Chaos to Calm

High Cholesterol and what to do about it for Women Over 40

Sarah McLachlan Episode 58

Is your doctor pushing statins for high cholesterol? Before you fill that prescription, let’s uncover the real story behind high cholesterol in women over 40.

Many people believe high cholesterol is a health disaster waiting to happen, but the reality is more nuanced. In this episode, we dive deep into why cholesterol rises during perimenopause and menopause, and how it’s actually working to protect your body.

Key takeaways:

  • Understanding cholesterol’s role: Discover how cholesterol supports hormone production, cell structure, digestion, and more.
  • Cholesterol and inflammation: Learn why cholesterol isn’t the root cause of heart disease but rather a response to what’s going on in your body and the arteries.
  • Natural management: Get practical advice on how to naturally manage cholesterol levels through diet, lifestyle changes, and stress management.

Sneak Peek: "Blaming cholesterol for cardiovascular disease is like blaming firefighters for a fire because they’re always at the scene. Cholesterol is responding to an issue, not causing it."

For women faced with the challenges of high cholesterol perimenopause, understanding what’s driving it, and how to manage your cholesterol levels naturally is crucial. This episode will empower you with the knowledge to make informed decisions about your health.

Tune in now to get the full picture and practical tips on managing your cholesterol naturally.

Links & resources mentioned in the episode:

Send us a question for the FAQs segment or your feedback, we’d love to hear from you.

Find out more about Sarah, her services and the Freebies mentioned in this episode at https://www.ThePerimenopauseNaturopath.com.au

  • OPEN NOW: Discover how to use food as your most powerful medicine, smoothing hormonal fluctuations and easing perimenopause symptoms naturally. (Yes, you have more options than hormone therapy!) Say goodbye to feeling out of control and hello to feeling more like your old self every day, with PerimenoGO (because who wants to pause anyway?!)
  • The Perimenopause Decoder is the ultimate guide to understanding if perimenopause hormone fluctuations are behind your changing mood, metabolism and energy after 40, what phase of perimenopause you're in and how much longer you may be on this roller coaster for.
  • Been told your blood test results are "normal" or "fine" while you feel far from your best? Discover the power of optimal blood test analysis with The Blood Test Decoder: Optimal Ranges for Women Over 40.
  • For more, follow on Instagram at @theperimenopausenaturopath.

Hello, and welcome to the Chaos to Calm podcast episode number 58. I'm Sarah, the Perimenopause Naturopath, your guide through this wonderful journey of perimenopause. If you're over 40 and feeling like you're changing hormones or hijacking your mood, energy, and weight, and you want to change that in a holistic way.

This is the place for you because each episode I share with you my views on what the heck is happening in your body, why you're feeling the way that you are, and what you can do about it with actionable advice to help you feel more calm and control, less stressed and comfortable in your body, mind and clothes again.

I'm so glad that you've joined me. Let's get on with the discussion of today's topic. So we can start shifting your perimenopause experience from chaos to calm. Now, I wonder if you've had blood tests. Well, for two things, I'm wondering, have you had any blood tests done recently? Hopefully you've had some done in the last 12 months.

I've done a whole podcast on optimal versus normal blood ranges, but I also talk in that a whole bunch about why it's really great to do blood tests. You'll hear me talk about it all the time because they give you a lot of feedback and you can see what's happening inside your body, especially if you're looking at them from those optimal ranges and understanding the markers from a functional perspective, straight off the bat.

I'm totally sidetracked today. I will put the link to my blood test decoder freebie in the show notes today so that you can have a look at the optimal ranges and what your blood tests are telling you. Why is that relevant today? Well, I'm wondering if you've had blood tests done, has your doctor pointed out higher cholesterol levels in your blood tests and maybe suggested medication to bring them down?

Because for lots of women over 40, that happens. Many women come to me either already taking a statin medication or it's been suggested that they should think about it and do it. Now, I'm probably going to have to do a couple of podcasts on cholesterol because I've got a whole rant in me about why the current levels or like the market lab ranges inappropriate.

