Expert: Sharon Erdrich - 1/9/2012

Question
QUESTION: First and foremost, thank you for volunteering your time and energy to share your knowledge and expertise with those of us who are most grateful. In order for you to answer my question, I would like to provide you with a little background data...

I am ostensibly very healthy and always have been. I say ostensibly because I have assiduously avoided doctors my whole entire life. So in truth, I have not been medically checked out. Luckily, though, I have always felt fine and had plenty of energy.

A few years ago tragedy struck,and I decided to cope and/or punish myself by eating copious amounts of unhealthy food for an extended period of time. [I would literally eat a 1/2 gallon of ice cream and one dozen donots at one sitting late at night.] This went on until about 4 months ago, when I began to take better care of myself and went back to eating mostly vegetables and some whole grains and virtually no processed foods. About three months ago, I broke my leg and ankle and have been bed ridden for the entire 3 months.

Since I had met my deductible,I went to see a doctor last Friday for a check up,heart was fine, but blood work came back 270 total cholesterol, hdl was 46 and ldl was 197.

Finally, my question...could I have caused my cholesterol to become so elevated because of how I was eating for a few years, even though I stopped 4 months ago and have been eating healthy since then? and more importantly, if so, is there a chance that if i continue to eat healthy, I can rectify these high numbers?

Thank you for any insight and advise you might be willing to proffer.

ps  my mother has had off the charts high cholesterol for the last thirty [30] years along with way off the charts hypertension, but she is a medical anomaly...she has never and still does not want to take any meds, and believe it or not, she is still going like the energizer bunny. healthy and energetic and happy at age 91!

so, evidently i may come by this genetically. i would however like to bring my numbers down without meds. so, if you would not mind, would you please outline for me [and others] what things can i do [and what should i not do] so i can try first to do this systemically?

thank you for your guidance

ANSWER: Hello JJ
While it's well understood that bad food choices and sedentary lifestyle are factors that increase the risk of developing high cholesterol, most people underrate or poorly understand the impact of stress.  
In almost every person with elevations in cholesterol, lowering stress levels will see a reduction in the cholesterol.  And this stress can be both external as well as internal.  The worst internal stress is inflammation - which can come from something as simple as a bit of gum disease.  Some years ago TIME magazine did a feature article called "The Fire Within".  Good reading if you can get a copy.  Cholesterol is a necessary building block for your cortisol (stress hormone) as well as your sex hormones.  Thus elevated cholesterol is a symptom.... NOT a disease itself.

Having said that. the other factor is genetics.  We do know that there is such a things as "familial hypercholesterolaemia"... ie you can get it because of your parents!!  However, this is not to say that because   your parent/s have high cholesterol you will get it.  
There is also much evidence to suggest that higher cholesterol levels (particularly after the age of 70) are protective.  People with low cholesterol do have a higher chance of a significant cerebral haemorrhage - something just as bad as a stroke!.

Srategies to lower cholesterol are different depending on what, exactly, is elevated.  Your HDL level is adequate.  Your LDL level is high - this can be lowered by things such as reducing your stress levels, removing as much saturated fat from the diet as possible, vitamin B3, red yeast rice (go to iherb.com for this), increasing soluble fiber in your diet.  You don't mention your triglyceride level - if this is elevated then the best way to reduce this is fish oil - a good quality omega 3 fish oil, (eg Carlsons), with at least 1000mg EPA per day, and reducing all sugar in your diet.

I hope this is helpful - good luck!

---------- FOLLOW-UP ----------

QUESTION: thank you for your response.

could my elevated numbers be a result of my punishing myself for a few years with eating nothing but saturated fats?

would it also be possible that it might take longer than the 3 months to right my numbers, after the elongated period of making incredibly horrific choices? also, in being bed ridden, i of course have not been active. do you think that i could bring the ldl down. when i am able to be more active?

soluble fiber...what is that exactly? whole wheat cereal? [with no sugar or anything added]

in answer to your query, the triglyceride level was not elevated, so are you saying that increasing fish and/or supplementing omega 3 would not be indicated in attempting to lower the cholesterol.

bottom line...i am eating basically mostly raw vegetables, some whole wheat, alot of flax seeds ground, almonds, sunflower seeds [both raw and unsalted]very little white meat chicken and salmon, and some fruit,ie blueberries. and no sugar or processed foods at all. since i have been doing this for 3 months now, do you believe it would have already come down if it was going to?

stress ah yes, i have alot of financial stress,and i know how counter intuitive that is for my health. you also mentioned internal stress...how does one go about lowering internal stress?

so where do i go from here, in your expert opinion?

thank you for taking the time to provide with some much needed guidance.

