Season 2 of the Science of Self-Healing Podcast has a NEW host! Please welcome Dr. James Odell, the Medical and Executive Director for BRMI, as well as a practicing naturopathic doctor for over 35 years.
In this episode, Dr. Odell emphasizes the crucial role of cholesterol in the human body while questioning the precision of current cholesterol measurement methods for assessing cardiovascular risks.
He argues that the real concern regarding cardiovascular health arises when the cholesterol molecule becomes oxidized and corrupted. Instead of the current cholesterol measurement methods, he proposes using enhanced biomarker tests, which are better predictors of cardiovascular issues.
Dr. Odell then delves into the many potential risks linked to statin use. The episode provides a comprehensive perspective on managing cardiovascular health and concludes with practical tips to naturally lower oxidized cholesterol levels.
Transcript of Why We Need to Rethink Cholesterol & Statin Drugs
Dr. James Odell: Hello, everyone, and welcome to the Science of Self-Healing podcast. For health and wellness knowledge from a different perspective. Produced by the Bioregulatory Medicine Institute, also known as BRMI. We are your source for unparalleled information about how you can naturally support your body's ability to regulate, adapt, regenerate, and self-heal. I'm your host, Dr. James Odell, the medical and executive director for BRMI, as well as a practicing naturopathic doctor for over 35 years. And remember, this podcast is for informational purposes only and is not intended to be a substitute for the direct care of a qualified health professional who oversees and provides unique and individual care. The information here is to broaden our different perspectives and should not be construed as medical advice or treatment. Let's get started.
In this episode, I will discuss the importance of cholesterol and specific factors that can corrupt this molecule, leading to its potential participation and cardiovascular disease risk.
Much of the reason for the keen interest in cholesterol has its roots in selling pharmaceuticals designed to lower cholesterol.
What is Cholesterol?
First off, what is cholesterol? Cholesterol is a molecule critical to health. Unfortunately, it has been oversimplified and demonized by conventional medicine in the mainstream media as the major cause of heart disease and vascular endothelial dysfunction. The endothelium is the inside lining of the vascular system.
The Bioregulatory Functions of Cholesterol
The bioregulatory functions of cholesterol are very important. Cholesterol fulfills many biological functions and is necessary for successful cellular homeostasis. Every cell membrane in our body contains cholesterol because cholesterol is what makes our cells waterproof. Without cholesterol, we could not have a different chemistry on the inside and outside of the cell.
When cholesterol levels are not adequate, the cell membrane becomes leaky or porous. This is a situation where the body interprets this as an emergency, releasing a flood of corticoid hormones that work by sequestering cholesterol from one part of the body and transporting it to areas where it is lacking. Thus, cholesterol is the body's repair substance.
As we see, scar tissue contains high levels of cholesterol, including scar tissue in the arteries. As such, cholesterol helps in nerve conduction and is vital to proper neurological function.
It plays a key role in the formation of memory and the uptake of hormones in the brain, including all important serotonin. When cholesterol levels drop too low, the serotonin receptors cannot function.
Cholesterol is a major component of the brain. I'll say that again. It's a major component of the brain. Much of it is in the myelin sheaths that insulate nerve cells and in the synapses that transmit the nerve impulses. This myelin sheath allows electrical impulses to transmit quickly and efficiently along nerve cells. If the myelin is damaged, these impulses slow down. The myelin sheath is rich in cholesterol because it is derived from compacted layers of the Schwann cell membrane. It helps in providing protection and insulation and allows more efficient conduction of nerve impulses.
Precursor for Hormone Production
Cholesterol is an extremely important biological molecule that not only has roles in membrane structure and is important for neurological function, but it's a precursor for the synthesis of steroid hormones. Cholesterol is the precursor to all the hormones produced in the adrenal cortex, including the glucocorticoids, which regulate blood sugar levels, and mineral corticoids, which regulate the mineral balance and sex hormones. Corticoids are the cholesterol based adrenal hormones that the body uses in response to the stress of various types. They promote healing and balance in the tendency or inflammation. Cortisol allows the body to manage and respond to stress through its effects on intermediary metabolism. In other words, it increases the gluconeogenesis and inflammatory and immune responses.