But I'm just going to park that for today. I'm not going to get started on that. I just really want to go through the basics of cholesterol today and talk about why it's really crucial for your body, especially in perimenopause and menopause and help you understand why it does rise, and what we can do about it, what that means. Of course, the sun has just come out, so now I'm all squinty. Hopefully it'll go away in a moment. All right. So what is cholesterol? It is a waxy substance. It's in your blood, but it's needed by every cell in your human body. Amazing, I bet lots of you didn't even know that.

And our body produces most of what it needs in the liver. Only a small amount comes from our diet. So hold onto that little factoid for later. Cause we're going to refer back to that as well. So cholesterol is really essential in your body. It's for building cells, making hormones, vitamins, aiding in digestion.

So it's not all harmful as we're made out to believe like, Ooh, we should be frightened of it and worried about it all the time. Actually, it's really vital. And that's part of the reason why medication is not always great because it's lowering something that might is actually helpful and healthful in our body.

So we're going to unpack a bit of that today as well. Cholesterol metabolism starts in your liver, and that's where it's produced. The liver packages cholesterol into particles called lipoproteins, and they transport it through the bloodstream to other tissues and organs. And then excess cholesterol is carried back to the liver, in the blood by another, a different lipoprotein.

So there's a few different types of cholesterol. So let's talk about that. First of all, you've probably seen on your blood tests, the LDL, the low density lipoprotein. This is the one they call the baddie and it's the one that transports cholesterol from your liver to the rest of your body and high levels of LDL, associated with a higher risk of cardiovascular disease. It's not the whole story. They're not the whole story on themselves because LDL has subtypes and some of them are more dangerous than others. Like we have the small dense LDL, the lipoprotein B, they are more likely to contribute to plaque buildup and cardiovascular disease. But then we have these large fluffy LDL lipoprotein A, and they're less likely to contribute to plaque buildup.

And they're associated with a reduced risk of cardiovascular disease. So you see that one marker that we have of LDL, it doesn't tell the full story, and I'm going to come back another day and talk about all these things, all these myths versus the facts around cholesterol. Today we're just doing the basics.

That's a note for me. Stay on track, Sarah. So we also have, yeah, so unless you do a blood test that is a fractionated LDL testing, you don't know how much you've got of all of these. And it does make a difference. To your health risks and where you're at. Very low density lipoproteins carry triglycerides to your tissues.

Triglycerides is something I would actually pay more attention to than necessarily, than your LDL because they have a stronger measure of your cardiovascular risk, in my opinion. And there's lipoprotein I, and I mentioned the high density lipoprotein, your HDL, and this is the one that transports cholesterol back to the liver from your organs and tissues.

And this is the one that people call the good cholesterol. And so you do want this one elevated and generally information tells you to keep LDL lower. And I will comment on that in a future podcast. And there's also this thing called chylomicrons. They are large particles that transport triglycerides as well.

Like I mentioned before, cells use cholesterol for essential functions and excess cholesterol is generally stored in your liver or in your fat cells. So some of the things that cholesterol does for us is helps in hormone production. It's a precursor to our essential hormones, including estrogen and progesterone.

And so these and how important these hormones are. I've done, I talk about them all the time, funnily enough, because I'm the perimenopause naturopath and they're a big part of our perimenopause experience. But you see if we're, you can see how it may having less of those hormones in our body may contribute to like naturally elevating our cholesterol in our bloodstream.

It makes sense. It happens for most women in late perimenopause to menopause. Cholesterol is really important for our cell structure. It helps maintain the structure and the fluidity of our cell membranes, making sure they function properly. This is really important because if our cells aren't able to move, and in our arteries and veins as they are, as we want them to, and they aren't able to maintain the shape that we need them to, the receptors on those cells are not going to be the right shape for the keys like insulin. If you've listened to my insulin podcast, I talked a lot about lock and key analogy there. So if ourselves aren't structured in the right way, other vitamins, minerals, hormones, other compounds, neurotransmitters, things like that can't bind to them in the way that we want them to.

