Aging is Cholesterol Starvation

Aging is Cholesterol Starvation

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

For years, we have been told that a normal component of our biochemistry is somehow working against us. Cholesterol in general—and LDL in particular—has gained a negative reputation due to its association with heart disease and stroke. The medical community has often encouraged patients to lower cholesterol levels at all costs, often labeling certain cholesterols as “good” (HDL) or “bad” (LDL). However, there are no good or bad molecules in the body—they all have a function. It is when an imbalance occurs that these molecules may cause harm to the body, which means that not only too much, but too little cholesterol affects health.

Why Does the Body Produce Cholesterol?

Cholesterol is a substance found in all cells in the body. Most cholesterol is made in the liver. Cholesterol is vital to health because it serves as the starting material for producing sex and adrenal hormones, vitamin D, as well as bile for digestion.

The two main types of cholesterol are:

  1. High-density lipoprotein (HDL), which helps dispose of excess cholesterol by transporting it to the liver to be expelled
  2. Low-density lipoprotein (LDL), which comprises the majority of cholesterol in the body and may collect in artery walls, increasing the risk for atherosclerosis, blood clots, strokes, or heart attacks

In the September and November 2018 editions of Ray Peat’s Newsletter, Dr. Peat highlights facets of cholesterol that are ignored, specifically the relationship between cholesterol, heart disease, and aging. His article Cholesterol in Context states that aging “seems to be a state of cholesterol starvation.” In other words, the ability to make cholesterol diminishes as we age. Along with other results of aging, including reduced production of hormones such as DHEA and progesterone, the change in cholesterol production affects many functions in the body.

Cholesterol Esters

According to Dr. Peat, certain fatty acids (found in oils such as corn, canola, and soy) interfere with an important protein carrier for cholesterol. This carrier protein removes excessive amounts of cholesterol.

Cholesterol also reacts with fatty acids to form conjoined molecules called esters. The ester forms cause toxicity. Through this toxicity, esters may cause neurodegeneration, atherosclerosis, cataracts, kidney disease, and cancer.

Cholesterol and Thyroid Hormones

Thyroid hormone plays a role in converting cholesterol into sex hormones, adrenal hormones, and vitamin D. As early as the 1930s, researchers found a connection between thyroid deficiency and clogged arteries. When patients had their thyroid gland removed, cholesterol levels would rise and the metabolic rate would drop.

In Hypothyroidism: The Unsuspected Illness, Dr. Broda Barnes remarked that increasing cholesterol levels were a better indicator of low thyroid levels than other existing tests for thyroid. Replenishing thyroid may bring cholesterol levels down and increases metabolism. It may also protect against and reverse atherosclerosis.

Aging Skin

Even with adequate sun exposure, our ability to make vitamin D diminishes as we grow older. This is because aging skin has less cholesterol. Interfering with cholesterol production (by using statin drugs, for example) may accelerate skin aging. Lowered cholesterol levels also contribute to the lack of hydration in the skin and body tissues. Loss of hydration not only contributes to the look of aging—causing the skin to appear dry and wrinkled–but it may also decrease metabolism.

Red Blood Cells

Because it is a hard waxy substance, it is easy to visualize that cholesterol hardens our arteries and other tissues when its levels are too high. But low cholesterol in red blood cells contributes to hardening of the cells, thickening the blood and causing the cells to break more easily. Red blood cells carry oxygen to all of our tissues, so disrupting their flexibility and strength in turn compromises energy production in all cells and tissues in the body.

Mitochondrial Disruption

Mitochondria produce the energy in the cell that provides vitality throughout the body. Dr. Peat believes that the side effects of decreasing cholesterol with drugs are directly related to cellular disruption in the mitochondria. He writes that low cholesterol (and the drugs used to decrease and maintain these low levels) contributes to depression, suicide, violence, and an increased risk of death from cancer.

Heart Disease and Cholesterol

Conventional medicine has instilled the idea that cholesterol levels should be low. This mindset is based on the hypothesis that the higher the cholesterol, the more prone we are to atherosclerosis and heart disease. However, this position fails to consider the many functions of this critical molecule. Dr. Peat’s writings present for consideration the myriad roles cholesterol serves throughout the body, such as how adequate amounts of free cholesterol are needed to forestall the aging process.

  • Barnes BO. Hypothyroidism: The Unexpected Illness. New York, NY: Harper; 1976.
  • Ferrara A, Barrett-Connor E, Shan J. Total, LDL, and HDL Cholesterol Decrease With Age in Older Men and Women. Circulation. Jul 1997;96:37-43.
  • Peat R. Cholesterol in Context Part I. Ray Peat’s Newsletter. September 2018.
  • Peat R. Cholesterol in Context Part II: A Formative Medium. Ray Peat’s Newsletter. November 2018.