The adrenal cortex also produces sex hormones, including testosterone, estrogen and progesterone out of cholesterol. Thus, without cholesterol, you cannot produce these hormones. The hormones testosterone, estrogens and progesterone are critical for reproductive bioregulation and responsible for sexual differentiation, libido, spermatogenesis, and ovarian follicular production.
Precursor to Bile Acids
Additionally, bile salts are composed of cholesterol and those who suffer from low cholesterol often have trouble digesting fats. As we know, bile helps emulsify fats and activates your pancreatic enzymes. People without gallbladders cannot produce enough bile and usually have to supplement bile, though often surgeons don't tell them this. So cholesterol acts as a precursor to bile acids required for the regulation and digestion of fats and plays a central role in maintaining cellular membrane rigidity and fluidity. It allows lipids to be digested via emulsification and subsequent breakdown by the pancreatic enzymes.
Cholesterol is also important for the all important production of vitamin D. Without adequate cholesterol, vitamin D can remain deficient. As we know, vitamin D is critical for immunity. Often people have diagnosis of cancer, have low D levels, thus low cholesterol, whether it's due to an innate error of metabolism or induced by cholesterol lowering drugs, which I'll get to here in a minute, can be expected to disrupt the production of adrenal hormones and lead to blood sugar problems, edema, mineral deficiencies, chronic inflammation, difficulty in healing, allergies, asthma, reduced libido, infertility and a variety of reproductive problems.
Cholesterol is thought to function as an antioxidant and as such, protects us against free radical damage that leads to heart disease and cancer. Low cholesterol levels are often associated with increased rates of cancer, as are low vitamin D levels.
Now that we understand the importance of cholesterol, let's discuss how this molecule can be corrupted. It has been known for over two decades that the real problem is not simply elevated low density lipoproteins, or what they call LDL, but rather oxidized low density lipoproteins. If cholesterol becomes oxidized, then this can be a detriment to your health.
The Real Issue with Cholesterol
Although very high levels of LDL cholesterol are generally not good, the primary problem is not LDL itself, but rather when it is oxidized. More than half of the people suffering a heart attack have normal cholesterol levels. Cholesterol is susceptible to oxidation, leading to the formation of what's called oxysterols. An oxysterol is a derivative of cholesterol obtained by oxidation involving enzymes or prooxidants. Several oxysterols are associated with age related diseases such as cardiovascular disease, eye diseases like cataracts, age related macular degeneration and certain neurological diseases, as well as cancers. In other words, low density lipoproteins, or LDLs, are susceptible to oxidation by reactive oxygen free radicals, in particular one that's called myeloperoxidase. Myeloperoxidase LDL makes it atherogenic. This causes lesions in the vessels or plaque lesions. Myeloperoxidase is an enzyme released by white cells that are involved in disease activity from the luminal aspect of the arterial wall. When the arterial wall is damaged or inflamed, myeloperoxidase is released by the white cells called macrophages. Myeloproxidase then oxidizes the LDL, making it atherogenic, which then oxidizes HDL too. That's the good cholesterol, and it renders it dysfunctional. This results in inflammation linked to plaque formation in the artery wall, known as vasculitis.
Biomarker of Atherosclerosis
Myeloperoxidase can be measured in the laboratory. Remember that because you could ask for it. You could ask for your myeloperoxidase to be conducted. It is seen that individuals with elevated myeloperoxidase levels are more than two times as likely to experience cardiovascular mortality.
