We have got cholesterol completely wrong

Here are six things that we need to know about cholesterol:

i)    It is virtually impossible to explain how vital cholesterol is to the human body. If you had no cholesterol in your body you would be dead. No cells, no bone structure, no muscles, no hormones, no sex, no reproductive system, no digestion, no brain function, no memory, no nerve endings, no movement, no human life – nothing without cholesterol. It is utterly vital and we die instantly without it.

ii)    Cholesterol is so vital to the body that our bodies make it. The body cannot risk leaving it to chance that we would get it externally from food or some other external factor – that’s how critical it is.

iii) There is no such thing as good cholesterol and bad cholesterol. Cholesterol is cholesterol. The chemical formula for cholesterol is C27H46O. There is no good version or bad version of this formula.HDL is not even cholesterol, let alone good. LDL is not even cholesterol, let alone bad. HDL stands for High Density Lipoprotein. LDL stands for Low Density Lipoprotein. (There are three other lipoproteins, by the way, chylomicrons, VLDL and IDL).

Fat and cholesterol are not water soluble so they need to be carried around the body in something to do their vital work. The carriers of such substances are called lipoproteins. We can think of lipoproteins as tiny ‘taxi cabs’ travelling round the blood stream acting as transporters. So, lipoproteins are carriers of cholesterol – oh – and triglyceride and phospholipids and protein. All lipoproteins carry all of these substances – just in different proportions. LDL would more accurately be called the carrier of fresh cholesterol and HDL would more accurately be called the carrier of recycled cholesterol.

iv)    The standard blood cholesterol test does not measure LDL  – it estimates it. The fasting blood cholesterol test can only measure total cholesterol and HDL. There are two other unknowns in a four variable equation – LDL and VLDL. The estimation is refined further using the Friedewald equation (named after William Friedewald, who developed it).

Total cholesterol = LDL + HDL + Triglycerides/5 (Ref 1) (More detail here.)

As any mathematician will tell you, one equation, with four variables, only two of which can be measured, is a fat lot of good. We need at least one more equation or known variable, to avoid circular references. This also means that:
–    All other things being equal, LDL will rise if a) total cholesterol rises and/or b) if HDL falls and/or if c) triglycerides fall.
–    All other things being equal, LDL will fall if a) total cholesterol falls and/or b) if HDL rises and/or if c) triglycerides rise.

No wonder an inverse association is observed between LDL and HDL – it is by definition. More surprising is that a fall in triglycerides, which would be welcomed by doctors, would be accompanied by an automatic increase in LDL, all other things being equal, which would not be welcomed by doctors. And you thought that this was scientific.

v)    Statins stop the body from producing the cholesterol that it is designed to produce. They literally stop one of our fundamental body processes from being able to function. The intelligent view on statins is that in the very limited arena where they appear to have some ‘benefit’ (men over 50 who have already had a heart attack), they ‘work’ by having anti-inflammatory properties and that the fact that they lower cholesterol (by stopping the body from being able to produce this vital substance) is a very unfortunate side effect. (Drug companies should work on developing something that has the anti-inflammatory benefit without this huge and damaging side effect – it’s called aspirin).

One in 500 people have familial hypercholesterolemia and may have a problem clearing cholesterol in their body (rather like type 1 diabetics who can’t return their blood glucose levels to normal). For anyone else to be actively trying to lower their vital and life affirming cholesterol levels is deeply troubling.

vi)    “Cholesterol in food has no impact on cholesterol in the blood and we’ve known that all along.” Ancel Keys.

Ancel Keys, the same man who did the brilliant Minnesota starvation experiment, spent the 1950’s trying to show that cholesterol in food was associated with cholesterol in the blood. He concluded unequivocally that there was not even an association, let alone a causation. He never deviated from this view.

Cholesterol is only found in animal foods (it is a vital substance for every living creature). Hence the only foods that Keys could add to human diets, to test the impact of cholesterol, were animal foods. Given that he concluded that eating animal foods had no impact on blood cholesterol levels, it follows that animal foods per se have no impact on blood cholesterol levels (not that high cholesterol is a problem – quite the contrary – but that’s another story).

There is no need, whatsoever, to avoid liver, red meat, other meat, fish, eggs, dairy products etc for any cholesterol that they may contain, or for any other reason.

The body makes cholesterol. I worry about a number of things, but I don’t worry that my body is trying to kill me.

