Essential for the proper functioning of the body, cholesterol is not bad in itself. But present in excess blood, in its “oxidized” form by stress or poor diet, it promotes a pro-inflammatory cascade and becomes a cardiovascular risk factor – among others, less known and just as deleterious.
Furthermore, we must not neglect little-known avenues – such as the role of hypothyroidism – in the management of a cholesterol level that is too high, or the dangers of a level that is too low. Sophie Schaeffer’s explanations (in photo)micronutritionist, and his advice for taking action on the plate.
A lipid essential to the body
Cholesterol is a lipid – a fat that is not soluble in water – and it is an essential molecule for the proper functioning of our body, explains Sophie Schaeffer, who lists four main functions.
“It is part of the composition of our cell membranes. It allows the production of steroid hormones (estrogens, progesterone, cortisol, DHEA, etc.). It is also involved in the production of vitamin A of which it is a precursor and finally, it is essential for the digestion of fats, notably through the production of bile.”
Good or bad: the false trial
It is often demonized by talking about “good” and “bad” cholesterol. “To be transported, cholesterol needs lipoproteins, a bit like little “trucks: LDL and HDL”, explains the nutritionist.
“LDL transports cholesterol to the cells, depending on their needs, while HDL carries excess cholesterol back into the cells, to the liver where it is either eliminated or used for other functions.” It is the first, LDL, which has a bad reputation. “However, it is not harmful in itself. Its function is just as essential as that of HDL.”
Cardiovascular risk: one factor among others
LDL is a cardiovascular risk factor when it circulates in excessive quantities in the blood, in an oxidized form. “It can oxidize for multiple reasons: particularly in cases of stress or poor diet. Oxidized cholesterol promotes a pro-inflammatory cascade that can lead to coagulation disorders and therefore cardiovascular risk.”
However, putting this risk solely down to cholesterol, and in particular LDL, “it’s a very reductive vision, underlines the micronutritionist. Other factors must be taken into account. Smoking, high fasting blood sugar and being overweight are just as harmful, as are certain so-called “residue” factors.els”. It is therefore interesting to take into account the presence of low-grade inflammation – which goes unnoticed but which can be revealed by an ultrasensitive CRP assay (1) –, an unhealthy microbiota or “a high level of homocysteinemia (2) These are also markers of cardiovascular risk.”
1. Ultrasensitive C-reactive protein (CRPus) is an inflammatory marker measured in the blood.
2. The blood level of homocysteine, an amino acid, is also a marker for assessing and monitoring cardiovascular risk.
Only 20% of cholesterol comes from food
“20% of cholesterol is provided by food, but the majority, 80%, is made by the body.” However, indicates Sophie Schaeffer, diet is an interesting lever of action to fight against hypercholesterolemia by reducing excessively high levels of cholesterol in the blood and above all by limiting the oxidant risk.
“The higher the glycemic index of the foods consumed, the more insulin we produce and the more cholesterol we produce. A diet with a low glycemic index is therefore recommended (read elsewhere).”
The role of the thyroid
There are other little-known causes of high cholesterol, including hypothyroidism. “It is the thyroid hormone T3 which allows cholesterol to enter the mitochondria to contribute to the production of hormones. If T3 is lacking, cholesterol accumulates in the blood circulation. It is therefore sometimes enough to regulate the functioning of the thyroid to act on excess cholesterol. This may be enough to avoid initiation of treatment with statins.
Alternatives to statins
“In certain cases, statins are essential medications, particularly in cases of familial hypercholesterolemia with a history of cardiovascular disease, explains Sophie Schaeffer. But you should know that these medications also lower cholesterol levels in the brain. Several studies claim that they increase the risk of dementia or Alzheimer’s disease. They also have many side effects: fatigue, muscle pain, cognitive disorders…”
“Apart from any family risk factor, you can start by changing your lifestyle by opting for a low GI diet. (read elsewhere). If there is a risk, we can also dig a little deeper, look for a problem with the thyroid and measure the anti-oxidized LDL antibodies to detect oxidation or the ultrasensitive CRP which is the mark of low-grade inflammation. The interest of these additional examinations is to explore avenues in functional health to lower cholesterol while avoiding the overprescription of statins, when possible.”
