Cholesterol - cause or correlation?

[greg-brown-fife]

I am somewhat confused as to whether high cholesterol is a CAUSE (even The Main Cause) of atherosclerosis, or whether there is just a statistical correlation. The context for me is that I am advised to take statins but have chosen not to. Instead, I have tried very hard to optimise the diet and excercise measures that promote good health and reduce the risk of a cardio event. I have also learned recently how important regular sleep in sufficient quantity to reduce all sorts of health risks including cardio risks. A specific aspect of my diet is to minimise inflammatory food intake and include a lot of anti-inflammatory foods. One year on from my triple bypass and I feel in great health.

[Adaboo]

Hi, after all my reading about it I feel it’s inflammation that is the primary cause. I’ve changed my diet too and cut almost all sugar, low carb and lots of walking. Statins gave me muscle problems so I don’t take them. Let’s hope we are right 😅

[Hidden in reply to Adaboo]

“Plaque that accumulates on the inner walls of your arteries is made from various substances that circulate in your blood. These include calcium, fat, cholesterol, cellular waste, and fibrin, a material involved in blood clotting.”

While not saying that inflammation plays no part in atherosclerosis, the fact is that arteries are occluded by matter.

[Adaboo in reply to Hidden]

I agree they are occluded from the substances you mention, but according to more recent studies it’s inflammation that causes damage to our arteries and cholesterol then goes to the damage like a plaster. Because our bodies make cholesterol that will always happen so we need to stop the damage in the first place. We all have to do what we feel is best for ourselves though and I would never persuade anyone to stop meds’

[Hidden in reply to Adaboo]

Interestingly, statins are not the only cholesterol lowering medication and, among the large family of statins, not all will produce the same side effects. But of course there is the nocebo effect where people read about side effects and get them - even when they are not given a statin: en.m.wikipedia.org/wiki/Nocebo

[Adaboo in reply to Hidden]

There are also people like my brother who can hardly walk now because of muscle pain and had no idea it was because of the statins.

People also get better because they believe they will too, isn’t that great! 😁

[Chappychap in reply to Adaboo]

Did you discuss this with your doctor and fully explore all the alternatives to statins? There are several alternatives, including other prescription medication and even over-the-counter alternatives such as Niacin. But you absolutely need your GP's help in navigating through these options.

[Adaboo in reply to Chappychap]

I have got my cholesterol down by diet thankfully. I did discuss it all with my doctor but anything that blocks cholesterol production also unfortunately blocks other nutrient pathways. I have a movement disorder and statins affected my muscles hugely. My brother has been on them for 3 years and now walks like an old man as he hurts so much. There has to be quality over quantity sometimes. Niacin is an option although at present my cholesterol is good. Plant sterols and Citrus of bergamot are good too. My GP has to follow nice guidelines but does admit a lot of people on statins then don’t change their diet/ lifestyle at all as their cholesterol numbers are good they think that’s enough, but they will continue to get worse because they haven’t changed their lifestyle. That was an interesting point.

[Chappychap]

With respect, I think you are taking huge and unnecessary risk.

The advice of both the NHS and the British Heart Foundation is clear, there is no cure for our atherosclerosis and it will always be with us. The best we can hope for is to keep it in check with medication and lifestyle changes. To arbitrarily abandon 50% of your tool kit by refusing medication is quite a gamble.

I don't doubt that you feel great, but "feeling" great and "being" great aren't the same thing. Losing a few pounds and starting to exercise regularly have both made me feel great, but I'm not prepared to take that surge of wellbeing as substantive evidence that I'm now safe to walk away from medication.

Have you at least had lipid tests that prove all the important measures of your cholesterol levels have fallen into the safe zone and are being held there without medication?

[Hidden]

Hi, greg-brown-fife,

I also learned that sleep is one major factor. Congats for your effort to improve your diet and excellent results on "feel good factor" which is essential in life.

I find that modern medicine falls short of looking at the complex human biology as a whole, that includes hormones, sleep quality, stress level, what you eat, how much you eat, when you eat etc, even pollution, mental health and other environmental factors e.g. triggers. They also look at one organ only at a time when our organs are all connected to each other! It never ceases to amaze me. I'm currently looking at Okinawan diet, or likely a modified version.

[greg-brown-fife]

Thanks all who have commented on my posts. For sure, we have to make our own decisions after taking account of all we can find out from the medical professionals and others. the comment that our biology is really complex sits strongly with me. Full knowledge of the underlying causes of lots of moden diseases seems relentlessly ellusive. My cholesterol levels are coming down very slowly with my current lifestyle regime, probably not as much or as quickly as my cardiologist would like. I asked to have my triglyceride levels meansured while my half yearly blood tests were taken. My request has been acceded to once, and I find my levels are very low - said to be good, as triglycerides are a fat in the blood too, not just cholesterol. My isn't more made of that. The only answer I can come up with is that there are no drugs available to lower triglycerides. I am so unconvinced by this drugs first approach to health.

[Qualipop]

I have low cholesterol but still had a totally blocked artery and two more with smaller blockages. Some of it is hereditary, some age and I'm sure inflammation has a lot to do with it.

[JonathanH]

Statins are anti-inflammatories as well as cholesterol-lowering drugs. Here is an extract from the abstract of a peer-reviewed paper:

"Ample evidence exists in support of the potent anti-inflammatory properties of statins. ... Randomized clinical trials have demonstrated that further to their lipid lowering effects, statins are useful in the primary and secondary prevention of coronary heart disease (CHD) due to their anti-inflammatory potential."

You can read the full paper at ncbi.nlm.nih.gov/pmc/articl...

I think that it is prudent to take statins.

[greg-brown-fife in reply to JonathanH]

You may be right, I don't know. I start with an aversion to an approach to health that looks to drugs as the first response to anything wrong. I also consider that the statistical results for statins happen in the context of pretty awful western diets among a large section of the population. I don't know of equivalent evidence of cardio risk when people have very healthy diets, do sufficient excerice and get proper sleep. When I was diagnosed with angina and was later advised to have a triple bypass, I was more than a little shocked because I thought I had a decent diet. When I did some homework on the subject, I saw that there was lots of room for improvement in my diet. I eat may anti-inflammatory foods and avoid the worst inflamatory ones. My cholesterol levels are slowing coming down, although I'm not sure that it has to come much further down. My triglyceride levels are very low, and some medics believe that is a stronger indicator of cario risk than cholesterol levels. My immune system no longer produces excess inflammation. Since I started this diet 18 months ago, I haven't had a cold or flu, which is remarkable, because all my life I've had several serious colds or flus every year. I could say quite a lot about the issue of side effects, but this piece is more than long enough.