It is important to recognize that even though cholesterol gets a lot of attention, it is not necessarily the most important (or even an especially significant) factor in preventing heart disease. Other factors, such as nutritional support and optimizing thyroid function (in women) and testosterone levels (in men) may also decrease the risk of heart attack.
Although the cholesterol-lowering medications in use today can be lifesaving in those who have already had a heart attack or have angina, they only decrease heart attack deaths by 1.4 percent in those without a previous heart attack (called "primary prevention"), and they are not without risks. Some of these include muscle pain, liver inflammation, and depletion of the nutrient coenzyme Q10. This nutritional deficiency can then contribute to fatigue and congestive heart failure, and I believe that anybody on Mevacor related cholesterol-lowering medications (most are) should take 200 mg a day of coenzyme Q10.
To put it in perspective, cholesterol medications lower the risk of heart attack death by less than 2 percent, while owning a cat is associated with a 30% lower risk of heart attack death, and having high vs. low normal thyroid function is associated (in women) with a 69 percent lower risk of dying of a heart attack.
Although cholesterol is NOT the main cause of heart disease, heart and blood vessel diseases are the number one killers in the U.S. Increasingly, heart disease is occurring because the heart muscle is not making enough energy. This can occur because of a number of changes, and is a subset of the "human energy crisis" occurring worldwide. This is why decreased heart function is a part of CFS (the heart muscle has trouble making energy just like the rest of the body), and CFS/fibromyalgia also improve (often dramatically) using the nutritional energy powerhouses discussed in "Addressing Heart Health Naturally."
So why all the fuss about cholesterol? Two main reasons:
- We have a test to measure it, and
- Drug companies make over 10 billion dollars a year on these meds.
The second reason is the main one.
Meanwhile, taking cholesterol medication can cause muscle pain (including fibromyalgia) and heart failure, which the physician will usually mistakenly blame on something else. Except for those with a history of heart disease, or cholesterols over at least 250, I WILL NOT USE CHOLESTEROL MEDICATIONS IN CFS OR FIBROMYALGIA! Often, when the medication is stopped, the CFS/fibromyalgia symptoms lessen over the next month or two—making it clear that the medication was a factor.
A few key points:
- Cholesterol can often be optimized safely and naturally without the medication.
- If the cholesterol is high, optimizing thyroid function will often lower it (and likely protect the heart WAY more effectively than cholesterol medications)—even if the thyroid tests are "normal."
- In men, if the testosterone level is under ~ 450, using natural testosterone (not the dangerous high dose synthetics some athletes use) will often markedly lower cholesterol while also decreasing diabetes and high blood pressure—and leave you healthier overall. I aim for a testosterone level over 700.
- If taking cholesterol medication, be aware that they cause Coenzyme Q10 deficiency. I strongly recommend that you take 200 mg of Coenzyme Q10 daily as well. After you stop your cholesterol medication, I would continue the Coenzyme Q10 for 3 more months. Stopping any medication should be done with your physician's OK. See the American Board of Holistic Medicine to find a knowledgeable holistic physician if yours will not work with you.
- Cholesterol serves a critical function in your body, as it is essential for making stress hormones (e.g., cortisol and DHEA), estrogen, progesterone, and testosterone. Lowering it too much is not healthy.
Let's look at safe and natural ways to lower your cholesterol.
- Begin with an exercise program and, if overweight, bring your weight down.
- In men, especially if you are overweight, have high blood pressure, and have diabetes (or are prediabetic), this may ALL be coming from too low of a testosterone level. If your total testosterone is under 450 on the blood test, I would consider using prescription natural testosterone (Androgel or Testim or compounded) to bring your level up over 700. For more information, see "Effect of Testosterone on Metabolic Syndrome."
- In women, consider a trial of prescription natural Armour Thyroid—even if the labs are normal. High cholesterol is often caused by low thyroid and the tests are horribly unreliable (they miss the majority of those who need thyroid hormone). Consider an exercise stress test before beginning exercise or thyroid. Both are very healthy for the heart, but could unmask heart disease in those with severe heart blockages. For more information, see "Thyroid Hormone Deficiency—An Overview."
- Enjoy eating your eggs and cholesterol. Study after study shows that eating 6 eggs a day for 6 weeks has no effect on cholesterol blood levels. Yet this myth persists. Avoid saturated fats (hard fats) and margarine (butter is much healthier and tastier than margarine).
- Eat 1-3 cloves of garlic a day. Crushed into olive oil, it makes a yummy treat that may drop your cholesterol. In addition, have a cereal with oats (e.g., Life, Cheerios, Quaker Oats Squares) for breakfast. Simply adding garlic and oats to your diet can lower your cholesterol almost as much as many medications. Artichokes also lower cholesterol.
- Herbals can be quite effective as well at maintaining a healthy cholesterol level. I recommend an herbal supplement that supports healthy cholesterol levels; look for one that contains inositol hexaniacinate (flush-free niacin), berberine, chromium, artichoke, policosanol, and deodorized garlic.
- If triglycerides are also elevated, especially be sure to avoid sweets and add Acetyl-L-Carnitine 1,000 mg a day to the above for 3 months to see if it lowers the triglycerides.
- If on cholesterol lowering medications (statins), be sure to take Coenzyme Q10 (200 mg a day. I use the Enzymatic Therapy CHEWABLE brand as quality is an issue for Coenzyme Q10 ).
Jacob Teitelbaum, M.D. is one of the world's leading integrative medical authorities on fibromyalgia and chronic fatigue. He is the lead author of four research studies on their treatments, and has published numerous health & wellness books, including the bestseller on fibromyalgia and chronic fatigue syndrome From Fatigued to Fantastic! and his newer The Fatigue and Fibromyalgia Solution. Dr. Teitelbaum is one of the most frequently quoted fibromyalgia experts in the world and appears often as a guest on news and talk shows nationwide including Good Morning America, The Dr. Oz Show, Oprah & Friends, CNN, and Fox News Health.