And it changes the physiology, the function in our body, how we feel and so much more. And another thing that cholesterol does for us is helps with our digestive health. So I talked about the gallbladder in the last episode and cholesterol is part of the bile acids. It's actually how we, our body helps, maintain levels of cholesterol in our body is by excreting them through bile.

So I talked about how important it is to make sure our gallbladder, has a little spurts of bile and releases it into the intestines so that it can help with eliminating waste and bile contributes some waste to the elimination process. Now I'm going to talk about why cholesterol isn't the villain.

So I've already alluded to that, but let's go a bit deeper into it. And I'm trying to keep it, simple. So, it's like most things in our body they're quite complex. I'm just going to simplify it. So it's easier to understand and we can get the, the main points from it, which is really what we need to understand. We don't need to understand too much about the detail. 

Alright, so you might have heard people talk about arteriosclerosis. That's the medical term for your arteries hardening, thickening, and narrowing. And that develops over a very long time. Too much cholesterol in your bloodstream can be a factor. Now people used to think that excess cholesterol was just deposited in your blood vessels like scale in a pipe.

So if you've ever, looked at a water pipe over time, you see on the inside, it's got a whole lot of buildup around it. That's that calcium scale or the other minerals from the water and it narrows the pipe. So there's less water can move through it in time. It's similar. That's what people thought it was in our arteries.

And so less blood can flow through there. And sometimes you'll get a complete blockage. That's not how it works. So it's more to do with inflammation, inflammation that, esoteric term that we talk about, it's part of our immune response is inflammation. And most people, especially as we age and depending on your lifestyle and what you eat and what you drink and things like that, you will have small inflammations or damage in the walls of your blood vessels.

And these can develop in a few different ways. And I'll talk about some of the main ways that I think contribute to women having these elevated cholesterol levels in a little bit. So in people who have high LDL cholesterol, there's some immune cells, the phagocytes, they're scavenger cells in our blood.

They eat more cholesterol particles. I think of them like Pac Man going around eating it all up. And then they become quite, and phagocytes are sticky. As they get bigger, more cholesterol eating, there's more chance that they're going to stick to the blood vessel wall putting cholesterol on the blood vessel wall.

Now, inflammation, that damage that causes contributes to the inflammation as well, weakens the blood vessel wall, and then that can tear. And if blood comes into contact with that cholesterol rich deposit, a blood clot can form there. So, our bodies are trying to seal the wound in the blood vessel wall, just like, if you graze your knee or something like that, or you cut yourself, you get a scab forms.

If you cut your skin, it's a similar process happening inside our bodies in our arteries, but if this happens, the consequences will depend on various things, like including how big the blood clot is. So a big clot can block the blood vessel. And that's when you might have a heart attack or a stroke. But the blood clots that form are often only small and just enough to fix the damage in the blood vessel wall.

And then they don't have any noticeable consequences. So we're thinking there around cholesterol, helping to seal and heal. Okay. So cholesterol is not causing the problem. It's there to help heal the problem. So the cut will heal. The damage in the artery that's going to heal, but it can lead to scarring just like when you get a cut or you've got a graze on your knee, you might get a scar there as well.

And then they can get calcification on the blood vessel wall there. And that, if that happens time after time, it's gradually going to make the blood vessel narrower and then block it completely. Okay. So inflammation can develop in any artery in your body, anywhere. But they're, they're just more dangerous depending on where they're located.

If they're near the arteries that carry blood to the brain and the heart, like in, in your neck or around your heart, then you, you might get chest pain or, reduce blood flow to your brain. And, that's when you might have a stroke or a heart attack there as well. So if it's blocked, no blood's going to flow to that part of the brain or the heart. And you can get damaged to the heart muscle or the brain, cells and nerves. Now let's talk about what, so I hope, what I want you to take from that is that there's inflammation or damage to the arteries. That cholesterol is then helping to heal and seal.

Okay. So we're not blaming cholesterol for the cardiovascular disease because it's like blaming a firefighter for a fire because they're always at the scene. Cholesterol is responding to an issue. It's not necessarily causing the issue. So the real culprits are that inflammation and damage to the arteries.

