Is Your Cholesterol Too High or Too Low?


“Your cholesterol number is high…”

….a phrase still scary to many of us. So many of my patients are on prescribed statin drugs, yet (for the very first time) the Scientific Advisory Panel for the 2015 Dietary Guidelines for Americans suggests that we should no longer advise the public to be concerned about cholesterol intake from food.

As as a Licensed Dietitian and Clinical Nutritionist trained in Functional Medicine, I navigate the cholesterol minefield discussion on a regular basis. Sadly, in my opinion, in the 1960’s Dr. Ansel Keys used controversial data to set us on a course of artificially lowering cholesterol levels using statins and encouraging the intake of more processed foods using unhealthy inflammatory oils, high sugar, high carb, fat-free and low-fat foods.

Modern medicine and the pharmaceutical industry gladly went on to praise the creation of cholesterol-lowering drugs that stemmed from Keys’ work. Keys constructed his hypothesis after studying the diets and heart disease in countries across the globe. But his research left out nations with data that did not match the hypothesis, and even within the data he published, populations existed in which diet and heart disease were wildly out of sync with his model.

By 1970, an English researcher named John Yudkin would argue that sugar in the diet was the cause of heart disease in wealthy nations, but Keys, sensing that his theory was suddenly vulnerable to reconsideration, aggressively led the charge to have that research discredited.

In Functional Medicine, we believe the real culprit with chronic diseases, including cardiovascular disease and heart conditions is out of control inflammation levels in the body which have gone completely unchecked. Sugar is indeed an inflammatory food that lowers your immune system’s ability to respond. This may be why, even with today’s high use of statins, heart attacks are still among the leading causes of death. The recent report (November 2017) that John Warner, MD, President of the American Heart Association, further supports the fact that modern medicine has not solved the puzzle in what is being done (or not being done) to prevent heart attacks:

ANAHEIM, California – American Heart Association President John Warner was away from the AHA’s Scientific Sessions with his family Monday after having a minor heart attack during the organization’s flagship scientific conference.

Warner, a practicing cardiologist and the CEO of UT Southwestern University Hospitals in Dallas, had the episode Monday morning. He was taken to a local hospital, where doctors inserted a stent to open a clogged artery.

On the opposite end of the cholesterol spectrum, what can happen if our cholesterol goes too low (with or without medication)? Should we be worried about that too?

Cholesterol is actually an essential compound in our body, so much so that our liver spends a lot of time making it (another reason why dietary cholesterol levels have less than 20% impact on total blood cholesterol)! Let’s look further at some of the functions of cholesterol in our bodies and the effects of not having enough:

Structural integrity

Cholesterol provides structural integrity to every cell membrane in our body, as well as the membranes of intracellular compartments such as our mitochondria. It actually helps, too, to stabilize important functional proteins in our cell membranes, so that they can do their jobs properly (like regulate glucose entry into cells, or initiate blood clotting). But doesn’t it make our cell membranes too rigid, I hear you say? Well, it can in excess. But if you don’t have enough of it, your membranes can actually lose their integrity, becoming inappropriately permeable and vulnerable to oxidative stress. That can affect all kinds of cellular functions. Consider, too, how this might play a role in skin and intestinal barrier permeability, as well as at the blood brain barrier.

Nerve impulse transmission

Cholesterol is vital for nerve function. Each of our nerves is coated with myelin, which is 20% cholesterol by weight. This coating serves as an important insulator to protect the integrity of that electric impulse and communication throughout the body. And since nerves communicate with cells all over our body, any area of our body can be affected by poor nerve function.

Learning and memory

Learning and memory depend on cholesterol. In fact, the brain contains 25% of the body’s cholesterol and it has been shown that cholesterol is essential for the formation of synapses which are a key mechanism in how we learn, how we store information in our memory and in general mental function.


Cholesterol is necessary for the proper function of serotonin, the body’s feel-good chemical and major neurotransmitter in the gut. In fact, the chronic depletion of cholesterol has been shown to impair the activity of serotonin receptors and may cause depression.

Cholesterol is used to make bile acids which are essential for proper absorption of fats, fat-soluble vitamins A, D, E and K, as well as fat-soluble phytochemicals. These are vital for many body systems including the immune system, vision, bone health, blood clotting and anti-oxidant reactions.

Hormone synthesis

Steroid hormones are synthesized from cholesterol. These include the stress hormone cortisol, aldosterone, which regulates blood pressure and electrolyte balance, and sex hormones including testosterone and estrogen which affect libido, fertility, mood, bone density, and more. Not least, cholesterol is the precursor to the hormone-like vitamin D, which is widely recognized as having a large role to play in various aspects of health and chronic disease.

While avoiding dietary cholesterol doesn’t have much effect on circulating levels, adding cholesterol to your diet can help restore balance if your levels are depleted (such as from long-term statin use). Liver and eggs are especially good sources (choose clean, organic versions of course!). Head on over to our recipe page to check out our ideas for delicious (healthy fat) recipes!


Panel suggests that dietary guidelines stop warning about cholesterol in food

Gropper SS & Smith JL. 2013. Advanced Nutrition and Human Metabolism. Wadsworth, Cengage Learning.
Sun S, Yang S, Mao Y, Jia X, Zhang Z. Reduced cholesterol is associated with the depressive-like behavior in rats through modulation of the brain 5-HT1A receptor. Lipids Health Dis. 2015 Mar 24;14(1):22.

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