Last February, The Food and Drug Administration mandated “important safety changes” to the warning labels on statin medications, a group of cholesterol-lowering drugs used by tens of millions of Americans. Under the new rules, drug makers are required to warn of potentially serious memory and other cognitive disturbances associated with the use of these medications.
It’s difficult to imagine that a pharmaceutical approach to lowering cholesterol could have any downside. After all, cholesterol is associated with so many health issues—from heart disease to strokes and even cancer, or so it seems. The data supporting its pivotal role in heart disease dates back to the origins of the now revered Framingham Heart Study, which began in 1948.
The information from this study, which followed 5,209 men and women and their offspring, has been manipulated over the years to convince one and all that we must do everything in our power to rid ourselves of cholesterol in order to pave the way to a brighter, healthier tomorrow. Hence the ever-pervasive egg-white omelette option on breakfast menus.
So why the FDA’s alarming mandate? Why jeopardize the popularity of statin drugs, the virtual darlings of the pharmaceutical industry, which continue to generate annual sales of about $30 billion in America?
To fully understand what may seem like a capricious decision on the part of the FDA, it’s important to take a closer look at cholesterol, the continued target of aggressive vilification.
Cholesterol is a fundamental component in the protection of every cell in the human body, including brain cells. So critical is cholesterol for the brain that while the brain represents about 2 to 3% of our total body weight, a full 25% of the cholesterol in the human body resides just in this organ.
Cholesterol is the precursor from which our bodies manufacture such vital molecules as the sex hormones progesterone, estrogen, and testosterone as well as the digestive bile acids that allow us to derive nutrients from the foods we eat. Cholesterol is the raw material from which we're able to manufacture vitamin D when exposed to sunlight, an adaptation that has certainly helped us survive for the past 2.6 million years.
Vitamin D, which does far more for us than simply build strong bones, has been shown to activate more than 900 individual genes, most of which can be found in the brain. These genes code for such life-sustaining activities as reducing inflammation, enhancing energy utilization, neutralizing viruses and bacteria, and helping the body rid itself of deadly cancer cells.
Cholesterol, in and of itself, serves as a brain antioxidant, protecting our delicate neurons, their fatty membranes, their building block proteins, and even their DNA from the damaging effects of free radicals.
Cholesterol plays a central role in brain health. When the brain is deprived of cholesterol, one of its most fundamental structural and functional components, it creates fertile ground for some of our most feared and pernicious maladies, such as Alzheimer's disease, depression, and even risk for suicide.
This could explain why data from the Framingham Heart Study, the very same study that first demonized this precious chemical, is now revealing a clear and compelling relationship between low cholesterol levels and decreased brain function (in areas such as learning ability, memory, attention and concentration, and abstract reasoning).
Other reports are now showing direct correlation between low cholesterol and an increased risk for depression and even suicide. And the prestigious journal Neurology recently published a report showing that elderly folks with the highest cholesterol levels may have as much as a 70% reduced risk for dementia.
It looks like the FDA had our backs on this one, at least in terms of implementing a change to raise awareness of what can happen when a vital part of our biochemistry is disrupted. While the debate over the ultimate efficacy of statins continues, it's clear that we can't simply take a cavalier attitude toward using these medicines to lower cholesterol. Healthcare practitioners should remember the primary axiom of medicine, primum non nocere: above all, do no harm.
Here are some actionable tips to help you deal with cholesterol:
1. Get your good fats.
There is no relationship between healthful cholesterol-containing foods like eggs, grass-fed beef, and organic dairy products and risk for coronary artery disease. These foods provide wonderful healthful fats, good for your heart and brain.
2. If you're taking a statin and plan to continue, consider adding 200mg of coenzyme Q10 daily.
Coenzyme Q10 is an important antioxidant and statins inhibit the body’s ability to make this vital chemical.
3. Ask your doctor to check your vitamin D level.
While there is no ideal dosage, what matters most is that you take enough of the supplement to achieve a blood level in the range of 60-80 ng/ml. This often requires at least 5,000 international units of vitamin D3 daily, especially in individuals taking statin drugs.
4. Ask your doctor to check your blood level of oxidized LDL.
This form of LDL is far more valuable in determining risk for heart disease compared to the standard LDL value. Higher LDL is associated with higher blood sugar levels, and that’s yet another reason to adopt a lower carbohydrate diet.
David Perlmutter, M.D. is a board-certified neurologist and Fellow of the American College of Nutrition. He is the recipient of numerous awards for his innovative work in brain research, including the 2010 Humanitarian of the Year Award and the 2002 Linus Pauling Award. Dr. Perlmutter received his M.D. degree from the University of Miami School of Medicine. He is the author of the #1 New York Times best seller GRAIN BRAIN, the GRAIN BRAIN COOKBOOK, BRAIN MAKER, and BRAIN WASH. He serves as medical advisor to the Dr. Oz Show. You can connect with Dr. Perlmutter on his Facebook and Twitter.