Cholesterol’s essential for optimal health as it forms an important part of the cell membrane, keeping the cell permeable and fluid. Neurons are insulated by a myelin sheath that is cholesterol-rich, allowing for rapid transmission of nerve signals. It also plays a vital role in the hormonal systems of the body and for the manufacture of bile acids, which help break down fat in the diet; steroid hormones such as estrogen and testosterone; and vitamin D. There’s no doubt that you need it, so what causes it to clog arteries?
IT’S IN THE DETAIL
The idea that high cholesterol causes heart disease was based on the detection of cholesterol in the plaque of people with coronary artery disease. Cholesterol is insoluble in blood, so it’s transported in the bloodstream by carriers called lipoproteins. It’s clear that cholesterol is essential to life, but the lipoprotein it’s bound to plays a key role in whether it injures or protects the arterial wall.
A common misperception is that there are two types of cholesterol. In reality, cholesterol is cholesterol; the variance comes in the molecules that carry it. The two you have likely heard your doctor talk about are:
• High-density lipoprotein (HDL), the ”good“ cholesterol carrier that helps to keep cholesterol away from your arteries, preventing build-up of arterial plaque (HDL takes cholesterol back to the liver)
• Low-density lipoprotein (LDL), the ”bad“ cholesterol carrier, which may cause cholesterol build-up in your arteries by forming plaque that makes your arteries narrow and less flexible (atherosclerosis). LDL takes cholesterol to the cells in the body.
Researchers have found that metabolic processes such as exposure to free radicals (oxidation) and high blood sugar levels (glycation) cause damage to lipoproteins, converting them from cholesterol-transport vehicles into highly reactive molecules that can damage the delicate cells that line our arteries (endothelium). The endothelium lines the entire circulatory system, from the heart to the smallest capillaries. When it’s functioning like it’s supposed to, it helps to regulate blood clotting; blood pressure (by producing dilation or constriction of the blood vessels); assists the body’s immune response; and controls the volume of fluid and the amount of electrolytes and other substances that pass from the blood into the tissues. When the endothelium is dysfunctional, the ability to perform one or more of these functions is reduced. Damage to the endothelium by reactive lipoproteins causes plaque to form and clog arteries.
Another important factor is the size and density of the lipoproteins. Large LDL particles are much less dangerous than small LDL particles because they're less readily damaged by oxidation. Large LDL particles are also less inclined to penetrate the blood vessel lining. Also, large HDL particles offer better blood vessel protection than smaller HDL particles.
GETTING RID OF THE BAD
Prescribing statin medication is what doctors typically do to prevent and treat coronary atherosclerosis. But cholesterol and LDL are only partial players in the atherosclerosis process. To effectively lower heart disease risk, reduce other factors including inflammation, oxidation, high blood pressure, poor blood sugar control, excess body weight, fibrinogen (a protein involved in clot formation), excess homocysteine (an amino acid), low vitamin K, insufficient vitamin D, and hormone imbalances.
Although statin medications are effective for lowering cholesterol, they shut down your body’s ability to produce the cholesterol it needs for proper cell, brain and hormone function. It’s also well known that statins are responsible for depleting coenzyme Q10 levels, a vital substance that metabolises energy in the body. A recommended daily dose is 100-200mg coenzyme Q10 or ubiquinol to overcome statin-induced deficiency or to treat symptoms of statin damage such as muscle pain. Unless your condition is genetic, it can be controlled through diet, under supervision.
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