Now, let's talk about some of the reasons, most what I think most common reasons that people would have that inflammation. So, inflammation or damage to the arteries can be caused by high blood glucose levels, the body, because glucose is a big spiky molecule.

This is where you get, if you're watching the video of this, you get to see my interpretive dance. So glucose is big and spiky. And if we have high blood glucose levels, we have lots of these big spiky molecules floating around in our arteries, poking holes in there. And so the body's going to send cholesterol there to plaster up, patch up all the holes.

And we get elevated blood glucose levels from consuming lots of refined carbohydrates and sugars, and that can also, when we have an excess of glucose, those glucose molecules can attach to other cells, which is something called glycation. And that leads to damages the cells lining the artery.

They're called endothelial cells. So glycation is from high blood sugar, sugar molecules bind to the proteins or the fat lipids. And that leads to stiff and dysfunctional blood vessels. Remember I was saying before we want really fluid cells. It's the same with our arteries and our blood vessels.

We need them to be fluid and to be able to move as well. And if they've got sugar molecules attached to them, that cannot happen. So that damage from the big spiky glucose molecules or glycation triggers that immune response, that inflammatory response. The liver's prompted to produce more cholesterol that's transported by the lipoproteins to the site of the inflammation to try and aid in the repair and patch up the holes.

So high blood sugar levels, we know that in perimenopause and menopause as estrogen declines, we are naturally more insulin resistant, which means we have higher blood glucose levels. We also know if we're living a typical modern woman life in her forties and fifties, your cortisol, your stress hormone is going to be elevated.

And one of the things that cortisol does is increases your blood sugar levels. So it's not, not surprising that this is happening for us there because it's in combination with our hormones, estrogen and progesterone that you would normally use cholesterol, they're declining. So we're using less of it, but we're also having this other physiological response in increasing our blood sugar levels and our insulin resistance.

So you see, cholesterol's part of your body trying to repair the damage, it's a symptom of a problem. And the problem is often elevated blood glucose levels and insufficient bowel release, insufficient bowel motions, general, negative markers of health or poor health markers. As I see them as a naturopath.

Okay. So one thing I wanted to point out too, as I said, I mentioned before that I pay more attention to triglycerides. And the reason that I do that is triglycerides tell us a lot about your blood sugar levels. And because they are made up with excess glucose as well, and they are elevated by high refined, a diet, high and refined carbohydrates. So white flowers, sugar, processed foods, things like that. That's why I pay more attention to the triglycerides because it's telling me alongside your blood glucose levels, and so you get insulin markers. It tells me a lot about what's happening in your body there and what, what the driving factor is, what that cause is that we need to work on.

 Most of the time it's balancing your blood glucose levels and your insulin and getting them back into a smoother flow across the day and avoiding spikes and crashes. So, yes, in some ways, yes, increased LDL does, it does contribute to arteriosclerosis. Certainly, that's not deniable.

The more that your body's having to patch up and put cholesterol in your arteries, it's blocking them, of course, but we need to look at the driving factor. And this is the difference here, I think, between Western medicine and how naturopathic medicine looks at things. Is we're looking for that driving factor in the cause.

We're not just trying to like reduce your body's cholesterol production overall and suppress that we're actually looking to resolve the problem. So we get that long term symptom resolution. That's what I'm always doing with my clients and helping them do. And it means that then we've got the opportunity for preventative care and to avoid medications.

And because the sequelae. The flow on effect of taking things like statins can be because it impacts other molecules like CoQ10 and your energy, it impacts how you feel overall, there's a lot of side effects with statins there too, but particularly things that might be important is, vitamin D depends on cholesterol to be produced. And we know that vitamin D every cell in our body, including the nucleus, the very important instructions inside the cell have vitamin D receptors. So we don't know all the things that it does, but we know it's really super important. And we particularly know that vitamin D has a a relationship with weight and the lower your vitamin D levels are, the harder it is to lose weight.

