Episode 61: What You Need to Know About Heart Health: Is Cholesterol The Enemy We Once Thought It Was?
In today’s episode, Dr. Lisa and Dr. Toni discuss why you need cholesterol, if lowering it really does benefit your heart health, the negative effects of statins, and important risk factors you need to investigate and address for your cardiovascular health.
Why is your heart health important?
February is Heart Month in Canada and the United States
Heart disease is the leading cause of death for women in the United States, responsible for about 1 in every 5 female deaths.
A woman dies of heart disease in Canada every 20 minutes. Retrospective research shows that early signs of an impending heart attack were missed in 78% of women. Two-thirds of heart disease research focuses on men.
Women’s heart disease tends to appear in the smaller blood vessels of the heart rather than the major coronary arteries. This means that symptoms might not fit the classic textbook picture of heart disease. Women are more likely to experience chest discomfort (rather than a crushing pain), shortness of breath, fatigue, indigestion or nausea, back or neck pain.
Angiograms are not effective at diagnosing disease in the smaller blood vessels and stress tests are less sensitive for women.
Women’s hearts are impacted by pregnancy, menopause and hormonal changes throughout their lives.
What causes heart disease? It might surprise you to find out that it’s not as simple as the idea that cholesterol is bad and low cholesterol is a good thing.
What is cholesterol?
- Cholesterol is in all of your cells and on your cell membranes to help maintain fluidity of the cell and cell communication
- You have different types of cholesterol eg. HDL (high density lipoprotein), LDL (low density lipoprotein), VLDL (very low density lipoprotein)
- 85% of cholesterol is made by your liver
Why do you need cholesterol?
- Allows the arteries and veins to withstand the pressure of the blood flowing through them and heals them after we have any injury.
- Most of your hormones are made from cholesterol including your sex hormones. Without enough cholesterol you could see issues with your hormone balance.
- Vitamin D is made from cholesterol and sunlight in your skin, and is important for the health of your bones and immune system.
- Bile is made from cholesterol and is needed for absorption of fat and fat-soluble vitamins (like vitamin D, E, K and A).
- Cholesterol in your cells helps your immune system fight off infections. LDL binds and deactivates bacterial toxins that can cause damage to your cells.
- Cholesterol levels in the blood have been found to increase post-surgery, which can aid in the healing process.
- About 25% of all cholesterol is taken by your brain. The connections between your brain cells are dependent on cholesterol and you would have no learning or memory without cholesterol.
Cholesterol can cause damage to your cardiovascular system when there is a lot of inflammation and oxidative stress that causes your cholesterol to be oxidized and more “sticky”, leading to atherosclerosis or plaque build-up in your blood vessels.
It’s important to look at the environment that your cholesterol is in, instead of just treating a single blood marker.
Research suggests that 50% of people who have heart attack or stroke have normal cholesterol levels!
What can cause high cholesterol?
- High levels of sugar binds with proteins in your blood and makes them “sticky” and attaches to your blood vessel walls starting atherosclerosis
- Low thyroid function or hypothyroidism
- Nutritional deficiencies, such as B vitamin, vitamin C or magnesium
- Trauma including surgery
- Toxic chemicals, heavy metals, pollution
- Abnormal intestinal microorganisms causing damage to your gut lining
- Hyperinsulinemia or high levels of insulin in your blood, also known as insulin resistance
- Medications like thiazide diuretics, beta blockers, certain steroids
Does it make sense to take a statin medication to lower your cholesterol level?
It’s important to look at more than your LDL cholesterol level.
You can calculate your Framingham score using this Risk Calculator based on your age, blood pressure, family history and other info to see how much a statin medication or other interventions will impact your risk of cardiovascular events like heart attacks.
44 randomly controlled studies showed lowering LDL cholesterol doesn’t lower events like heart attacks or death.
There is no reduction in death rate if you take statin, even in people high risk of heart disease who have already had a heart attack, median increase in life by taking statin daily for 5 years is 4.2 days
Other info you need to know about statins:
- Side effects of statins is under-reported – real world evidence or community studies like US Statin Usage survey of 10,000 people shows that 75% of people prescribed statins will stop within a year, over 60% of people stop because of side effects (often muscle weakness and pain, but can also increased liver enzymes and blood sugar, digestive upset, headaches, reduced memory or rash)
- Statins deplete CoQ10, which is an essential nutrient to produce energy in cells
- Stopping statin doesn’t increase your risk of death
- Statins work in small percentage of people and tends to only benefit if it reduces your level of inflammation
- TheNNT.com provides non-biased summaries of research – more people with low risk of heart disease on statin will develop diabetes than will avoid heart attack
Lab tests to consider:
Cholesterol (or lipid) panel – total, HDL, LDL, triglycerides
Cholesterol particle size including VLDL
Oxidative stress – oxidized LDL, urinary 8-OHdg (8-hydroxydeoxyguanosine)
Inflammation – High sensitivity C Reactive Protein
Homocysteine – marker for cardiovascular health and B vitamin status
Thyroid panel – TSH, free T4 and T3 – for more info, see Episode 42
Blood sugar – HbA1c, fasting glucose and insulin – for more info, see Episode 45
Food sensitivity testing
Hormone testing including cortisol levels
Naturopathic approach to address cholesterol and cardiovascular health:
- Eating foods from the Mediteranean diet – high veggie and healthy fat intake
- Quitting smoking can raise HDL cholesterol
- Incorporating Omega 3 fatty acids – 2-4 g/day has been shown to decrease triglycerides by 25-30% and can also reduce inflammation
- Increasing your fibre intake – 10g psyllium/day has been shown to lower LDL by 7%
- Discussing the use of Plant sterols with your health care provider, which can reduce LDL cholesterol by 5-15%
This Week’s Mama Must Have:
Dr. Toni has been using her light box in morning to reduce the winter blues – for more info, see Episode 47
Dr. Lisa has been enjoying Ten Percent Happier Podcast with Dan Harris, especially their 21 day meditation challenge in January – start at episode 309 on fostering self-love and self-compassion. So much good stuff there!
Dr. Lisa is offering her next Wild Collective group in February – join or get on the waitlist for the next online group at wildcollectivetoronto.com
Dr. Toni’s next Online HypnoBirthing Prenatal Class for expecting parents starts Sunday, Feb 28 at 5:00pm MST and the next free intro to HypnoBirthing masterclass is available on Sunday, Feb 21 at 6:00pm MST. Register at https://www.hypnobirthingcalgary.com/
Thank you for joining us today!
Please tell your perimenopausal mama friends about us, too!
Stay safe everyone!