-Disease
10. Zawadzka-Bartczak E. Activities of red blood cell anti-oxidative enzymes (SOD, GPx) and total anti-oxidative capacity of serum (TAS) in men with coronary atherosclerosis and in healthy pilots. Med Sci Monit. 2005 Sep;11(9):CR440-4.
11. Ghee study: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215354/