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What Does Research Say About Cholesterol Levels & Guidelines?

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What Does Research Say About Cholesterol Levels & Guidelines?

The 2015 Dietary Guidelines are a stark reminder that we simply cannot trust the U.S. government for dietary advice and that they have knowingly withheld information from us for literally decades about correct cholesterol levels and guidelines.

Are Cholesterol Level Guidelines Misleading?

When the Washington Post delivered the message that “The U.S. government is poised to withdraw longstanding warnings about cholesterol” on February 10, 2015, Americans probably weren’t anticipating the true ramifications of what these amendments would really mean. We have been told to dismiss decades’ worth of warnings against superfoods like raw milk, butter, and cheese and have been given advice to consume highly toxic hydrogenated oils.

Buried as a passing comment on page 90 of the 571-page Scientific Report of the 2015 Dietary Guidelines Advisory Committee: “Previously, the Dietary Guidelines for Americans recommended that cholesterol intake be limited to no more than 300 mg/day. The 2015 DGAC will not bring forward this recommendation because available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum (blood) cholesterol, consistent with the AHA/ACC (American Heart Association / American College of Cardiology) report. Cholesterol is not a nutrient of concern for overconsumption.” (1)

The “new” cholesterol guidelines tell us something we’ve observed in natural health for decades. Your body’s cholesterol level has nothing to do with the amount of cholesterol you consume. This information about cholesterol guidelines has been well known since Uffe Ravnskov, MD, PhD blew open Pandora’s box when he published his book Kolesterolmyten (“The Cholesterol Myths”) in Sweden in 1991 and in Finland in 1992. As Dr. B.J. Hardick points out, “To be fair, we cannot place all the blame on the U.S. government. The “cholesterol is harmful” hypothesis has been around for quite a while.” (2)

  • 2650 B.C. Huang Ti – the Yellow Emperor of China recorded a “hardened pulse” and suggested that it was associated with a high salt intake.
  • 400 B.C. – Hippocrates suggested that illness resulted from an imbalance of four bodily humours: yellow bile, black bile, blood, and phlegm.
  • 1500 AD – Leonardo da Vinci first described atherosclerosis via the term “tunics.”
  • 1772 – English physician, William Heberden, reported that the blood serum of an obese patient who experienced a sudden death was thick like “cream.”
  • 1799 – Coronary artery hardening was first described by English physician, Caleb Hiller who found a gritty substance in coronary arteries while doing an autopsy.
  • 1815 – London surgeon, Joseph Hodgson, advanced a novel theory of atherosclerosis. Hodgson suggested that inflammation was the underlying cause of the disease rather that a natural part of the aging process. In that same year, however, cholesterol was discovered by a French researcher and Hodgson’s theory was largely ignored.
  • 1841 – Carl Von Rokitansk, one of the first pathologists, proposed that the deposits he observed in the inner layer of arteries were derived from substances circulating in the blood. The primary component of arterial plaque was shown to be cholesterol just two years later.
  • 1949 – “Cholesterol is Harmful” hypothesis advanced by J. W. Gofman, an American physician who was researching fats in the bloodstream and proposed LDL-caused plaque.

The theory gained more support when autopsies of young soldiers killed in the Korean War showed that 77.3 % had cholesterol deposits in their coronary arteries. One main argument has been that cholesterol is the main instigator in arterial occlusion much like septic sludge clogging up a drain pipe. However, according to cardiologist Michael Ozner, “The vascular tree is an active, living organ that expands and contracts in response to different stimuli, not a network of rigid metal conduits. Its walls are permeable – and cholesterol does not just build up inside an open space like so much drainpipe sludge.”

And according to the Williams Textbook of Endocrinology, 11th ed, “Initially, it was thought that the [arterial] lumen was progressively narrowed by the accumulation of macrophages, the proliferation of smooth muscle cells, and the deposition of cholesterol.” “As atherosclerosis progresses, there is a compensatory expansion of the lumen that maintains lumen size rather constant… It is the acute thrombosis, not arterial lumen stenosis that is responsible for infarction in most cases.”

