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 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.

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

UPDATE: Following numerous blog comments from people “worried about cholesterol”, I’ve written this post.


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)

309 thoughts on “We have got cholesterol completely wrong

  • So I am 48 and my cholesterol has been “high” (around 275) for years. Both grandfathers died of a heart attack, and my father had triple bypass surgery at around 65 years old. My brother also has “high” cholesterol. How do I know if it is familial/genetic and something to be concerned about OR if it’s “high” but fine?

    • Hi Kimberly
      Your cholesterol is not high!
      This may help https://www.zoeharcombe.com/2015/03/worried-about-cholesterol-andor-statins/

      Particularly follow the link to the post on how normal has been redefined https://www.zoeharcombe.com/2014/06/diabetes-cholesterol-bp-normal-is-no-longer-normal/

      You may have a hereditary heart condition, but you don’t have high cholesterol. Did both grandfathers have contributory lifestyles? smokers? worked in industry? Father similarly? There may also be a male line genetic heart issue, which would affect you and your brother differently. This is not uncommon.

      Hope this is of interest
      Best wishes – Zoe

      • Wow, way to give someone who’s CLEARLY at risk for heart disease the WORST advice possible. A cholesterol of 275 is HIGH. Wait, nevermind…I guess you know more than the American Heart Association. I’m sorry for stopping by and chiming in!

        • Keep in mind that the American Heart Association is in bed with the FDA , USDA, and the pharmaceutical companies! It’s all about money and funding! So do AHA know more? They should , but they’re not telling us because it just might interfere with their funding!

          • You said it all!!!!

          • Winner!! Crisis = funding Therefore we shall always have a crisis. There is far more money in research and treatment than in cures.

          • So true, Clint. These types of articles are so worthless. I hate to say that but it’s true. I know the author means well, but there is so much disinformation circulating that nobody knows what to believe anymore. I don’t believe anything other than eating whole, natural foods and organic if possible. I eat raw egg yolks daily. It’s changed my life. I don’t know how the pure, clean cholesterol and all the amazing nutrients do it but my health has markedly improved. Nobody knows. That’s why there is a God. We would all do well to just stop reading this garbage because tomorrow, some new “research” will come out with a new story just to confuse and mislead. Best wishes to all!

        • David, what do you know about it? I have had similar #’s to that womens most of my life. I have had every test done to see if there is any blockage anywhere in my body and they always come back negative. I have never taken a statin even though Dr’s in my past wanted me to do so. There’s a lot of money to be made by drug companies scaring people into thinking they will die if they don’t take their drugs. Every person is different and you can’t just assume that what western medicine tells you is the truth. Talk to all the people who’s family members died because of some adverse reaction they had from some drug some Dr prescribed them.

          • I have to agree. The statin thing makes my skin crawl. Literally. My 83 year old mother has heridatery Cholesterol above 8 ( measured differant in SA) and is still alive. What gives?

          • So true, Kat. All this disinformation is about money. So sad…

          • A friend of ours on statins lost his memory for some time. Didn’t even recognise his wife & daughter. It was very scary for them all.

        • Wow, what a brain-dead stupid moron you are, David! Your mom must have been working the streets when she conceived you.

          • I am new to this blog and I am sorry to see that some people resort to name calling. I would hope with any disagreement, it would be communicated with respect. My cholesterol was a high of 298. I have been trying a vegan diet to see what happens and doing my own research online. This article has been very informing and definitely is contrary to what we have been taught and I will be curious to learn more.

          • Not sure David deserves that kind of language. I don’t however trust any organisation funded by pharmaceutical companies. They are simply profit motivated and are prepared to mortgage peoples health for it. Some doctors just prescribe statins automatically without even checking cholesterol. Do I trust Dr Zoe Harcombe above the AHA. You bet! She’s not in it for the money.

          • Replay to Erika with the 83 yo mom who has high cholesterol.

            Erika—It is KNOWN that low cholesterol for those over 60 years old is bad for CVD. Higher cholesterol is needed for those over 60 years old.

          • Proctor and gamble

        • The American Heart Association is a special interest group and WAY behind in its science. Please reread the article to learn why the number 275 tells you pretty much nothing about your heart.

        • High cholesterol is associated with heart diseases. The reason why hasn’t been proven.
          High cholesterol is a indicator of trouble, not necessarily the troublemaker. It is used to repair your cells. Yet to high levels can cause a clot of cholesterol. Most likely because to cause to damage hasn’t been removed.
          The cause to repair failure is most likely due to high levels of insulin.
          I say likely because all are different but this fits the large majority may beyond 50% of us.
          Our livers produce cholesterol in the right amount that is needed for the moment.

          You could view cholesterol as a plaster, if someone pokes in a still wet plaster you have to redo it. And here glucose and insulin comes in. They poke an irritated the damaged area. So more cholesterol is needed. If you get inflation in the damaged area the cholesterol that is supposed to heal the area can become a infected fat cloth.

