New truths about cholesterol

In my previous article, “New Perspectives On Treating Heart Disease,” I outlined some of the really good and some of the questionable aspects of the new cardiovascular disease risk assessment and treatment guidelines. In this article I’ll explain what you deserve to also be aware of to reduce your cholesterol and cardiovascular disease risk that is not covered in the new guidelines.

Guideline Summary

I previously commented that while the new cholesterol guidelines are highly scientific, they are still far from sufficient to cause any appreciable improvement in patients’ lifestyles. I say this because, although they direct physicians to provide lifestyle guidance to reduce cholesterol, most doctors simply are not taught much about nutrition and real-life implementation of nutrient-rich diets.

Nearly all physicians are scientific-minded; and while the science is available about the benefits of phytonutrients of all types and their risk-reducing effects, the panel of experts involved in the new guidelines did not consider this data. In addition, physicians are not taught how to be personal-life coaches and really don’t want to perform that type of function because of the amount of time this requires with each patient.

Furthermore, because the guidelines focus so much attention on who should take a statin and who should not, physicians will simply rely on the risk calculator provided in the guidelines and use each patient’s other risk history to make that decision.

Unfortunately, the risk calculator has been shown [1] to overestimate heart disease risk by 75 percent to 150 percent when the calculator was applied to three large-scale primary prevention studies: the Women’s Health Study (WHS), the Physicians’ Health Study (PHS) and the Women’s Health Initiative Observational Study (WHI-OS). This means that far more people will be prescribed statin drugs to control their cholesterol than the data supports. The risk calculator does motivate patients to look seriously at their heart attack risk. So let’s just hope that it pushes them toward more serious lifestyle improvements instead of just further reliance on statins.

It is good to know there are healthy options other than statin drugs to assist in lowering cardiovascular risk.

Many of these options are not included in the new guidelines for a few obvious reasons. Alternative options to reduce cholesterol don’t have the large, well-designed studies behind them that drug companies pay for. Nevertheless, the studies have been performed; but they get hidden in the sea of headlined studies done by pharmaceutical companies to highlight their products (including studies of statins).

Another reason alternative options are overlooked is linked to the extra time healthcare providers need to learn about them. It also requires a significant time commitment to teach patients about things like stress reduction and other non-supplement interventions (that I discuss below).

Finally, most physicians don’t appreciate the power of these other natural options. I’ll share more of these healthy options with you in this and my article next week.

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How To Lower Inflammation, Cholesterol And Your Risk For Cardiovascular Disease

So you want to lower your risk of heart attack? You’ve likely heard over and over that to do this you must reduce inflammation in your body. This can be done by consuming nutrient-rich whole food, reducing your emotional stress level and getting consistent enjoyable exercise — and then use nutrient supplements to help even further.

I’d like to give more details on this. We know that statins lower cardiovascular risk mostly because they reduce inflammation, even in folks with normal cholesterol levels. Therefore, long before taking a statin drug, I’d recommend we all consider how to eliminate or reduce these causes of inflammation and contributors to cardiovascular disease.

Inflammatory factors include:

  • Sleep deprivation or poor-quality sleep. [2]
  • Obesity, which raises blood volume, increases insulin production (which is inflammatory), and increases inflammatory cytokines. [3]
  • Poor intestinal health from a leaky gut, certain food allergies and even hybridized wheat products. [4] A  great deal of autoimmune inflammation begins in the gut.
  • Synthetic prescription drugs, including antibiotics that promote overgrowth of resistant bacteria, yeast and parasites.
  • Chemical food dyes, preservatives, pesticides, herbicides, etc. The 12 foods that are most susceptible to pesticide residues that I recommend you buy organic (aka the “dirty dozen”) are apples, celery, cherries, tomatoes, cucumbers, grapes, hot peppers, nectarines, peaches, potatoes, spinach, strawberries and sweet bell peppers.
  • Digestive enzyme deficiency and low stomach acid.
  • Eating large amounts of sugary desserts, snacks and drinks.
  • Consuming too many servings of transfats in fast food and frozen foods.
  • Cow milk protein (dairy), which can be antigenic (causing inflammatory immune reactions).
  • Chronic low-grade infections.
  • Hormone imbalances, including thyroid, sex or adrenal hormone imbalances.
  • Abnormal blood sugar (diabetes) or elevated insulin levels, which can be done without using drugs. [5]

Balancing Hormones And Reducing Stress

Even before you begin taking supplements to reduce your risk for cardiovascular complications, it is wise to get your body in balance.