 

Ref 1: EH Mangiapane, AM Salter, Diet, Lipoproteins and Coronary Heart Disease: A Biochemical Perspective, Nottingham University Press, (1999). (See reference 159 The Obesity Epidemic)

56 comments on “We have got cholesterol completely wrong
  1. avatar Maree Maddison says:

    Hi Zoe, went to see doctor the other day on an unrelated matter but asked her to test my cholesterol as I have been following a Paleo lifestyle for 7 months and lost 10 kilos. The doctor didn’t want to retest as I was low risk last time.
    Cholestorol 7, trig 1.1, Hdl 1.7, ldl 4.8, ratio 4.1
    She relented and I had the test and low and behold the doctor wanted to see me as my cholesterol is now 8.
    Cholesterol 8, trig 1.2, Hdl 2.2, ldl 5.3, ratio 3.6
    I am thankful I researched and found your article because there is no way I would take statins. I am 59 y/old 173cm and now weigh 63.4 kilos, another kilo and I will be the same weight I was at Age 19.

  2. avatar anonymous says:

    you are dead wrong

  3. avatar anonymous says:

    How many Uturns make one return to back on the original path. I think it two; this means you need one more uturn to start going in the right direction.

  4. avatar Sandra says:

    Dear Zoe, I’m female,70 active, eat real food including butter and other saturated fats. My total cholesterol level is about 8 and I have refused up until now to take a statin. I thought I was healthy (unmedicated!) until I (recently and with some urgency) had to have a stent put in my left artery which was severely restricted. My consultant believes strongly that I should take a statin because of its anti-inflammatory effect (and, of course, cholesterol lowering which I don’t agree with) and quoted the ‘4S’study. What is your view of this study as it appears to show a benefit of taking a statin (simvastatin) if you’ve already got CVD? Any comments would be welcome as this has come as an unwelcome shock. Thanks, Sandra

  5. avatar Carrie says:

    I am a 36 year old Female , I have the E/4 E/4 Gene wich is said to cause worry for early Coronary artery disease. Which would make sense because my father passed away at 34 and his father at 48 both from heart attacks. They have said my so called bad cholesterol is high but my so called good cholesterol is even higher. I’m very confused I refuse to take cholesterol medication because it makes me feel weak. Any suggestions?

    • avatar Zoë Harcombe says:

      Hi Carrie
      I’m really sorry to hear this. Your gender may help – there may be a condition that affects the males in a family and not the females, or less so the females. Stress is serious for heart disease so the less you can worry about this the better – easier said than done I do appreciate.

      This post signposts to all the other key articles I’ve written on cholesterol and statins: http://www.zoeharcombe.com/2015/03/worried-about-cholesterol-andor-statins/.
      The presentation recommended at the end (Dr Malcolm Kendrick) is vital to watch (only half an hour). One of the myths he unpacks is familial hypercholesterolemia – the principles apply to genetic conditions generally – the wrong question is being asked.

      If you ever want children, make sure you’re not on statins – you can’t make a healthy baby without plenty of cholesterol. As for good vs bad cholesterol – there’s no such thing. C27H46O – that’s the chemical formula for cholesterol. No other version.

      I hope the reading helps. If this were me I would follow basic principles of healthy living: don’t smoke; don’t be sedentary; don’t abuse alcohol or other drugs; don’t eat processed food and manage stress.

      Best wishes – Zoe

  6. avatar Kate says:

    Hi. I read the article with interest. I’ve been worried about statins for a while. Recently my mother 73 years old had a mini stroke and was prescribed lipitor. They said it was to lower ger cholesterol to 4. Hers is only 5.8. Her triglycerides were 2.2 up from 1.8. They said tgat the stayin would more importantly make her veins widden or relaxed or something and it will help prevent a catastrophic stroke. I challenged them on a number of points based on the patient info sheet included in the box. They denied everything except muscle pain. My mum had some of her kidney removed last year because of a cyst. Her creatinine is up. They still thought that was ok to take the drug. She hasnt started but all her friends are on it. The drs have her running scared and now I’m afraid I’ve done erong by ger by telling her not to start it. My mum has a terrible time working out if something is a side effect. She is in pre diabetes but controlled by diet. Any ideas? Realky? Will this drug alone minimise the risk of further strokes? She was given asprin and a blood pressure medicine. I figure the blood pressure med and the asprin are enough. I’m confused. A reply will ve awesome. Thanks

    • avatar Zoë Harcombe says:

      Hi Kate
      I literally said “OMG” out loud when I read your post.

      This post may be of even more interest than the one above: http://www.zoeharcombe.com/2015/03/worried-about-cholesterol-andor-statins/

      When you read the patient leaflet – check the bit that warns against use in over 70 year olds! That’s because even the drug companies know that higher cholesterol is better in older age. Statins do not widen veins or relax anything – this is what statins do http://www.zoeharcombe.com/2013/10/how-statin-drugs-really-lower-cholesterol-and-kill-you-one-cell-at-a-time/
      Statins impair the body from doing one of the functions that it is designed to do – make cholesterol. They don’t stop this production completely or we would drop dead the instant we took a statin. They will have side effects – no drug has only one effect. As a minimum – they will reduce CoQ10 production (that’s the energy ‘spark plug’ in the body) – hence the tiredness/muscles aches etc.

