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Total Cholesterol Roller Coaster from "Paleo" to "Primal" to "Perfect Health"? (*8 Month Update)

by (19479)
Updated about 17 hours ago
Created July 29, 2011 at 7:15 PM

(I know that total cholesterol is an inadequate measure of health and that the exact relationship between cholesterol and health is still uncertain (AND that this topic has been brought up in numerous other threads, so if this question gets closed I understand), but it is representative of something going on in the body and thus I have a desire to know if anyone else has had a similar experience.)

Last December, during the final month of my HSAD ("Healthy" Standard American Diet) my total cholesterol was 188. Over the course of my adult life, my numbers have been consistently within the 160-190 range, so this was par for the course.

After 7 weeks of Paleo (following the recommendations found in Cordain and Wolf's books, low sat. fat, moderate protein, no dairy, etc.) my total cholesterol dropped to 180.

After finishing my 90-day Paleo challenge (see the whole thing here) I decided to switch to a more Sisson-esque "Primal" diet that included cheese, cream, and fattier cuts of meats such as beef, pork, etc. and a drastically reduced carbohydrate intake.

After a month of "Primal", my total cholesterol was found to be 285 (this was a fasted reading) and the overweight phlebotomist told me that I might need statins. Admittedly, I did have a momentary freak-out, but I was reading "Good Calories Bad Calories" at the time and decided to "stay the course".

Just this past week, I gave blood and received my numbers again. Since the last reading, my diet has since gone even lower carb and higher in fat, but my total cholesterol has dropped to 248.

I'm definitely relieved to see this as the consensus seems to be that cholesterol levels, while not an issue of grave concern, shouldn't skyrocket indefinitely.

There are plenty of threads discussing what seem to be abnormally high TC readings with some individuals after switching to Paleo/Primal, but I want to know if anyone has, like me, seen their numbers "normalize" after a period of time.

*8 Month Update*

Since originally posting this question, I have steadily increased my carbohydrate intake (daily fruit plus some sort of starch from sweet potatoes, regular potatoes, plantains, beans, and white rice) swapped out some animal fat (no more heavy cream, limiting eggs to 6 per week, less butter) for more plant oils (coconut, extra virgin olive oil, nuts/seeds) and cut down on my pork intake (yup, that means bacon) though I still eat red meat like beef and venison regularly.

Exercise has mostly stayed the same although I have begun to incorporate the vilified "moderate intensity cardio" back into my routine in the form of weekly mountain bike riding and spinning.

Even so, I was still a little worried going in to our I had a health screening at work today, and the results were as follows...

Total Cholesterol 190 mg/dl (optimal, as indicted on the testing paperwork, = less than 200)

HDL 74 mg/dl (optimal = higher than 50)

TC/HDL Ratio 2.6 (optimal = less than 4.0)

LDL did not register as it was too low (optimal = less than 100mg/dl)

Triglycerides did not register as they were less than 45mg/dl (optimal = less than 150)

Fasting blood glucose 88mg/dl (optimal = less than 100)

Blood Pressure 121/70 (optimal = less than 120/80)

Body fat 13.1% ("healthy" = 8% to 19%)

6 ft tall and 192lbs = BMI 26 (optimal = 18.5 to 24.9)

The RN looked at my results and basically said that she couldn't recommend that I do anything other than "keep doing what I am doing". We eventually decided that I could technically "drink more water" just so that she could write something on her sheet.

(On a funny side note, in our discussion she assumed that I was eating "low fat dairy". I mentioned that I don't eat much, but if I do it is cultured sour cream, so I still get my "probiotics". That seemed to make her happy.)

3ce6a0d24be025e2f2af534545bdd1d7
26182 · October 23, 2013 at 3:41 PM

please stop spaming the boards.

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39841 · March 12, 2012 at 7:15 PM

I'd suspect that it'd be a safe thing to eat weekly or so, but huge amounts daily is not something we're designed to cope with. Such a large pool of LDL makes me a bit nervous given that we have substantially more oxidative stress than our wild ancestors. Keeping those lipoproteins from becoming oxidized seems like it'd be quite a lot more difficult if one's LDL is double that of what we were designed to have. The burden of proof is on the butter/cream advocates. "HGs have...uh...parasites...." simply doesn't cut it.

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19479 · March 12, 2012 at 6:59 PM

Thanks Travis. I've also dropped a few pounds since switching things around (despite being low-carb I was continually gaining weight previously) so it feels good to have found a way of eating that seems to balance both my cholesterol and weight! That grass-fed heavy cream was damn good though!