The REAL Root of Heart Disease

In 2002, the British Journal of Medicine published a very controversial study that discusses what researchers have coined the “Hound of the Baskervilles Effect.” After examining death certificates from 209,908 Chinese and Japanese Americans and 47,328,762 white Americans they discovered that “Cardiac mortality increases on psychologically stressful occasions.” (3) The important 2004 INTERHEART study, published in the world renowned journal Lancet, confirmed that stress is actually the primary cause of heart disease. This study systematically evaluated 15,152 cases of acute myocardial infarction (heart attack) in 52 countries and discovered that the REAL cause of heart disease is not cholesterol, but multiple factors.

According to the study: “Abnormal lipids, smoking, hypertension, diabetes, abdominal obesity, psycho-social factors, consumption of fruits, vegetables, and alcohol, and regular physical activity account for most of the risk of myocardial infarction worldwide in both sexes and at all ages in all regions. This finding suggests that approaches to prevention can be based on similar principles worldwide and have the potential to prevent most premature cases of myocardial infarction.” Out of all of these many risk factors, research indicates that psychological stress is actually the #1 cause.

Persistent severe stress makes it two and a half times more likely that an individual will have a heart attack compared to someone who is not stressed. Stress and depression combined increase the risk “threefold!” (4) It makes one wonder why MD’s dole out statins like candy if stress is the primary cause of heart disease, doesn’t it?

The Statin Debate for Cholesterol Drugs

In a world that generally acknowledges bad habits in respect to eating and exercise, statins were going to provide the ultimate solution to a frightening and escalating problem: Premature death from heart failure and stroke. More than 25 years have come and gone since the first commercial statin was produced. Many ‘miracle’ medications throughout recent history claimed to have been discovered. Freud found this in his beloved ‘Coca,’ and AZT was to actually extend the lives of HIV and Aids sufferers.

Nitrous oxide went from being a recreational stimulant to being welcomed worldwide as an anesthesia, and levodopa was uncovered and announced that it would reverse all symptoms of Parkinson’s disease. Some of these medications would simply raise people’s spirits, while others were declared to be nothing less than miraculous in their ability to treat an illness without side effects. The search to find a drug, that produces nothing less than healthy normality and a return to equilibrium, has long since possessed the mind of man. Yet, in due course, all were discovered to be, in some measure, flawed. Science has a history of making giant leaps and proclaiming big announcements – shortly before falling flat on its face.

Are statins set to join the long list of medical miracles, which turned out to be not quite so miraculous? Despite the best efforts of the pharmaceutical industry, the statin versus cholesterol controversy continues to gain momentum, and faith in this modern medical miracle continues to experience a bombardment of questions under the banner of mistrust. Without a doubt, these are drugs and your response to them needs to be carefully checked by your MD, whether you are starting them up or coming off of them. I won’t tell anyone to take or not take statins, but my goal is for you to be healthy and live freely without them!

The History of Cholesterol & Statins

In 1910, Adolf Windaus reported that atherosclerotic plaques contained a higher concentration of cholesterol than those in normal aortas. (5) In 1939, a Norwegian clinician, Carl Muller was the first to describe a genetic trait in some families where high cholesterol levels were cited as the possible cause of early death from heart failure. (6) Cholesterol became the bad guy. To a certain degree, those basic observations eventually secured the destiny of cholesterol for the next 7 decades. It became the scapegoat for plaque in aortas, which is a major cause of heart attacks and strokes.

Those with a genetic predisposition to the condition, which became known as familial hypercholesterolemia, were at greater risk than most. Or so we believed… For a number of people, a life lesson was about to begin. A medical leap of faith was made to explain how patients were not genetically predisposed to develop heart disease since cholesterol is either synthesized in the body or obtained through diet. We were all eating the wrong things, right? So diet had to be the cause. As people rushed to avoid the dreaded saturated fats, sales of butter plummeted and margarine rocketed. Supermarket shelves became stacked with low-fat, cholesterol-free, and “healthy.” Yet, deaths from heart failure continued to rise.

Then statins rode into town in September 1987. (7) Lovastatin, the valiant warrior, had arrived and, apparently, just in time. It became the solution to a century-old problem. Statins were going to lower cholesterol levels and save many from an early grave. Although praised for contributing to reducing heart attacks and strokes, this medication provides very little benefit. The side effects cause a happy statistical balance with the benefits and, in many cases, far outweigh any positive effects. Matters are now being made worse by the rising tidal wave of opinion that cholesterol may not be the bad guy after all.

