421: Debunking Cholesterol Myths & the Truth About Statins: What Your Doctor Isn’t Telling You

ELLA: 00:00:00

Hey, you're on air with Ella, and we are about to dive into one of the most misunderstood aspects of health. I'm absolutely convinced after all of the research that I've done for this show that is about cholesterol and the role that it plays in heart health.

And for decades, cholesterol has been blamed as the villain behind heart attacks. And statins are one of the most prescribed drugs in history.

They are prescribed to anyone and everyone who has high ldl, at least here in America, and they are treated like a size fits all universal solution. But what if I told you that so much of this narrative is at best incomplete and at worst, wrong?

Today, I'm breaking down the myths that have been created over time, and I'll be sharing insights from the leading medical experts who are blowing a hole in so much of the narrative that has been created around cholesterol. Now, I am doing this with full disclosure that I'm not equipped to tell you anything about cholesterol.

All I'm doing today is I am sharing the research that I have done and then I spent hours on the show notes for this episode so that you can dive into the research. I've listed four books that are must reads.

If you're being told or a family member is being told that it is time to get on statins because your cholesterol is, quote, too high, I have many, many studies cited in these show notes, et cetera, my job today is to translate it for you and leave the rest of the research, the decisions up to you. You ready to jump in? Let's go. Welcome, you're on air with Ella, where we share simple strategies and tips for living a little better every day.

If you're interested in mindset and wellness or healthy habits and relationships or hormone health, aging well and eating well, honestly, if you're into just living better and with more energy, then you're in the right place. We're not here for perfect. We're here for a little better every day. Let's go. Hey, it's Ella.

Yes, we're going to jump into a conversation debunking a lot of the myths that have been created and sustained around cholesterol and heart health.

Before we do that, I'm going to share a couple quick updates and I will timestamp this episode so that if you're new here, you can just skip this bit for a few minutes and jump right into the show. I just wanted you to know, though, that I am holding events in several more locations that I want my women to know about. Do you live in Australia?

n October. So that is October: 2025

And I would love to know if you're there and if you're interested in getting together.

I'm pretty sure that we're going to do an event in Brisbane, but depending on your responses, you know, maybe we'll just create a dinner in Melbourne. All right. Secondly, if you live anywhere near the east coast or can easily get to Washington, D.C.

in early October. October of: 2025

You just go to my website@onairela.com and there are several places to join the mailing list. But I will put a link directly in the show notes when you open up this episode in your app so that you can just jump over there immediately.

Let me hear from you. I design these events based on interest. So if I don't hear from you, no event. If I hear from you, good times had by all.

Okay, I really want to jump in to this conversation about cholesterol. So let's go. Okay. When you think about cholesterol, I don't. I don't have high cholesterol.

So this has never been something that I've really thought about. I'm probably not predisposed to it as a mostly vegetarian anyway.

But when I think about cholesterol, the first thing that comes to mind for me is like, very bad. I think it's like a waxy, like, substance. It clogs up your arteries. If you have really bad cholesterol, you're going to have a heart attack.

You probably should be on medication. And I have had recently several good friends who are healthy, who eat really well, who are honestly, like, really healthy.

They're on the upper curve in so far as diet and fitness goes. And both of them, the people that I have in mind right now, both of them have been told by their doctors that they need to start statins.

And like I said at the top, I don't have any right to have an opinion about whether someone should start statins or not. Okay. It just didn't sit right with me.

I'm one of those friends that if you tell me something, I'm gonna go do three hours of research and then Send you all of these links that you need to dive into or summarize it for you. Okay, that's me. So I did that and I started unveiling so much research, it's actually been out for a little while.

I'm just, I'm new to the party here because again, this has never been top of mind for me.

But when these two people in such a short time told me that this was going on for them, I was like, something just doesn't sit right about you starting statins in your 40s and continuing them for the rest of your life. I just wanna, I learned so much.

And I'm going to attempt today to share just the highlights with you and direct you to more resources because at the end of the day, this is for me to share some of what the experts rather are saying, some of what the research is revealing, and then give you what you need to go on this journey for yourself. But perhaps bringing a little new information to your practitioner.