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39841 · March 12, 2012 at 6:37 PM

Good to see that cutting out most of that dairy fat brought your cholesterol down within the range that normal humans have. I'm going to get a blood draw tomorrow and see where mine is, but I assume that the precipitous decline I saw after halting butter intake has continued.

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19479 · March 12, 2012 at 2:20 PM

That's really all I'm saying, the evidence regarding which type of fat is 'good' can go both ways. I'm not saying that the !Kung san are the ideal, but they are an example of a healthy people that rely upon a high PUFA nut as a staple food. If someone was to tell me that saturated fat is "bad" I would say, wait, what about the Inuit? What about the Masai? Even though they may show atherosclerosis, they don't die of CVD (http://aje.oxfordjournals.org/content/95/1/26.abstract). There is just more to the story, and it is something we're still not 100% certain of.

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716 · March 12, 2012 at 1:13 PM

THere's no real conclusive evidence in either way, i guess. BUt yea I read the whole article and I did glance over that favorable proportion over 60-unfortunately it said nothing about how old they got, just as surviving cancer can mean just 5 months more than the ones who died, very arbitrary info.. Also, most HG pops have parasites in their infections, but the Kung seem to be rather susceptible, which could definitely be in part to their pufa nuts. Not conclusive, i understand, but if i were to emulate any culture, it would not be the kung san. P.s. how did you find out my secret identity =)

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19479 · March 12, 2012 at 5:27 AM

Also, I read Paul's post and there was no discussion of high PUFA from mongongo nuts having anything to do with their rates of parasitic infection (Paul's post did discuss how parasitic infection could partially explain the !Kung's low cholesterol numbers). The rates of parasitic infection probably have to do with the fact that there are a hell of a lot of parasites in their environment. He also said in the comments "But if they hadn’t had the infections, they would also be 6 inches taller and have serum cholesterol of 190 mg/dl." Which seems to describe me to a T.

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19479 · March 12, 2012 at 5:10 AM

@Steve (or should I say "Lenny") Did you read the whole article before picking out a quote that supports your assumption that the !Kung die early due to PUFA induced chronic disease? If you had, you would have found this..."In a total population of 466, no fewer than 46 individuals (17 men and 29 women) were determined to be over 60 years of age, a proportion that compares favorably to the percentage of elderly in industrialized populations. The aged hold a respected position in Bushman society and are the effective leaders of the camps."

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6709 · March 12, 2012 at 3:45 AM

Lucky you bro, Im pretty sure my TC is going to be in the 4 digit range in a few weeks!! Hope it clogs the testing machine so badly it needs to be replaced like my arteries are going to need to be.

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716 · March 12, 2012 at 1:46 AM

this is the paul jaminet link http://perfecthealthdiet.com/?p=4003

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716 · March 12, 2012 at 1:45 AM

You realize by bring the !Kung San in to the picture, you're just handing me this argument on a silver platter... A quote from your own article (http://jefferson.library.millersville.edu/reserve/ANTH201_Trussell_Chapter05-Lee.pdf) :"“life expectancy...is difficult to calculate, but I do not believe that many live beyond 45.”" Even most people on the SAD don't get diseases of civilization when they're 45. And PaulJaminet discusses their cholesterol levels and high incidence of infection. Maybe it's due to their healthy pufa nuts? P.S.I never argued with diversity of macros, just using plantoils

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19479 · March 12, 2012 at 12:17 AM

Furthermore, how do you explain the diversity of diets (in terms of macro-nutrient ratios as well as the proportion of plant and animal based foods) that hunter gatherer groups exhibit (http://www.naturalhub.com/natural_food_guide_nuts_uncommon_Ricinodendron_rautanenii.htm) all while remaining free of Western Disease?

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19479 · March 12, 2012 at 12:12 AM

Studying modern hunter gatherers doesn't teach us anything that can be readily applied? So the fact that the !Kung San consume and average of 1,200 calories per day from mongongo nuts (see pg. 32 of http://jefferson.library.millersville.edu/reserve/ANTH201_Trussell_Chapter05-Lee.pdf) that are 44% pufa (http://www.naturalhub.com/natural_food_guide_nuts_uncommon_Ricinodendron_rautanenii.htm) while remaining free of the "diseases of civilization" doesn't call into question the assumption that increased PUFA automatically increases CVD risk?