© 2019 Women’s International Pharmacy

Edited by Michelle Violi, PharmD; Women’s International Pharmacy

For any questions about this article, please e-mail

Carol Petersen at

Aging is Cholesterol Starvation2019-09-25T10:30:54-05:00

Book Review – The Statin Disaster by Dr. David Brownstein

Book Review – The Statin Disaster by David Brownstein, MD

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy

In this latest of Dr. David Brownstein’s books, he clearly states that statin medications fail to prevent or treat heart disease for nearly everyone who takes them. He also points out the shortcomings of the “cholesterol equals heart disease” theory. Dr. Brownstein is concerned because most busy practitioners do not take the time to fully understand the statistics used in drug studies well enough to critically examine the findings. This leaves practitioners to rely solely on the conclusions presented by the study investigators, who are often funded by pharmaceutical companies interested in bringing new drugs to market. Because of this, we are exposed to exaggerated claims of effectiveness when the actual facts may show otherwise.

What Are Statins?
Statins make up a class of drugs that lower the level of cholesterol in the blood by reducing the production of cholesterol by the liver. Statins reduce production of cholesterol in the liver by blocking an enzyme responsible for cholesterol production.

Dr. Brownstein introduces us to a statistical concept known as the “number needed to treat.” This number can be calculated from data provided in studies, telling us how many people need to be treated with a medication for one person to benefit. The ideal number is one. When the number needed to treat is one, every person treated benefits from the treatment. Examples of therapies with a very low number needed to treat include patients with type 1 diabetes using insulin and patients with low thyroid function taking thyroid.

However, many of the drugs currently in use have a high number needed to treat. Numbers of 200 or more are seen regularly in studies using statins. In other words, 200 people need to be treated before one person will benefit. This might be acceptable if statins had no adverse effects and were completely without risk. Unfortunately, this is not the case. Adverse effects associated with statin use include muscle pain and damage, digestive problems, memory loss and confusion, increased blood sugar levels and Type 2 diabetes, and liver damage. These adverse effects may not happen to everyone, but if the number needed to treat for statins is 200, 199 people out of 200 using statins are taking the risk of experiencing an adverse effect while experiencing no benefit at all from the statin drug.

Based on Dr. Brownstein’s evaluation of the studies that have been done using statins, he states statins are effective for approximately 1% who take them. In other words, statins fail 99% who take them.

Is Cholesterol Good Or Bad?
The current perception about cholesterol is that there is “good” cholesterol and “bad” cholesterol. Cholesterol is neither good nor bad. We forget how important cholesterol is to our body’s daily functions. Cholesterol is an essential substance needed by every cell in the body. The human body uses cholesterol to make hormones, vitamins, and substances that help digest foods. If cholesterol levels are too high, our body is telling us something is not right. It would make sense to pay attention to our body’s signals and try to find the underlying cause of the elevated cholesterol levels rather than using medications to artificially lower levels. In addition, driving our cholesterol levels too low may create a whole new host of problems including problems with our immune systems and our resilience to infection.

How Do Hormones Play a Role?
Let’s zero in on hormones. Cholesterol is the source material for all sex hormones including estrogens, progesterone, testosterone, and adrenal hormones such as DHEA, and hydrocortisone. Our brains depend upon the hormones made from cholesterol as much as the rest of our body does. Progesterone and pregnenolone protect the nervous tissue throughout our body. Elevated cholesterol may simply be a signal the body is working hard to replenish these hormones in the event hormone levels are low. Cholesterol levels may also increase when thyroid hormone production is inadequate. Correcting sex hormone deficiencies and hypothyroidism for patients may bring their cholesterol levels down. Dr. Brownstein says he often sees patients in his practice where supplementing with sex or thyroid hormones brings cholesterol levels back into the normal range.

Dr. Brownstein says evidence-based medicine should be used and embraced. He feels the information is out there to expose statins as “one of the greatest failures in modern medicine.” According to Dr. Brownstein, our acceptance of such poor standards is mediocre medicine. We can and should determine what really makes a difference in our health. Reading his book will get us started.

  • Brownstein D. The Statin Disaster. West Bloomfield, MI: Medical Alternatives Press; 2015
Book Review – The Statin Disaster by Dr. David Brownstein2019-02-08T16:51:54-05:00

Foot Fat Pad Atrophy

Foot Fat Pad Atrophy

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy


Here’s another one to add to the number of signs and symptoms of declining hormones: Is the heel or bottom of your foot causing you pain? Are you finding yourself seeking relief in the Dr. Scholl’s section of the pharmacy? It could be due to foot fat pad atrophy.

The foot fat pads are the tissue that protects your foot on the ball of the foot and at the bottom of the heel. Atrophy means shrinking or disappearing. The foot pad tissue under the foot does decline with age. Menopause and surgical menopause increase the rate of decline. Obvious mechanical issues, such as being overweight, can also have a negative impact and hasten the loss of the plumpness of this tissue.

If plantar fasciitis (painful inflammation of the bottom of the foot) has been an issue, your practitioner may have used one or more injections of “cortisone” to relieve pain. Unfortunately, this “cortisone” is not the same as the cortisone hormone the body produces; it is actually a synthetic analog that can lead to even more atrophy of the foot pads.

