Cholesterol Good - Statins Bad.

Photo by Coffeefy Workafe on Unsplash

The idea that cholesterol is bad for you is rooted in a rather comical and simplistic conception of what cholesterol is.

Imagine the liver as a demon organ holding up your blood vessels, like a plumber might wield a piece of pipe in one hand, while pouring hot bacon fat down that pipe with the other. The more fat it pours down your vessels, the more atherosclerotic they become - increasing your chances of a heart attack or stroke.

Next comes 'good and bad cholesterol' - another simplistic interpretation. The idea is that your liver produces LDL - and high LDL is bad. The story further claims that LDL carries triglycerides and cholesterol to peripheral tissue - which lays down plaque. Whereas HDL transports cholesterol back to your liver.

It's actually quite a cute image if you make the Liver an adorable cartoon character plotting your death.

Of course, this is mostly nonsense. It is not surprising, then, that these ideas came from the same group of charlatans (Ancel Keys et al) who pushed the notion that saturated fats are bad for you (also, nonsense). For the definitive exploration of the decades long fraud that cemented this notion in the medical industry's consciousness, check out Timothy Noakes' breakdown of the evidence:

https://thenoakesfoundation.org/news/ancel-keys-cholesterol-con-part-1

Is this relevant to your life?

Only you know the answer to that, but yes - extremely.

This information is relevant to everyone from the recently retired, to recent graduates embarking on their new career.

Usually between the ages of 25-30, most young adults get regular health check-ups if not for personal health maintenance, then for our employer. One element of a regular check-up is your lipid profile, which reports such things as:

• Total cholesterol

• HDL cholesterol

• Triglycerides

From these values they can also calculate (not measure) LDL cholesterol:

LDL = Total - HDL - Triglycerides/5              *Friedewald's Equation

If you have been naughty, your serum cholesterol may go above what a lab considers 'normal.' Once your doctor catches wind of this 'above normal' cholesterol, he may recommend that you start taking a statin.

Statins are HMG-CoA Reductase inhibitors, a class of lipid-lowering agents that are believed to result in lower risk of mortality from cardiovascular disease by virtue of their ability to decrease LDL cholesterol.

Back to Basics

So far, we have used a lot of technical terminology that makes us sound really smart and gives the impression that we understand what is happening. That way, you will do what we tell you to fix the problem we claim to understand.

To understand the scale of the problem, we must first define the terms.

For starters, LDL and HDL are not cholesterol. They are lipoproteins. Lipoproteins contain cholesterol, triglycerides, and other proteins in varying proportions.

Lipids are a general class of macromolecules which are soluble in non-polar solvents. In very broad strokes, things that don't mix with water can be classified as a lipid. Put another way, a lipid is something that is dissolved by another thing that can also dissolve fat.

Fatty acids (like saturated and unsaturated fatty acids), triglycerides and cholesterol are in the category of lipids.

This is cholesterol:

This is a triglyceride, which contains 3 fatty acids:

Very different macromolecules sharing the common attribute that they are dissolved by other non-polar solvents.

Despite our scientific understanding of lipids, WebMD offers a rather misleading conception of cholesterol:

Incorrect.

Cholesterol is the building block of hormones, cell walls, nuclear membranes, secretory vesicles, repair mechanisms, and energy storage. It’s not just a 'waxy, fat-like substance.'

Furthermore, it is misleading to say that your 'body needs some cholesterol.'

Cholesterol is the principle sterol synthesized by all animals. Every cell is capable of producing cholesterol, and its production is essential to all animal life. The process of making cholesterol begins with the mevalonate pathway - aka the HGM-CoA Reductase pathway. This pathway produces isoprenoids - a diverse class of over 30,000 molecules which includes cholesterol, vitamin K, coenzyme Q10 and all steroid hormones.