          You do not want to have high levels of cholesterol in your blood for long periods. It is normal to have fluctuating levels. But if it constantly high, then you are in trouble. Very rarely does anyone’s liver have a condition where it produces to much. That’s why it’s most likely due to a different problem, and the most common issue is related to high consumption of foods that gives a insulin reaction.
          The official recommendation is 60-70% carbs. And that usually translates to 200-300g of carbs.
          To maintain health one should eat 50-100g. And to restore health 10-40g of carbs.

          On the later diet you want make sure you eat enough water and salt, your body will tell you how much salt you need. Because it will start burning fat instead of storing it. And you will lose water and salts with it.

          If you get very hungry you increase fat intake, if you don’t get hungry at all you need to decrease fat intake.

          Protein also gives a insulin reaction so don’t over eat. If you are diabetic especially type one make the change very slowly and get down to roughly 20g of carbs per day. You will have to adjust your insulin intake accordingly. I have reduced my insulin to a quarter and have a hba1c of 45 mmol/mol or 6,3%. There is a third standard but I don’t now my values there. This is after 3,5 months. Lost 13 kg and never hungry.

          My cholesterol is even considered to low, from actually having “to high” for a diabetic, at the high limit for non diabetic, they used to feed me cholesterol medication but I have refused to take them for quite a while.

          Eating cholesterol as e.g. eggs (whole egg) actually gives your liver less burden in producing it by itself. On average you will have 1300mg of cholesterol per day produced, eat an egg and it goes down to 1100mg as a egg roughly contains 200mg.

          Don’t be afraid of cholesterol, but find out why yours is high, i bet you that if you slowly cut your carbs to roughly 1/10 of your normal consumption and make sure you replace it with good healthy fat it will go down.

          And yes WHO and other health organizations are largely to blame for allowing biased and poorly executed research reports direct the recommendations. It’s not necessarily intentional or corrupt but it’s definitely is incompetent and lacy.
          Many who tries their best and have best intentions still are biased whether they are acknowledge it or not.

          Well we know high cholesterol is related to heart disease, but they forgot to find out why.

          • How do you know anything you just said is even true? Because that is what the “research” says? We are lied to continually. You are simply regurgitating what has been drilled into your head for decades by people who really don’t give a damn about you. It’s all about making money…..and killing you off. It’s the sad reality. Best of luck!

          • Why does 70 % of people that have heart attacks or heart events have low to normal cholestrol?

          • This is great information thank you!

          • Bingo… Insulin. Visually we can even identify the contributor to the decline on health across populations. Drugs, foods with sugar… It isn’t the cholesterol that goes to repair the damage, it is the sugar laden SAD that is killing human beings.

          • They actually do know how LDL, which is NOT cholesterol but a carrier of it, is tied to atherosclerosis and CV disease. It is due to HIGH amounts of LDL. WAIT… It’s not what you think. LDL and cholesterol are, of course, VITAL to your health. The problem is when you have high levels of GLYCATED or OXIDIZED LDL particles. This happens when the LDL particle is damaged by high glucose levels in the blood. It is all tied to glucose. Sparing all the lengthy specifics, when the LDL particle is damaged, the cell receptors cannot attach to the LDL particle which prevents the LDL from being processed into HDL. This damaged LDL continues to float around in the blood. The body uses cholesterol as a “bandage” to aid in the reconstruction of cell walls. Arterial walls get damaged due to differing stresses. This glycated or oxidized LDL gets used to aid in the repair of damaged arterial tissue along with the healthy LDL but it cannot be processed later due to the oxidation and it builds up. This is what we see in the calcification score. When a doctor suggests that you take a statin based on a high LDL score, request a fractionation test. This test is not generally done because of the cost involved, but it will tell you whether your LDL particles are small, damaged particles,(glycated or oxidized), or if they are large, “fluffy” healthy particles. If the variance is highly in favor of the healthier large particle LDL, the high total level of LDL is not to be worried about. The problem comes when the inverse is true. If the level of small damaged particle LDL is high, that is when LDL is problematic.

          • Totally WRONG!!! What a shame, peoples brains are definitely shrinking due to a lack of CHOLESTEROL. Confounders and/or variables giving rise to CVD/Stroke: NaCl, Sucrose, Smoking, SFA’s, TFA’s, Stress, Lipid Oxidation, Processed Foods, Refined Carbs and my personal favorite “Excessive Calorie Intake”….LOL, the list goes on and on. What’s next?

        • For men over 60 there is no added risk of higher cholesterol at any level. Under 60, there is a small risk. For women, there is no risk. It’s unfortunate that people have been so brainwashed by the pharmaceutical and vegetable oil industries and with bad and falsified science.

        • I don’t trust anything any American Association of anything says. They’re all telling us what the all powerful drug companies tell them to say. I trust the science. I do my research.

        • Here’s some nutritional advice from the AHA in 1995 – “To control the amount and type of fat, saturated fatty acids and dietary cholesterol you eat, choose snacks from other food groups such as low fat cookies, low fat crackers, unsalted pretzels, hard candy, gum drops, sugar syrup, honey, jam, jelly, marmalade”

          Crackers, pretzels, candy, gum drops, sugar, syrup, honey, jam and jelly!! This was their advice in the midst of what the CDC called “An obesity epidemic” and during a time when global cases of diabetes rose to 370 million.

