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Ask the Doctor About Low CholesterolQuestion: All the doctors are telling us to lower our cholesterol, but what can I do to raise my cholesterol level? I am concerned because I have cholesterol around 130 and I know that this is associated with cancer and other problems. Answer: You are right to be concerned, especially given the results from the Honolulu Heart Program. To quote from the article: "Our data accord with previous findings of increased mortality in elderly people with low serum cholesterol, and show that long-term persistence of low cholesterol actually increases the risk of death. Thus, the earlier that patients start to have lower cholesterol concentrations, the greater the risk of death" (The Lancet, Vol 358, Number 9279, Aug 2001). Over the past few years this question comes up time and again, usually from people who have a lot "wrong" with them including cancer, AIDS and chronic fatigue; and it has also come from people like yourself who feel well. Given the frequency of this question, I would like to address it in a generic sense, without reference to a particular case. My first real run-in with the phenomenon of low serum cholesterol came about 15 years ago with my first AIDS patient. Like many AIDS patients he was well versed in alternative medical theories and treatments. As a result of his extensive reading, he was convinced that he could overcome AIDS if he could detox his body sufficiently. He went on many fasts, did juice cleanses, bowel cleanses, and took many natural medicines for his condition. He ate no meat and no fat, only vegetables, fruit, seeds and grains, mostly raw or sprouted. He was a wonderful fellow with a huge heart, but over the years I saw him waste away before my eyes. The newer AIDS drugs staved off his death for awhile but eventually he succumbed to his condition. About a year before his death we happened to do a blood profile which showed that his total serum cholesterol was 86, the lowest I had ever seen. (Normal is 150-250, although this depends on who defines normal.) From that point on, when I had a patient who was in extremis from a tough illness (usually cancer or a chronic auto-immune disease), I would often check the serum cholesterol and find similar but not as extreme results. Cancer patients often die with a serum cholesterol between 100 and 150. The same holds true for many other chronic illnesses, especially those associated with bodily wasting (cachexia). It is as though, in the wasting process, as all the fat is "burned," so too is the cholesterol. This phenomenon is well described in medical literature where we are told that low serum cholesterol is a consequence of the wasting, not the cause. This seems to agree with my experience with this situation: When a person has wasting and a low serum cholesterol, it doesn’t matter how much fat or cholesterol the person eats, it seems to have no effect on the serum total. The curious thing about this conclusion that low serum cholesterol is the consequence, not the cause, of the patient’s illness is that, when it comes to heart disease, doctors say just the opposite. In this case we are told that the high cholesterol is not the result of whatever is causing the damage to the blood vessels, but is the actual cause of this damage. This, to put it mildly, is a head-scratcher. How these disparate conclusions have come about is a long tale which has been well told elsewhere (see especially The Cholesterol Myths by Uffe Ravnskov, MS, PhD), but it reminds me of the similar confusion that surrounds whether "infections" cause illness or whether (as in nature) micro-organisms feed on and recycle debris. If you put inappropriate material into your compost pile, nasty organisms will come to break this material down. A simplistic surmissal might be that the compost pile has an infection; rather, I think we can all agree that micro-organisms are nature’s recycling tools. The interesting history of why and how modern medicine got the micro-organism/infection story backwards is told in a fascinating book, Modern Medicine: The New World Religion by Olivier Clerc. In any case, the latest twist in the modern cholesterol tale is that current recommendations for treating heart disease by lowering the serum cholesterol advise doctors to reduce the total cholesterol to the range of 80-130, exactly the levels one sees right before the person succumbs to chronic wasting disease. I can’t help but be shocked by the potential consequences of this misguided policy. So what should you do if you find that, without obvious underlying illness such as cancer, AIDS or a chronic auto-immune or "infectious" condition, you turn up with a cholesterol below 150? The first and most important thing is to try to take an unbiased assessment of how you are feeling. Try to find a source of some imbalance that perhaps you have been overlooking. For instance, do you feel run down, fatigued, achy most of the time? Does something hurt that you are trying to ignore? In other words, a low serum cholesterol often means your body is struggling with something and you are using up your reserves. As you are on the lookout for the source of the struggle, you should as soon as possible adopt a traditional diet, including the liberal use of good fats (butter, egg yolks, cod liver oil, etc.), lacto-fermented foods, bone broth and all the other healing elements of this regime. If a source of the trouble is discovered (in one patient we discovered
an underlying hepatitis, in another chronic Lyme’s disease), it
should be
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Thomas
Cowan, MD, is a physician in private practice in San Francisco, California,
a board member of the Weston A. Price Foundation, and a regular contributor
to our "Ask the Doctor" column. His book The Fourfold Path to
Healing is now available from NewTrends Publishing,