The Risk of Developing Another Disease

Statins are used in two different ways. With “primary prevention,” when patients have no pre-existing condition, the gains are less noticeable. Studies found that 98% of patients experienced no benefit and only 1.6% over a 5-year period had a heart attack prevented. The percentage that avoided a stroke fell further to 0.4%. (8) These medications are also used to treat those with a pre-existing heart condition, which is known as “secondary prevention.” In such patients, there are some possible benefits, which may, for some, outweigh the risks related to side effects.

Research has shown that the main benefits are for men under the age of 80 with a pre-existing heart condition. (10) Even in such cases, however, 96% of patients with a pre-existing heart condition see no benefit from taking statins. (9) 10% of the patients suffered muscle damage as a direct result of taking statins, whether they received treatment as a primary or secondary patient. In the majority of cases, these patients would have been perfectly healthy prior to being prescribed statins. Even more alarmingly, 1.5% of the primary prevention patients developed diabetes as a direct result of the medication.

Patients need to ask themselves if the possible statistical prevention of one serious illness justifies the risk of developing another? Statistics reveal that nearly 1 in 5 patients receiving statin treatment are between the ages of 45-64. (10) A large percentage of people who take statins are still of working age and most likely in employment. The economic consequences of needing to increase sick days or ending employment due to treatment-induced illnesses are rarely considered or calculated. Neither are the reductions in quality of life inflicted on a previously healthy patient.

Side Effects Of Statins On Healthy People

Generally, the following side-effects of statin drugs can be considered “common,” which means they affect up to 1 in 10 people and are proven to do so in most studies: (11)

The uncommon side effects, which means up to 1 in 100 people can be affected, are reported as:

  • Dizziness
  • Fatigue
  • Hepatitis
  • Insomnia or nightmares
  • Loss of appetite
  • Memory problems
  • Pancreatitis
  • Peripheral neuropathy (tingling or loss of sensation in hands and feet)
  • Physical weakness
  • Ringing in the ears
  • Skin problems
  • Vomiting
  • Weight gain

Rare side effects, which affect only 1 in 1000 people, include:

  • Bruising or bleeding easily
  • Jaundice
  • Visual disturbances

Many of these side effects, whether they are common, uncommon, or rare, can result in permanent injury or restrict the patient in carrying out everyday activities. For example, it is recommended that driving and operating machinery be suspended when experiencing some of these side effects. Quality of life notwithstanding, to a working man or woman this can seriously disrupt employment or restrict potential career prospects.

Cholesterol & Statins – Not a Clear-Cut Case

The flames are continuously being fanned in regard to the controversy between statins and cholesterol, and statistics, terminology, and phraseology compound the confusion. Professor Kausik Ray, professor of cardiovascular disease prevention at St George’s Hospital, London,  gave an interview (12) in which he declared statins could be beneficial. He said, “…high cholesterol levels are related to coronary heart disease.”

A clear enough statement surely, but is the choice of words misleading? Surely the relevance is not whether they are “related,” but are high cholesterol levels the “cause“? If they are not, the treatment regimens grow increasingly suspicious. This is a fine example of how expert statements can be misleading or misinterpreted and shows how such statements and opinions litter the research and findings relative to the risks and benefits of statin treatments particularly in respect of those “needing” primary preventative medication. The Centers for Disease Prevention and Control (CDC) have made some confusing statements about the issue of cholesterol. Their “Facts” page advises us that: “71 million Americans (33.5%) have high LDL (low-density lipoprotein) or ‘bad’ cholesterol.” (13) “Just over 13% of U.S. adults had high total cholesterol…” (14)

Should we be more worried about LDL cholesterol than we are about total cholesterol? (According to the CDC, it’s definitely a more widely spread problem.) Not so much, according to other sources – including the same sources that originally declared LDL levels to be the root of all evil: In November 2013 the latest cholesterol guidelines from the ACC/AHA (American College of Cardiology and American Heart Association) were published. (15) Although running over 80 pages in length, the cholesterol guidelines seem to make a clear U-turn when it comes to cholesterol levels, or at least regarding clinicians relying on such indicators as being reliable in identifying the potential of future illness. Surprisingly, the new ACC/AHA guidelines have no set targets for LDL levels. Instead, it is recommended that doctors use the new online calculator designed for assessing whether or not patients should be prescribed statins. It seems that lifestyle and overall diet are now to be taken into consideration when assessing the potential for treatment.