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716 · March 11, 2012 at 10:40 PM

Since when was your cholesterol ~300 mg/dl? Stating your 285mg/dl TC during the first month of adopting a radically increased SFA diet doesn't count--your body is still learning to adapt (that's why it went down to 245mg/dl the after a little while). And studying modern hunter gatherers doesn't teach us anything that can be readily applied--cholesterol is not the problem, it's something else that cholesterol merely mirrors, with many possible variations that are perfectly fine (compare masai and traditional inuit). SO yea....

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19479 · March 11, 2012 at 8:21 PM

@ Steven, elevated cholesterol levels may not be bad in and of themselves (i.e. a sign of deficiency, imbalance, etc. in some other physiological system) but we do not see modern hunter gatherers (the best surrogate for paleolithic humans that we can directly study) with ~300mg/dl total cholesterol, which happened to me following a switch to LCHF paleo. Regardless of the theory behind it, in practice it was not working for me. I recommend checking out the following study... http://www.sciencedirect.com/science/article/pii/S0735109704007168

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716 · March 11, 2012 at 7:30 PM

why did you swap animal fats for nuts/seed oils and olive oil fats? I don't understand why you would wants nuts, protein powders, and pseudo nut milks.... Your cholesterol numbers may be more in line with mainstream standards, but given the increased pufa intake your risk for CAD is increased. Lab values mean very little in the scheme of things, honestly...

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19479 · March 09, 2012 at 3:18 AM

ROB, I average about a tbsp a day of coconut oil and I don't count calories, but I would imagine that fat still makes up the majority of my total intake. A typical day for me is breakfast (either 2 eggs, meat, and white rice or a chopped apple with coconut flakes, raisins, walnuts, and baker's chocolate mixed with protein powder and almond milk) lunch (green salad with sour cream and mustard, 1/4 baked chicken or 2 burgers, potato and vegetables cooked in olive oil) and then a light snack for dinner (coconut oil "cookei dough", chicken lettuce wraps, or pistachios and beef jerky).

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19479 · March 09, 2012 at 3:15 AM

ROB, I average about a tbsp a day of coconut oil and I don't count calories, but I would imagine that fat still makes up the majority of my total intake. A typical day for me is breakfast (either 2 eggs and some meat or a chopped apple with coconut flakes, raisins, walnuts, and baker's chocolate mixed with protein powder and almond milk) lunch at work (large mixed salad dressed with sour cream and mustard, baked chicken or hamburger patties, and vegetables cooked in olive oil) and then a light snack for dinner (coconut oil mixed with almond butter and cacao nibs or pistachios and beef jerky).

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16131 · March 09, 2012 at 1:36 AM

thanks for the update! Updates are so critical in getting great info here!

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3521 · March 09, 2012 at 12:47 AM

How much calories are you eating now? Do carbohydrates make up most of your caloric intake? About how much coconut oil are you eating?

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1138 · July 29, 2011 at 9:17 PM

+1 because I hope you're right Jack. I love me some dairy. Even more now since I went primal because I buy the really good stuff! :)

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18412 · July 29, 2011 at 8:43 PM

CaveDad - I think your numbers look pretty good. CMast says a good place to be is with an HDL:TC ratio of 1:3.5 or less and you are right at 1:4. Then again, your LDL is probably calculated, and with your trigs at 48, I bet your LDL calculation is overestimated based on the equation used, indicating that you TC is probably also overestimated.

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17949 · July 29, 2011 at 8:40 PM

Smart doctor. "This guy is probably at a low risk for atherosclerosis despite high LDL so let's not vaporize his brain". Makes me smile.

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18412 · July 29, 2011 at 8:27 PM

It seems pretty clear that dairy fat does indeed raise LDL, and in most people, HDL right along with it. It didn't raise my HDL a bit, but tuat may be due to a nutrient or mineral deficiency for me. I am not convinced that the fact that dairy fats raise HDL and LDL is a bad thing. It may just be the body's natural response to facilite the fat consumption. If dairy has so many other positive benefits in most people, it seems odd that they would all be cancelled by some weirdo counterbalance effect that it also damages your cardiovascular health at the same time.

Medium avatar
19479 · July 29, 2011 at 8:26 PM

I suppose it's confession time. My name is Tony, and I've been in dairy denial.

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1515 · July 29, 2011 at 8:21 PM

I tend to agree about the dairy fat after seeing my fasted TC rise from 236 to 400. HDL went from 77 to 90, Triglycerides from 28 to 54 on a much lower carb, higher (dairy) fat diet. It's too early to tell where it will or would settle. Doc recommended eating less fat... no thanks, but how about different fat? I also wondered if it's my body being in a situation where it needs high cholesterol, but 400?