ANSWER: Hi again
Yes, the period of dietary indiscretions and immobility (plus the associated stress with that!!) would explain a sudden rise in cholesterol, however I would expect that your blood tests should start to trend downwards after 3-4 months of altering your diet and lifestyle.  Important to consider is the fact that we don't know what your levels were before all that.
It sounds like your dietary approach is a therapeutic one - well done!!  

You could start by adding a quality dietary antioxidant to your regime, however, I suspect a herbal anti-inflammatory with liver support is probably needed - I suggest you see a herbalist for this to get a more detailed picture and a specific prescription.

Best wishes
Sharon

---------- FOLLOW-UP ----------

QUESTION: one last time i am back. so it seems clear, according to you, that even with mindful eating and getting active again [which will still be a while] and losing the added weight, my numbers will probably not go down.

so as i said, where to now...what do i do??? what is my objective at this point? [as i said. my 91 yo mom has outrageously hi cholesterol and has had so for well over 30 years and is going strong thankfully] do you recommend meds [not my first choice at all] will the dietary antioxidant and/or the herbal anti-inflammatory ostensibly lower my numbers? and what are these in mere mortal speech...for instance,what are these things exactly, and would i find a herbalist working at a health food store? i know absolutely nothing of which you speak.  

what about elevating the hdl,which was 46? can i and will that help the composite picture?

thank you for responding to my queries. i am most appreciative. however, below are three you did not answer, just in case you may have overlooked them/

what is soluble fiber...what is that exactly? whole wheat cereal? [with no sugar or anything added]

in answer to your query, the triglyceride level was not elevated, so are you saying that increasing fish and/or supplementing omega 3 would not be indicated in attempting to lower the cholesterol

stress ah yes, i have alot of financial stress [worrying about having enough money to support my child],and i know how counter intuitive that is for my health. you also mentioned internal stress...how does one go about lowering internal stress?

thank you once again for this opportunity to gain a little insight, so i can learn to take care of myself, resulting in my being able to continue to be helpful to others.

Answer
Hello JJ
Your questions are numerous, long and complex - which is difficult to address in such a forum and I am somewhat busy, so sorry if I skipped over things.

Losing extra body fat is a good move and I would not personally recommend any medication at this stage.  As I said before, elevated cholesterol is a symptom, not a disease.  However the ultimate decision on medication is one you  need to make, having considered all the facts, including the possible side effects of such medication.

Raising HDL helps to "cart out" the LDL (ie remove it from the system), so strategies to increase it are beneficial - exercise is one of the best ways to do this.  Increasing vitamin B3 intake also helps increase it.

When you are your target weight and have good strategies in place in terms of stress reduction and the diet is fine-tuned, it would be good to compare your test results with what they were when they were at your "worst", to see if there was a trend in the right direction.  Everyone is different - what may take someone 3 months to achieve may take another person 18 months...

Soluble fibre is found in a range of foods. "Used up" cholesterol is excreted by the liver into the bowel. Soluble fibre binds it and prevents it being reabsorbed further down the digestive tract.  A useful list of foods is here: http://www.nutritionfoundation.org.nz/nutrition-facts/energy/fibre

Correct - adding fish oil to your regime would not be of benefit - and may actually increase your LDL level.

The lowering of internal stress, as I alluded, is best done with herbal medicine, which can help with frank stress as well as the internal "inflammatory" state as well.

When looking at your cholesterol levels, consideration also needs to be given to the Ratio - which puts the total cholesterol in perspective HDL.  Cardiologists generally acknowledge that this figure is more important than Total cholesterol or isolated LDL.

Yes, I suggest you find a medical herbalist in your area.  A registered naturopath (or ND) would also be able to help.  Here in New Zealand people use Google to search or enquire via the national herbalist or naturopathic association.  You probably have these in your state as well. Asking at the local health food store may also be beneficial.

Good luck!