What Autoimmune Patients Should Know About Cholesterol
Cholesterol is usually ignored until it’s “too high.” But what is too high, what is too low, and what is optimal? And what about triglyceride levels? The answers to those questions can sometimes be controversial, even among doctors using a natural approach to lowering cholesterol. Conventional doctors, on the other hand, ignore the possibility that high-density lipoprotein cholesterol (HDL)—what’s known as the “good” cholesterol—can actually be too high.
In this blog post, I’m going to address the subject of lowering cholesterol naturally and why raising HDL cholesterol as a health-promoting strategy may actually backfire in some patients, especially those with autoimmune disease.
What Are LDL and HDL Cholesterol?
Cholesterol is a waxy, fat-like substance produced by our liver. It’s necessary for good health, but very high levels have been seen in heart disease. Most of the cholesterol in our body is made by our body. We do get some from our food but the amount absorbed is minimal compared to what we make ourselves.
Cholesterol moves around in the body by attaching to proteins called lipoproteins, which carry it through blood. There are several types of cholesterol, each is named for the lipoprotein that carries it through the blood. This includes low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol. LDL is considered the “bad” cholesterol, since elevated levels have been linked to higher risk of coronary heart disease. HDL is considered the “good” cholesterol, but as you will see later in this article, HDL is not always beneficial. Very low-density lipoprotein (VLDL) cholesterol is another type of cholesterol. VLDL carries more triglycerides through the blood, whereas LDL contains more cholesterol.
Health Benefits of Cholesterol
Cholesterol is often portrayed as the bad guy, but in truth our bodies need a certain amount of cholesterol. It’s essential for many processes in your body. It’s part of all cells. Your brain even contains large amounts of cholesterol because your brain cells need it to function properly and send communication signals throughout the nervous system. It’s the backbone of vitamin D production and it’s also used to make hormones. In short, we need cholesterol. Without it, our bodies couldn’t function even at basic levels. The problem only arises when cholesterol levels are high, in particular high levels of LDL cholesterol.
What Are Triglycerides?
Both cholesterol and triglycerides are fats found in your blood, also known as lipids. When your doctor orders a lipid panel to check your cholesterol levels, triglycerides also are included on the test. Triglycerides are not cholesterol, but they are another type of fat found in your blood and the main storage form of fat in the body. When you eat refined carbs like baked goods, pasta, and breads, your body converts the extra calories from these types of food into triglycerides, which are stored in your fat cells as a type of energy reserve. When you need that energy, triglycerides are released from those cells.
While triglycerides aren’t the same as cholesterol, they can be a helpful indicator of underlying issues. Because they are affected by eating too many refined carbs, high triglycerides usually correlate with issues such as insulin resistance and low thyroid function. High triglycerides also can be a sign of prediabetes, type 2 diabetes, or metabolic syndrome, a cluster of risk factors for heart disease. They can cause hardening of the arteries (arteriosclerosis).1 Really high triglyceride levels are also linked to inflammation of the pancreas (pancreatitis).2
What Is a High Cholesterol Number?
So, what is normal? Most doctors will tell you a healthy cholesterol level is under 200 with some doctors trying to get levels as low as possible. But dropping cholesterol levels too low can do more harm than good in certain situations. For example, low cholesterol levels are linked to impaired late-life cognitive function, cognitive decline, and dementia in older patients. The same connection doesn’t apply to middle-aged patients, however.
From a functional medicine perspective, due to the importance of the cholesterol molecule in many aspects of health, we usually like to see levels of total cholesterol between 150 and 200.
More important than the total cholesterol number in the body is the ratio of the lipoproteins in our bodies. Most labs will calculate the ratio of total cholesterol to HDL on a basic lipid panel. This ratio should be low, suggesting you have optimal levels of HDL “the good cholesterol.” Ratios of total cholesterol to HDL under 3 are shown to be protective for the cardiovascular system and to reduce heart attack and stroke.