      The pre-diabetes bit is especially alarming. Google “statins diabetes lawsuit” and see why I’m alarmed.

      This may be of interest too: http://drmalcolmkendrick.org/2015/10/27/how-much-longer-will-you-live-if-you-take-a-statin/

      Your mum is the one who needs to make a decision and you’re helping her as I would my mum. It’s really easy for me and my mum – even if you think statins might help – the evidence states that they may gain c. 3 days and the forums will tell you the cost of side effects. At 73 you need cholesterol to repair more than ever; you need muscles at their best to avoid falls, you need cholesterol in the brain to maximise mind function…

      Hope the suggested reading provides some balance to the doctor view
      Best wishes – Zoe

  7. avatar Angela A Stanton PhD says:

    Thanks for this awesome article! What you wrote is so correct and I am so excited to see the full picture in one place! I am sharing everywhere I can. I just recently switched to regular “old fashioned” fat after having studied up on the importance of fat and cholesterol as well and realized how silly we have been by accepting the low fat stuff. After all, there is not a cell in our body that is not made of fat and cholesterol is a large part of that. Also, the brain is 70% fat(as per Perlmutter’s books) and 20% cholesterol. So all this low fat business is really harmful for the body as a whole in general. I am really grateful for a friend for sending me your way. I will be reading your other articles as well!
    Angela

  8. avatar Carole says:

    Hi Zoe
    I was put on statins to control my cholesterol level after having a stent inserted in an. artery. I’m not worried about my cholesterol; my view is that I don’t think there is one healthy level which everyone should try to achieve. I think everyone’s level is, and should be, different because our bodies make what we need to survive. I don’t think my body is out to kill me!!! However, I’m very worried about statins but I’m too scared to stop taking them because of emy stent. I mentioned stopping them to my GP but he said I’ll probably be on them for life. started taking a BComplex vitamin and 50mg CoQ10 daily without his knowledge because I read an article that said statins deplete these in the body. I don’t know if it’s harmful or not but it seems you can’t always get true answer from your GP. I certainly am confused.
    Carole

  9. avatar Caroline says:

    Fantastic article. So well said! I’m looking forward to reading your books!

    I was wondering if there’s any evidence that certain ways of eating can reverse heart disease (clogged arteries)? Pritikin says so but they are so commercial I don’t know whether to believe them. I want my husband off statins and Zedia, and I’ll cook any diet shown to support his health.

    Thank you!

    • avatar Zoë Harcombe says:

      Hi Caroline
      Thank you! You may like this one too http://www.zoeharcombe.com/2015/03/worried-about-cholesterol-andor-statins/

      This may help on the ‘clogged arteries’ question: http://www.zoeharcombe.com/the-knowledge/fat-does-not-clog-up-our-arteries/
      Don’t think of the problem as something clogging arteries – especially not fat! Think of the problem, as the post describes, as something damages the arterial wall and then a plaque forms over the damage while the damage is being repaired. If the same harmful behaviour keeps causing damage then the plaques continue to form. Two key things are then able to cause a heart attack – a piece of the plaque breaking away and blocking a blood vessel or the plaques forming on top of each other to the extent that the block the vessel where the damage is.

      The solution in this way of looking at things is to not cause damage to the arterial wall. What can do this? The suspects are smoking, stress, sugar, chemicals/pollutants etc.

      You should read this brilliant series on what really causes heart disease:
      http://drmalcolmkendrick.org/2016/01/18/what-causes-heart-disease/
      http://drmalcolmkendrick.org/2016/01/21/what-causes-heart-disease-part-ii/

      Currently up to part Vii so keep reading! Hopefully you will be convinced by the end that cholesterol does not cause heart disease and statins won’t help.
      Best wishes – Zoe
      p.s. best diet? My personal view is real food: meat, eggs and dairy from grass living animals; fish; vegetables; fruit in season; nuts and seeds. Bit of red wine and very dark chocolate and life’s good!

  10. avatar Stephanie Price says:

    i’m 38 year old female, and my cholesterol is 247. Am i safe?

  11. avatar oxi says:

    This must be the most intelligently written diet-related article I’ve ever read. Thank you.

