Cholesterol - The Real Story

Contrary to popular belief cholesterol is not fat. Cholesterol is a waxy substance that is produced by the liver and also ingested through foods we eat. It often has fatty acids contained in it and therefore it is considered to be fat, but it is not fat in and of itself.



Up to 80% of cholesterol is used to make cholic acid which is essential in bile salts that are, themselves, necessary for digestion and absorption of fat from the diet. Additionally, cholesterol is used to make the hormones progesterone, estrogen and testosterone.



There is a significant amount of cholesterol in the skin that helps the skin to resist water absorption and water evaporation. The presence of cholesterol in the skin also helps to decrease the penetration of toxic agents such as solvents etc.



Perhaps one of the most important roles of cholesterol is in the formation and maintenance of cellular function through the integrity of cell membranes as well as many of the membranes of the other structures within the cell including the organelles that produce energy. Membrane integrity is essential for life and for health and the prevention of disease. A breakdown in cell membrane integrity will lead to ill health and disease. In addition to cholesterol benefit in our skin as a protective agent there is scientific evidence that cholesterol protects cell membranes from oxidative/free radical damage. The significance of cell membrane function is covered extensively at our chelation seminars.



Here is a substance that is, in fact, a health enhancing life necessity but purported to be life threatening. Cholesterol has gotten a bad rap.



We are told that we eat too much cholesterol in our diet and that elevated levels in the blood cause hardening of the arteries that, in turn, cause heart attacks and strokes. We are told that lowering cholesterol is essential to decrease the aforementioned disease process and its sequela. Low fat diets are prescribed and if that isn't effective, cholesterol lowering drug therapy is prescribed. This philosophy has been touted for so long as scientific fact that it is accepted without question by the majority of physicians and patients, in spite of the fact that there are thousands and thousands of people who have low cholesterol levels in their blood and have blocked arteries all over their bodies, and those who have elevated cholesterol levels without any problems.



The rest of the cholesterol story explains why these exceptions occur, why cholesterol is a problem for some and not for others. With this additional data you can think for yourself and decide for yourself.



As we stated at the outset, cholesterol is not fat. Cholesterol often has fatty acids, the basic building block of fat, attached to it. Cholesterol/fatty acids are carried from one area to another through the blood stream by a substance called lipoprotein. This is a form of protein that acts as a carrier, a basket if you will, which carries fat around to the cells for use as a source of energy. The two primary lipoproteins are low density lipoprotein (LDL) and high density lipoprotein (HDL). The LDL principally carries fat to the cells and the HDL carries the fat away from the cell. LDL is considered bad and the HDL is considered good. Herein lies another bit of misinformation. LDL and HDL are not cholesterol at all but simply the carriers that carry the substances of cholesterol and fatty acids to the cells and away from the cells. The good and bad terms are derived from the fact that the HDL is considered good because it carries fat away from the cell decreasing the potential of the fat being deposited, whereas the LDL carries the fat to the cell increasing the potential for it to be deposited. But there is more to this story.



In recent times the terms free radicals, free radical damage and antioxidants have become familiar jargon. Taking antioxidants has become popular but few people understand the importance of free radicals and the damage they create and the antioxidant's potential to prevent that damage. Those of you who have attended one of our chelation therapy seminars have a good understanding of what all of this means.



It is very important as far as cholesterol is concerned to understand that the LDL structure (fatty acids with protein) is the primary source of plague in hardening of the arteries. The HDL form of lipoprotein (protein with fat attached) is not the type of lipoprotein which contributes to plague build up and as we said earlier, actually helps to lower the fat in the area by carrying it away from tissues. It is important to note that LDL, even though considered bad, is an essential part of the body's mechanism for handling fat and as such, is necessary and beneficial. The reason that it could be considered bad is not because of its mere presence, but rather because of changes that take place which alter its natural or beneficial form to an aberrated, detrimental form. The process that alters the natural LDL is called oxidation, caused by free radicals. This damage can be prevented by utilizing anti- oxidants.



To summarize, LDL cholesterol/ fatty acid is normal in the body and has a function. When it becomes altered by free radical damage it is transformed into a detrimental form. The native or normal LDL can pass freely through tissues such as the lining of arteries. The damaged LDL cannot and gets stuck in the artery wall. The scientific evidence of this has been known for years and continues to proliferate.



An article that appeared in the New England Journal of Medicine in 1989 entitled "Beyond Cholesterol" spoke directly about this. The article reviewed numerous studies over many years including studies back to the 70's and early 80's.



Blood flow through an artery can be impaired by another major mechanism apart from a blockage of the blood flow from plague. Arteries can go in spasm decreasing blood flow, often significantly. This process is often a cause of angina. A study that appeared in 1990 in the Journal of Clinical Investigation, detailed evidence that coronary artery contractions can be caused by oxidative LDL. Evidence also exists that oxidized LDL, not normal LDL, impairs the function of the cells lining arteries that function to initiate blood vessel dilation.



We have previously discussed one of the benefits of HDL is that it carries lipids away from tissues. Numerous research projects are identifying an enzyme associated with HDL that inhibits the oxidation damage of LDL. In other words, this may be a major way the HDL is protective and the so-called "good guy".



The Journal of the American Medical Association published an interesting article in the December 8, 1999 issue entitled "Smoking and Atherosclerotic Cardiovascular Disease in Men with Low Levels of Serum Cholesterol". The study showed, not surprisingly, that smoking was a risk factor for atherosclerotic vascular disease and also that "a low cholesterol level confers no protective benefit against smoking related ASVD". How does smoking damage the body? Primarily from free radical damage. Cholesterol is not a problem unless it is damaged; smoking damages it and it becomes a problem whether the level in the blood is high or low. Lowering the cholesterol in the blood does not decrease its potential to damage. The article is proof of what some of us have been saying for years and is proof of the known science on the cholesterol subject.



The most important factor is not the amount of cholesterol, or even the type, but whether it is clean or dirty, normal or damaged.



Conrad G. Maulfair, Jr. D.O