So, when LDL is oxidized, it not only directly damages the blood vessels, but it also serves as a marker for oxidative stress. Certain micronutrients can act as antioxidants and help this situation, particularly ascorbic acid like vitamin C or Alpha-tocopherol, and Coenzyme Q10. They've all been shown to prevent LDL from oxidation and this progression of atherosclerosis. In short, plasma levels of ox-LDL are a sensitive biomarker of atherosclerosis. Additionally, elevated myeloperoxidase levels may also be measured to ascertain a degree of vascular damage. Again, you could ask your physician to conduct this test.
Elevated Myeloperoxidase
Myeloperoxidase test. Elevated levels of ox-LDL are associated with accelerated atherogenesis, coronary artery disease, acute myocardial infarction, that's a heart attack, and stable and unstable angina. Elevated ox-LDL has also been associated with metabolic syndromes, impaired glucose tolerance, insulin resistance, and untreated hypothyroidism. Unfortunately, oxidized LDL nor the myeloperoxidase are rarely ordered or even discussed by primary care physicians, although this is the real reason why people develop atherosclerotic plaquing.
Oversimplification of LDL’s as an Indicator of Atherogenicity
The idea that LDL, or the low density lipoproteins are bad, is really a gross oversimplification. There's also particle sizes that come into play. The size of the LDL particles and the assessment of the number of LDL particles has been suggested as a more reliable method of assessing the potential for atherogenicity.
LDL Particle Size Matters
There are basically two types of LDL in relationship to particle size, small dense LDL and large, buoyant LDL. The small, dense LDL particles are like little darts that tear holes in the lining of the vessels. Thus, the small, dense LDL are worse. But the large, buoyant LDL particles are like large, fluffy balls. They're unable to cause any damage and may actually prevent the small, dense LDL from causing damage. For this reason, a simplified cholesterol test that does not separate these two types of LDL cannot accurately or adequately predict risk. Also, the ratio of total to HDL cholesterol, as well as the non HDL cholesterol, which is similar, are better predictions than the total cholesterol or LDL cholesterol of the potential of atherosclerotic plaquing. But they are nowhere near as predictive as some of the newer markers, like LDL particle size or myeloperoxidase. Now we see how important cholesterol is to our body, and that just simply measuring LDL and HDL cholesterol is really not adequate, that what we're really looking for is how oxidized LDL cholesterol is.
Statins
Now, I want to take you into another realm of cholesterol lowering medications, or what's called statins. Statins are a class of drugs that inhibit this enzyme. It's called HMG-CoA reductase. It's an enzyme, simply speaking, and they inhibit this enzyme, and so they're called HMG-CoA reductase inhibitors. By inhibiting this enzyme, however, which is actually a very important enzyme, it causes many different side effects, and you probably have either experienced this or have heard about it. But statins have become the mainstay of chemical therapy for elevated LDL cholesterol and are among the most profitable medicines generated by the pharmaceutical industry, hugely profitable, and they'll still continue to be so because they're pushed by almost every physician out there.
But statins not only inhibit the production of cholesterol, but actually a whole family of intermediate substances, many of which have actually very important, if not critical, biochemical functions. Both inhibiting all important cholesterol synthesis and its intermediaries are a part of the reason why statins cause side effects. Cholesterol is one of three end products of the mevalonate chain. The other two are ubiquinone and dolichol.
Ubiquinone, or also known as Coenzyme Q10, you probably either take it or have heard of it, is a critical cellular nutrient in the body, and it's synthesized in the mitochondria. These are like the powerhouses of the cells, but it plays a very important role in ATP production in the cells and functions as an electron carrier to the cytochrome oxidase system – that's our main respiratory enzyme. The heart requires high levels of Coenzyme Q10, and it is critical to nerve function and muscle integrity. The bioenergetic effect of CoQ10 is believed to be fundamentally important in its clinical application, particularly as it relates to cell’s exceedingly high metabolic demands, like the heart, what they call the cardiac myocytes, or the cells within the heart. Within the myocardium, Coenzyme Q10 is also vital for the formation of elastin and collagen.
