Updated: June 2023
So, if we are going to be real about things, most of my patients are older than 45 years old. Most of them are losing 1% of muscle mass annually which comes naturally with aging and lack of exercise/protein deficient diets.
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Before coming to me, most of my patients were unhealthy and had been taking statin drugs long term which can compound the problem and contribute to a more rapid loss of muscle mass.
This is a BIG HEALTH PROBLEM. In my opinion, it is epidemic in proportion and in most cases could be completely avoided.
*Disclaimer: I am going to spend the next page or two talking about statin drugs that are used to lower cholesterol. If you aren’t on a cholesterol lowering medication, that’s fantastic! Skip the next couple of pages and learn about how cholesterol could be tied in with Alzheimer’s Disease, Adrenal Gland Dysfunction, Type 2 Diabetes, and Poor Libido.
Is Cholesterol the Enemy?
First, let’s dispel the myth that cholesterol is bad. You need cholesterol. You don’t want cholesterol to be sky high, but you don’t have to freak out when it’s mildly or moderately elevated either.
Homocysteine is 4 times more predictive of a stroke or heart attack than cholesterol. So why does cholesterol get all of the press?
I had a new patient yesterday who had a stroke a few years ago and she can’t use her right arm and hand not to mention her pain and other neurological deficits.
I asked her the question, “have you had your homocysteine level checked?” I knew the answer would be, “no” or “what’s that?” That’s the same answer I get every time I ask previous stroke and heart attack patients that question.
What if she had known that her homocysteine levels were sky high before the stroke and could have done something about it? What if the stroke could have been prevented and she could still use her right arm and hand and live life without her pain and permanent nerve damage? What would that have been worth?
In addition, once you have had a stroke or heart attack, your risk for a second life threatening stroke or heart attack is much higher. What about prevention of a second stroke?
Why had she not heard of homocysteine before she became my patient? Why have all patients who have had a stroke or heart attack not heard of homocysteine?
I don’t understand it. Not everything in life makes sense but this just seems like it should be standard practice.
It is my opinion that homocysteine should be checked on all patients (young and old) so that damage to the fragile and delicate arterial system could be prevented.
Roles of Cholesterol
Of course, significant elevations in total cholesterol values do mandate change (in dietary and lifestyle habits) but it is usually not a need for panic or short term statin use unless the levels go up to around 300.
Newsflash: Your body is made up of cholesterol. In fact your liver and cells in your body make significantly more cholesterol than you take in through your diet.
Your brain is made of sterols which are derivatives of cholesterol.
Your sex hormones are made from cholesterol.
Cholesterol is found in all of your cell membranes.
Cholesterol is a powerful Antioxidant.
Antioxidants help prevent damage to body tissues. They also help damaged tissues repair. All aging is from free radical damage. The wrinkles on your skin were caused by free radical damage.
Cholesterol is a precursor for Vitamin D production. If you only knew how many patients I’ve tested who had low vitamin D levels and they were taking a statin drug to lower cholesterol. It’s unbelievable!
This isn’t rocket science. If you take a cholesterol lowering medication, line up to get your prescription of synthetic vitamin D next.
By the way, I’ve said that expression – “this isn’t rocket science” many times throughout my life but I actually have a rocket scientist as a patient! Isn’t that cool? It’s right up there with when I get to treat a celebrity. He is thriving and tells everyone that my care has changed his life.
Can Cholesterol Lower Libido?
Many people begin taking statins to lower their cholesterol and then wonder why their libido isn’t what it used to be. In addition, there is a phenomenon known as Pregnenolone Steal or “The Cortisol Shunt”.
The Cortisol Shunt is important because the body will actually choose stress over sex.
If you have blood sugar dysregulation, chronic stress, or chronic pain (which causes chronic stress on the whole system), your body will shunt (or “steal”) a hormone called pregnenolone (made from cholesterol by the way) away from the chemical pathway that makes female and male sex hormones.
Instead of producing female and male sex hormones, pregnenolone will go into another pathway and eventually turn into cortisol which is a stress coping mechanism.
Pregnenolone tries to go through two chemical pathways. When someone is dealing with physical or even mental stress (pain and/or infections can do both), pregnenolone will be stolen from the sex hormone pathways and pushed through the pathway to produce cortisol.
Sex Hormones Come From Cholesterol
Do you see a recurring theme here when it comes to what I said earlier about statin drugs and low libido or poor sexual function/desire?
Statins lower cholesterol, therefore people taking them will have altered sex hormone levels. I know I sound like a broken record because I spend so much time and repetition talking about liver function, blood sugar dysregulation, cortisol, adrenal gland function, thyroid hormone conversion, sleep regulation, insulin resistance, gastrointestinal health, etc… but you should be able to understand it better after reading the entirety of this article.
I have been talking about tissue repair and healing. Another very important point that has to be discussed here is that when many of my patients begin care, they have been taking statin drugs to lower their cholesterol for years.