      • There are a couple things to note. Genetics are inherited, but your epigenetics, you can change through a healthy lifestyle which can reverse the negative effects of “bad” (disease causing) genes. Also, I believe our diet and nutrition habits are passed down just as easily as our genetics. I wouldn’t worry about natural foods which are high in cholesterol and would avoid processed foods. Finally, I highly recommend taking a magnesium citrate (300-400mg) supplement which blocks calcification of the arteries and reduces muscle cramps (remember your heart is a muscle). Societies with the lowest rates of heart disease have the highest amount of naturally occurring magnesium in their water supply. –Tim @ Forever29Nutrition.com

    • Hi Zoe – I love this article. I have been concerned about my cholesterol for about 6 months now. However yesterday I received information from my newly assigned doctor that something called a “10-year risk” formula has my stroke and heart attack risk at 2%. It think that’s good news. I’m a vegan, don’t smoke, my blood pressure and resting heart rate are low, no diabetes… in other words, in every other respect I’m pretty healthy. My previously assigned doctor gave me 3 months to change my cholesterol readings. I researched and researched and concluded that trans fat was the culprit so I cut that category out. 3 months late nothing changed. So when my ‘new’ doctor told me 241 and hdl of 51 my heart didn’t sink but didn’t rejoice either as I truly didn’t want to go on statins. However, being the doctor that he is gave me the 2% news and told me to test my cholesterol every 3 months so he could keep an eye on it. Now that is truly the kind of doctor that I’ll stick with! Thanks for the information!

    • I would look into Dr essestynes study on heart disease study and the cholsterol levels he says prevents chd.

    • There were almost no heart attacks a hundred years ago. A hundred years ago, human beings had essentially the same genetics as they do today. How is Coronary Heart Disease genetic, considering that scenario? My personal story : https://youtu.be/kv1KJzgKz5U

      • Hi Ron
        Sorry for the tardy approval – the link went into spam – just happened to spot it
        Best wishes – Zoe

    • Cut out vegetable fats. Cardiovascular disease was unknown before the introduction of the first cottonseed oils and then Crisco in the ’20s.

  • Dear Ms Zoe,

    I swear to God, i was almost die. I have been dieting since many years, and I ALWAYS heard that AVOID bad fats! Since i have using expensive products, such as omega 3 cold liver etc..but i became, in short more dehydrated, thinning hair, bloated, loss of appetite, gaining weight, loss of muscles, but most important i still feel shit loss of memory and much much more…thanks alot.. I Knew something which is naturally born could not be dangerous! My question is, do we really need all these so called GOOD FAT? I dont believe it any more.

  • Hi Zoe
    I have a concern – my family has a history of elevated total cholesterol (290-300 mg/dl). My son (28yo) is vegan his total cholesterol is 95 HDL 50 And LDL 42. But dietary cholesterol is a minimal influence on T. Cholesterol. Is it possible he has altered the normal biosynthesis/mevalonate pathway by changing his lipid chemistry?? Is this even possible? Is there even a fatty procurer to consume to shift it back to just normal? How low is too low T. Cholesterol? I sent him to the lipid clinic in my hospital and they thought it was fine.

    • Hi Steve
      Wow! That’s 2.45mmol/l in our terminology. Dr Malcolm Kendrick would be wondering how your son still functions!

      This may be of interest on the cholesterol: https://www.zoeharcombe.com/2015/03/worried-about-cholesterol-andor-statins/

      On health generally, I would be very worried about nutrients that vegans miss out on. I hope son is taking supplements and I hope they work in the same way that nutrients in food do. This may be of interest https://www.zoeharcombe.com/2011/08/the-vegetarian-myth-lierre-keith/

      The starting point of the normal biosynthesis/mevalonate pathway is Acetyl-CoA (https://www.zoeharcombe.com/2013/10/how-statin-drugs-really-lower-cholesterol-and-kill-you-one-cell-at-a-time/) and this is a by product of the Krebs cycle, so is normally impacted by carbohydrate (and not fat). Everything a vegan eats contains carbohydrate, so this is a bit puzzling (do note the compete inaccuracy of the chol test though – one of the links from the ‘worried about’ article).

      Most lipid clinics probably think you can’t go too low in cholesterol but then they’re stupid enough to be trying to lower it all the time anyway!

      I would be more worried about general diet than cholesterol but I know that vegan/veggie is something you can’t debate with someone (I was veggie for c. 20 yrs so speak from experience.) Interestingly, the average age of vegans is low – they seem to change – probably when the health problems hit. Little consolation, but true.

      Best wishes – Zoe

      • Thanks Zoe
        I was a surprised by the lipid clinic advice also.
        He take vitamins and natural yeast for a.a ‘s and some vitamins & works out daily.
        So probably a consult with a dietitian will be next.
        Thanks again

      • I have 2.5, been lower, been at 5.5 and then they gave me meds as Im diabetic. I believe thats why I ended up with cholesterol stones in my gul bladder and that is now partly why it’s so low. Feeling great by the way.