  12. avatar Jorge Zapp says:

    I (74) am a survivor living on a diet of 30% vegetables and ultralow Glycemic Index grains almost raw (no conventional wholesome Cereals) plus a paradoxical 70% meat and saturated fat, with my ‘normal’ cholesterol over 300 mg/dl, but perfectly clean arteries with an (SSS) index on an isonitril stress test of… -0- just like a skinny kid; I can breathe every 40 seconds with normal heartbeat and with a BMI of 20, after having been obese 10years ago, diabetic and arteriosclerotic years ago. A REAL Gatherer/HUNTER diet, Why does it work this way?

  13. avatar jean says:

    Hi Zoe

    Thanks for your interesting informative and refreshingly open, honest and unbiased work!
    Over the years I’ve constantly been ‘praised’ by medics for having such consistently low cholesterol levels (ranging from 3.1-4.2)…oh dear : (
    I now accept/believe that this isn’t a good thing at all. So my question ( unusually I guess), is how can I increase/build my cholesterollevels?
    I’m 61 years old, and although aerobically pretty fit, am getting more health challenges than I anticipated.
    I see an excellent Chinese traditional herbal medicine practionner, who certainly wasn’t impressed by my low cholesterol levels! She is a trained medical doctor, medical herbalist and acupuncturist – she is very much on the side of cholesterol and of strengthening the body’s own systems.

    Thanks and best wishes
    Jean

    • avatar Zoë Harcombe says:

      Hi Jean

      So sorry for the delay in approving this – a month’s worth of comments have just appeared – I wondered why it had gone quiet!

      There’s more reading here (http://www.zoeharcombe.com/2015/03/worried-about-cholesterol-andor-statins/) including a link to an article showing higher cholesterol = lower mortality. I still wouldn’t worry – I would never get my cholesterol measured and then there’s nothing to worry about! Your body is making the cholesterol it needs. So long as its not low because you’re artificially lowering it, a low cholesterol level can be a sign of health (no need to make more). You could increase VLDL (and therefore total cholesterol) by eating lots of carbs, but I would not recommend this for anyone!

      Best wishes – Zoe

      • avatar Francisco Navarro says:

        Well, I’m
        Making noise!!!
        Thank you. I will read the comments. Just recently I was told by a nutritionist “you have to eat, animal!!!!
        You need cholesterol!!!!”
        So I am looking for a way to raise it.

  14. avatar John Theobald says:

    Hello Zoe, thank you for an excellent and informative article. My personal view of statins is that they’re a slow form of suicide, and completely useless.

    I found this statement to be confusing “The intelligent view on statins is that in the very limited arena where they appear to have some ‘benefit’ … they ‘work’ by having anti-inflammatory properties and that the fact that they lower cholesterol … is a very unfortunate side effect.” My understanding is that their original purpose was to lower cholesterol, and that the anti inflammatory aspect is secondary.

    You may find this book to be of interest if you have not already seen it; The Cholesterol Myths http://www.ravnskov.nu/CM

    You may also find this video interesting; Understanding Heart Attacks
    http://www.screencast.com/users/GNM/folders/GNM%20Videos%20%28English%29/media/41d1f30b-44ee-4018-8b25-e86e0a6285e6

    Sincerely
    John

  15. avatar dean says:

    my Thai hairdresser friend,he has very high cholesterol over 3 times the normal range..and is on daily tablets, is excessive alcohol bad for high cholesterol and should he stop his tablets, is spicy food a issue with high cholesterol also. His Thai culture and does high cholesterol cause face/ eyes swelling as he has this after drinking alcohol. He is extremely psychologically and physically sexual even for 42 years old thankyou. Very concerned at the differing opinions on high cholesterol. Especially is lowing it by medication reduces life expectancy.

  16. avatar David says:

    Hi Zöe,

    Great article! I have been a chiropractor for 24 years, I have always looked at blood tests as snap shots for a day and not months. I have always stressed to my patients that cholesterol is good, so good our body makes it. I watched one of my patients waste away on a statin drug, and a low meat diet. Aches and pains loss of muscle mass, etc. If cholesterol is high that means there is a problem that the body is trying to fix. Is a persons cholesterol going to spike if they workout, body buildSo yesterday I woke up to, “Good Morning David, this is Faith, and I’ve been personified for a short while so we can talk.” I’ve been typing on that yesterday and today. , Crossfit train or if they spend all day in the garden digging or cutting wood? Is a physically demanding job going to spike the body’s need to repair itself? Could an car crash, or injury cause cholesterol to spike? Could a stressful situation, a divorce or loss of a loved one, loss of a job, even being a peace officer, fire fighter, be stressful and use large amounts of steroid based hormones? Could using a statin drug suppress testosterone in a man, and have to use ED meds, to keep the intimate life going? I say yes to all those, and it’s a scam and a sham and a shame, what under/over educated health care providers do to patients. Thanks again.
    DKSDC

