When humans don't understand something we have a way of creating a very volatile and erratic relationship with it. It's not really our fault, that's just how it works when we try to wrap our heads around and force an explanation to something we can't (or aren't able to) comprehend. It can easily cycle between known and unknown or good and bad over time, sometimes changing directions at a moment's notice, dependent on the available data to us and our perception of that problem. The key component to these situations is that this happens when we try to make conclusions from an incomplete picture.
Heart disease and cholesterol are prime examples of that.
The conventional approach to cholesterol has evolved from treating it as just another molecule with several functions in the body when it was first noticed to sheer hatred and fear for quite a few decades to now more of a restrained worry. But since things are always evolving (and hopefully progressing) I wanted to keep you updated on some of the latest thinking because it will probably be several years before it trickles down to general medical practice.
Cholesterol: Where Are We Now?
Nothing has changed on a molecular front. That much we KNOW. Cholesterol is still cholesterol. What's changed is how we are slowly moving away from categorical villainism to situational or partial villainism.
Meaning, it's still generally seen as bad for you to have high cholesterol but it depends on what kind, type, shape, etc. and/or what other tests show in conjunction. The dietary guidelines on cholesterol have basically been dropped as of a couple years ago and many people are back to loving enjoying foods with cholesterol again without fear of bringing on a heart attack.
So cholesterol is bad in some forms or in some conditions but not all.
That's the general feeling. Some people are still convinced it's a bad thing regardless of the trend of mild acceptance and warn us to lower and manage it at all costs. Conversely, others are increasingly convinced it doesn't matter at all and is an innocent bystander in all this. Not surprisingly, I highly doubt either of these are the right way to look at it.
So you could rationally make the argument that it's somewhere in the middle of the two extremes. That it does play a role in heart disease and is something to keep an eye on but only in the context of the rest of health and other potential markers and risks of heart disease. This is where health practice has been headed and, in many cases, is already there. Which is a good thing. It's a much better place to be than the extremes.
Use cholesterol as one clue in the heart disease puzzle. Don't put everything on its small shoulders. One measurement of total cholesterol shouldn't mean anything. Not even LDL cholesterol. Looking at the whole picture of cholesterol is now becoming more common practice. As is relating it to markers of inflammation and insulin resistance. If a doctor is still concerned with just a total cholesterol test then they are behind the curve and falling further behind each day, particularly if they are prescribing drugs simply for a cholesterol score over 200.
So that's where we are today. But what does the future hold for our little handyman?...
Cholesterol: Where Are We Headed?The future of cholesterol is uncertain. But I think there's some hope that it will get its fair shake here in the not too distant future.
Does that mean I think it's innocent? No, I mean I think it's being included as an independent variable when it's really an dependent variable. Meaning it's being measured and controlled for as a leader when it's merely a follower. I've thought for quite some time that we've been looking at cholesterol all wrong and there are some indications that we can benefit not from simply absolving it from all blame but from reframing how we look at it's role in the body.
The body is doing hundreds, if not thousands, of different things at each moment with both immediate and long term concerns. It is constantly adapting to what we do and don't do and it almost always does what it wants to in spite of what we do to it. That means that it is always changing, giving here, taking there. Up regulating this, down regulating that. Increasing one process to react to what we just did while decreasing something else to average out the long term impact of that same thing.
Cholesterol, as a general substance, is one of those things. Always adapting to or reflecting different changes or processes in the body. On a deeper level, it's responsible for so many things that it makes it near impossible to categorize it as a "heart disease" related molecule.
A quick step back to the bigger picture before I focus in on my point...What is the function of cholesterol? The most noteworthy and well studied roles in the body, but not all, are...
- Hormone production. Cholesterol plays a part in producing hormones such as estrogen, testosterone, progesterone, aldosterone and cortisol.
- Vitamin D production. Vitamin D is produced when the sun's ultraviolet rays reach the human skin surface and interact with cholesterol.
- Bile production. Cholesterol produces bile acids which aid in digestion and vitamin absorption.
- Cell membrane support. Cholesterol plays a very important part in both the creation and maintenance of human cell membrane, particularly in the brain.
- Cellular repair. Cholesterol aids in the repair of internal damage, including blood vessels, by providing raw material and reducing inflammation.
And that last function, it's helping in the repair of the inner vascular lining and plaque formation, is what got us to ignore, forget and/or forfeit all of it's other (way more important) functions.