    • As someone who just ended a 10 year long vegan diet, I have to say it’s probably one of the worst things I’ve done to my body. While I rarely got sick, my quality of life degraded drastically, but so slowly I didn’t really notice. I was tired all the time, I had skin problems, my eyes bothered me a lot, had trouble sleeping, grumpy a lot and no matter how hard I worked out I was weak as a baby. I recently went back to eating meat as part of a healthy diet and I was shocked at how much better I felt after only a few days. I now sleep like a baby, my skin has improved drastically, I’m in a great mood all the time, I’ve made more strength gains in the gym in the last few weeks than I have in the last several months as a vegan and my eyes no longer bother me. My vision isn’t perfect, but I think it might have improved a bit and my eyes no longer feel like they are covered in sand.

      Your body needs the nutrition that you can only get from meat and going without is a really bad idea.

  • Why eat cholesterol if our bodies make all the cholesterol it needs?
    It makes sense to eat what is essential or what our body doesn’t make enough of but not to consume what our body already makes for proper function ..
    Maybe it is not just the cholesterol in animals that is dysregulating so many peoples health.

    • Why eat carbohydrate if our bodies make all the glucose it needs?

    • Our bodies make “emergency” cholesterol if they are dangerously low, no I don’t know this for a fact, but I imagine it is the same process as a low carb or no carb diet, it can turn proteins into sugars. However, this is a very inefficient method of making it and your body can go into shock. I can’t see this as any different.

      Balanced diet has been recommended by most nutritionists for years. They are fuzzy on the specifics, but generally, if you get some of everything, you are more or less healthy.

    • Thank you, Zoe!! We don’t have any idea, for the most part how our bodies really work. Nature has a purpose for all things so if there is cholesterol in a food, it has a purpose; maybe good or bad. I don’t know. But to say that our bodies make all the cholesterol it needs? I have a hard time with that. I don’t believe anything anymore. Too much disinformation. I eat raw egg yolks daily and feel better than I ever have and have been able to taper off an anti-depressant much easier. It’s the pure, clean cholesterol and nutrients in the egg yolk that are changing my brain chemistry and healing me. How it is absorbed and used? I have no idea but it works.

    • Hi Ashley
      It’s beyond good – every human would die instantly without it. Great question, because it shows the nonsense for what it is!
      Best wishes – Zoe

      • Thanks for this excellent post!

        What materials does the liver and intestines use to make cholesterol? Triglycerides? Stored body fat? Stored fat in the liver? I assume the intestines would use saturated fat in the diet? Does the intestine just ignore any ingested cholesterol?

        Does sugar that has been converted to fat in the body play a roll in cholesterol production by the liver?

        Do any ingested unsaturated fats ever get used for cholesterol production?

        Thanks AgainMatt

        • Hi Matt
          Many thanks for your kind words.

          If you Google “cholesterol pathway” and choose images, you can see the pathway by which cholesterol is made. The starting point is Acetyl-CoA, which is very interesting if you know your Krebbs cycle – think carbohydrates!

          There’s a passage in my 2010 obesity obesity book where I show how stupid it is to think that dietary fat clogs arteries. I give the example of having just consumed some super high sat fat coconut oil:

          “The oil passes from our mouth very quickly into the pharynx (the part of the throat that goes from behind the nose to the start of the oesophagus) and then into the oesophagus (the muscular tube through which food travels from the mouth to the stomach). From there it goes into the stomach (the main area for food ‘short-term’ storage and digestion of protein and carbohydrate). Fat is not digested until it passes from the stomach into the small intestine (where almost all nutrients are absorbed) and, from there, it passes into the large intestine (the main function of which is to transport waste out of the body and to absorb water from the waste before it leaves). So, our coconut oil has quite a journey through our digestive system and we haven’t yet started to describe how it can go anywhere near our arteries.
          “In Chapter Eight we learned that chylomicrons are formed in the intestine, as a result of digestion, and chylomicrons are the transport mechanism for taking dietary fat (and cholesterol) from the digestive system into the blood stream and from there to the different parts of the body to do their vital work. As any young biology student will know, arteries pump blood around the body from the heart. There is no artery to take dietary fat away from the intestines.”

          Just research Acetyl-CoA – that’s the starting point of cholesterol production.
          Best wishes – Zoe

          • And all the people resisting against this are just parroting their doctors.

            In a biology textbook, it talks about the role of carbohydrates (energy for the body), proteins (building blocks), fiber (roughage to pass stuff out of the body), fat (these carry nutrient inside them and store such for long term, they also insulate the body), and cholesterol (digestion, hormones, and regulation of the body).


            Any doctor telling this stuff knows zilch about real nutrition and should be… (medical equivalent of being disbarred) for practicing quack medicine.

      • Hi Dr. Harcombe,

        I’m curious about your thought regarding the role cholesterol plays in the production of bile duct stones.

