The Internet teems with self-proclaimed experts in every discipline. They exercise free speech saying whatever they choose, ignoring all consequences. The freedom to speak one’s mind is a right that can never be eroded; yet it must be wielded with responsibility and intellectual honesty. And herein lies a pervasive problem. People who know very little are saying an awful lot. In the case of cholesterol, erroneous information can lead to unnecessarily dire consequences – heart attacks, strokes, and even death. Let’s look at LDL, what we know to be true and what we also know to be false.
LDL is a lipoprotein particle that carries cholesterol in our blood. Cholesterol requires such a transporter, as it would crystalize without it. (Knife-like crystals would then literally tear apart the linings of our blood vessels. Not a pretty image!) LDL’s main purpose is to deliver its cargo, leftover cholesterol, to our liver for disposal. It does not – I repeat, it does NOT – carry cholesterol to any other part of our body to be used for beneficial purposes. But many on the Internet say otherwise. They use our body’s undeniable need for cholesterol as evidence that LDL is necessary for brain health, hormone production, and optimal cellular function. And yet there is absolutely no evidence to support their claim. They state that lowering LDL with medications like the statins can lead to dementia and general cellular dysfunction (among countless other things). Their contention is that lowering LDL will leave our cells starving for cholesterol. Again, there is no evidence to support this. And, what they neglect to tell their readers is that every cell in our body has the capacity to make its own cholesterol. So if levels become too low, cells turn up their cholesterol-manufacturing system and create as much as they need. These charlatan fear-mongers also fail to let their information-craving audience know two essential facts. First, LDL undeniably causes vascular disease. And second, statins have unequivocally been shown to reduce heart attacks, strokes, and death.
Supporting the first fact are century-old trials that validate the causal relationship between LDL and cardiovascular disease. But the most compelling information has come on the scene only just recently. Proof positive (to the best of our current scientific capacity) comes in the form of Mendelian Randomization studies (MR studies). These studies use the random assortment of genes during the process of reproduction to eliminate what we call “confounders”, conditions that falsely produce findings while oftentimes going unrecognized. MR studies are actually nature’s superior form of Randomized Controlled Trials (RCT), the bedrock of modern science. And, to date, every LDL MR study has consistently shown that LDL is more than simply associated with cardiovascular disease; it is a major cause. Patients with genetically low LDL are protected from disease, while those with genetically high LDL, such as Familial Hypercholesterolemia (FH) patients, are besieged by disease. In sum, high LDL is bad. Don’t let anyone tell you otherwise.
The second fact is also backed by innumerable studies and clinical trials. Statins – when given to the right patients – decrease heart attacks, strokes, and death. Statins save lives. Again, please don’t let anyone try to convince you otherwise. As to who are the “right” people to receive statins, we have guidelines to help us decide, but the ultimate decision is one that should be made between patient and physician.
The bottom line, whether it is with LDL or any other serious issue we strive to understand, we must all be very careful about our sources. My credo is to always find a primary resource. In the case of LDL, read and listen to the real experts, those who spend their lives understanding the issues with the sole goal of helping patients become healthier and live longer, better lives.
Learn more about preventive cardiology at www.preventivecardiologyinc.com.
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