Cholesterol Questions? You’re Not Alone
"My doctor is giving me 3 months to get my cholesterol down or she's putting me on a statin."
This can feel scary for many reasons.
You may not WANT to go on medication.
But you also might be afraid of high cholesterol causing heart disease.
Does it seem like you're too young to have all these old-people problems?
First of all, I want you to know that you have non-medication options, and medication might not be as bad as you though. First, let's look at the cause of high cholesterol. For some folks, high total cholesterol just runs in their family. It's important to do more nuanced testing for them and make sure it's not causing more problems.
Is high cholesterol connected to my blood sugar?
It probably doesn't surprise you to know that blood sugar has a bit to do with your cholesterol numbers. Especially the triglycerides! This is a marker of prediabetes and it can be reversed by getting better control of your blood sugar. In fact, I’ve seen high triglycerides get cut in HALF in 3 months using a CGM to manage blood sugar. If you've been following me for long, you already know a little about that since wrangling blood sugar is my specialty.
High triglycerides almost always means high insulin levels.
In fact, “dyslipidemia” is just one of the signs of metabolic syndrome (aka prediabetes). When our diets cause consistently high blood sugar levels, we end up with hyperinsulinemia. This is just a fancy way of saying that our insulin levels are really high all day long in order to keep our blood sugar levels in check. It’s the first step towards diabetes. But that high insulin can raise your triglycerides and inflammation. And inflammation can wreck havok on your whole system. So blood sugar is DEFINATELY a place to look.
Once you know what it is, you can do something about it. Metabolic syndrome, prediabetes… that’s all reversible. Catching it NOW means preventing type 2 diabetes and all these other complications that come with it.
Download a free e-book to learn more
Can poor sleep affect my cholesterol levels?
Sleep can have something to do with it too. Often, when we have a patient who seems to be eating well and exercising but just not improving their cholesterol numbers, it's because of poor sleep. There are a number of simple things you can do to improve your sleep, but a sleep study can give you a lot of insight on it too. Sleeping better can really change your life. With my history of extreme insomnia, I track my sleep using an Oura ring. You don't have go to those lengths, but since it's something critical to MY health, I prioritize it and the investment has paid off big. (That's why I call it an INVESTMENT!!)
Poor sleep hurts in a few ways. One, research shows that chronic sleep deprivation can cause dyslipidemia all by itself. But also, chronic sleep deprivation can raise cortisol levels. Cortisol is a stress hormone which makes us more insulin resistant AND makes us crave less healthy foods. So it also makes blood sugar harder to manage. Sleep is a double whammy!
Should I take a statin?
Statins are the class of drug most commonly used for high cholesterol. They have been beneficial for many people. However, they are not without a cost. Studies are showing some have an increased risk of developing diabetes when taking a statin. This is possibly because they are damaging to mitochondrial function (you know, the powerhouse of the cell?). And type 2 diabetes is a mitochondrial disease. Myopathy (muscle weakness) is the most common side effect of statin use. To be clear, I'm not telling you NOT to take them. Just to weigh your pros and cons and be smart about it. We want BETTER life through pharmacy, not WORSE. Cardiovascular disease is a big killer, but that shouldn’t stop you from asking a few more questions and finding out what other options you have. (The important things to do is then ACT on those other options.)
Statins work by blocking the enzyme HMG CoA Reductase. This blocks your endogenous production of cholesterol AND a few other important things. It reduces your production of Coenzyme Q10, which is a critical part of your electron transport chain which helps make ATP in your mitochondria. Many recommend supplementing with CoQ10 when you take a statin for this reason. I can’t say that will correct the CoQ10 depletion 100%, but CoQ10 supplementaion is a very safe supplement and I often recommend my clients take it when they take a statin to try and prevent some of the muscle weakness that is likely to happen.
What are Lp(a) and apoB?
ApoB stands for apoliproprotein B-100. When you get tested for apoB, this tests for all of the lipoproteins including chylomicrons, VLDL, LDL and IDL. You could say it’s the new “bad cholesterol”. These are the lipoproteins which transports cholesterol OUT of your liver and the literature suggests it’s a better marker than looking at total cholesterol or just LDL.
Lp(a), pronounced el-pee-little-ay, stands for lipoprotein (a). It’s is considered an independent marker for risk of atheroschlerotic cardiovascular disease. So if it’s elevated, you have a higher risk for heart disease and stroke. Genetics will be the determining factor with this one. If you have it, you have it. So it’s a good idea to get this test done once and get it done as soon as you like. This would be a way of deciding if your borderline high lipids (apoB or LDL) levels warrent aggressive treatment.
In a nutshell, high apoB and high Lp(a) would be the deciding factor for using some kind of medication to lower cholesterol, in my opinion.
What are the best CoQ10 supplements?
Ubiquinol is a good form. There a few brands I like using. The choice has to do with what dose you want, if you don’t swallow pills and need a liquid, if you want to combine it with some EPA/DHA to minimize your pill burden, and the like.
Below is a link to my online dispensary “Fullscript”. You can create an account and search under my “favorites” for CoQ10. Don’t hesitate to email me and ask for a little guidance, as I do get a commission from this dispensary, just like a store or Amazon does.
Answer me this.... Since diabetes risk, cholesterol and heart disease risk all go together, doesn't it make sense that you should be able to reduce your risk for all of them at the same time? It does to me.
Without boring you with too much information here, I want to encourage you to get these labs done: FBG, HA1c, lipid panel, homocysteine, hsCRP, complete blood count, complete metabolic panel. Note your blood pressure (and if it's been trending upwards) and your waist circumference.
Does diabetes cause high cholesterol?
The short answer is, “Yes.” Even if you're in the range of being pre-diabetic, you might really benefit from focusing on your blood sugar for a while. I can tell you, this can make you feel so much better. If your blood sugar is problematic and you improve it, you can also improve your sleep, lose belly fat, gain energy, reduce inflammation and pain… and just feel better. When I help my clients with this, we focus on eating MORE nutritious food... not on deprivation. Well, there might be deprivation of the bread before meals or that 10 PM bowl of cereal. But the answer usually lies in eating MORE nutritious foods and some moderate exercise.
This stuff is really reversible. But only if you get to the root cause and address THAT… not just cover up the symptoms.
I look at elevated cholesterol as a SYMPTOM that there is something wrong in our bodies. Blood sugar, sleep, nutritional deficiencies, poor-quality food, eating damaged fats, not enough exercise, toxic exposures.... they can all add up. It may be your body's way of telling you it's time to start making a few changes.
Are you listening?
After reading this, I hope you have MORE questions about your cholesterol and are curious about the root cause.
I also hope you are ready to take some action. Because this can be the wake up call you needed!
If it’s time to take a more active role in your health and start feeling better.
Follow this link the get both the e-book and access to a free quiz that I’ll evaluate for you.
Move the needle quickly! We use a CGM…
We like to combine education with a clever wearable device called a continuous glucose monitor (CGM). These CGM’s give use 24/7, real-time data on how our food, sleep, stress and exercise affects our blood sugar. Past participants have seen marked improvements in now just their A1c, but also tryglycerides, belly fat, sleep and energy levels. It helps us customize a strategy that is perfect for you.