And there are several different tests you can ask for, there are several different data points you can share.

The only agenda that I have here is that people do not just blindly start taking prescription medicine when they may not need it and are very likely to be under informed about the side effects of those medications. Statins are not a one size fits all and we're going to talk about it.

But one fact that I want to share with you before we get into debunking specific myths is that the way we even think of cholesterol is again, arguably wrong and at best completely lacking in information.

So part of what I was very surprised to learn at the top is that not only is cholesterol not the enemy, but it is extremely critical to our immune function, to our hormone production and even our longevity. So cholesterol is not just a risk factor, it's actually an essential component of optimal health. That alone was new information to me.

In a recent study published in jama, the Journal of American Medicine, they published a study highlighting a U shaped relationship between cholesterol levels and mortality risk. Okay. A U shape, meaning we actually need to find a balance for optimal health, not just aim for rock bottom numbers.

I hope that alone is new information to you and that everything else I'm about to share with you is at least illustrative and inspires you to do your own research. If you or a loved one is facing this conversation with your own health practitioner. Okay, myth number one that I want to discuss with you.

Myth number one is cholesterol is inherently evil. Cholesterol is bad.

And what you read in the commercials that you see and just general sort of media might have you believe that cholesterol is like public enemy number one when it comes to heart health. And that is just a really misleading and dangerous message for anyone, much less the medical and health care community to be pushing.

As I said, cholesterol is a necessary ingredient to many important roles in your health. It's part of cell membranes, it prompts production of crucial hormones, it is essential for cell repair and even fetal development.

Idea that LDL is bad oversimplifies an extremely complex system. In short, it's essential to the human body. It plays several key roles and just going for rock bottom. LDL totally oversimplified.

And by the way, let's talk about HDL and LDL for just a minute. HDL is high density lipoprotein and LDL is low density lipoprotein. Okay?

And when physicians talk about cholesterol's harms, they're usually referring specifically to low density lipoprote. LDL and LDL transports cholesterol around the body, depositing it in blood vessels.

And then its cousin HDL has long been thought of as the good cholesterol because it typically ferries cholesterol away from other parts of the body to the liver. But here's myth number two. Lowering LDL guarantees positive health outcomes or guarantees protection.

But lowering your LDL alone is like cleaning up spilled water while ignoring the leaking pipe causing it the first place. You are treating a symptom and not the root cause.

Lowering your LDL alone, like in a vacuum, does not address systemic inflammation or insulin resistance, which turn out to be two critical drivers of heart disease. Now, Dr. Peter Attia and other experts, they represent, they recommend different tests instead of just the LDL C tests.

And I will share exactly what to ask for later in the episode. Okay, but in short, cholesterol isn't the enemy ldl. It is one piece of a much bigger puzzle. So picture this.

A 45 year old woman goes in for her checkup and her LDLs come back slightly elevated. And her doctor immediately suggests statins. This happens every day. But here's the thing.

She exercises, she eats a relatively healthy diet, she has no family history of heart disease and her inflammation markers are low. So she's actually at no significant risk from cholesterol alone.

And her doctor may be focusing on that one number instead of looking at her her overall health P Again, this happens all the time.

And the point here is that it is not just about cholesterol insulin resistance, and metabolic factors matter much more than we have been led to believe in this cholesterol and statin story. Now, it's important to note something. High LDL levels can definitely signal risk. Definitely. Definitely. For sure.

The research says that there is no question about that. But what is more nuanced here is that they are not a universal predictor.

It's bad practice, in my view, to prescribe medications without understanding a confluence of factors about somebody's health. And There's a researcher, Dr. Natalie Pamir, her research revealed that HDL's protective effects.

Okay, so the good stuff, HDL's protective effects vary by race. In fact, there is no benefit for black adults. There is no benefit for black adults in high HDL numbers.

I'm oversimplifying her research, but that outcome alone challenges the simplistic good versus bad narrative of HDL versus ldl.

What more nuanced research is showing is that insulin resistance, driven by what we're eating and how we're living our lives, is a critical metabolic driver of heart disease, refined carbs and sugars, and all of those things that spike your insulin, which can lead to obesity and diabetes and cardiovascular damage. Your metabolic health is an enormous factor in the cholesterol picture, in the heart health picture.

