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Dumb Doctor on "Cholesterol"

Cholesterol Demonized


Please name any substance your brain regulates and your liver produces that causes you to die young.



A 2018 article explains that the evidence against cholesterol-lowering drugs has been suppressed and exaggerated. The author, Maryanne Demasi, completed a doctorate in medical research at the University of Adelaide and worked for a decade at the Royal Adelaide Hospital as a research scientist specializing in rheumatoid arthritis research. She has also worked as an advisor to the South Australian Government's Minister for Science and Information Economy. The abstract from her paper titled, "Statin wars: have we been misled about the evidence? A narrative review" is provided here.


"Statins are the most widely prescribed cholesterol-lowering drugs in the world. Despite the expiration of their patents, revenue for statins is expected to rise, with total sales on track to reach an estimated US $1 trillion by 2020.


A bitter dispute has erupted among doctors over suggestions that statins should be prescribed to millions of healthy people at low risk of heart disease. Concerns exist that the benefits have been exaggerated and the risks have been underplayed. Also, the raw data on the efficacy and safety of statins are being kept secret and have not been scrutinized by other scientists.


This lack of transparency has led to an erosion of public confidence. Doctors and patients are being misled about statins' true benefits and harms, and it is now urgent that the raw data from the clinical trials are released."


The LDL structure is composed of cholesterol, as are the membranes of any cell in your body. LDL is NOT just a carrier of the cholesterol molecule. Any fat, healthy or unhealthy, is transported through the water-based bloodstream in LDL. Livestrong wrote, "What’s the Connection Between Cholesterol and a Weight-Loss Diet?" Triglycerides, the molecules produced from excess glucose in the bloodstream, are stored in fat cells. The fatty acids carried by LDL are important because these fats can be used as fuel for cells.


Triglycerides are best thought of as the means for storing and transporting the fatty acids we need for fuel. Fuel cannot be burned unless delivered to the furnace, and lipoproteins like LDL are the delivery vehicles.


When LDL is lowered with a statin drug, triglycerides are less able to be transported to be burned as fuel in cells. The consequences are:


  • greater dependence upon sugar as a fuel

  • Inability to lose weight because stored fats, converted to triglycerides, cannot be transported to be burned, so they stay stored as fat.

  • Being unable to burn fats efficiently leads to insulin resistance and diabetes. There is a well-documented association between statin use and diabetes. Now you know how those drugs contribute to diabetes.


 

The Livestrong article quoted Roger Blumenthal, MD, a professor of cardiology at Johns Hopkins and director of its Ciccarone Center for the Prevention of Cardiovascular Disease. He said


"Most people who lose weight also improve their dietary choices, eating more fruits and vegetables, for example. But theoretically, if you lose weight on a diet of cheeseburgers and fries, you could raise your LDL."


Interesting comment considering Johns Hopkins Medical School has been a proponent of the ketogenic diet for 100 years.


Comments like this are not helpful and infer that LDL only transports harmful fats. This is not the case. Vitamin A, a vital nutrient for the brain and eyes, is transported by lipoproteins. The brain, predominantly composed of fats, is nurtured with fat-soluble nutrients like vitamin A and omega-3 fatty acids, and the lipoproteins carry these building blocks to the brain. Other fat-soluble nutrients that lipoproteins transport include Vitamins D, E, and K and necessary fats, including fish oils and the essential fatty acids EPA and DHA.


 

Here is an interesting coincidence. The brain is very active but less so during sleep. Imagine if your bicep was always active, curling a weight all day. By the end of the day, it would be exhausted and relish a good night's sleep to recover. That is your brain every day.


Consequently, brain cells use roughly ten times more oxygen than the average of the rest of the cells in the body. Your bicep would also use more oxygen if it exercised all day long. Two simple facts explain the importance of the cholesterol molecule and LDL that transports cholesterol to the brain.


1. The brain uses ~25 percent of the oxygenated blood leaving the heart. The brain is only about 2.5 percent of the mass of the body. Thus, it uses ten times more oxygenated blood, on average.


2. Twenty-five (25) percent of the cholesterol found in the body is in the brain.

Isn't it interesting that 25 percent of the oxygenated blood and 25 percent of the cholesterol are in the brain?


Coincidence?


Cholesterol, per Harvard, is a critical component of all cells. When cells are very active, they are more likely to break down and be rebuilt, just like an active muscle. "No pain - no gain." Pain results from breaking down cells that rebuild stronger than the ones replaced. Consider the bicep example and the soreness you would experience the next day if you curled a weight all day. Due to its constant activity, the brain needs more repair substances, and cholesterol is the most important of the lot.

