Cholesterol is a risk factor for heart disease and peripheral vascular disease, but not for stroke unless it is extremely high. Total cholesterol should be less than 200, with LDL or bad cholesterol less than 130. HDL, the protective or good cholesterol, which functions to carry cholesterol away from blood vessels, should be over 50. The most important number is the ratio of total cholesterol to good cholesterol (Chol/HDL), and this number should be less than 4.0.

Unfortunately, many physicians are prescribing statin drugs to patients with high cholesterol who have no history of heart disease. In women with no history of heart disease, cholesterol-lowering drugs provide no benefit in preventing heart attacks. In men with no history of heart disease, you have to treat 50 men to prevent one heart attack.

In men and women with a history of heart disease, LDL cholesterol should be brought into the range of 60-80.

Cholesterol reduction alone, however, does not always translate into clinical benefit. Ezetimibe is a newer cholesterol-lowering drug (also known as Zetia, and is a component of Vytorin) that enhances the cholesterol-lowering effect of statin drugs by reducing intestinal absorption of cholesterol. A recent study, however, reveals no improvement in carotid intima-medial thickness using Zetia. Thus, it offers no reduction in arterial blockage. Billions of dollars have been spent on a drug with no evidence of efficacy.

The statin drugs are not benign and frequently cause muscle pain and weakness that can be severe and debilitating. Symptoms may take weeks to resolve after the drug is stopped.

High cholesterol does not always mean heart disease is imminent. We have numerous patients in their 70's and 80's with high cholesterol and no disease. Some have cholesterol as high as 250-300, with LDL up to 200.

One useful test to assess risk is a coronary artery calcium score. Calcium is deposited within coronary arterial walls as part of the disease process. The higher the calcium score, measured by C-T scanning, the greater the risk of cardiac events. If the calcium score is zero, there is virtually no risk, no matter how high cholesterol is. Many patients with high cholesterol have calcium scores of zero. I tell them statin drugs will be of no benefit.

The best way to lower cholesterol is to change food choices. Eliminate dairy products, especially cheese and ice cream, keep milk to a minimum and use organic or raw milk. Some people believe raw milk is completely safe and will not elevate cholesterol levels. I have seen no studies on this. I recently lowered my cholesterol 40 points just by stopping dairy products.

Eat no more than 7 eggs a week. Reduce intake of meats, especially fatty meats like lunch meats and hot dogs. Eat as many fruits and vegetables as you can. They contain no cholesterol.

Supplements to lower cholesterol include niacin, fish oil, and plant sterols. We have a potent formulation called Lipichol, which contains all these supplements. The dose is two packets per day.

You can see changes in cholesterol levels within one month of making dietary and supplement changes. In many people, these nutritional changes and the addition of supplements are more effective in lowering cholesterol than statins, and they offer no risk. When the cholesterol falls low enough, we reduce or discontinue statin drugs.

- Dr. Sosin is the Founder and Medical Director of the Institute for Progressive Medicine in Irvine, California. He has authored two books, Alpha Lipoic Acid: Nature's Ultimate Antioxidant, and The Doctor's Guide to Diabetes and Your Child.

^{The information contained on this blog is provided for educational purposes only and is not intended to diagnose, treat or cure any illness or condition. The recommendations contained on this site have not been reviewed by the U.S. Food and Drug Administration (FDA). No content contained on this site is a substitute for professional medical advice, diagnosis or treatment. Never increase, reduce or discontinue any medication or treatment without first consulting your doctor.}

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