We know that the hormones cortisol, thyroid and aldosterone directly affect blood pressure. As recognized in the new heart disease risk guidelines, keeping blood pressure at a normal level is critical for shrinking cardiovascular disease risk. (Aside from influencing your blood pressure, these hormones play a direct role in the health of your cardiovascular system.)

Cortisol is an important hormone that closely affects blood pressure. In turn, stress directly leads to cortisol secretion. And when stress is chronic or frequently repeated, the continually elevated cortisol can:

  • Trigger hyperglycemia and make you prone to high insulin levels and insulin resistance.
  • Promote central obesity (belly fat).
  • Lower thyroid hormone by blocking the conversion of T4→T3 in your liver.
  • Lead to memory impairment, hyperlipidemia and immune system suppression (a prednisone effect).
  • Cause hypertension largely by stimulating adrenaline (epinephrine), which initiates the “fight or flight” sympathetic nervous system response. This response is characterized by an increased rate/force of contraction of the heart muscle and constriction of blood vessels.

These factors have motivated a huge effort to emphasize the necessity of keeping stress under control for cardiovascular-risk reduction. Numerous stress-reduction techniques are available to help fight the risk of heart disease. [6]

Low thyroid hormone affects the metabolic rate of every body tissue and affects the function of these tissues and organs. When thyroid function is low, it can not only cause fatigue, sensitivity to cold, constipation, weight gain or depressed mood, but it can also disrupt the cardiovascular system. Some European endocrinologists boldly state that low thyroid function is the true leading cause of cardiovascular disease, based on their clinical observations. [7]

An easy way to correct both hypertension and hypercholesterolemia in someone with low thyroid is by using natural thyroid hormone supplementation. [8]

Aldosterone is the hormone that directly controls blood volume through its effects on salt and water retention or the kidney’s elimination system. This hormone is made from progesterone in your adrenal gland. The reason this matters: Aldosterone secretion is closely tied to the other hormones produced in your adrenal gland, including progesterone, cortisol, DHEA, testosterone and the estrogens. Under chronic or frequently stressful conditions, the production of aldosterone is affected by a “cortisol steal” effect.

In my next article I’ll explain the amazing phytonutrients now proven to reduce cardiovascular disease risk that were not included in the new guidelines.

To knowing how to feel good for health,

Michael Cutler, M.D.
Easy Health Options

[2] Alanna Morris, Dorothy Coverson, et al. Sleep Quality and Duration are associated with Higher Levels of Inflammatory Biomarkers: the META-Health Study. Circulation, 23 November 2010; 122: Abstract: A17806. Found online at:

[3] Neil M Johannsen, Elisa L. Priest, et al. Association of White Blood Cell Subfraction Concentration with Fitness and Fatness. BJSM  Published Online First: 17 October 2008. Found online at:

[4] Cutler M. Gluten Unveiled. Published online Aug 12, 2013 at:

[6] Cutler M. Alter your Lifestyle to Naturally Shrink Blood Pressure. Published online Sept 30, 2013 at:

[7] Barnes, Broda O: Solved: The Riddle of Heart Attacks, Robinson Press, Fort Collins, CO,


[8] Ibid.

Dr. Michael Cutler

By Dr. Michael Cutler

Dr. Michael Cutler is a graduate of Tulane University School of Medicine and is a board-certified family physician with more than 20 years of experience. He serves as a medical liaison to alternative and traditional practicing physicians. His practice focuses on an integrative solution to health problems. Dr. Cutler is a sought-after speaker and lecturer on experiencing optimum health through natural medicines and founder of the original Easy Health Options™ newsletter — an advisory on natural healing therapies and nutrients. His current practice is San Diego Integrative Medicine, near San Diego, California.