Earlier this week, a young appearing middle-aged woman came to see me because she was concerned that her cholesterol levels were too low. In fact her total cholesterol and LDL levels were less than 80 mg/dL (~2 mmol/L) and 35 mg/dL (~1 mmol/L), respectively; similar levels are observed in healthy newborn babies. Her low cholesterol levels were not the result of a low cholesterol diet and she was not taking any cholesterol lowering medications. It turns out that she was lucky enough to have inherited a protective gene that will keep her “bad” cholesterol levels low for the rest of her life and her blood vessels free from significant blockage, provided of course that she maintains an otherwise healthy lifestyle.
Not too long ago, concern reigned high that low cholesterol was unhealthy. Because cholesterol is a vital structural component of cell membranes in all of our tissues and organs including the brain, naysayers suggested that very low cholesterol levels, would pose increased risk of neurologic and psychiatric issues. Their concerns voiced in books and other outlets that garnered considerable media attention included depression as well as homicidal or suicidal tendencies.
However, the “cholesterol myth” has finally come to pass for 2 reasons:
- Natural selection studies have demonstrated that patients with very low LDL due to a genetic alteration (such as the woman I presented) also have a tendency toward longevity.
- Medications that drive LDL well below 70 mg/dL is associated with a reduced risk of future cardiovascular events. In fact, the recent FOURIER study found that lowering LDL all the way down to 10 mg/dL continued to be associated with reduced cardiac risk. We anxiously await the new cholesterol guidelines to determine whether there will be new LDL lowering targets based upon the level of cardiovascular risk. In the meantime, keeping LDL levels down with lifestyle and medication when needed has been shown time and again to effectively reduce your overall cardiovascular risk. Michael Miller, MD is Professor of Cardiovascular Medicine at the University of Maryland School of Medicine in Baltimore, Maryland USA. Everything you need to know about natural ways to lower your cholesterol is discussed in his latest book, “Heal Your Heart: The Positive Emotions Prescription to Prevent & Reverse Heart Disease“.