        I’m a 44 yo male that is usually in good shape but have fluctuated with weight over the last twenty years. I have low blood pressure and excellent cholesterol levels. The most i’ve lost was sixty pounds but have been able to keep that off. I do fluctuate from 5-15 pounds between summer and winter. Can’t seem to put the beer down when I’m grilling in the summer.

        The problem is that in my late twenties I had a severe gall bladder attack and had my gall bladder removed but about five years ago I suffered a blockage from a bile duct stone and then again last year. In all three events I had lost a substantial amount of weight about six months preceding the occurrence.

        I’m thinking what precipitated the last attack was that i completely cut out fats because I suffered from a major acid reflux event and couldn’t eat fat without causing major stomach pain. I was diagnosed with mild chronic gastritis. After eating virtually no fat for about six to seven months, as I got my reflux under control I started challenging my stomach again but eating more fatty foods and then wham – bile duct attack. It’s an extremely painful and frightening thing to deal with.

        I’m wondering if you have any ideas or recommendations regarding eating an optimal amount of fat to “flush” the ducts and not have the body produce the cholesterol if it doesn’t have to. Is there a recommended diet? My specialists keep telling me there is nothing I can do, that the combination of fat, bile and salt is too difficult to figure out but I would at least like to verify that have zero fat can be very dangerous – a statement they’ll never make. As a matter of fact my primary keeps telling me to be on a low fat diet.

        In any case, I’m so glad I just stumbled onto your site and read your amazing advice. I hope you can shed some light on my situation as well.

        Thanks so much!

        • Hi Ted
          I can’t give medical advice – just opinions and information.

          On information – your comment “excellent cholesterol levels” makes me think that you think low cholesterol is good. This may be of interest: https://www.zoeharcombe.com/2015/03/worried-about-cholesterol-andor-statins/

          On stomach environment/cutting out fats, you may find this interesting https://www.youtube.com/watch?v=lvSWgwKJavw

          One of the main things that leads to gall stones/gall bladder removal is a low-fat diet. The gall bladder thinks it has become redundant with little fat to manage – contents crystallize and that’s the stone formation/pain/whip the gall bladder out scenario. The gall bladder is there for a reason but docs whip it out as if it has no purpose! Following removal of a pretty important organ, you can suffer consequences – bile duct stones/blockages etc. And that’s where you are…

          My dietary recommendation for human beings is simply – eat real food. The only debate is – what should that real food be. If you choose foods for nutrient density, you would naturally choose meat, fish. eggs, dairy, nuts, seeds, green veg and not much else (https://www.zoeharcombe.com/2014/04/healthy-whole-grains-really/)

          It may help to keep a food diary and to see what you’re eating when things are going well and what you’re eating when they don’t go so well. This may be quite individual. However, I would be surprised if anything other than real food helps you. This would mean no more beer/sucrose/flour/veg oils.

          You’d die on a zero fat diet by the way – you need the essential fatty acids to survive and fat soluble vitamins (A/D/E/K) ditto. You can try to take these as tablets and consume no fat but I would not forecast good things for your health!

          Food for thought hopefully!
          Best wishes – Zoe

  • Zoe: I am 57 and am convinced my high cholesterol is genetic. For most of my life, my total cholesterol numbers ranged from 215 to 250. About two years ago, I greatly reduced sugar from my diet. My triglycerides came down to 94! Unfortunately, my LDL shot up to 180 (higher than ever). When my triglycerides were 223 my LDL was 123 (this is crazy!). I exercise about 30 minutes every day and eat very sensibly (no fast food junk). I am NOT on statins (and never have been). About three years ago, I got an ultrasound test on my carotid arteries. I was told the left is fine but the right produced inconclusive results. About eighteen months ago, I had the same test. Left side is still fine, but now, the right side showed minor signs of plaque build-up. I hate the idea of having an operation to open the artery (if it should become substantially blocked), but I sure don’t want a stroke, either. What is going on in my body and what can I do to stop and reverse it?

    • Hi Alan
      I can’t give advice and I’m sorry you’ve been given what is, in my opinion, unnecessary worry. That’s why I put together this post with links to other interesting posts.

      250 is below the true average before statins became the new smarties by the way. Your exercise/diet/drug decisions look good to me.

      This video may also be of interest if stents get discussed https://drmalcolmkendrick.org/2014/09/12/watch-this-2/

      Hopefully you’ve got a good doctor prepared to discuss options, pros & cons of each and to present the facts in a way in which you can make the right decision for you. Check out cardiologist Dr Aseem Malhotra in the UK – there will be articles and talks of his on line. He addresses the need to work with patients in this way really intelligently.

      Good luck with everything
      Best wishes – Zoe

  • At 58 I have plaque in the arteries of my legs and carotid artery plus have been diagnosed with a fatty liver and slight liver fibrosis.

    I refused statins and tend to believe that inflammation is at the bottom of this.

    I was an Olympic athlete and ended pro sport at 38 continuing with a little gym work but not much aerobic work. My weight is only a few kilos over my competitive weight.