And you can address insulin resistance through diet, exercise, stress management, sleep, all the big rocks that we're always talking about. And you can dramatically reduce your risk of heart disease by managing those factors. Again, I am not saying don't take statins, go exercise.

I am not making this a binary, and I'm not making this a linear equation.

What I'm sharing with you is that so much research is showing how diet and exercise and stress management and sleep management can actually leverage your cholesterol numbers, more than our medical practitioners are sharing or even aware of. And so many people are immediately put on statins. And cholesterol is like a passenger on this bus, Right? It's not driving the bus.

Systemic inflammation is driving the bus. And cholesterol is along for the ride, while inflammation and insulin resistance are steering us toward bad health outcomes.

All right, let's deep dive into statins. So statins are the medication that's prescribed when you are told your cholesterol is too high. Okay.

In the simplest terms, and they are among the most prescribed drugs globally, but their benefits are often overstated, and then their risks are severely underplayed. According again, to the. These are not my opinions. Okay? Everything has a big fat asterisk next to it and is like, according to the Research.

The latest research. I just think we need to talk about this in a more balanced way rather than immediately being handed a prescription.

Again, my objective is to help equip you with new insights, but also the questions to ask your doctor if you end up going down this road with them. Let me share an anecdote with you. I had a friend who was prescribed statins after his LDL came back high during a regular checkup.

Within weeks, he started experiencing muscle pain and brain fog, but he was told to stick with it. And it turns out that his LDL wasn't even dangerously high.

And his real risk factors like stress and poor sleep and some of the big rocks that I mentioned before, they weren't addressed at all. They weren't even mentioned. He could have benefited more from lifestyle changes than medication. Arguably, there's more.

Statins have a dual impact on sexual health. They boost nitric oxide. We've talked about nitric oxide before.

We've talked about the role it plays in performance and in sexual performance, like erectile dysfunction. Not enough nitric oxide is bad, right? It's a key element in ed, a lack of nitric oxide, much greater propensity toward erectile dysfunction.

Statins actually boost nitric oxide. So positive mediator of erections. But they also suppress testosterone production by blocking cholesterol synthesis there.

I read study after study about this. Probably five studies about this, and they are cited in the show. Notes, notes. The jury is still out. They say, yeah, it suppresses testosterone.

It definitely suppresses free testosterone a lot by a significant amount. Others say, no, it's not a significant amount. Like, it's definitely suppressing testosterone, but not by a significant amount.

And then others say, well, it did for some, but the older you get, the higher the impact is on sexual health. So, in short, statins improve nitric oxide. Okay?

They enhance nitric oxide, which improves blood flow, but long term use can reduce free testosterone and may possibly cause testicular atrophy. Okay, that's not mentioned. No one's telling you that the jury is out on how much statins affect erectile health.

And we are constantly talking about no production and ED in the context of men. But let me tell you something that I learned from Dr. Kelly Casperson. If it's affecting men that way, it's affecting women the same way.

We just don't talk about them. So it is suppressing hormone production in women as well. It's not suppressing testosterone in men only.

It's just that only men are studied and the woman's clitoris is comparable to the men's penis.

So if it's happening to the penis, my understanding this is my understanding with a big fat asterisk next to it is that it's going to have the same impact on the women's clitoris. In short, I'm not here to tell you to get off satins.

I'm here to tell you what questions to ask about satins and what you might want to start researching for yourself. But let's get off our genitals for a minute. Okay? Let's talk about some of the other side effects of statins that are rarely, if ever mentioned.

I'm telling you for whatever point of view you want to have, there's a study to back it up. So I found this really, really fuzzy. You you could justify any opinion you want to justify with the current research.

Some people are like, yes, this is really helpful. It really aids in primary prevention, especially for younger people. And then other people say statins can be really bad them later in life.

The benefits, in short, are not universally applicable. That is something the research agrees on. Statins are not a one size fits all.

The benefits of statins can vary significantly based on individual factors, including your age, your gender, and overall health status.