    Thank

  17. avatar Angela jones says:

    Hi Zoe,

    My husband had blood work done which states his cholesterol /HDL ratio is 10.9H and should be >4.9. His HDL cholesterol was 30L, his non-HDL cholesterol was 29th and his LDL cholesterol was 264H. His doctor wants to start him on a statin but won’t because of high protein numbers in his liver testing. I want to know if these numbers are really important after reading some of your articles or if I need to just dismiss the numbers all together? I think fish oil and an aspirin a day would be better!
    Thanks in advance,
    Angela Jones

  18. avatar Joanna McNeill says:

    Hello Zoe,
    I live in Canada. Recently my doctor gave me a prescription for 10 mg of Crestor after a second blood test that ‘supposedly’ showed that my cholesterol had gone up after my last test four months earlier. I say ‘supposedly’ because when I compared the results of the two tests, there was a noticeable difference, particularly with the triglycerides from 3.78 down to 1.74! I was stressed around the time of the second test and had been quite upset the night before the test and didn’t sleep well either.
    1st test – 12 hour fast
    Cholesterol 7.94 Range should be (1.70) mmol/L
    HDL 1.28 Range should be (>1.10) mmol/L
    LDL 4.94
    Total chol/HDL Ratio 6.2

    2nd test – 14 hour fast
    Cholesterol 7.16 Range should be (1.70) mmol/L
    HDL 1.24 Range should be (>1.10) mmol/L
    LDL 5.13
    Total chol/HDL Ratio 5.8

    After reading this very informative article, I was curious about your comment regarding HDL being a carrier of RECYCLED cholesterol and LDL being a carrier of FRESH cholesterol. If that is the case, then wouldn’t having low HDL and higher LDL be a good thing?! Please let me know where more information about fresh and recycled cholesterol can be found. Thank you so much for providing valuable health information that empowered me to say NO to going back on statins which I went off a few years ago.

    • avatar Zoë Harcombe says:

      Hi Joanna
      You may enjoy this one too – http://www.zoeharcombe.com/2015/03/worried-about-cholesterol-andor-statins/
      It signposts elsewhere to the key articles I’ve written about cholesterol and statins.

      Ideally you would never have had a cholesterol test (at least you’ve spotted that they are about as accurate as a child throwing a ball). However, at least you escaped the system – nice one!

      On the specific question (a good one) – LDL carries cholesterol (and triglyceride and protein and phospholipids) to the cells in the body. If not much cell repair is needed, then there is more for HDL to take back to the liver to be recycled. (Another thought – if cholesterol were trying to kill us, surely the body would get rid of it – not hang on to every bit and have a recycling system?!)

      The body makes the cholesterol needed to keep us healthy (if left alone and not impaired with statins and plant sterol margarines etc). If LDL cholesterol (i.e. the cholesterol content of the LDL lipoprotein) is low generally – and the body makes what it needs – that’s a sign of a healthy person. If HDL cholesterol (i.e. the cholesterol content of the HDL lipoprotein) is high generally – that’s also a sign that not much LDL cholesterol was needed for repair. Defacto – person is quite healthy. Low LDL and high HDL are thus MARKERS of a healthy person, not MAKERS of a healthy person. If you try to lower LDL, getting the causation the wrong way round, you do an ignorant and harmful thing.

      There won’t be much sense written about cholesterol as 99% of what is written is supporting the cholesterol scam, which makes money beyond wild dreams. Anything on this site will be brilliant: http://drmalcolmkendrick.org/
      Anything by Dr David Diamond, Dr Duane Graveline, Dr UFfe Ravnskov (try this? http://www.ravnskov.nu/myth1.htm)

      Hope this helps
      Best wishes – Zoe

  19. avatar Arash says:

    Thank you for the article and the nice work.
    One point which was not clear for me in this article was if we humen need additional cholesterol intake in order to keep the normal physiological cholesterol levels in our body or the endogenous cholesterol produced mainly by our liver is enough?
    I appreciate an answer.
    Thank you.
    Arash

    • avatar Zoë Harcombe says:

      Hi Arash
      Sorry I missed this one – the answer is that the body is designed to make all the cholesterol it needs. Cholesterol is so utterly life vital that the body cannot and does not leave it to chance that we could get cholesterol from food.

      I find this really interesting. The term “essential” in nutrition means something that it is “essential” we consume in our diet, because the body cannot make it (like essential fatty acids). Cholesterol is even more essential than this – the body takes no chance and makes it.

      Kind of tells you how important this substance is eh?!