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1515 · July 29, 2011 at 8:19 PM

I tend to agree about the dairy fat after seeing my fasted TC rise from 236 to 400. HDL went from 77 to 90, Triglycerides from 28 to 54 on a much lower carb, higher (dairy) fat diet. It's too early to tell where it will or would settle. Doc recommended eating less fat... no thanks, but how about different fat? I also wonder if it's my body being in a situation where it needs high cholesterol, but I doubt I need a LDL of 294, even if it's the harmless kind.

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1515 · July 29, 2011 at 8:16 PM

I tend to agree about the dairy fat after seeing my fasted TC rise from 236 to 400. HDL went from 77 to 90, Triglycerides from 28 to 54 on a much lower carb, higher (dairy) fat diet. It's too early to tell where it will or would settle. Doc recommended eating less fat... no thanks, but how about different fat?

Medium avatar
19479 · July 29, 2011 at 8:15 PM

I agree that statins are dangerous and essentially useless. If cholesterol is produced in response to cellular stress, shutting it down is simply addressing the symptom of an underlying problem rather than addressing the problem itself. Whether high cholesterol is a "problem" in the first place also seems to depend more on the specific microfractions, which, I unfortunately do not have access to at this time.

Medium avatar
19479 · July 29, 2011 at 8:11 PM

Thanks for sharing the perfecthealthdiet.com link. I think that elevated cholesterol as a response to cellular (or "vascular") damage makes much more sense than the conventional wisdom that presupposes cholesterol itself as the problem.

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1515 · July 29, 2011 at 8:08 PM

I have to agree about the dairy fat after seeing my fasted TC rise from 236 to 400. HDL went from 77 to 90, Triglycerides from 28 to 54 on a much lower carb, higher (dairy) fat diet. It's too early to tell where it will or would settle. Doc recommended eating less fat... no thanks, but how about different fat?

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1515 · July 29, 2011 at 8:07 PM

I have to agree about the dairy fat after seeing my fasted TC rise from 230 to 400. HDL went from 77 to 90, Triglycerides from 28 to 54 on a much lower carb, higher (dairy) fat diet. It's too early to tell where it will or would settle. Doc recommended eating less fat... no thanks, but how about different fat?

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1436 · July 29, 2011 at 8:01 PM

Agreed. Also, have you seen this: http://perfecthealthdiet.com/?p=2547

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13692 · July 29, 2011 at 7:37 PM

You need to provide more information regarding HDL, LDL, Triglycerides since TC in isolation doesn't tell us squat

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39841 · July 29, 2011 at 7:47 PM

Your rise in LDL-C and TC are mostly the result of consumption of cream/butter, and to a lesser extent, cheese. Dairy fat tends to have a ratio of myristic/palmitic/lauric acids that will spike LDL-C like nothing else. If you continue to eat high fat, but cut out dairy, your LDL-C will plummet. Mine dropped by 20-something% in 5 weeks, though I would imagine that there is variability between individuals.

As to whether high LDL really matters, I can't say, but my gut feeling is that it is not optimal, and dairy fat consumption is as recent as wheat consumption. Personally, I feel that the dairy industry raises cholesterol and the statin industry lowers it. This oscillating paradigm is great for business, but not so much for us.

If you'd like to play it safe, skip dairy and supplement calcium via some other means.

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1515 · July 29, 2011 at 8:07 PM

I have to agree about the dairy fat after seeing my fasted TC rise from 230 to 400. HDL went from 77 to 90, Triglycerides from 28 to 54 on a much lower carb, higher (dairy) fat diet. It's too early to tell where it will or would settle. Doc recommended eating less fat... no thanks, but how about different fat?

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1138 · July 29, 2011 at 9:17 PM

+1 because I hope you're right Jack. I love me some dairy. Even more now since I went primal because I buy the really good stuff! :)

Medium avatar
19479 · July 29, 2011 at 8:26 PM

I suppose it's confession time. My name is Tony, and I've been in dairy denial.

2870a69b9c0c0a19a919e54cb3a62137
1515 · July 29, 2011 at 8:21 PM

I tend to agree about the dairy fat after seeing my fasted TC rise from 236 to 400. HDL went from 77 to 90, Triglycerides from 28 to 54 on a much lower carb, higher (dairy) fat diet. It's too early to tell where it will or would settle. Doc recommended eating less fat... no thanks, but how about different fat? I also wondered if it's my body being in a situation where it needs high cholesterol, but 400?

