What is LDL and Why is it Called the "Bad" Cholesterol?
LDL, “bad” cholesterol, or low-density lipoprotein (LDL) gets a bad rap as a risk factor for atherosclerosis and increasing the risks of heart attacks and stroke, which together are the number one cause of death. LDL may serve some useful functions and it should be understood physiologically instead of indicting it as “bad” and blindly taking potentially harmful medications to lower it. LDL is simply oxidized fat, like rancid olive oil or butter left out of the refrigerator too long. LDL and rancid fat acquire oxygen molecules and become less dense when the fluffy gas molecules (oxygen) attaches itself to the fat molecules, much as dense wood becomes less dense, left-over, dusty ashes in a fireplace after wood is burned or oxidized. When oxidized fat proceeds to flow through our blood vessels, burning and oxidizing its way, too much of it may proceed to light little fires, like taking tiny blow torches to the inside of our arteries. The damage caused by this “oxidative stress,” is sealed over by plaque in a repair process, which is usually composed of a hodgepodge of clot, fat and calcium. If a lot of repair plaque builds up, one may be diagnosed with atherosclerosis, arteriosclerosis or coronary heart disease. No wonder doctors prescribe medications to lower LDL.
The Dangers of Plaque Build-up
The plaque may eventually and slowly block off an essential artery which deprives a vital organ, such as the heart (e.g., heart attacks) or the brain (e.g., strokes), of enough blood flow. This can happen slowly, giving us time to make an intervention such as getting stents placed in the coronary blood vessels. The plaque is a living, breathing tissue that gets its blood supply from an external source (outside of the artery), and like a dry, calloused area on the skin, it can suddenly split open and bleed and form a clot. When this happens to a vital blood vessel, a sudden “event” can happen like an unexpected heart attack or a stroke. The gradual blocking of an artery can give us lots of warning and produce symptoms like angina in the heart or TIAs (transient ischemic attacks) in the brain, but the sudden rupture of a plaque can be a medical emergency, which necessitates calling 911 and getting a person to the ER ASAP. Clot-buster medication may be administered to break down the clot and limit the ongoing damage of a stroke or heart attack. Aspirin and other “blood-thinners” are prescribed and taken preventatively to limit the damage of a clot rupturing in a blood vessel that feeds blood to a vital organ like the heart or brain.
What is Oxidative Stress?
Oxidative stress is a natural process but an imbalance of antioxidants and free radicals can lead to damaged cells. Some “oxidative stress” and it’s cohort, “inflammatory stress,” is necessary for survival, such as when we are sick and the immune system fights off an infection in the body. But long-term, uncontrolled oxidative stress not only accelerates the aging process but can contribute to many health conditions such as diabetes, heart disease, cancer, Parkinson's and stroke.
Toxins are often oxidized to make them reactive (Phase I detoxification pathways) so that they can be conjugated to a molecule (Phase II detoxification pathways) to make them water soluble. I like to get genomic testing for all patients to discover their unique detoxification capacity. Since we are about 70% water by weight, water soluble toxins simply are dissolved and float out of the body. When an invasive germ meets a white blood cell, it may get splashed by peroxide or ozone (respiratory burst) since most primitive germs are anaerobic, which means that oxygen kills them. The same is true of cancer cells, so most cancer chemotherapy utilizes high oxidative molecules, causing cancer cells to respond by synthesizing high levels of the anti-oxidant, glutathione, which is a reason why cancer chemotherapy stops working at some point. Oxidative stress is necessary as it kills germs and cancer cells, which is why integrative doctors sometimes order oxidative therapies, such hyperbaric oxygen, IV peroxide and ozone, and high dose vitamin C (which turns into peroxide). However, too much oxidative stress causes LDL to increase and can damage cell membranes, the insides of our arteries, and our DNA, causing mutations and rapid aging, much as “friendly fire” from our own troops can kill our own soldiers.
Natural Options to Lower Oxidative Stress
Oxidative stress must be tempered, like when one adjusts the burning of wood in a fireplace to lower or increase its warming effects. If we are hitting hit by friendly fire, a strategy needs to be adjusted. The degree of oxidative stress can be lab tested in a NutrEval, by measuring glutathione, CoQ10, and other parameters, and by measuring “bad” cholesterol or LDL, so that we can estimate the degree of oxidative stress and the need for antioxidants. Green and rooibos tea, higher doses of vitamin C, glutathione sublingual or intravenously, and various herbals such as curcurmin can be prescribed and used. Generally, most people have some excess oxidative stress and the use of these tempering agents helps most people and prevents heart attacks and strokes and a wide array of other chronic diseases. However, the Gant Team’s motto applies here, that “If we don’t test, we’ve guessed.” The blind use of oxidative therapies in a patient already suffering from oxidative stress, or the use of antioxidant therapies in a patient who lacks oxidative assistance, like a cancer patient, is absolutely contraindicated.
Currently, I am prescribing a concentrated and absorbable product called UltraCur Pro for any patient who has been shown, on diagnostic testing such as elevated LDL cholesterol, to be suffering from too much oxidative stress and inflammation. The attempt here is not to eliminate oxidative stress completely or lower it too much since it could be saving their life. I only attempt to find the “Goldilocks” region, not too hot and not too cold. Eliminating infections like Lyme Disease and Candida, detoxifying pro-oxidant heavy metals and other toxins, and destroying cancer cells, is the ultimate “cure” as it removes the whole reason for oxidative stress to exist at all. However, on the journey to that “cure,” oxidative stress and inflammation may need to be tempered, so antioxidants like UltraCur Pro are needed. Or, in aged people like me with a genetic and family history tendency to suffer from blood vessel injury, we “cut to the chase” so to speak, even if we overkill oxidative stress, and use lots of antioxidant teas, herbs, supplements and foods which are absolutely indicated to prevent the number one cause of death, heart attacks and strokes.
Essential Fatty Acids and Oxidative Stress
One last factoid. We all require essential fatty acids of the omega 3 and 6 varieties, which come from seeds, nuts and fish. These essential fatty acids, which I usually supplement in my patients, have lots of double bonds in their structure which confers neuroplasticity to our cell membranes and our brain. Unfortunately, these essential fatty acids are some of the most susceptible molecules to oxidation and rancidification. Anyone supplementing with these oils should take some measures to lower their oxidative stress as discussed above, and thus protect their essential fatty acids on their way to promoting health and wellness. Otherwise, once an essential fatty acid oxidizes, it can work against us and damage our cell membranes. Work with a functional medicine physician so that all the necessary pieces are in place to improve your health: test, get a solid plan in place and monitor and update the plan to get better results.
Charles Gant MD, PhD, is a physician, author and teacher and has practiced Integrative and Functional Medicine for over three decades. He specializes in getting to the root cause of health issues to support healing at the molecular level. Areas of interest include ADHD, substance use disorders, chronic diseases, metabolic, hormonal and immune disorders, infectious disease, Lyme and co-infections, genetic testing and more. He is an expert in interpretation of functional medicine testing to diagnose precisely what is deficient in each patient, and then replenish those missing, essential items.