Myths About Cholesterol – Debunked

You feel per­fect­ly healthy and nor­mal. It doesn’t feel like any­thing has changed since your last blood test. So, when your rou­tine blood­work comes back show­ing high cho­les­terol, you’re very surprised.

This is a com­mon expe­ri­ence for peo­ple with high cho­les­terol. There are no symp­toms, and the only way to detect it is through a blood test.

Before you start pan­ick­ing or throw­ing out your car­ton of eggs, take a moment to under­stand what high cho­les­terol real­ly means and how you can man­age it to main­tain a healthy level.

There are sev­er­al pop­u­lar mis­con­cep­tions float­ing around about high cho­les­terol and how to treat it. But here’s the truth behind some of the most com­mon myths.

MYTH: All cho­les­terol is the same.

FACT: There are actu­al­ly two types of cho­les­terol in your blood: low-den­si­ty lipopro­tein (LDL) and high-den­si­ty lipopro­tein (HDL). They’re often referred to as ​“bad” and ​“good” cholesterol.

LDL is the ​“bad” one. This is what makes up most of your blood’s cho­les­terol. Too much LDL can cause ath­er­o­scle­ro­sis, where fat builds up in your arter­ies (blood ves­sels that car­ry oxy­gen-rich blood from your heart to the rest of your body). Over time, ath­er­o­scle­ro­sis can cause your arter­ies to nar­row, which may pre­vent blood from get­ting where it needs to go. This can even­tu­al­ly lead to life-threat­en­ing con­di­tions like a heart attack or stroke. 

HDL is ​“good” cho­les­terol. Unlike LDL, high amounts of HDL can actu­al­ly decrease your risk for heart attack and stroke. It does this by car­ry­ing bad cho­les­terol to your liv­er so that it can be bro­ken down and flushed out of your body.

In addi­tion to LDL and HDL, it’s impor­tant to pay atten­tion to your triglyc­erides. These are the most com­mon fats found in the body. When com­bined with high bad cho­les­terol or low good cho­les­terol, it can fur­ther increase your risk for heart attack and stroke. 

Also read: What Is Cholesterol?

MYTH: As long as your HDL is high, it doesn’t mat­ter if your LDL is high.

FACT: High lev­els of HDL are very help­ful – to a cer­tain extent. HDL only car­ries a frac­tion of the cho­les­terol in your blood and doesn’t com­plete­ly elim­i­nate LDL. In oth­er words, hav­ing high HDL won’t can­cel out high LDL. 

Also, when it comes to HDL, it may be pos­si­ble to have too much of a good thing. Lev­els that are too high can actu­al­ly cause ath­er­o­scle­ro­sis to progress faster. 

MYTH: Peo­ple with high cho­les­terol shouldn’t eat eggs.

FACT: There is a dif­fer­ence between the cho­les­terol found in your blood and cho­les­terol found in food (dietary cho­les­terol). Dietary cho­les­terol comes from ani­mal-based foods, like eggs, but­ter, high-fat meat, and full-fat dairy prod­ucts. There’s also dietary cho­les­terol in foods made with these ingre­di­ents, like baked goods. 

Until very recent­ly, it was thought that eggs and oth­er foods with high dietary cho­les­terol were major con­trib­u­tors to heart dis­ease. How­ev­er, new­er research tells a dif­fer­ent sto­ry. The real asso­ci­a­tion between the two may be that foods high in dietary cho­les­terol tend to be high in things that are linked to heart dis­ease (like sat­u­rat­ed fat). Cer­tain cho­les­terol-rich foods, like eggs, like­ly aren’t increas­ing your blood cho­les­terol – it’s the foods like bacon and ham that peo­ple often pair with eggs that are problematic. 

MYTH: Fam­i­ly his­to­ry of high LDL is the main cul­prit of high cholesterol.

