We have been told for more than 50 years that cholesterol is our enemy–that it causes heart attacks and strokes and the lower it is the healthier we are. But some physicians are beginning to question the cholesterol connection to heart disease. Cardiologists Robert DuBroff and Michel de Lorgeril offer a fascinating glimpse into “Cholesterol Confusion and Statin Controversy” at this link (World Journal of Cardiology, July 26, 2015).
According to a cardiology friend of ours: “you can’t have too low a golf score or cholesterol levels.” Some readers wonder, though, if that is always true.
Q. My father takes Niaspan and atorvastatin (Lipitor), which have lowered his cholesterol to 110. Isn’t that too low?
He has severe arthritis, memory problems and debilitating fatigue. I worry that he is taking too much medicine, but he says the doctor knows best and refuses to question him.
A. The issue of whether cholesterol can be too low remains controversial. There is evidence, however, that low cholesterol levels may increase a person’s risk of stroke caused by bleeding within the brain (Stroke, July, 2013). The authors note that “Higher level of low-density lipoprotein cholesterol [so-called bad LDL cholesterol] seems to be associated with lower risk of hemorrhagic stroke.”
There is evolving evidence that if a person suffers a thrombotic stroke (caused by a blood clot) that low levels of LDL cholesterol may increase the risk that this kind of stroke could be transformed into a more dangerous bleeding (hemorrhagic) stroke (European Review for Medical and Pharmacological Sciences, 2016).
Depression and Cholesterol Levels?
Researchers have also found that depression is more common in people with very low cholesterol. A meta-analysis involving more than 30 studies revealed a link between low serum LDL cholesterol levels and depression (Journal of Affective Disorders, July 19, 2016).
Let’s not forget that the sheath around neurons (myelin) contains cholesterol. We suspect this was not an accident of nature. The authors of the above article note that some researchers have hypothesized that:
“the mechanism guiding the relationship between low cholesterol and depression pathogenesis may, at least in part, involve cholesterol-mediated alterations in nerve terminal structure and function.”
Balancing Risks and Benefits of Cholesterol:
Very high LDL cholesterol probably puts a person at risk of a heart attack or stroke caused by a blood clot. Like Goldilocks and the porridge, we think there is probably a middle ground between too high and too low. Finding that balance remains tricky and controversial.
Some people have found that cholesterol medications such as simvastatin (Zocor) or atorvastatin (Lipitor) may contribute to fatigue, arthritis or memory problems. A Mediterranean-type diet may actually help reduce the risk of heart problems without causing the side effects some people experience with statins.
We summarize information on a range of factors, the dangers of too low cholesterol and guidelines for optimal levels in our Guide to Heart Health. You can also find a wide range ways to help control cholesterol in our book, Best Choices From The People’s Pharmacy. You will learn much more about the dark side of statins and the optimal range for blood fats like cholesterol. Perhaps your father will be willing to read the information in our book and discuss it with his physician.
Revised by Joe Graedon: 9/1/16