However, just two days after the cholesterol guidelines were published, the calculator itself was found to be flawed. The parameters continue to grow and include an increasing number of the population despite shifting the focus away from using LDL as the definitive guideline. The UK, following on the heels of the US, produced draft cholesterol guidelines stating that people with a 20% risk of developing CDV in the next 10 years, should be reduced to include people with only a 10% risk. (16) This brings them more into line with the US who state the statin threshold should be 7.5% for a 10-year risk period.

This basically translates into more people taking aggressive drugs. The cholesterol guidelines from both the US and the UK advise that more patients should be put on “high intensity” treatment. This means changes from treating patients with simvastatin, a medium-intensity treatment, to atorvastatin, which is high-intensity. Clearly, the impact of even medium-intensity treatments already has significant side effects. The insinuation is that if patients have their level of medication increased, then the side effects would increase proportionately. The main driving force to increase medication in this manner is one of “cost saving.”

One would presume that the cost savings have only been calculated relative to reducing treating patients with heart failure, not by incorporating costs relating to treating the side effects of the treatment! In fact, for years we have seen that one of the main issues relating to the statins and cholesterol controversy is one of money — lots of it! In 2009 total revenues exceeded $25 billion. (17) At last count, over 25 million Americans were on statins and this was without taking into consideration the effects of the new guidelines. The indications are that in the future the figures will double. (18) The income, of course, does not include the profits pharmaceutical companies make treating the side effects of statins. For them, the numbers are clear. The more preventative treatments they provide, the richer they become. The benefits to patients however are less obvious.

The Need for Cholesterol

Cholesterol is essential to the human metabolism. It is required for Vitamin D synthesis, the digestion of fats through bile salts; it forms part of each and every cell. It regulates numerous hormones; it is a powerful antioxidant and assists in repairing injuries. If cholesterol levels fall too low, patients risk neurological or immune dysfunction. The human body can no more function on low levels of cholesterol than it can on low levels of blood.

There can be little doubt until the scientific community independently investigates all the pros and cons of the statins and cholesterol relationship, the controversy will continue to escalate and, quite possibly, result in increasing mistrust of Big Pharma and the powers that be. As the problems with the US online calculator clearly show, the issues have not been deeply thought through prior to widening the net of treatment. Nothing, it seems, is either certain or clear. Although amendments have been turned into cholesterol guidelines, in most cases advising that diet and lifestyle should be taken into account in addition to laboratory test results, the medical establishment is continuing to incorporate an increasing number of people into the boundaries of needing statin treatments.

Fortunately, there is a growing body of MD’s practicing functional and integrative medicine, who are working to keep patients well without the uses (or pressures) of modern medicine. Many individuals improve their situations and restore their health through a better lifestyle, without negative consequences.

References:

  1. https://health.gov/sites/default/files/2019-09/Scientific-Report-of-the-2015-Dietary-Guidelines-Advisory-Committee.pdf
  2. http://www.drdalepeterson.com/Copy_of_Cholesterol_Low_Part_1_c.html
  3. https://pubmed.ncbi.nlm.nih.gov/11751347/
  4. https://pubmed.ncbi.nlm.nih.gov/15364185/
  5. https://www.nobelprize.org/prizes/chemistry/1928/windaus/biographical/
  6. https://www.jlr.org/content/46/2/179.full.pdf
  7. https://www.nature.com/articles/nrd1112
  8. https://www.thennt.com/nnt/statins-for-heart-disease-prevention-without-prior-heart-disease-2/
  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2956535/
  10. https://nchstats.com/2013/11/14/statistics-on-statin-use/
  11. https://www.nhs.uk/conditions/statins/side-effects/
  12. https://www.telegraph.co.uk/lifestyle/wellbeing/healthadvice/9486430/Is-there-a-cholesterol-cover-up.html
  13. https://www.cdc.gov/cholesterol/facts.htm
  14. https://www.cdc.gov/nchs/data/databriefs/db92.htm
  15. https://www.heart.org/en/healthy-living/healthy-lifestyle/prevent-heart-disease-infographic
  16. https://www.nhs.uk/news/heart-and-lungs/more-adults-should-be-taking-statins-says-nice/
  17. https://www.visiongain.com/report/cholesterol-lowering-drugs-market-forecast-2015-2025/
  18. https://www.cbsnews.com/news/13-million-more-americans-would-take-statins-if-new-guidelines-followed-study/

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