Statins and Muscle Breakdown
Statin drugs are notorious for causing body aches and pains. The primary reason for statin induced pain is the fact that statins can cause a side effect called Rhabdomyolysis. Rhabdomyolysis is the breakdown of skeletal muscle tissue.
Understanding that statins can break down muscle tissue which can cause joint aches and pains is a pivotal point for many of my patients. Side effects are just that: Side Effects! Some are minor and some are more serious.
I like my muscles and my joints and I like feeling good. My functional medicine background largely centers on maintaining healthy muscles and joints primarily in the preservation of muscle tissue. Check out the article I published called Is Protein The Fountain of Youth?
Alzheimer’s and Dementia
I also focus a great deal of attention towards brain health and cognitive function. Prevention of cognitive decline is one of my main goals for myself and my patients.
Just like I want to keep my muscles healthy, I want my brain to be as healthy as possible and to last me for my whole life. Don’t you?
The effects of Alzheimer’s disease and dementia are devastating. For me personally, that would be the worst way to go. I want to keep my memories and remember all of the good times with my loved ones. It seems crazy that something like cholesterol could play a major role in long term brain health but it is that important.
Back to Stress vs. Sex: Where does cortisol come from?
Two small organs called the adrenal glands make cortisol. The adrenal glands sit on top of the kidneys. When you see a big dog coming at you, your adrenal glands produce cortisol and release it into your bloodstream so that you will be either able to run or fight.
That is what is called the “fight or flight” mechanism. Consistently, my new patients are in a chronic state of fight or flight. In those cases, the adrenal glands are just worn out. They are exhausted. Spent. Their levels of anxiety are through the roof.
I always suspect adrenal problems and blood sugar dysregulation if someone comes in and they can’t sleep or have altered circadian rhythm (sleep/wake cycles).
Adrenal Gland Fatigue
Also, if you crave salt, are sensitive to bright lights, agitated easily, have ridges on fingernails, have headaches, have fibromyalgia, or your sleep wake cycles are altered, overactive adrenal glands will release too much cortisol into the bloodstream. If cortisol is too high then you’re not going to be able to get good quality sleep.
The same protein carries progesterone that carries cortisol. Therefore if someone has a high level of cortisol, they’re not going to have a lot of progesterone. The adrenal glands will get fatigued or exhausted and that can lead to thyroid problems.
All of this can lead to dysmenorrhea, PMS, infertility, polycystic ovarian syndrome and other “female” issues.
How do we find out about cortisol levels in the body? There is a laboratory test called the Adrenal Salivary Index Test (ASI). It is performed by giving saliva samples and then sending them to the lab for analysis.
The ASI shows levels of DHEA and progesterone so we can see if it’s a hormonal problem causing the blood sugar shifts. It also shows levels of Secretory IgA’s (SIGA). SIGA’s are good antibodies that your immune system produces and places in the mucosal lining of your digestive tract.
Remember, a large percentage of your immune system is in your digestive tract. When SIGA’s are very low, it’s because of chronic abuse of cortisol but it also shows inflammation. SIGA levels can be high due to gut inflammation, food sensitivities, or an infection in the gut.
Also, remember that the gut is called the 2nd brain. This can be critical when dealing with anxiety. An unhealthy gut is an inflamed gut. So, your 2nd brain can be very inflamed and cause your entire nervous system to be out of balance leading to anxiety and/or depression.
When low cortisol levels are seen on the Adrenal Salivary Index Test, it raises strong suspension that there could be a chronic viral infection that’s causing down regulation of the Hypothalamo-Pituitary-Adrenal (HPA) axis. It may not always be a virus but there’s going to be something there that’s pulling that HPA axis down.
A patient with low cortisol levels is going to be very tired. They are often sensitive to bright light and their blood pressure will usually stay the same or go down when you compare standing to sitting blood pressures.
Low cortisol levels can also cause dizziness when going from a sitting to standing position. Not all of these will happen for every patient but some of these signs or symptoms are usually present.
When I find that there is a dip in cortisol levels, it is a confirmation that there is adrenal fatigue. I don’t rush to recommend adrenal glandulars right away.
Often, the adrenals are usually fatigued as a result of other problems going on inside the body. I work to figure out what those are and treat them in order to help the adrenals function better.
The adrenals are responding glands. They respond to what’s going on in the body, so you have to fix what’s going on to create overall better function and health.
I’m going to spend some time explaining the cortisol – insulin – brain connection and why all of this is so important.
The hippocampus (in the brain) coordinates cortisol release. So, if you’re having a break in the circadian rhythm, you can be suspicious that it’s the hippocampus and the hippocampus is what is involved with Alzheimer’s disease.
If there are breaks in the circadian rhythms, (sleep patterns) a person has a much higher risk for developing Alzheimer’s disease. The hippocampus is very sensitive to insulin. If you have too much insulin in the system, the hippocampus is not going to be very happy.
I write a more about insulin resistance and brain health in my article: Type 2 Diabetes, High Triglycerides, and Insulin Resistance.