Statin Associated Muscle Symptoms
The main reason for the discontinuation of statin therapy is statin associated muscle symptoms or what's called SAMS. SAMS, that's statin associated muscle symptoms, which are the most well documented side effects of statins. These SAMS are by far the most prevalent and most important event that causes over 70% of all statin adverse events. And this is muscle related. So you start taking statins and you start experiencing myalgia, myopathy, myositis, an elevated CK, that's creatine kinase. This is at its most severe level, but these people actually that have this problem report severe joint pain and even abdominal pain.
Tendinopathy Side Effects of Statins
Other skeletal related side effects include tendinopathies. This is where the tendons develop disorders as well as arthralgias. So these SAMS present usually symmetrically or bilaterally, and they can affect most of the muscles in the body, particularly in the lower extremities. So people feel it in their hips, in their legs. Symptoms can occur at rest or shortly after exercise, and usually occur within one month after the initiation of the statin therapy or after an increase in dosage.
Another issue is neuropathies. This is peripheral neuropathy. This is when the nerves that become impaired are characterized by weakness, tingling and pain in the hands and feet, as well as difficult walking. Long term statin therapy is associated with neuropathy, peripheral neuropathy. There's been many studies behind this, and physicians and pharmacists are aware of this potential toxicity, but rarely talk about it.
Myotoxicity Side Effects of Statins
What's even more true to the heart of the matter, and probably the most concerning effect of this inhibitory drug, this HMG-CoA reductase inhibitor, or the statin, is the myotoxicity effect on the myocardium. This is the heart, basically. So it can create a potential for heart disease. Now, of course, people are taking statins to prevent heart disease, but at the same time, statins have this potential for actually creating heart disease within the myocardium. And so primarily the reason is that they inhibit the CoQ10. And the CoQ10 as I mentioned, is crucial for mitochondrial function and also for the cellular energy of the heart. The myocardium cannot function properly when it's deprived of CoQ10, and this can weaken the cardiac output and result in a potential myocardial damage. And this myocardial damage can be long term – it could be permanent.
Coronary Artery Calcification Side Effects of Statins
Equally concerning is mounting evidence now points to statins as a potential causative factor in coronary artery calcification. This occurs through the depletion of the CoQ10 impairing ATP generation and inhibiting critical selenium enzymes. Selenium enzymes necessary for protecting the heart vessels from plaque. Statins inhibit the synthesis of vitamin k2, the cofactor for the matrix GLA-protein activation, which in turn protects the arteries from calcification. So here people are thinking that statins are going to protect them from atherosclerotic plaquing by inhibiting cholesterol, when in fact it can cause calcifications of the coronary arteries. So, doctors continue to prescribe these statins, even though research continues to amount and shows that statins are very damaging to not only the muscles, the nerves, but also the heart.
Cognitive Impairments of Statins
What's even more concerning, though, is the cognitive impairment that's becoming to be apparent. Symptoms of confusion and forgetfulness and memory loss have also been reported within just a few days after the initiation of statin therapies. While other reports describe symptom onset years after commencing statin use, observations indicate that statins seem to cause a range of cognitive problems, especially in elderly patients. This concern was enough for the FDA to issue a warning cautioning that statins may cause cognitive impairment of certain individuals. Believe me, they wouldn't put a warning out there unless it was true.
Of course, the aging population faces an increase in disease burden due to chronic neurogenic degeneration conditions, along with dementia, but statins can actually accentuate this. Partially this is because, as I'd mentioned, statins are critical to brain architecture and function of the brain and central nervous system. Brain cholesterol is involved in synapse development, synapse formation and dendrite differentiation and long term potentiation.