In addition, as Dr. Sergey Dzugan points out in The Magic of Cholesterol Numbers, cholesterol levels elevate when the body senses a deficiency of the sex and adrenal hormones, which are normally produced from cholesterol. So statin users beware! When taking statins, not only do cholesterol levels fall, but the ability to make hormones drops even further. Statin drug use may be a source of foot pain from accelerated foot fat pad atrophy.

If you are experiencing foot pain, have your practitioner check for hormone deficiencies, including vitamin D (which is also made from cholesterol). These deficiencies may be the underlying cause of your foot pain.

Foot Fat Pad Atrophy2017-12-14T15:16:50-05:00

Book Review – The Magic of Cholesterol Numbers by Sergey A. Dzugan, MD, PhD

Book Review – The Magic of Cholesterol Numbers by Sergey A. Dzugan, MD, PhD

Written by Carol Petersen, RPh, CNP – Women’s International Pharmacy


Dr. Dzugan may just turn the medical industry upside down with this book. He sets the stage by explaining that—fueled by pictures of seriously clogged arteries—we have bought into the delusion that elevated cholesterol levels signal that cholesterol is on the warpath to attack our arteries. Statins aim to reduce cholesterol levels by interfering with the production of cholesterol, and to do so in a limited fashion; hence, they are currently the most commonly prescribed drug. Dr. Dzugan contends that this approach is not viable, and asks the question: Why does cholesterol get such a bad rap?

First of all, he says it is because cholesterol is a steroid, which in and of itself carries negative connotations. We immediately think of the synthetic testosterone-like hormones abused by body builders. Or maybe we think about prednisone, which is close enough to hydrocortisone and cortisone to relieve inflammation but does so at the cost of other severe side-effects. Dr. Dzugan believes that there is no place in the human body for these man-made hormone mimics. Cholesterol, on the other hand, is so prevalent in and important to the brain that it is formed independently in the brain. Thankfully, statin drugs cannot pass the blood brain barrier to interfere with that process!

The term “steroid” simply refers to the shape of the molecule. Hormones made by the testes, ovaries and adrenal glands are all called steroids. Vitamin D, which is produced in the skin, is a steroid. Bile, which is made in the liver to emulsify and promote absorption of fats, is a steroid. Cholesterol is essential to our body function, in and of itself, as well as being a building block for other hormones.

Dr. Dzugan also asks: Why don’t people question the basis of the so-called LDL and HDL cholesterol numbers? These are simply measures of lipoproteins (fat combined with protein) that help shuttle cholesterol around the body to where it is needed. Total cholesterol is calculated as the sum of LDL plus HDL plus triglycerides divided by five. Triglycerides are not cholesterol but are used to estimate VLDL (very low density lipoproteins), which carry about 20% cholesterol. The LDL consists of approximately 50% cholesterol and the HDL is shuttling about 30%. However, the percentage of cholesterol that each is carrying is not accounted for in the total cholesterol equation. If we were to view figuring out our true cholesterol level as a typical math word problem, we would most likely be perplexed as to how to determine the correct answer. And if we did, just exactly what would the answer mean?

Somehow, medical research has not yet answered the question: What does it mean when cholesterol levels rise? When a woman is pregnant, her cholesterol levels skyrocket. This is because a pregnant woman needs to create an astonishing amount of hormones. When cholesterol levels are high outside of pregnancy, it is possible that something is blocking the creation of the hormones made from cholesterol. When cholesterol levels are low, it is possible that there is a problem with hormone formation.

Dr. Dzugan’s theory (backed by clinical case studies and two published reports) is that high cholesterol occurs when normal hormone production is failing, and that by identifying and replenishing the deficient hormones with bioidentical hormones, cholesterol levels fall and the patient’s health improves. He believes that the cardiac risk factors associated with high cholesterol are not because of the cholesterol levels, but because of the underlying hormone deficits. Dr. Dzugan notes that changing diet rarely succeeds in lowering cholesterol levels, but restoring hormones does.

Dr. Dzugan practices what he calls “hormone-restorative therapy” rather than lipidology (a new medical practice specialty). He notes that, by restoring hormone balance, HDL levels may decrease rather than increase because higher amounts of lipoproteins are no longer needed to shuttle cholesterol back to the liver.

Dr. Dzugan is not the first to draw this connection between cholesterol levels and hormone balance. Dr. Jens Moeller reports on normalizing cholesterol levels by treating low testosterone levels in his landmark book Cholesterol: Interactions with Testosterone and Cortisol in Cardiovascular Diseases. And Dr. Broda Barnes reported in his book, Hypothyroidism: The Unsuspected Illness, that high cholesterol levels were the best blood indicators for low thyroid; he also found that high cholesterol numbers fell when those patients went through thyroid hormone therapy.

Imagine! What if the next time you visited your medical practitioner, they measured not only your cholesterol numbers but also your hormone levels and adjusted accordingly? If Dr. Dzugan’s theories ring true, this could be in your future.

Book Review – The Magic of Cholesterol Numbers by Sergey A. Dzugan, MD, PhD2017-12-14T12:14:19-05:00