What's Good About Cholesterol? Part 1 of 2

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The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

Cholesterol. You’ve read about it. It scared you away from eggs. Then Aitken’s diet and the other low-carb, high protein diets said eat eggs. Starchy snack foods are labeled “Cholesterol Free”. Does that make them good for you? A few years ago a popular prescription chosterol medication called Baycol was pulled off the shelves. Does that make all cholesterol medications bad for you? And what is this good cholesterol, bad cholesterol stuff mean anyway?

Let’s start with, what is cholesterol? Cholesterol is a naturally occurring substance in the body that is essential for life. If you had no cholesterol in you, you would die. It is used to make bile acids which help your digestive system work, hormones which help regulate different body functions and it is also found as an important part of the cell membrane which is located around every cell in your body. Although cholesterol is essential for life, you don’t have to eat any. Your body, mostly your liver, can make all the cholesterol you need.

So what does all this LDL, HDL, VLDL stuff mean? When your liver makes cholesterol, it puts it into the blood stream. Cholesterol is a kind of fat, so it doesn’t mix with blood, which is mostly water, very well. The liver has to mix the cholesterol with proteins and other stuff to get it to stay in the blood. This mixture of cholesterol (a lipid or fat) and protein is called a lipoprotein. If you take a blood sample and spin it really fast, it separates based on density. So different layers in the sample have different densities. Low Density Lipoprotein or LDL is often called “bad” cholesterol because it transports cholesterol and other lipids from the liver to places like the lining inside the arteries. Through a complicated series of events, these cholesterol deposits can cause blockages that slow or stop blood flow. If blood flow to the heart muscle is stopped, that is a heart attack. If blood flow to the brain is stopped that is a stroke. High Density Lipoprotein or HDL is called “good” cholesterol because it transports cholesterol and other fats from the cells lining the blood vessels to the liver. This can decrease the chance of blockages.

Diet and exercise are very important to prevent and treat cholesterol problems, but I’m going to talk about medications. The most common LDL lowering medications are a group of medications called the statins. The statins stop an important step in the liver’s synthesis of cholesterol, so the liver makes less cholesterol. So the statins do a good job of reducing LDL. They are also generally well tolerated. They can cause some stomach upset which can usually be fixed by taking them with food. Much more rarely they can cause muscle pain and/or liver damage. Your doctor will check for liver problems with blood tests, and if you get body aches all over see your doctor. The prescription drug Baycol was pulled off the market because it caused liver problems more often than other statins.

There is a lot of good news about statins. If you take your statin as prescribed and get your LDL, HDL and Triglyceride numbers where your doctor wants you can reduce your risk of having a heart problem or dying of a heart problem by 14-40%. Besides lowering LDL cholesterol they seem to protect the heart in other ways. There are theories that the statins have a good effect on the lining of the blood vessels called the endothelium. There has been some study of statin drugs reducing the risk of breast cancer in women. The results are not conclusive but are interesting and promising. There have been other reports that statin drugs reduce the incidence of prostate and kidney cancer. Again there is not enough evidence for everyone to take statins to prevent cancer, but more research should be done.

As always if you have any questions or concerns about these or other products, ask your pharmacist.