What You Need to Know About Cholesterol

heart-healthIf you’re over the age of 40 and you’re reading this article then you’ve heard your doctor discuss or even check your cholesterol levels. But what does it all mean? Abbreviations, number values, and sometimes even the dreaded medication. Let’s sort through all this get a better understanding of what cholesterol is, what it does in your body, and what your cholesterol should be.

After we get a handle on what cholesterol is and what it’s role is on your body we’ll discuss how you can manage your cholesterol through nutrition. Finally, we’ll discuss cholesterol medications, what the side effects are, and what questions you should be asking your health care professional.

What is Cholesterol

Cholesterol is a a fat-like substance that is sticky like cold butter and is found in each and every one of the cells in your body. It is transported through your bloodstream in small packages called lipoproteins. Lipo (lipid), meaning “fat”, and protein packages. The fat is on the inside and the protein is on the outside.

Types of Cholesterol

There are two kinds of lipoproteins that carry cholesterol throughout your body: low-density lipoproteins (LDL) and high-density lipoproteins (HDL). Having healthy levels of both types of lipoproteins is important.

LDL cholesterol sometimes is called “bad” cholesterol. A high LDL level leads to a buildup of cholesterol in your arteries. This is what leads to heart disease. HDL cholesterol sometimes is called “good” cholesterol. This is because it carries cholesterol from other parts of your body back to your liver. Your liver removes the cholesterol from your body.

Cholesterol’s Role

Cholesterol is the thing that allows you to actually move. Plants and bacteria have rigid cell walls whereas your cell walls can change shape and rigidity due to the amazing modified steroid, cholesterol. Your body also needs some cholesterol to make hormones, vitamin D, and substances that help you digest foods.

Your body makes all the cholesterol it needs. However, cholesterol also is found in some of the foods you eat. Different genotypes process the cholesterol found in foods in different ways. This is why two people eating the exact same thing every day will have drastically different cholesterol levels. Your genetics matter.

The Cholesterol Numbers Game

When you get the results of your cholesterol from you practitioner you will normally see 4

(google images)

(google images)

different values; total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. These totals are normally measured in milligrams per deciliter.

Total cholesterol refers to the total of LDL, HDL, and triglycerides in your blood. for example if your total cholesterol is 200 mg/dl it means in each deciliter of your blood there is approximately 200 milligrams of LDL, HDL, and VLDL (very low-density lipoprotein, which is the triglyceride-carrying component of lipids which we will discuss in a separate article).

Below is a chart of statistically what is considered normal cholesterol levels for the average person.

cholesterol-levels-chart

(cholesterolmenu.com)

Keep in mind, some people genetically have high or low cholesterol and it is perfectly safe and normal for them. These chart depict the mean average. To gain a better understanding of your cholesterol levels talk with your healthcare practitioner about your results over an extended period of time to discuss regularities or irregularities to determine this.

High Cholesterol and Nutrition

We touched briefly on how different genotypes process different cholesterol in food based on the nutrients that are absorbed with cholesterol. Some body’s simply have a better way of disposing of excess cholesterol. Those genotypes are generally the ones that are allowed more animal products such as meats, fats, or cheeses. Every genotype is going to react differently to these types of cholesterol. Some can process cholesterol found in meat but be unable to process cholesterol found in cheese. Unless you know your genotype you wouldn’t know which is best for you. So if you have high cholesterol and don’t know your genotype how do you lower your cholesterol?

Foods High in Cholesterol

Well, we know that cholesterol is only found in animal products, so decreasing the amount fatty animal products you consume is a start. Opt for leaner meats such as fish, chicken, turkey, and

(google images)

(google images)

lean beef cuts such as tenderloin. Swap your butter or margarine for olive oil. Avoid cheeses as much as possible. Eating as close to a pescetarian (fish) nutrition profile as possible will help.