    I have high cholesterol but look fit, eat healthily, drink some red wine and smoke a cigar from time to time.

    Everyone thinks I’m 40 but the pad symptoms and fatty liver are real.

    Your best advice would be appreciated. I won’t take statins as even red rice yeast made me feel terrible.


    • Hi Nick
      As I’ve just replied to Alan above – I can’t give advice. This link may help with information https://www.zoeharcombe.com/2015/03/worried-about-cholesterol-andor-statins/

      My first question would be – do you really have high cholesterol or have you been part of the goal post moving exercise?! (see the “normal” post in that link above).

      If you’re not already familiar with it, you may like to explore all the thinking on carbohydrate and disease. NAFLD (non alcoholic fatty liver disease) & fructose is a very interesting area (try Dr Robert Lustig). You may have carb loaded as an Olympic athlete? (congrats by the way! That’s seriously impressive) Dr William Davis may be good (Wheat Belly book) for carbs (wheat esp) and inflammation.

      I would never take statins either!

      Again – as I suggested to Alan: “Hopefully you’ve got a good doctor prepared to discuss options, pros & cons of each and to present the facts in a way in which you can make the right decision for you. Check out cardiologist Dr Aseem Malhotra in the UK – there will be articles and talks of his on line. He addresses the need to work with patients in this way really intelligently.”

      Good luck exploring
      Best wishes – Zoe

  • Hi Zoe,

    Have you looked at the research of Professor Brian Peskin at all?
    He has done a lot of research on cholesterol and also the body’s need for Omega 3 and 6 oils.
    It seems to go along with a lot of what you are saying.


    • Similarly for Jordan Rubin – his recommendations on diet saved mu life 15 years ago.

  • There are 100s of strict scientific studies on HMG-CoA reductase inhibitors out there that would argue against you. Most have p-values way less than 0.05, so they didn’t hit their endpoint by chance. I support people sharing their point of view, but the people on here taking medical/health advice from a PhD instead of an MD, DO, PA, NP, PharmD is just scary.

    • wrong, read this: http://www.drperlmutter.com/wp-content/uploads/2015/02/Statin-data-corruption.pdf. We listen to them because our bodies are made up of chemical reactions from the foods we process and the other chemicals we produce ourselves. You, as an MD have between 13-24 hours of nutrition and are hardly anyone to listen to on fixing any issue. You treat a lot of things but looking at the rise in chronic diseases, you are doing no good. So stand to the side and lets get to the root of things here finally.

      • That study does nothing other than prove that they’re effective. An NNT in the low 80s for rosuvastatin is nothing short of impressive for a primary prevention drug. The same PhD on this website has promoted the use of aspirin in posts below. Do you know the NNT of aspirin? It’s >250!!!

      • Right on
        Finally someone who knows what they are talking about and willing to stand by the truth for the health benefits of all
        I have 30 years in the natural healing arts and can honestly say that science is almost always misleading
        A whole other story in and of itself
        The body has a self healing capacity given the opportunity
        When overwhelmed it needs help naturally speaking
        Hello lifesyle changes body mind and heart
        It definitely needs no more interference
        eg an additional unwanted ocillation as the Germans would say
        And no more toxic interference such as most drugs would offer
        I applaud you Zoe for standing upward

    • Baloney. I can do more good for my health than following some greedy pill pushing MD. Eat raw eggs and forget the MD hype.

  • Hi Zoe, I am really interested in your articles as my doctor recommended a cholesterol test recently as part of a regular physical.
    I am 53, weigh 138 lbs, 5ft 6 in, blood pressure 120/80. Sugar levels are fine too. I’m several years post menopausal, and live in the tropics, although of British ancestry.
    My results were 334 total, 223 triglycerides, 53 HDL, 236 LDL, 45 VLDL, risk 6.3.
    My doctor said this was too high and recommended regular exercise (which I was not doing) and reduced saturated fat diet, (butter, red meat) and to eat more fruit, veg, pulses, olive oil, omega 3 in fish and also capsules, and garlic capsules. And she wants me to re test in three months.
    My diet is actually not bad normally.
    I don’t mind stepping up the exercise and avoiding a lot of refined carbs, but do you definitely think that the readings are not high?
    Thanks, Rose

    • Hi Rose
      This is my main cholesterol/statin post – https://www.zoeharcombe.com/2015/03/worried-about-cholesterol-andor-statins/
      Check out the link (first link in the article) to the “normal” post. You’re below the true average – which was even higher before they started statinating everyone.

      You should do some movement/exercise (walking/dancing/gardening/cleaning – natural stuff) because it’s great for all round health. Not sure it would make any difference to cholesterol and who cares about cholesterol anyway?! (Apart from pharma companies trying to get you on drugs and doctors too dull to have worked out the scam – the bright ones have)

      Sunbathing reduces cholesterol naturally – as it turns it into vit D – that’s the healthy bit! Sounds like you’re in the right place to get some sun (never burning etc)

      The article “worried about…” recommends not having cholesterol tests – you’re a classic example as to why! Someone with nothing (cholesterol related) to worry about now worrying!
      Best wishes – Zoe

      • thanks Zoe. I did read your article about the true normal, but I also appreciate your personal response!