A study from the University of Oxford suggests that statins may not be beneficial for all, they said importantly, statins may interact with other medications, contributing to adverse drug reactions and avoidable hospitalization. Second point, as with efficacy, the burden of statin adverse effects in older people has not been well studied.

As a result, it is still not possible to know the balance of risks and benefits for this age group. They simply have not studied the adverse effects of statins in people who start them when they're later in life.

In conclusion, the gains made in increasing lifespan may not have been accompanied by similar gains in a healthy life. That excerpt is referring to the fact that some people argue that statins increase lifespan span. It's debatable.

I saw somewhere that it was four days. It can increase lifespan by four days. That number was bandied about. But what it's not doing is being matched.

It's not accompanied by similar gains in health span. So people are experiencing a slight boost in lifespan and not health span because of the side effects.

Current evidence for starting statins among older people is insufficient to support this approach. I mean, there's more of this. I'm not going to sit here and quote study after study, but again, I did link these in the show notes.

Let's talk about some of the risks that they don't share with you. 20 to 50% of statin users experience side effects. Muscle pain, brain fog, erectile dysfunction, already mentioned.

But the guidelines rarely discuss these trade offs and practitioners even less. And then just the general overuse to me is a yellow flap. Statins may absolutely benefit high risk patients, especially post heart attack patients.

Like, there's a lot of research that talks about their benefit, but they are over prescribed to low risk individuals. For example, one of the studies that I found estimated a 600% increase in eligibility for statins between the late 80s and recent history.

So in other words, in that period, the late 80s to now, there has been a 600% increase in eligibility for statins. When we talk about eligibility, it means they're lowering the bar for where your numbers need to be for them to say, yep, get on a statin right away.

And again, many of the researchers are now saying that lifestyle interventions should come first, especially depending on the age of the patient. In short, statins are among the most prescribed drugs globally. But their benefits are often overstated and their risks are underplayed.

And for primary prevention, people without prior heart disease statins show no measurable improvement in lifespan, according to several studies. Again, they're linked. Okay, let's go back to lowering our LDL cholesterol. That is generally supported by the medical and the research communities.

But what is left out is that lowering your LDL doesn't address the systemic inflammation or insulin resistance that I mentioned before. An extremely low LDL may actually weaken your immunity and correlate, correlate with higher cancer risk, according to some studies.

Further, genetic high cholesterol. Right, Because a lot of people talk about that, they're like, oh, this is genetic. I eat really well. I don't eat that much fried food.

I don't eat just copious amounts of meat. So I don't understand why I have high cholesterol. It's my genetics. Well, genetic high cholesterol affects only one in 250 people.

So a lot of these cholesterol fears are, according to the new research, overblown. Now, Dr.

Peter Attia, he argues that the standard test that we do for LDL should be replaced by or supplemented with LDL particle count via a test called apob. It's literally apob and it's pronounced apob. Anyway, APOB is a better risk marker than LDL as it reflects more accurate data.

So again, there's a list of tests that we can ask for instead of just the simplified, arguably over overly simplified, LDL tests that your practitioner is accustomed to giving. You. But let me bring this whole picture together for you now. Okay?

We've talked about the myth that all cholesterol is bad and that cholesterol is always harmful. Not true. It's actually completely essential for your, your immune system, your brain, for fetal health, et cetera.

We have talked about cholesterol not necessarily driving the bus toward heart disease and that systemic inflammation and metabolic are actually the ones driving the bus and cholesterol is along for the ride.

We've busted the myth or at least raised some yellow flags around statins being a completely safe, one size fits all solution for absolutely everybody. And we have talked about how statins have, like, a dual impact on sexual health.

We've also talked about how lowering LDL cholesterol is not the panacea that we think it is. It is, again, just not that simple, people.

But let's talk about what the emerging consensus is now on the new research on the more recent research on cholesterol and heart health. And that involves several things.

Several solutions, including precision medicine, a focus on metabolic health, and what the experts call advanced lipidology. Okay.