2870a69b9c0c0a19a919e54cb3a62137
1515 · July 29, 2011 at 8:19 PM

I tend to agree about the dairy fat after seeing my fasted TC rise from 236 to 400. HDL went from 77 to 90, Triglycerides from 28 to 54 on a much lower carb, higher (dairy) fat diet. It's too early to tell where it will or would settle. Doc recommended eating less fat... no thanks, but how about different fat? I also wonder if it's my body being in a situation where it needs high cholesterol, but I doubt I need a LDL of 294, even if it's the harmless kind.

2870a69b9c0c0a19a919e54cb3a62137
1515 · July 29, 2011 at 8:08 PM

I have to agree about the dairy fat after seeing my fasted TC rise from 236 to 400. HDL went from 77 to 90, Triglycerides from 28 to 54 on a much lower carb, higher (dairy) fat diet. It's too early to tell where it will or would settle. Doc recommended eating less fat... no thanks, but how about different fat?

2870a69b9c0c0a19a919e54cb3a62137
1515 · July 29, 2011 at 8:16 PM

I tend to agree about the dairy fat after seeing my fasted TC rise from 236 to 400. HDL went from 77 to 90, Triglycerides from 28 to 54 on a much lower carb, higher (dairy) fat diet. It's too early to tell where it will or would settle. Doc recommended eating less fat... no thanks, but how about different fat?

Af1d286f0fd5c3949f59b4edf4d892f5
18412 · July 29, 2011 at 8:27 PM

It seems pretty clear that dairy fat does indeed raise LDL, and in most people, HDL right along with it. It didn't raise my HDL a bit, but tuat may be due to a nutrient or mineral deficiency for me. I am not convinced that the fact that dairy fats raise HDL and LDL is a bad thing. It may just be the body's natural response to facilite the fat consumption. If dairy has so many other positive benefits in most people, it seems odd that they would all be cancelled by some weirdo counterbalance effect that it also damages your cardiovascular health at the same time.

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1926 · July 29, 2011 at 8:35 PM

I just got back from the Dr. today, and I think my cholesterol numbers are very interesting.

In 2009 at 216 lbs and on a very unhealthy diet of frootloops, pb&j, and healthy choice boxes, here is what my numbers were.

TC 212 TriG 84 HDL 52 LDL-C 143

My BP was 126/88

Today.. I am 177 lbs, and Paleo/Lacto (for now, might ditch dariy to see what happens)

BP was 111/70

TC 260 TriG 48 HDL 64 LDL-C 186

My Dr. told me to eat less red meat, more fish and chicken.. and that because of my high HDL and low TriG he didn't recommend statins.. so I will keep him, AND keep eating my red meat. I'll be interested to see how dairy will effect my LDL in 6 months.

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18412 · July 29, 2011 at 8:43 PM

CaveDad - I think your numbers look pretty good. CMast says a good place to be is with an HDL:TC ratio of 1:3.5 or less and you are right at 1:4. Then again, your LDL is probably calculated, and with your trigs at 48, I bet your LDL calculation is overestimated based on the equation used, indicating that you TC is probably also overestimated.

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17949 · July 29, 2011 at 8:40 PM

Smart doctor. "This guy is probably at a low risk for atherosclerosis despite high LDL so let's not vaporize his brain". Makes me smile.

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14 · October 23, 2013 at 3:40 PM

Hey guys,

yes the numbers will normalize eventually. There are a lot of people who have no idea how to interpret results. for those I first recommend that they read this popular guide on how to understand test results.

http://loweringcholesterolguide.com/understanding-test-results/

Then you can start working on lowering your cholesterol!

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26182 · October 23, 2013 at 3:41 PM

please stop spaming the boards.

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18635 · July 29, 2011 at 8:07 PM

...but I want to know if anyone has, like me, seen their numbers "normalize" after a period of time. realized I answered without taking this into account and just generalized my thoughts on cholesterol.

Medium avatar
19479 · July 29, 2011 at 8:15 PM

I agree that statins are dangerous and essentially useless. If cholesterol is produced in response to cellular stress, shutting it down is simply addressing the symptom of an underlying problem rather than addressing the problem itself. Whether high cholesterol is a "problem" in the first place also seems to depend more on the specific microfractions, which, I unfortunately do not have access to at this time.

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