      Best wishes – Zoe

  20. avatar john says:

    This is my Lipid result Total HDL LDL Triglyceride
    5/1 5.5 1.4 3.5 1.2
    28/8 7.2 1.9 5.0 1.7
    The previous result on the January this year was when I had returned from 12 weeks overseas trip I had gained about 6kg on that result the the GP wanted me to double cholestrol tablets on those result I decided that I would change my diet by eliminating all processed and go to the gym,and stop taking my medication as well I also ride a bicycle. I am 67yrs old .Anyway my question what am I doing wrong cause I would have thought it would have helped with lowering these figures

  21. avatar Pam Slade says:

    I’ve been very interested by the info on this website. Im thinking of stopping my statins, which I’ve taken since my Lateral Medullary Syndrome stroke 5 years ago, back then I was 72 yrs old, 5’7″and weighed around 10.5stone. I am now 77, a bit shorter, and weigh 8stone 12lbs. and losing. I’ve been told by a dietician at my surgery to start eating all those rich foods and dairy that I’ve been denying myself for 5yrs. My BMI is apparently fine. Oh and I take aspirin.
    Wouldn’t it make more sense to is discontinue statins and aspirin but continue with healthy balanced Diet?

    • avatar Zoë Harcombe says:

      Hi Pam
      That needs to be your decision – this is where I’ve captured links to the key things I’ve written about cholesterol and statins. http://www.zoeharcombe.com/2015/03/worried-about-cholesterol-andor-statins/

      One very important thing to point out – which your doctor should have done and I’m appalled that they haven’t – is that most statins have warnings in the patient leaflets for over 70s. That’s as close as the drug cos get to saying don’t take them over 70! Here’s an example leaflet – you can check your own. https://www.medicines.org.uk/emc/medicine/2498
      The evidence for living longer with HIGHER cholesterol is vast.

      The jury is out on aspirin. There has been research in the past saying that is helps the heart. There is evidence that it can damage the stomach lining. This can be mild or serious. Recent suggestions have also emerged about aspirin helping cancer and I recently met one of the pioneer researchers in this area – Prof Peter Elwood. It’s a judgement call on aspirin therefore and a good doc should be able to present you with the pros and cons – with absolute risk numbers (not relative) to help you make an informed decision. If your doc doesn’t know about statins and patient leaflets, I doubt this has happened!

      Hope this helps
      Best wishes – Zoe

  22. avatar Anna says:

    Dear Zoe,

    I was relieved to come across your website and I have read most of your comments on cholesterol. I recently had my cholesterol tested and my overall result was 7. My GP said given my family history of heart disease (my sister died aged 44 from a heart attack, my father aged 68 – both were heavy smokers, my mother had a stroke in her 80s and is in a nursing home, my uncle is on medication for high bp) she said I had a 12% chance of heart/stroke attack. This seems really high to me – and terrifies me! She recommended either medication, or a re-test in 6 months after trying a low cholesterol diet. I opted for the latter – but realise I do eat healthily anyway so there is very little I can change. My bp is apparently perfect and I appear in good health. I eat wisely and certainly tick all the right boxes on the pamphlet of how to avoid saturated fats. I have never smoked.

    With my family history should I be worried? I don’t want to take statins unnecessarily based on this one result. Should I be looking at something other than cholesterol as an indicator that I may have a problem in the future? Is it possible to see what state my arteries are in? Could my cholesterol level of 7 be my norm, and I should stop worrying?

    Any advice would be very welcome,

    Anna

    • avatar Zoë Harcombe says:

      Hi /Anna
      I can’t give advice on your personal health. I can say that 7 is a completely normal reading (see 1 below) and I personally wouldn’t worry about this (but then I wouldn’t have a cholesterol test in the first place – about as useful as knowing how many hairs there are on my head!)

      This post may help – it’s gathered together the key things I’ve written about cholesterol and points to other things to read.
      http://www.zoeharcombe.com/2015/03/worried-about-cholesterol-andor-statins/

      1) 7 is not high. The first link in that post takes you here: http://www.zoeharcombe.com/2014/06/diabetes-cholesterol-bp-normal-is-no-longer-normal/
      You are part of the scam (in my view) to redefine normal so that more people can be medicated.

      2) You don’t say how old you are – even the patient leaflet cautions against anyone over 70 going near statins (I’m not saying you’re anywhere near that, but does you doc know this?) Is doc saying I want you on these for x years and then you must stop or does doc know as little about statins and cholesterol as most I’ve met/heard about.

      3) One of the other links takes you here: http://www.zoeharcombe.com/2013/10/how-statin-drugs-really-lower-cholesterol-and-kill-you-one-cell-at-a-time/
      Does doc know the consequences of blocking the mevalonate pathway? Do you?!

      With your family history your doc should be saying Don’t smoke! And I guess you don’t.

