The Cholesterol Conversation We’re Not Having
Last week, Science Daily ran a story announcing a “new treatment that cuts cholesterol by nearly 50 percent, without statins or side effects.”
Exciting? Sure. But it also made my heart sink just a little. Because headlines like that are why so many people come into my practice proudly saying,
“My doctor says my cholesterol’s down to 120 — isn’t that great?”
And I have to smile gently and say,
“Well… not necessarily.”
Cholesterol: Villain or Vital Substance?
Somewhere along the line, cholesterol became a four-letter word. We blamed it for our heart disease, our strokes, even our memory loss. But the story isn’t that simple — cholesterol is actually one of the body’s most vital building blocks. And it turns out that low cholesterol risks are real.
You need cholesterol to:
- Build your sex and stress hormones — estrogen, progesterone, testosterone, cortisol, DHEA.
- Support your thyroid hormones.
- Produce vitamin D from sunlight.
- Form the myelin sheaths that insulate and protect your nerve cells — kind of like electrical tape around a wire.
- Keep your cell membranes flexible and functional.
And yes, it even helps regulate your mood. When total cholesterol dips below about 160 mg/dL, the risk for depression, anxiety, irritability, relapse, and even self-harm rises.
Cholesterol supports serotonin production — your “feel-good” neurotransmitter.
I know this firsthand. At one point in my own health journey, my cholesterol dropped below 160 — I was constantly tired, unmotivated, and simply felt off. It turned out I was dealing with an infection that was interfering with fat absorption.
Once I addressed it and brought my cholesterol back up, my energy returned.
When levels drop too low, the low cholesterol risks become clear. It’s like your body’s battery losing its charge. You need cholesterol to make cortisol and thyroid hormones to keep your metabolism humming.
And when that happens, it doesn’t just drain your physical energy — it can dim your mental sharpness, emotional resilience, and overall vitality.
Low cholesterol isn’t just a number; it’s a signal that your brain, hormones, and mitochondria may be running on empty.
So, What’s the Problem With “Lower is Better”?
For decades, public health messaging has treated cholesterol like a moral failing.
We vilified eggs (oops). Then we demonized coconut oil because it was “saturated fat” (double oops).
As I wrote years ago in a Healthy Fats post:
“Vilifying coconut oil reduces it to a single nutrient and misses out on all the other health-promoting benefits that it contains.”
Every whole food that contains fat — whether it’s an avocado, a walnut, or yes, a coconut — carries all three kinds of fats: saturated, monounsaturated, and polyunsaturated. It’s the balance and source that matter, not the presence of saturated fat itself.
In fact, research from Harvard and other major institutions shows that coconut oil actually raises HDL (the “good” cholesterol) — the one that helps clear fats and inflammation from your bloodstream. (Although this was a small sample of 100 participants, check out the results from “Trust Me, I’m a Doctor” on BBC2.)
The Bell Curve of Balance
In integrative medicine circles, we’ve observed what looks like a bell curve of optimal cholesterol:
- Below 160 mg/dL, the body starts running out of raw materials for hormones, vitamin D, and serotonin. In fact, studies of several European countries found that the seven nations with the lowest intake of saturated fat had a threefold increase in mortality risk for men and a 4.5-fold increase for women.
- Above 223 mg/dL, the risk for plaque, inflammation, and a cardiac event climbs.
So the sweet spot? Somewhere between 180 and 223 mg/dL — where your brain, hormones, and heart can all do their jobs.
It’s a reminder that low cholesterol risks are real. Especially when we push numbers down without understanding what those numbers actually mean for the whole body.
That’s why, in my practice, we don’t just look at the number on the lab report.
We look at:
- LDL particle size — are they tight and inflammatory or fluffy and harmless?
- HDL ratios — are you successfully shuttling used fats back to the liver for cleanup?
- Omega 3:6 balance, inflammation markers, and blood sugar regulation.
It’s not about “good” vs. “bad” cholesterol. It’s about communication between systems.
What the Science Daily Article Missed
The new PCSK9 gene-silencing therapy is fascinating — it works by quieting the gene that destroys LDL receptors, letting the liver clear cholesterol more efficiently.
That’s fantastic for people with familial hypercholesterolemia (a genetic condition where cholesterol runs dangerously high).
But for the rest of us? It raises an important question:
“At what point does lowering cholesterol stop being protective — and start robbing the brain, hormones, and immune system of what they need?”
That’s the nuance missing from the “lower is better” narrative.
Reframing the Conversation
Instead of chasing the lowest possible number, let’s aim for resilience:
- Eat fats close to their original form — cold-pressed, whole-food, unprocessed.
- Choose organic, grass-fed, or wild-caught sources.
- Pair fats with plenty of fiber and antioxidants (think vegetables, herbs, and omega-3s).
- Ditch the processed sugars and refined carbs that truly inflame the arteries and raise oxidized LDL.
And remember: if your cholesterol is high, it’s not a moral failure. It’s a message.
Your body is saying, “Something in my system is off — let’s investigate.”
When we respect the body’s wisdom, we stop chasing perfection and start honoring balance — avoiding both high and low cholesterol risks along the way.
The Bottom Line
The goal isn’t “no cholesterol.” It’s understanding cholesterol — where it’s helping, where it’s harming, and how to support your body’s natural balance.
These new therapies may have their place for those with genetic cholesterol challenges, but for most people, lowering cholesterol at all costs can come with its own consequences.
So before we celebrate every scientific breakthrough as a universal solution, let’s remember that the best medicine is still personalized, thoughtful, and rooted in respect for how beautifully complex the body truly is.
True healing starts with wisdom, not fear. If you’re ready to understand your body’s signals — and find peace in your numbers — I’d be honoured to walk that road with you.
Through my Functional Health Report, powered by Optimal DX, you’ll receive a personalized analysis that uncovers the root causes of fatigue, pain, and emotional overwhelm. This one-on-one session will give you practical, compassionate insights to help you restore energy and well-being — because you deserve to feel vibrant and happy again.