Oxygen consumption and cholesterol levels go together. Where there is "fire," there is a need for repair.


Generally, the discipline of cardiology studies and administers drugs for the heart. Every once in a while, other groups publish data that crosses into areas like the cardiovascular arena. A case in point is the discipline of neurology. The NY Times wrote, "When ‘Bad’ Cholesterol Gets Too Low, Stroke Risk May Rise. The article states, "LDL levels below 70 were tied to an increased risk of hemorrhagic stroke." But the American College of Cardiology, responsible for setting LDL targets, states, "High-risk patients should be treated to lower LDL, achieving a target level < 70 mg/dL.


Translation: The ACC target for LDL increases stroke risk by at least 50 percent.


The NY Times article is based on a peer-reviewed paper in the journal Neurology. The conclusion to that paper states,


"We observed a significant association between lower LDL and higher risk of ICH (intracerebral brain hemorrhage) when LDL was <70 mg/dL, and the association became nonsignificant when LDL ≥70 mg/dL. These data can help determine the ideal LDL range in patients at increased risk of both atherosclerotic disease and hemorrhagic stroke and guide planning of future lipid-lowering studies."


The study also looked at very low LDL values in the range your cardiologist would be delighted with. In particular, the study shows that at an LDL of < 50, stroke risk increases by 270 percent. The NY Times summarized the data with the following statement. "They found that compared with people in the range of LDL 70 to 99 milligrams per deciliter of blood, people who had an LDL of 50 to 69 had a 65 percent higher risk of hemorrhagic stroke. For people with an LDL below 50, the risk nearly tripled."


The study on low cholesterol and stroke was substantial, following over 96,000 people for nine years. However, when this study is presented to cardiologists and primary care doctors, they tend to dismiss the findings. You see neurologists, not cardiologists, published this paper. I have observed that doctors put more value on the source of information than on the data itself!


Note that a range for LDL of 70 - 99 mg/dL is NOT normal. The ideal range for LDL is 100 - 160 mg/dL. The optimal total cholesterol level is around 220 mg/dL. Recall that total cholesterol is an aggregate of the LDL, HDL, and 20 percent of the triglyceride level. Therefore, an ideal total cholesterol value broken down into these three pieces is more like this:

• LDL - 140 mg/dL;

• HDL - 70 mg/dL;

• Triglycerides - 50 mg/dL (20 percent of that is 10).

Ideal total cholesterol = 140 + 70 + 10 = 220 mg/dL


Even though I criticized adding HDL and LDL together previously, I am now adding them - just like your ignorant doctors. Have I lost my marbles, or is there another explanation?


HDL and LDL are both good,


as is a total cholesterol value above 200 mg/dL.


However, the fraud that is not relieved by this realization that LDL is not bad is the phrase "total cholesterol."


• Triglycerides are NOT cholesterol;

• LDL is NOT cholesterol (it does contain some);

• HDL is NOT cholesterol (it does contain some);

• Total cholesterol is NOT total cholesterol.


What is "total cholesterol?" There is no such thing. It is an attempt to measure specific types of lipids (fats). Triglyceride fats are carried in LDL and HDL lipoproteins, as are many other fatty substances. Therefore, how can we specifically determine the quantity of the cholesterol molecule?


The Total Cholesterol calculation is of no value and is deceiving by implying it is something it is not and should not be calculated or used as defined.


 

In a future blog, I will answer the question, "If not 'total cholesterol,' then what?

 

Index & Upcoming (short) blogs on cholesterol and statins


Number 1: Cholesterol fun (true) facts - completed

Number 2: Is the actual cholesterol molecule important? c - completed

Number 3: What is an optimal TC value? Remember, no one knows their actual cholesterol molecule value. - completed

Number 4: Surprising fact about cholesterol as an antibiotic - completed

Number 5: TC simple math - dumb doctors - completed

Number 6: What is LDL really? - completed

Number 7: Statins - do they lower the cholesterol molecule? - completed

Number 8: What did we learn from the new "biologics" to lower "cholesterol" - completed

Number 9: Niacin and other "cholesterol" management treatments - completed

Number 10: What did Natasha Campbell-McBride say about cholesterol/lipids? - completed

Number 11: What is a QALY, and how does it relate to "cholesterol"? - completed

Number 12: Idiot doctor from Johns Hopkins, Roger Blumenthal

Number 13: Statin drugs CAUSE diabetes

Number 14: If not "cholesterol," then what?

Number 15: Who says statins do NOT extend life?





 

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