So it is literally a VITAL substance for so many aspects of the body. Cell membranes, brain function, hormones, digestion, repair. We can't live without it.
So does it make any sense to conclude that it is an actively problematic substance we should try to limit?
Or does it make more sense to look at it as reactive to what is going on inside the body?
Now we can zoom back in to the point of where we are headed with cholesterol...Cholesterol is a handyman. When there is stuff going on in the body, cholesterol steps up to get it done. When there's not much going on, cholesterol takes a break. It is, of course, way more complicated than that in actuality but when you look at the big picture that's what emerges. Cholesterol levels are a response to the body's processes not an individual illness promoter.
More specifically it appears to be a marker of energy flow/abundance throughout the system. Particularly in the processes of growth and flourishing, cholesterol levels reflect the need to repair, build and grow, so it makes sense that it goes up and down as we cycle through high and low energy times, either daily/weekly/monthly or seasonally. It changes when we change, so it can change quickly if we dramatically change our behavior. Sometimes even on a daily, weekly or seasonal basis.
As mentioned above, the body is perpetually reacting, based off it's genes and history, to it's environment and changing things behind the scenes literally every second of every day, to survive in the moment while planning for the both the short (next few days) and long term (months to years). We are, at any moment, a general reflection of our long term history and long term plan and a specific reflection of the short term adaptations to the last 2-3 days and next 2-3 days. I call it the 3 Day Rule. Meaning much of our current physiology (i.e. blood tests, energy levels, mood, etc.) reflects what we've done to ourselves the last couple days.
Enter cholesterol. It reacts to what we do and what we need, both short and long term. What's the biggest change we typically experience? Energy. Particularly when it comes to eating. We eat a bunch of calories for a couple days. Life is good. Let's get all those handymen back to work. Wait- then we don't eat as much for a day or two or diet for a month. Life is not so good. Hold off on all that action. Wait a bit and see what happens. Let's shut down all the work for now. Those handymen are still available but not being put to work. So cholesterol ends up just a slave to our environment. When we look deeper at the influx of both carbohydrates and fat we experience hourly/daily/weekly/etc., you start to see that cholesterol might be reacting to/reflecting our energy intake. There's also the often related stress, sleep and exercise components that impact our body's physiology and needs, particularly when it comes to energy needs and cellular repair.
The best video I've seen on this front was from a guy named Dave Feldman, who's been researching cholesterol for personal reasons for a few years now. He has made a connection between cholesterol and energy that is quite interesting. It's basically a guy doing his own reasearch and pilot study but is the first I've seen that addresses this connection. It's a long video but if you want to understand a little deeper it's a good watch.
Now, like everything else it's very limited in scope and his research doesn't explain everything but it does one very important thing: thinks of cholesterol a little differently. It's a energy dependent variable that pulses with our abundance. It's way more than just a heart disease molecule.
And that is where we I think we are headed. There's a growing interest in this realm. To step back and see cholesterol as a bigger picture kind of molecule. That it's just a part in a marvelous system, working for us, not against us. That if we measure blood cholesterol we see what's flowing in the river, not what (if any) is patching up the river banks. That we see a reflection on energy and work, not damage or threat.
We do also need to determine if high blood cholesterol is high because of high demand or high because we have normal demand but with a lack of getting dropped off at its work sites, which is what we often see with thyroid problems.
We also are going to find it does something we never knew. I'm predicting that things don't quite fully add up yet because there's a missing link or links yet to be discovered. There's a molecule/process/enzyme/interaction/hormone/connection that we don't even know exists that will change the game when we discover it.
Cholesterol: Know or NO?We KNOW what it is and what it does throughout the body but it's still a kNOw on how and why it is involved with things like heart disease and how exactly it works in the body, particularly in terms of how it's transported in things like LDL and HDL, with all the different sizes, shapes and types of these carrier molecules.
We KNOW it's a highly valuable and variable substance in the body and that it's not trying to kill you, it's trying to keep you alive.
We used to kNOw it's role in heart disease but now we are slowly moving to a point where we know it's a part of the heart disease process some of the time but there's a lot we don't have a full grasp on, including the how and why.
Although in general we don't actually know as much as we think we do, I actually think we are not too far away from it creeping closer to the KNOW category, which leaves me pretty hopeful. Until then, let's hope people stop thinking they kNOw what they're talking about when it comes to cholesterol and realize just how much we still have to figure out about our little waxy handyman.
Thanks for reading, have a great day!
P.S. I've written on cholesterol many times before, if you're interested.