Foods to Lower Cholesterol

Foods that help decrease the quantity of cholesterol in your bloodstream are high in soluble fiber. These are foods such as oatmeal, beans, sweet potatoes, brussel sprouts, purple passion fruit, avocado, and pears to name a few. Basically, the more plants you can eat the better your cholesterol will be.

(google images)

(google images)

There is an exception to the plant consumption and cholesterol lowering effect: coconut oil. For some genotypes coconut oil has no effect and sometimes even a lowers cholesterol, but there are certain genetic types that respond to the consumption of coconut oil by actually raising cholesterol levels. We recommend if you don’t know your genotype avoid coconut oil.

Medication and Side Effects

Your healthcare practitioner may prescribe medication if he/she feels your cholesterol levels are of concern. Below is a list of such medications as detailed by Mayo Clinic

Drug Class Drug Name Benefit Side Effects
Statins Altoprev (lovastatin)

Crestor (rosuvastatin)

Lescol (fluvastatin)

Lipitor (atorvastatin)

Livalo (pitavastatin)

Pravachol (pravastatin)

Zocor (simvastatin)

Decrease LDL and triglycerides; slightly increase HDL Constipation, nausea, diarrhea, stomach pain, cramps, muscle soreness, pain and weakness; possible interaction with grapefruit juice
Bile acid binding resins Colestid (colestipol)

Prevalite (cholestyramine)

Welchol (colesevelam)

Decrease LDL Constipation, bloating, nausea, gas
Cholesterol absorption inhibitor Zetia (ezetimibe) Decreases LDL; slightly decreases triglycerides; slightly increases HDL Stomach pain, fatigue, muscle soreness
Combination cholesterol absorption inhibitor and statin Vytorin (ezetimibe-simvastatin) Decreases LDL and triglycerides; increases HDL Stomach pain, fatigue, gas, constipation, abdominal pain, cramps, muscle soreness, pain and weakness; possible interaction with grapefruit juice
Fibrates Antara, Tricor, others (fenofibrate)

Lopid (gemfibrozil)

Decrease LDL and triglycerides; increase HDL Nausea, stomach pain
Niacin Niaspan, Niacor (prescription niacin) Decreases LDL and triglycerides; increases HDL Facial and neck flushing, nausea, vomiting, diarrhea, gout, high blood sugar, peptic ulcers, itching
Combination statin and niacin Advicor (niacin-lovastatin) Decreases LDL and triglycerides; increases HDL Facial and neck flushing, dizziness, heart palpitations, shortness of breath, sweating, chills; possible interaction with grapefruit juice
Omega-3 fatty acids Lovaza, Omtryg (prescription omega-3 fatty acid supplement)

Vascepa (Icosapent ethyl)

Decrease triglycerides; may increase HDL Belching, fishy taste, indigestion
Combination statin and calcium channel blocker Caduet (atorvastatin-amlodipine) Decreases LDL and triglycerides; lowers blood pressure Facial and neck flushing, dizziness, heart palpitations, muscle pain and weakness; possible interaction with grapefruit juice
Injectable medications Praluent (alirocumab)

Repatha ( evolocumab)

Decreases LDL in people who have a genetic condition that causes very high LDL levels Itching, swelling, pain or bruising at injection site; back pain; rash; hives; swelling of nasal passages; flu

There are cases when medication is required, but remember to be leery of any prescriptions or supplements. Talk with your practitioner about the reasons why he/she is prescribing them, Doctor-visithow long you should expect to take it, and if there are any alternatives to actually taking medication such as dietary changes or exercise. If your doctor cannot answer these questions for you or is prescribing medication or supplements you will be taking indefinitely, we recommend getting a second opinion.

Nothing you put in your body is without side effects and you have 100% control of what goes in. If you are unsure or uncomfortable about any recommendation your doctor gives you ask questions and do your research. Doctors are extremely intelligent and we need them, but your doctor doesn’t live with our body 24/7, you do. No one is going to have more information about how your body function than you.

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