The Cholesterol Conundrum

It’s no secret: I’ve got high cholesterol. Well, actually, that’s a bit of an understatement. The truth is that for an 18-year-old, my LDL (low-density lipoprotein) cholesterol level is astronomical and my HDL (high-density lipoprotein) cholesterol level is pitiful. According to the American Heart Association, a desirable level of LDL cholesterol—the “bad” kind that can forms clots in your arteries and causes heart attacks or strokes—is below 200 milligrams per decilitre of blood (mg/dL). Between 200 and 239 mg/dL is considered “borderline high risk,” and anything above that is “high risk” (1). Well, my latest LDL count was 240 mg/dL. On the other hand, my HDL cholesterol count is 17 mg/dL, when a desirable level is above 40 mg/dL. To clarify, HDL cholesterol is considered to be “good” cholesterol, though no doctor could really tell me why. Experts have suggested that HDL cholesterol may carry LDL cholesterol away from the arteries and back to the liver, where it is passed through the digestive system and excreted. Other doctors believe that HDL cholesterol “removes excess cholesterol from plaque in the arteries, thus slowing build-up” (2). But ultimately, no one really knows.

So, my problem is that I need to raise my HDL count and also lower my LDL count without prescription medicine. It sounded simple at first, but two years and five different diets later, I still have high LDL cholesterol and a dangerously low HDL count. Meanwhile, my doctor has dismissed my high cholesterol as hereditary and she insists that I’m capable of lowering my cholesterol on my own, that I don’t need medicines just yet. But it’s still quite a challenge (especially with the holidays coming up). My doctor told me to make sure that I exercise for at least half-an-hour each day (which I do) and eat right (sure, ok). But eat what?

I’ve read all the articles that advertise foods ranging from blueberries to honey and nuts as proven cholesterol reducers (3, 4). I’ve got a list of unappetizing foods I’m “allowed” to eat and every day at Rhoads or Erdman I go through the checklist and leave hungry (5). There are people who say avocados lower cholesterol, my aunt says I ought to eat cinnamon, one study says that a high-fiber diet will cure me, while another study revealed that a cup of fresh orange juice each day does the trick (6). Then there are the herbal remedies such as the 3,000 year-old Hindu treatment of guggal tree extract that was alleged to have properties that converted cholesterol into bile acids but was actually found to increase rather than decrease cholesterol levels (7,8). The problem here is that the headlines declaring that some food or other lowers cholesterol are popping up more frequently than I can keep track of and I foolishly follow these diet regimens that are not right for my body. Moreover, it doesn’t seem to me that these foods actively lower cholesterol, they just don’t make it worse. I know what not to eat (animal fats including dairy products and fried foods), so I suppose by manner of exclusion I know what I can eat. It’s about “getting it less wrong.” I’ll just have to discover which foods work for my own body to help cleanse it of cholesterol. However, I don’t think that I can solely rely on exercise and diets to lower my cholesterol. I feel as if I need to understand why I’ve got high cholesterol before I can understand how to solve the issue. Perhaps the cure to my cholesterol lies in its origin…

It would be so convenient if I could blame genes, but I’m the only one in my family whose got high cholesterol. So, it’s not great-grandma Rosalind’s fault. Also, I haven’t got diabetes or any other diseases that are proven to raise cholesterol levels, so that excuse won’t work. I’ve never had a particularly poor diet. I was a vegan for the past six years, so I didn’t really eat animal fats in the first place. I don’t smoke, don’t drink in excess, don’t have high blood pressure, and I’m obviously not above the age of 65. So why do I have high cholesterol?

I’ve accounted for all of the causes of high cholesterol listed on the American Heart Association website, but I’d like to propose one that wasn’t mentioned: anorexia (9). I suppose now I must confess that the fault is likely entirely my own. Between the ages of 14 and 16 I was anorexic. I would go for up to three weeks without eating. As a result, my body went into starvation mode and my liver had to work twice as hard as a normal liver in order to compensate for the nutrients I wasn’t receiving from food.

To clarify, cholesterol is synthesized by the liver. Most people don’t need an alternate source of lipids. Regardless of “whatever food you eat, the liver will take from it the necessary ingredients to produce cholesterol” (10). Only about 20% of the body’s cholesterol is from exogenous (dietary) sources while the rest is “synthesized by our cells, especially liver, adrenal glands, intestines, and sex organs” (10). Interestingly, “the ability of human cells to synthesize cholesterol is a mechanism designed for survival of the species during famine” (10). Each person needs a set amount of cholesterol, so when deprived of exogenous sources of energy, it begins to rely on the synthesis of endogenous source of cholesterol (10). A certain amount of cholesterol is necessary to the body because it fortifies cell membranes, functions to synthesize hormones, assists in the digestion of fat through bile synthesis, protects the skin, and is said to contain anti-oxidant properties (10). However, when my body was entirely deprived of food and thus essential nutrients, my liver had to work much harder in order to compensate for the lack of nutrients. At the same time, it had to maintain its cycle of glycogenesis in order to continue blood circulation and sustain other vital functions. In other words, my liver was overworked and extracting the maximum amount of cholesterol from minimal sources. The problem is that when I began to eat again my liver was still functioning as it was when it was in “starvation mode.” When I ate, especially when I ate foods high in fat, my liver was thoroughly extracting cholesterol, fats, carbohydrates, and other forms of energy in order to protect my body in case of future starvation. It was still overworking itself, even though it wasn’t necessary.

So, ultimately, my cholesterol level is so high because my body was trying to protect me when I was neglecting to properly nourish it. The high cholesterol is the result of both the foods I ate and the fact that I often failed to eat. Maybe the solution to my particular cholesterol problem lies solely in food after all and I’m going to have to work for the rest of my life to find a proper dietary balance. Of course, I may be jumping to conclusions rather swiftly and I may be completely wrong. I think that a survey of the cholesterol levels of formerly anorexic individuals ought to be conducted to see if there is any correlation between the two diseases. I already know of a few people who once had eating disorders and now suffer from high cholesterol levels. Regardless, if a correlation is discovered, cholesterol ought to promptly be acknowledged as one of the many long-term negative effects of anorexia. At the same time, dedicated doctors will need to help recovering anorexia patients work our dietary regimens that cater to their particular needs and not dismiss the high cholesterol as hereditary.


(1) http://www.americanheart.org/presenter.jhtml?identifier=183
(2) http://www.americanheart.org/presenter.jhtml?identifier=180
(3) http://news.bbc.co.uk/2/hi/health/3591384.stm
(4) http://news.bbc.co.uk/2/hi/health/2203073.stm
(5) http://www.all-about-lowering-cholesterol.com/foods-that-lower-cholesterol.html
(6) http://www.loweringcholesterol.net/show/raise-hdl-cholesterol
(7) http://news.bbc.co.uk/2/hi/health/1963645.stm
(8) http://news.bbc.co.uk/2/hi/health/3144157.stm
(9) http://www.americanheart.org/presenter.jhtml?identifier=235
(10) http://www.all-about-lowering-cholesterol.com/cholesterol-information.html