The Low Down on Lipids
In the world of standardized medicine practice the interpretation of laboratory tests, weight, blood pressure and other health measurements, fall under a black and white umbrella. That is to say, if your cholesterol is over 200, you need a statin medication. If your blood pressure is over 120/80, you may need a medication for that. If your BMI is over 30, you are obese. If you are over 50 you need a shingles vaccine. And so on. Standardized medicine has its place. It serves to care for large populations and can reduce risks for disease in the grand scheme of things.
But it does not address the individual’s specific health issues and which I believe, biased as I am, most alternative medical practitioners do very well.
Last week, I had a fourth-year naturopathic medical student observing me in the clinic. When I asked him what he would do for a patient whose cholesterol was over 200, he said he’d put him on a statin medication. While it’s true, a statin medication can reduce the risk of a cardiac event, as a naturopath, it is not my first line of therapy for high cholesterol. I want to look at the whole lipid picture, consider lifestyle choices, diet, exercise, family history, etc.
Cholesterol is not the enemy. It is essential for integrity and fluidity of cellular membranes, as a precursor to steroid hormones (testosterone, estrogen, progesterone, and cortisol) and for vitamin D. It also is involved in bone health, reducing the risk of osteoporosis as we age.
A lipid panel includes total cholesterol, LDL and HDL, and triglycerides. LDLs are also known as “bad cholesterol” and HDLs are “good cholesterol”. Truthfully, they are NOT cholesterol but proteins that carry cholesterol to and from cells. The LDLs, low density lipoproteins, carry cholesterol to cells and have the potential to deposit it into blood vessels where it can cause atherosclerosis. (Hardening of the arteries) This is more likely if you have a lot of inflammation in your body, if you eat more processed foods and “dirty fats” and if you do not have much fiber in the diet. Genetics also plays a role.
HDLs are high density lipoproteins, and they carry cholesterol to liver to be processed or cleared. Exercise, good fiber, green leafy vegetables, raw seeds, and nut oils (Cold pressed, not heated) and deep-sea, cold-water fish increase HDLs.
You can test for inflammation in the body through the blood through HS CRP (c-reactive protein). Unfortunately, insurance does not like to pay for this test but if you can afford it, it is often helpful.
If you have high cholesterol, low HDLs, high LDLs and high HS CRP and a family history of heart disease, then a statin medication ALONG with a good diet (Mediterranean or DASH) and regular exercise is advisable. If you have high cholesterol, high HDLs, and low CRP you can probably get away with making lifestyle choices that can improve your lipid profile even further.
I have seen many people dramatically change their lipid profiles with diet and exercise in as little as 3 months.
By Dr. Jennifer Means ND, LAc