Although the human brain only accounts for 2% of the total body weight, it contains as much as 25% of cholesterol and cholesterol derivatives. The brain is made up of 25% of cholesterol and cholesterol derivatives. Cholesterol is essential for the formation and function of the brain membranes, synapses, myelin, lipid rafts, et cetera. If the brain doesn't have enough cholesterol, these structures cannot form or function properly. Thus, it's really not surprising that statins can result in cognitive impairment, and there have been many randomized trials that have shown this. Actually, there's been reports involving transient amnesia or complete memory loss for a brief or lengthy period of time. These are the sufferers report incidents involving complete loss of memories, such as arriving at a store and not remembering how they got there, or not remembering their name or the names of their loved ones, or unable to find their way home. These episodes can occur suddenly and disappear as suddenly. This is described in Dwayne Graveline's book, Lipitor Thief of Memory, an interesting book.
How To Lower Oxidized Cholesterol
So, what can we do to lower oxidized cholesterol, which seems to be the most troublesome type of cholesterol? Well, one thing is that of course we can eat better and there's a lot of different factors that go into this. But I'm going to give you a little rundown of some things to maybe consider here and I'm going to go through it kind of quickly. But these are some basic ideas.
Aside from eating more fruits and vegetables, you want to avoid hydrogenated and partially hydrogenated oils or the trans fats, the polyunsaturated industrial seed oils such as corn, sunflower, cotton seed, peanut, soy, and canola oils. These are all linked to cellular congestion and inflammation which can lead to chronic diseases like heart disease.
Secondly, you want to avoid refined sugars, especially fructose, known to stimulate clumping of the blood platelets. Refined sugars are an anti nutrient and offer insignificant amounts of vitamins and minerals, but simultaneously rob the body of other nutrient stores. This can lead to chronic disease such as heart disease.
Supplements for Lowering Oxidized Cholesterol
Also consider supplementing cod liver oil or some type of fish oil. It doesn't have to be cod, it could be other types of fish. If you're averse to eating fish oil, then you could also get these omega three fatty acids from algae oil, but they're good sources of vitamin A, D and essential fatty acids.
Consider supplementing with evening primrose oil, borage, or black currant oil. These are all good sources of gamma linoleic acid or GLA. GLA is also of course present in a lot of green leafy vegetables and nuts. Most significant source for infants is breast milk. It's very important to breastfeed children, of course. GLA creates anti-inflammatory prostaglandins.
You want to eat food that contains abundant trace minerals, particularly copper. Copper deficiency is associated with clot formation and inflammation in the arteries. Plant sources include spirulina, which is a blue green plankton, shiitake mushrooms, green leafy vegetables like spinach, kale, swiss chard and the following fruits, avocados, guavas, pomegranate, blackberries, kiwi fruit, mangoes and papayas, unless you have an allergy to one of those.
Also, choosing better quality meat. I'm not sure about the meat that we're eating out there, but you really need to do your research when you start to consider buying meat at the store and make sure that it's really good meat from a farm that you know about, because industrial or commercial meat can lead to heart disease. There's a lot of substandard cattle out there and that are pumped full of hormones and antibiotics, and these toxins can cause a lot of different problems in the body.
Also avoiding fat milk, reducing fat milk and powdered milk products such as powdered whey. They contain oxidized cholesterol, shown to cause endothelial dysfunction and arterial wall dysfunction. It's important to take natural antioxidants to keep these fats from being oxidized, this LDL from being oxidized.
So vitamin C, vitamin E, rosemary extract, CoQ10, especially CoQ10, and quercetin all inhibit the oxidation of cholesterol. For the gut, which is very important, the microbiome of the gut, you want to consider pre and probiotics and rotating the culture of your probiotics. In other words, don't get stuck on just one brand. You want to introduce different species and strains into your gut over time. Additionally, don't undervalue the role of stress and adequate sleep can play in maintaining a healthy metabolic pathways in the body, and this can help to normalize cholesterol levels in the body.
I hope this helps you, and I hope you had a wonderful holiday and soon to have a happy new year, which will be soon to be year of the dragon. Please join us again in two weeks for another episode of the Science of Self-Healing.
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