      I hope the reading is of interest
      Best wishes – Zoe

      • avatar Anna says:

        Dear Zoe,

        Thank you for your quick and reassuring response. I am 63 – and a fairly active grandmother! I had a routine eye test and the optician noticed a small bleed at the back of my eye. She was not worried – said it was very small, like a little bruise and might just clear up. But given my family history wanted to have it double checked. She recommended a blood test. So the blood test I had covered diabetes (for which I came out as clear) and I presume the cholesterol test was thrown in too. I did not know this was being tested too. I am being referred to an ophthalmologist.

        My GP didnt say anything further about statins since I said I wanted to try improving my diet first. There are areas I can take more care with – I love cheese – so I can cut down how much I eat.

        I will look at those links you gave me.

        Thank you,

        Anna

  23. avatar Leslie Garsten says:

    What about fibrate drugs? My triglycerides are always high. 441 in Sept.then I went to India, lost 20 pounds in 5 weeks, very little fruit and dairy, felt great. Gained 15 pounds back since March, more dairy and fruit, more food intake.Triglycerides went up to 900. Got scared and started taking gemfibrozil 600 mg 2x day. Just had blood test this morning after 2 weeks medication. What should my approach be? Can you recommend an inexpensive self test for this?

    • avatar Zoë Harcombe says:

      Hi Leslie
      I’m sorry but I can’t give advice – I’m not a doctor and docs wouldn’t give advice on drugs without assessing you and medical history. You’ve seen the impact of carbs first hand. Carbs are a key (if not the key) determinant of VLDL/triglycerides, as this shows:

      Elizabeth Parks study in 2001 entitled “Effect of dietary carbohydrate on triglyceride metabolism in humans” concluded: “When the content of dietary carbohydrate is elevated above the level typically consumed (>55% of energy), blood concentrations of triglycerides rise. This phenomenon, known as carbohydrate-induced hypertriglyceridemia, is paradoxical because the increase in dietary carbohydrate usually comes at the expense of dietary fat. Thus, when the content of the carbohydrate in the diet is increased, fat in the diet is reduced, but the content of fat (triglycerides) in the blood rises.” (Elizabeth J. Parks, “Effect of dietary carbohydrate on triglyceride metabolism in humans”, The Journal of Nutrition, (2001).)

      This has the key stuff I’ve written on cholesterol/statins in one place with links elsewhere: http://www.zoeharcombe.com/2015/03/worried-about-cholesterol-andor-statins/

      I don’t know anything about cholesterol tests because it’s not something I care about. 900 is high by any measure, however – I would be trying to get docs to help work out why you have these levels – not just try to artificially lower them without understanding the cause.

      Best wishes – Zoe

    • avatar David Murphy says:

      Some years back I was unwell and got diagnosed with diabetes, very high blood tryglycerides and high cholesterol. the doc gave me meds to reduce blood sugars and also said to cut out carbs. Within a month the triglycerides were almost back to normal. He explained that the liver processed carbs into triglycerides and too much carbs (coupled with other health issues) led to too much fat in the blood.

      So you need to talk with your doctor about this, and maybe a good nutritionist about balancing your diet so the liver is not overloaded. You may have a liver problem for example that causes too much triglyceride production and needs specially controlled dieting (eg reduced carbs).

      BTW although British I was living in the US at the time and the doctor was not a specialist, but he had seen a lot of diabetes and related problems.

  24. avatar Tae Kim says:

    Are we really suffering from high cholesterol?

    I’ve read “Fat and Cholesterol are Good for You” by Ulfe Ravnskov and “Cholesterol Clarity” by Jimmy Moore, and have completely changed my views on cholesterol.

    I do admit that this is a very sensitive topic, because health is interestingly enough, a very ‘subjective’ matter. We do try to be objective through studies and researches, but it’s no secret that the human body is still largely unknown, and of course, studies being flawed and controlled by big pharmaceutical companies do not help.

    I think taking statins for the rest of our lives in order to control our cholesterol levels is just an act of negligence. There’s a clear line between preventing potential cardiovascular diseases and being just paranoid.

    Would it be really wise to artificially lower our cholesterol levels with drugs which has been proven to cause a myriad of other health complications? Or should we be focusing our efforts to naturally lower the “inflammation” within our bodies, not cholesterol itself?

    Some doctors are saying that the condition of “high cholesterol” is a disease invented by man.

    Many questions, many doubts, but one thing I do believe and know is that there is no bad cholesterol, our efforts should be more focused on how to lower inflammation levels which is the real culprit behind diseases associated with high cholesterol.

  25. avatar Joseph says:

    Dear Ms Harcombe

    You said “There is no need, whatsoever, to avoid liver, red meat, other meat, fish, eggs, dairy products … or for any other reason.”