    • No need to worry about high cholesterol. However, cholesterol is not produced just to float around in your bloodstream. It needs to be picked up and processed. This is done through the aid of T3 hormone and a couple of vitamine and minerals. Being menopausal you probably have a higher level of estrogen vs progesterone ratio which is very common. Due to this, estrogen has a negative effect on the thyroid and thyroid has to produce the T4 which is then converted by the liver into T3. The thyroid also produced T3 but only a little bit. So too much estrogen leads to high cholesterol.

      As said, high cholesterol in itself is not a problem but the rest of the chain that is depending on it such as hormone production by the adrenals (where your progesterone is produced!) will of course be negatively affected.

      It is worthwhile to have this looked at and then, if this is the case, look at how to reduce the estrogen.
      Also have a look at Dr Eric Berg. He has a book on fat burning through health but it is the health part that is very interesting in his book. Through this book I got my mums cholesterol down from 350 to 290 in 2 weeks while it has been around 350 for decades. She’s also post-menopause.
      good luck

  • Hi Zoe,

    What do you make of these statements: “If you decrease your LDL cholesterol by 1%, you decrease your chance of cardiovascular death by 2% to 3%. If you increase your HDL by 1 mg/dl, you decrease your chance of cardiovascular death by 2% to 3%”.

    This is the sort of thing I was taught studying Human Nutrition (only just last year) and taken directly from the Precision Nutrition website from their article on cholesterol.

    I am in complete agreement of your argument (and other topics on your website) but unsure how to respond to this sort of thing above.

    Thanks in advance.

    • Hi Emily
      Show me the evidence and I’ll show you the flaw in it!
      Best wishes – Zoe

  • Thanks so much for the explanation on cholesterol. I have trouble understanding as I was even learned from the college of nutrition about the rising of LDL and lowering of HDL but it didn’t give me the reality of cholesterol management.

    I heard about this from a colleague who learned about the need for a cholesterol in our body where she listened to Dr. Wallach’s lecture. But because, I am A nutritionist, I weight down listening to founder when it comes to promoting product in the end. I become skeptic to learn more about this cholesterol that he was actually right. We need it more.

    Now, my question is how would we then help our cholesterol healthy or support their function? Is it more of omega 6 higher ratio than omega 3? Say 3:1 of N6 against N3? or other factors than Fats and Oil to work on.

    • Hi Cristina – just leave cholesterol alone! The body makes it – let it do its job.

      Separately – too much omega-6 vs omega-3 is NOT a good idea. 3:1 n6 to n3 would be a good ratio – the average modern human processed food diet has a ratio of more like 20:1. Reducing vegetable oils generally would be a good population strategy.
      Best wishes – Zoe

  • Quite an interesting set of medical facts about Cholestrol with a proficient use of high school algebra.

  • Hi Zoe

    With all this information does this mean that you think a vegan diet is bad for your health as it contains no cholesterol, or it doesn’t really matter because your body will produce enough as it is ? I have been eating vegan for 6 months and have lost 10 kg and feel as strong and as healthy as I ever have.

    Thank you :)

    • Hi Jordy
      Here’s a quotation from Ancel Keys (the man often held to be responsible for the diet heart cholesterol hypothesis):
      “The evidence – both from experiments and from field surveys – indicates that cholesterol content, per se, of all natural diets has no significant effect on either the cholesterol level or the development of atherosclerosis in man” (p.182 – original emphasis) (Keys A, Anderson JT. The relationship of the diet to the development of atherosclerosis in man. In: National Research Council DoMS, ed. Symposium on atherosclerosis. Washington, 1954:181-96.)

      The answer is, therefore, cholesterol in food makes no difference – your body makes what it needs. There are other things that you don’t get in a vegan diet however (don’t shoot the messenger!): retinol; D3; K2; heme iron; B12. I would advise anyone taking this route to take supplements and hope that they are as good as nutrients found in food.
      Best wishes – Zoe

  • Hi Zoe

    Help! In February 2013 results of my bloods:
    Cholesterol 7.3mmol/l
    HDL 1.3mmol/l
    LDL 5.4mmol/l
    Triglyceride 1.17mmol/l
    Had the test done because I started a LCHF diet and my cholesterol levels have always been high and doctors have been chasing me to take statins.
    Then 3mths later May 2016 my blood work showed the following:
    Total cholesterol: 10.3mmol/l
    HDL 1.7
    LDL 8.0
    Triglyceride 1.34
    Have lost 16kg since beginning of Feb 2016 and feel fantastic…just these results that now have my doctors screaming that I need to take a statin.
    Have since then modified my intake of high fat by cutting out the dairy milk….increasing my olive oil intake, avos etc but still eating all other real fats but in moderation…still losing weight although smaller numbers.
    Meds I am on is vagifem (for the past year) and Eltroxin (last 10 years or more)
    Bottom line I do not want to take a statin but how do I argue this.
    Any help/advice you can give would be much appreciated.