FACT: In most cas­es, high LDL is caused by lifestyle. Some of the most com­mon behav­iors that can increase your bad cho­les­terol are:

• Eat­ing a diet that’s high in sat­u­rat­ed and trans fats
• Not get­ting enough phys­i­cal activity
• Smok­ing or being exposed to tobac­co smoke
• Being obese or overweight

That being said, your fam­i­ly his­to­ry can absolute­ly play a role. Famil­ial hyper­c­ho­les­terolemia (FH) is a con­di­tion that makes it hard for your body to remove bad cho­les­terol from your blood, and it’s passed down from par­ents to their chil­dren. It starts dur­ing child­hood, which means that cho­les­terol can start to build up from a very ear­ly age. 

There are sev­er­al rea­sons why your provider may sus­pect FH, such as unusu­al­ly high LDL lev­els, a fam­i­ly his­to­ry of coro­nary artery dis­ease or high cho­les­terol, or symp­toms of ath­er­o­scle­ro­sis (like leg pain when walk­ing or chest pain or pres­sure) at a young age. They may per­form a phys­i­cal exam to look for skin changes, like yel­low to orange bumps, that could be signs of fats build­ing up under the sur­face of your skin. In some cas­es, they may rec­om­mend genet­ic test­ing to find changes in your genes that are known to cause FH. 

Also read: Heart Dis­ease Risk Fac­tors: How Much Con­trol Do You Have?

MYTH: Every­one with high cho­les­terol needs to take medication.

FACT: As with any med­ical con­di­tion, every­one is dif­fer­ent. Treat­ment depends on a com­bi­na­tion of fac­tors, such as your over­all health, if you have oth­er risk fac­tors for heart dis­ease, or if you have FH. 

For many peo­ple, the first line of treat­ment is mak­ing lifestyle changes, like adopt­ing a more heart-healthy diet and los­ing weight. 

Read about our Culi­nary Med­i­cine pro­gram, where qual­i­fy­ing patients take lessons from board-cer­ti­fied culi­nary med­i­cine physi­cians, licensed dieti­tians, and sea­soned chefs to learn how the right foods can serve as medicine. 

In oth­er cas­es (like if some­one has FH), or if these changes don’t do the trick, it might be time for medication. 

Statins are the most com­mon and effec­tive med­ica­tions for high LDL. They change how your body process­es cho­les­terol, low­er­ing the amount of LDL in your blood. In addi­tion, they can decrease triglycerides.

MYTH: Statins are dangerous.

FACT: It’s nat­ur­al to be hes­i­tant about tak­ing a new med­ica­tion – espe­cial­ly those like statins that are like­ly life­long treat­ments. But most of the time, statins are safe and don’t cause side effects. 

Anoth­er big mis­con­cep­tion about statins is that they can sud­den­ly trig­ger dia­betes. It’s true that statins can raise your blood sug­ar slight­ly, increas­ing the risk for type 2 dia­betes. How­ev­er, this is often seen in peo­ple who already have blood sug­ar that’s high­er than nor­mal. Plus, research has shown that the ben­e­fits of statins out­weigh this small risk. 

MYTH: Young peo­ple shouldn’t take statins.

FACT: Start­ing a statin ear­ly may help stop or slow the pro­gres­sion of ath­er­o­scle­ro­sis and pro­vide life­long health benefits. 

Why do many peo­ple think statins aren’t for young adults? It could be because some nation­al guide­lines rec­om­mend statins for those ages 40 to 75 who are at high risk of devel­op­ing high cho­les­terol with­in the next 10 years. These guide­lines focus on the 40+ age group because most clin­i­cal tri­als include few­er par­tic­i­pants under 40, and the 10-year risk tends to be low­er in younger people.

If you have con­cerns about statins – or about any aspect of high cho­les­terol – make sure to reach out to your provider. They can help you find a treat­ment or pre­ven­tion plan that’s best for you.

Ready to take con­trol of your cho­les­terol? Sched­ule an appoint­ment online with a Duly Health and Care pri­ma­ry care provider.