    But what about over accumulation of iron in the body by eating too much meat? Also, antibiotics and hormones being pumped into animals these days?

    Further clarification will be great. Thank you for the wonderful work you are doing!

    Best Regard
    Joseph

    • avatar Zoë Harcombe says:

      Hi Joseph
      Many thanks for your kind words.

      I think generally we should worry far more about nutrient deficiency than having too much of a good thing. Rickets (vit D deficiency) is returning in UK children; there are far more cases of anemia than excess iron.

      On the excess iron – this post may help – http://www.zoeharcombe.com/2014/04/healthy-whole-grains-really/
      We would have to eat half a kilo of liver every single day to get the max recommended dose of 45mg of iron; or 2.5 kilos of eggs… In a normal (Real food) diet, we are still going to get nowhere near having too much iron.

      On the antibiotics/hormones, that’s why real foodies (like me) are also strong advocates of pasture grazing animals. Animals needs to eat real food too – or we don’t get the health benefit from our health.

      People who buy 3 chickens for £10, which have been unnaturally fed and fattened and have never seen the light of day, would be better off buying some of the cheapest (and healthiest) cuts from the butcher: liver; ox heart; rolled spare rib of pork etc. Not good for the poor chickens or humans!

      Hope this helps
      Best wishes – Zoe

  26. avatar Philip Evans says:

    Thank you, Zoe, for this enlightening article. I recently had my first Medicare physical after which my doctor told me my hdl cholesterol(his wording) was a bit high. He ordered a prescription for me which I am hesitant to pick up because I am not symptomatic, eat whatever I want, and have a normal body weight. I have started doing my research and came upon your article. I have made my decision NOT to take the medication. I am not relying on this one article that you wrote, not because it is not the best, most concise and logical essay on the subject – it is. It is because of the volume of supporting literature of your facts. I am not one to deny science based medicine, as it is still the only method through which mankind ever gets it right. Fortunately, it is science that also shows us when and where have gotten it wrong!

  27. avatar Kingsley says:

    Hi

    I found your read very contrary. And possibly useful.
    On 18 April I got my cholesterol results (see table below for results) and then set out an eating plan of no red meat, significant reduction of trans and saturated fats. Only use olive oil and little of suflower seed oil. No cheese. No eggs. Exercise 2x per week. I am 44. I weighed 90.5kg now I weigh 89 kg.

    10 June I got follow up test results. An as you can see below the results are rather paltry.

    According to your approach is my cholesterol too high? What is your recommendation ?

    My total cholesterol is:

    Total. LDL. HDL. TRI
    18april. 7.4. 5.5. 0.8. 2.3
    10june. 7.3. 5.5. 0.8. 1.9

  28. avatar Virginia Bunker says:

    Dear Ms Harcombe

    So refreshing to find a knowledgeable person who doesn’t think that cholesterol is bad. I’ve known for years (courtesy of Adelle Davis) that the body made its own cholesterol, and more than one can consume, so, as you say, I couldn’t believe our bodies want to kill us.

    Unfortunately, my husband believes his doctor, who believes wholeheartedly in all drugs. (Oddly enough, he’s a very honest caring guy, and a good doctor in many ways.) A couple of days ago, Dr. Sanjay Gupta said ***publicly on CNN*** that people who had no history of heart disease should not take statins because of the side effects, which I also knew. My husband has never had a heart incident, nor has any member of his immediate family. He’s been on statins for 10 years and suffers from many side effects which his MD manages to attribute to anything else. Any suggestions from you about which of your essays I could suggest to the doctor to read that might make him think a little more logically?

    Thank you,

    Virginia

    • avatar Zoë Harcombe says:

      Hi Virginia
      There is so much that doc could/should read:
      – The Great Cholesterol Con – Dr Malcolm Kendrick
      – Ignore the Awkward – Dr Uffe Ravnskov
      Here are a couple of my blogs, as requested
      http://www.zoeharcombe.com/2013/10/how-statin-drugs-really-lower-cholesterol-and-kill-you-one-cell-at-a-time/
      http://www.zoeharcombe.com/2015/03/worried-about-cholesterol-andor-statins/

      However – in my experience – docs wedded to the belief that cholesterol is bad and statins are good rarely change from this view and no amount of literature, articles etc will make them change their mind. It will just annoy doc that his wisdom is being questioned. The person who needs to read all of this stuff is your husband. He’s the one who is suffering the side effects He’s the one whose quality of life is being spoiled. See if you can get him to read any of this. Most men would ditch the tablets as soon as they saw “loss of libido” as a side effect. Has hubby read the patient leaflet?!

      Good luck!
      Best wishes – Zoe

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