And low cholesterol is good? Cholesterol is the mother hormone. Without it,?you die.
And low cholesterol is good? Cholesterol is the mother hormone. Without it,?you die.
To a degree, you are correct. However the lower limit of cholesterol (LDL) that is necessary is unknown. Traditionally it was said that the LDL fraction should be below 100mg/dl. If the patient had vascular occlusive disease (coronary, cerebral or peripheral arterial involvement) it was recommended to maintain an LDL less than 70 mg/dl in order to decrease progressive or recurrent issues. Statins lower the LDL in a somewhat dose-dependent manner. However more than a few patients can not tolerate the STATINS for whatever issue (frequently musculoskeletal) so the drug Zetia has been advised to further the effect of the statins (a booster so to speak!). Zetia without the statin is pretty useless. Newer injectable meds (PCSK-9 inhibitors), like Repatha are much more effective in lowering the LDL especially in those with quite high LDL levels seen in familial hyperlipidemia. They are much more expensive and at least initially were quite difficult to afford as insurers were reluctant to approve and cover their costs.
Recent studies, primarily from Europe have shown that the optimal low level of LDL to attain in order to optimize risk reduction is much lower than the 70 mg/dl that has been the traditional goal. Levels as low as 30-40 mg/dl are now touted as the goal and that level is almost impossible to attain without the use of the PCSK-9 meds.
This report interestingly showed no reduction in “events” despite the slightly lower levels of LDL in those who were given combination therapy (statin plus Zetia) which at least in that study showed the slight changes did not add benefit to the patient.
The bottom line is - talk to your doctor - Internist or Cardiologist - about what your goal level should be - discuss life-style and the changes that may need to be made - don’t use tobacco - exercise at least moderately, take your other preventative meds like low-dose aspirin, blood pressure meds etc as prescribed.
By the way, the European studies do not show any adverse effects from having LDL levels down to the 30mg/dl level (although some speculation has been made regarding psychiatric effect). So we don’t know the “optimum lower level of LDL” at this point in time. It does appear that “Lower is Better!”
High cholesterol seems to have contributed to the early deaths of most of my mothers side of the family. It was rare to see any of them make it out of their mid 60s. There is a balance of too high and too low. For my family too high seems to be a killer.