    • Hi Sandi
      Here’s my main post on cholesterol and statins: https://www.zoeharcombe.com/2015/03/worried-about-cholesterol-andor-statins/

      One of the early links in the post takes you to the inaccuracy of the test (BMJ article – 19%) Add to this – stress about the test/running late for the test – all sorts of random stuff and this is why I would ever take a cholesterol test!

      Huge congrats on the weight loss – that has done wonders for your health generally (and well being by the sounds of it).

      My top tip would be to sunbathe (assuming you’re northern hemisphere?) – convert cholesterol to vit D – the latter being the healthy bit. The former keeps docs happy because they don’t know what they don’t know!

      It’s your body – I would never have an argument because I would never take a test. If someone took a test without my knowing and then tried to put me on statins, I would refuse. That’s me – hopefully this has helped with info for you to decide what’s best for you.

      Best wishes – Zoe

  • Hello Mrs. Harcombe, I was diagnosed with ‘high’ cholesterol and the doctor suggested I went on statins. I said I would rather not and she suggested I had a blood test in six months. My cholesterol reading was 6. A friend recommended a cholesterol lowering flavoured drink (I am not sure about giving its commercial name.) It is made with plant lowering properties; there is also a margarine spread made by the same company. I have now been taking it for about six weeks. After reading the interesting messages on your site and your replies, I am now in a quandry as to whether I should carry on with this drink.
    I look forward to your advice – with very many thanks, Anne

    • I read this PDF link and it only verified what this article said.
      The pdf from your link explains how total cholesterol, HDL, and triglycerides are measured, how VLDL is estimated, and how that estimate is used to calculate (estimate) LDL. It said total cholesterol is HDL+LDL+VLDL, and uses the same calculation Harcombe states in this article…

      “[LDL-chol] = [total chol] – [HDL-chol] – [TG]/5
      where [TG]/5 is an estimate of VLDL cholesterol”…. (Quotation from your link)

      “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” (quotation from this article)…..

      So if you are disagreeing with something, please be more specific. I only see how this further validates everything I just read here.

  • 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.

  • 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.

  • 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

  • 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?

    • 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: https://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

  • 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

    • 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: https://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 https://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

    • What really bothers me, and would bother me about your mother too if she took statins, is this study I stumbled on some years ago about the tiny swellings statins can produce in brain cells: https://uanews.arizona.edu/story/research-reveals-possible-reason-for-cholesterol-drug-side-effects

      I can’t help wondering whether the alzheimers epidemic that has unfolded in recent years may be partially connected with the upsurge in use of statins?

  • 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!

  • 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.

  • 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!

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

      This may help on the ‘clogged arteries’ question: https://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:

      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!

      • I would be very interested in your view on a paper out recently that says, if I understand it correctly, that the epidemic of metabolic diseases is caused by chronic over-nutrition –


        The paper was too technical for me but seemed to affirm your suggestions on diet except that the emphasis would be on low energy dense foods – leafy greens, cruciferous vegetables, stems, bulbs, mushrooms, while eating very sparingly meat, fish, dairy, fruit, seeds and nuts, starchy veges, cereals, pulses etc.

        • Hi Cathie
          Many thanks for this – looks interesting – it will have to go on the (too long!) todo list, I’m afraid. Too many interesting studies and too little time :-)
          Best wishes -Zoe

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

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

  • 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?

  • 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

    • 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 (https://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

      • 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.

  • 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


  • 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.

  • 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.


  • 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

  • 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.

    • Hi Joanna
      You may enjoy this one too – https://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

  • 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.

    • 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

  • 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

  • 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?

    • 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. https://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

  • 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,


    • 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.

      1) 7 is not high. The first link in that post takes you here: https://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: https://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

      • 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,


  • 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?

    • 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: https://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

    • 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.

  • 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.

  • 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

    • 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 – https://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

  • 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!

  • 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

  • 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,


    • 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

      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

      • Hello,
        I’ve read a lot about Niacin to reduce cholesterol. What is your take on this?
        Also, what dosage would you recommend if in fact it works.

          • Hi Zoe,
            My last blood work showed higher numbers than the previous year. I’m 58, 129 lbs. in good shape and eat all the good stuff most of the time.
            Cholesterol 6.26 mmol/L
            LDL 3.97
            HDL 1.64
            Triglycerides 1.42
            Chol/HDL Risk ratio 3.82
            Also, I lost my job the day before my blood was taken. I was under a great amount of stress. Can this alter the outcome?
            Thank you for your reply.
            Good thing is I did get a new job!

          • Hi again – same question – why would you want to lower cholesterol?! And yes – stress can dramatically alter the outcome. The outcome is 19% unreliable anyway!

            Worry about something by all means – but make it something worth while! That link I sent you goes off to many other posts on my site – read the one about “normal” – because you’re there or a bit below already (notwithstanding that the test is about as accurate as counting sheep!)

            Best wishes – Zoe

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