My total cholesterol was measured at over 300mg/dL last month. (This would be 7.8mmol in the UK). Normally this is not an issue at all as I’ll get into, but it happened to be assessed as part of a life insurance underwriting medical. Now that I am self-employed and no longer covered by the excellent group employee benefits I enjoyed for the last 25 years I have to figure out these realities.
I’ve also been looking into some sort of health coverage and even though we don’t use the conventional medical system other than for annual check-ups, in the US it’s wise to have some sort of emergency coverage just in case. We started the process with a Christian healthcare-sharing ministry but they also applied a standard algorithm and wanted to impose a surcharge on our monthly contributions as I was deemed high risk. I gave them all sorts of other test results showing I was normal weight and had a cardiac calcium score of zero (no plaque on my arteries at all) but they insisted their guidelines were fixed.
This is frustrating for two reasons. Firstly the original guidelines on cholesterol levels indicating cardiac risk were based on flawed conclusions from the Framingham Heart Study (FHS) originating in 1948 and have since been superseded by new studies and a better understanding of cholesterol’s role in the body but the myth persists. And secondly the pervasive prescribing of Statins, a class of drug invented to lower cholesterol levels that is one of the best examples of doing more harm than good for most people. The marketing machine of Big Pharma is exploiting the first myth earning billions in the process and will ride the train as long as they can get away with it.
This is a long post but important to touch on three aspects of this issue for a full understanding.
Critical Functions of Cholesterol in Your Body
This is just a sample of what we know of cholesterol’s role in good health. There is much we don’t understand. What is clear is that 80% of our cholesterol level is just down to our genetic makeup. Only 20% is affected by our lifestyle including our diet but is also heavily affected by how much we exercise and how much stress we are under. Heart disease is definitely affected by what you eat but it’s sugar, processed foods full of hydrogenated vegetable oils and lack of nutrients that’s the problem not cholesterol.
Just 4 months ago I had a test as part of my regular annual physical and my total cholesterol was 260mg/dL (6.7mmol). I think I was actually eating more meat 4 months ago than I was more recently, and I was definitely exercising less previously than I am now. Our human bodies are immeasurably complex so I’m not going to worry about this one number when all other signs are that I am perfectly healthy.
Just for the record my LDL (so called “bad” cholesterol) was 170. This is the number a statin was designed to affect but in fact on closer examination of even the FHS data, a more accurate risk assessment would look at the ratio of Total Cholesterol to HDL (so called “good” cholesterol). In my case 266/87=3.05. Less than 4 is desirable, less than 3 is even better. I’m good!
Statin drugs are arguably the most successful pharmaceutical to ever come to market. Pfizer’s Lipitor generated over US$12 billion in the year 2006 (that’s with a “B”). It has since lost its patent so generic versions are available. In 2022 it generated only US$2 billion in sales for Pfizer – still worth fighting to protect such a robust revenue stream! They were touted to reduce “bad” cholesterol and in most people they do just that. You might have to switch around the several different name brand statins available to find one you can tolerate but if your objective is a score on a blood test you can get there. The only problem is this won’t make you any healthier.
The Myths About Cholesterol and Heart Disease
TRUTH: 70% of people who have a heart attack have cholesterol levels below 200mg/dL (5.2mmol). There is a slightly higher risk shown for young men who have levels above 350mg/dL (9mmol) but for older men and women of all ages high cholesterol is actually associated with a longer lifespan.
TRUTH: There is very little cholesterol in arterial plaque (and what is there is probably beneficial as mentioned above). Most of the material is a calcium deposit (a bit like limestone) and most of the fatty acids are unsaturated.
TRUTH: There is no evidence that saturated fat contributes to heart disease. The evidence is pointing more closely to the substitute fats invented such as hydrogenated vegetable oils and trans fats as well as sugar and ultra processed foods.
TRUTH: The original studies cited to link cholesterol levels with cardiac risk showed a dubious association at younger levels and over age 50 mortality actually went up as cholesterol levels dropped. More recent studies have looked at the randomized control drug trials for several statins and proved there is no clear correlation with cardiac risks.
The Dangers of Statin Drugs
There is more to the story of statins, cholesterol and heart disease than I’ve been able to cover here. So I encourage you to explore further. And of course make sure to discuss with your healthcare professional before stopping a statin that you are already on.
I’ve provided a couple of links – firstly to a paper published in the British Medical Journal that analyzed 19 different studies on the topic. And then to the website of Dr Aseem Mulhotra, an award-winning cardiologist in the UK who is outspoken on this issue. He has appeared on TV, in documentaries and written a helpful book called A Statin Free Life. You may also like the book The Great Cholesterol Con by Dr Malcolm Kendrick.
Back to my underwriting issue, I will continue to search out more enlightened policy providers who understand the true risks and avoid propagating the myth that encourages too many people to get on a statin drug which is only going to add to their future healthcare costs and even potentially increase mortality risk.
Adrienne Freedman
Thankyou so much for that! As you know my cholesterol level is very high but I’m still here and my mothers was this high and she didn’t die from anything related to heart.
Methinks a lot of people should read your article.
Will it be in the book?
Emma Tekstra
Yes you’ll definitely find some comments on statins in the book as one of the best examples of Big Pharma putting profits before your health and many doctors not reading past the marketing messages.
Richard Bennett
Great observation of the fallacies of cholesterol and its inherent risk. I’m in the same brackets for cholesterol mostly from my genetics. And yet I continue to have a robust lifestyle with a sensible approach to whole foods, sugars & less processed meals. It’s a shame how corporate and government bureaucracy’s continue to exploit these areas for profit.