The experts that I research advocate for a shift toward precision medicine instead of one size fits all and tailoring treatments to genetic lifestyle, age, gender, and metabolic health, rather than some universal slab of satin on it approach. So what should we be tracking instead of just these basic cholesterol numbers then?

The key is to get a more complete picture of your cardiovascular health. And there are ways to do this, and that means looking beyond LDL and HDL and considering several key factors.

Now, I am about to step out of my comfort zone and just read you some things. Stuff. Okay? But this is in the show notes and you can, you can print this out and take it to your practitioner. There's a triglyceride to HDL ratio.

Triglyceride to HDL ratio. This is a snapshot of your metabolic health. An optimal ratio is less than 1.5.

This information, again, can be taken directly to your practitioner and discussed with her. High sensitivity crp. This measures inflammation in your body, a major driver of heart disease.

And finally, looking at insulin resistance and metabolic health in general.

You want to learn more about metabolic health health, how well your body processes sugar and whether you are facing insulin resistance, experiencing insulin resistance, and to what degree. The latest experts, the latest research say that these are arguably stronger predictors of cardiovascular risk than cholesterol alone.

And if you're looking to go even deeper, you can talk to your doctor about these advanced lipid markers that I talked to you about which is APOB that measures the actual number of artery clogging particles in your blood and Dr. Peter Attia talks about this a lot. I will link to some of that. And then cholesterol efflux capacity. Again, never heard of that.

It measures how well your HDL is actually removing cholesterol, not just the amount of HDL in your blood and Dr. Dan Rader's research emphasizes this.

Again, all linked these are not everyday tests, but you can talk to your doctor and know that you have other options other than just taking statins. In short, a comprehensive assessment gives you a much clearer understanding of your true risk.

Okay, so just to bring you back to center, I want to remind you of one of the real culprits here is your metabolic health. And that means that is good, good news because you can impact your heart health through lifestyle and nutrition choices.

Unquestionably, there is no argument about that.

A focus on nutrition, on eating more whole foods in your diet, on moving your body, on managing your stress, on managing your sleep quality, and not just looking at a simple biomarker like LDL versus hdl. So much of this is within your control and the data agree.

Lifestyle changes can reduce plaque buildup and improve heart function and that offers so much hope and power. Beyond lifelong medication, there are several things that you can do besides go to the Show Notes and print them out.

There's so much more to read about this. I have four books suggested in the Show Notes for you that detail this by qualified people, not just a podcaster who's interested in the topic.

There is the Truth About Statins. There is a Statin Free Life. There is the Great Cholesterol Myth and the Great Cholesterol Con.

Those are just four samples of books that I'm recommending and linking for you in the Show Notes. I've also linked several podcasts that you can listen to with the experts themselves. If you want to dive deeper, you can just click on that.

At the end of the day, I just encourage you to advocate for your own best medical care. It's not easy and it's often not fun, but you are going to be the best advocate for you.

Do not just take what the person in the white coat is saying whole cloth. I implore you to educate yourself enough to go in and to be able to ask the questions that you deserve to ask. I'll close out with A quote from Dr.

Aseem Malhotra Malhotra.

He is a leading voice in busting our conventional narratives about cholesterol and statins and he says the following the best prescription is not in the pill bottle, but on the plate. The future of heart health is not about lowering a number. It's about optimizing the complex interplay of diet, hormones, inflammation and metabolism.

I hope that this is useful for you. I hope I've given you some information that you need.

Open up this episode in your app and click on Show Notes and you'll get loads more with references cited. Share this with others.

Help spread the word if you have loved ones who are being handed prescriptions whole cloth without any further exploration into the root causes, I would love to hear from you. I'd love to hear about your conversations with your own practitioners. And I know there is so much more to this story and you deserve the facts.

So good luck with your own research and let me hear from okay, if you enjoyed today's show, please share it with someone you care about. And be sure to check out our new YouTube channel and head to onairela.com for today's show notes.

You can also learn about how to work with me there on air Ella.com and I would love to hear from you. So if you DM me on Instagram, I promise I will reply. P.S.

all the links you need for us to connect are right here in your podcast app in the description for today's episode. Check them out. Thanks for listening and thanks for inspiring me. You are, quite simply, awesome.