Optimal Functional Ranges of Cholesterol and Triglycerides
Biomarker | Optimal Range | Standard Lab Range |
Total cholesterol | 150 – 200 | Less than 200 |
LDL | Less than 100 | Less than 100 |
Triglycerides | Less than 100 | 0-149 |
HDL | 60-85 | >39 |
Total cholesterol:HDL Ratio | 3 and under | <5 |
The Dark Side of HDL
Even though HDL is considered the “good” cholesterol, a higher HDL cholesterol number isn’t necessarily better. High HDL over 85 may actually be a sign of inflammation because HDL is known to be an acute phase reactant, meaning it can temporarily jump up when there is inflammation or infection. Higher HDL levels in certain people such as those with rheumatoid arthritis can also correlate with a higher risk of cardiovascular disease and osteoporosis.3,4
How to Lower Total and LDL Cholesterol
Many people choose to use statin drugs to lower their total and LDL cholesterol levels. However, these medications do have side effects. They can cause autoimmune myopathy5 (muscle weakness, sometimes with pain or spasms), so in people already predisposed to autoimmune conditions these drugs may not be the best option. Statins also deplete levels of coenzyme Q10, which is important for heart health, and block the production of vitamin K2 in the body, a vitamin which protects the arteries from calcification. Statins also don’t eliminate the root cause of heart disease, which is inflammation.
Lower LDL Cholesterol Naturally
If you’re wondering how to lower high cholesterol naturally, here are some tips. It is possible to lower LDL cholesterol with diet. Eating lots of vegetables and fruit and lean, organic meat can lower LDL cholesterol. Adding ground flaxseed to your diet also may help to achieve optimal LDL cholesterol levels. A moderate amount of exercise also goes a long way in maintaining normal cholesterol levels. In addition to diet and lifestyle changes, you can also try taking a supplement.
Cholesterol-Lowering Supplements
Several supplements can help lower cholesterol into normal ranges, as shown in the research. These include:
• Niacin – This vitamin may lower LDL cholesterol and triglycerides and raise HDL. The biggest problem with niacin is that when people take enough of it to lower cholesterol it can sometimes cause a temporary niacin “flush,” where the skin reddens and feels uncomfortably warm or itchy.
• Berberine – This botanical may reduce total cholesterol and LDL cholesterol.
• Amla fruit – Clinical studies are finding that Amla (Embilica officinalis) significantly lowers total cholesterol and triglycerides in both normal and diabetic people. It also improves HDL levels and lowers LDL levels.
How to Reduce High Triglyceride Levels
The best way to lower triglyceride levels naturally is through diet. Avoid foods and beverages sweetened with sugar and honey in order to have normal triglyceride levels. Opt for sweeteners like organic stevia that don’t raise your blood sugar. In order to have optimal triglyceride levels, you’ll also need to stay away from refined carbs like bread and pasta. Place an emphasis on vegetables in the diet and avoid fruits that raise the blood sugar. You can also wear a continuous glucose monitor to see how your body reacts to foods.
Dietary supplements can help, too. As mentioned above for cholesterol, niacin and amla can also lower triglycerides. Fish oil supplements may also help decrease triglyceride levels.
Cholesterol and Autoimmune Disease
If you have an autoimmune disease like lupus or rheumatoid arthritis, it’s a good idea to work with a functional medicine doctor to achieve optimal cholesterol levels and normal triglyceride levels. As I mentioned earlier, we want to make sure that our autoimmune patients don’t have too high an HDL level, as it could increase your risk of certain diseases. We also don’t want low levels. The goal is to find that sweet spot.
As a functional medicine provider specializing in autoimmune disease, I can help you normalize your cholesterol and triglyceride levels. The first step? Sign up for a free 15-minute discovery consultation, and if you come on board as a practice member, I can order the right lab tests and develop a customized plan. Cholesterol and triglycerides are just one aspect of health, and I can make sure that we’re addressing all your most important health needs. That way you’ll feel revitalized and healthy again. Your heart and immune system will thank you for it, too.
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