And Yeah, we know that vitamin D helps your immune system, your mood, lots of different things. So if we're taking a medication that's suppressing cholesterol levels and then being surprised that we're low in vitamin D. Even though we live, might live in Australia where there's lots of sun, we're putting lots of sunscreen on as well.

So we're interrupting that vitamin D process in other ways to or disrupting it, the flow on effect to our health and our overall health in the long term is quite significant. I'm not necessarily saying don't use sunscreen. Please don't take that the wrong way. But what I'm saying is that we do, and if your doctor has prescribed a medication that's between you and your doctor to discuss, not up to me to tell you to not take that.

That's outside of my scope of practice. But what I want to encourage you to do is start looking and seeing how you can tweak and adjust and change things to avoid the problem in the first place. And the problem with elevated cholesterol is not necessarily the elevated cholesterol. That's a response to a situation to an actual problem.

So the elevated cholesterol is a symptom of other problems. It could be it could be a little bit of diet. I'll talk about this in a minute. It could be, a diet, like I mentioned, refined carbohydrates and sugars, your blood glucose levels, insulin, your declining hormone levels there as well, your liver function, your bowel, your intestinal health and your digestive function and your bowel motions.

If you're constipated, all of these things are going to be contributing to it there as well. There's also genetics like we need to consider genetics. Some people have familial hypo, hypercholesterolemia, high cholesterol. That would have been much easier to say, should have just said that. So it can be a genetic reason for you to have high cholesterol.

And for some people, I would argue that that high cholesterol level is their natural state of health. That's where it needs to be for them. So if we're talking about factors, increasing your cholesterol and perimenopause and menopause. So I mentioned before that estrogen and the decline in estrogen and progesterone can impact your cholesterol levels because estrogen does help keep LDL in check. So that hormonal shift can result in higher LDL and lower HDL. Insulin, blood glucose levels can insulin they can both increase triglyceride and cholesterol production there as well. And high insulin also boosts your stress hormones and cortisol. So it is your high blood sugar levels.

And, but we know that cortisol raises your blood glucose and your fat storage. Episode 53, if you want to know more about why you need to pay attention to insulin in peri and post menopause, I talked about stress a bit earlier, how it elevates your cortisol, your stress response hormone and your blood sugar levels.

And that leads to higher cholesterol production. And in episode 42, I talk more about cortisol and what it does to your perimenopause experience. Also, we're more susceptible to feeling stressed or be responsive to the stress ores in our life because our natural stress resilience hormone, which is progesterone has is declining in perimenopause.

All right. So what do we do about it? If you grew up in the eighties, seventies and eighties, we grew up in the era when eggs were bad because they have cholesterol in them. So we didn't eat them. Well, I just want to say to you that about 80 percent of our cholesterol is produced by the body and the gut can only absorb about 600 milligrams of cholesterol per day, which is about two eggs.

So a low fat or low cholesterol diet isn't the solution, definitely not. We need healthy fats, but we also need to think about the quality of our diet. And I'm always talking about that. I want you to focus on, I have my four things I want you to balance on your plate. And that's the phytoestrogens, some plants, some colorful plants, vegetables, protein, and healthy fats, rich in omega three. So eating those healthy fats is not going to necessarily increase your LDL cholesterol, but eating in that particular way, so you'll notice there's no processed foods or ultra processed foods, particularly in there.

That doesn't mean I never eat them. Sometimes I do, but they're not a daily thing. Part of my diet, and I don't think they should be part of your daily diet either, especially not if you want to manage your cholesterol levels. Now, fiber from your plants and your phytoestrogens is really helpful in removing bile formed from cholesterol out of the bowels.

And that avoids that recycling or reabsorption of cholesterol and your other waste back into your bloodstream. So the biggest impact that you can have on cholesterol levels is healthy digestive function. Making sure you're eating your phytoestrogens, your plants and your healthy fats to help stimulate that release of bile from your gallbladder, your daily bowel motions, and the other aspect of that is then avoiding those processed and ultra processed foods, sugar and alcohol, because they're actually a bigger contributing factor to those triggers that will, all those things that trigger a higher cholesterol in your body. So I've talked to in the meal planning episode, which was maybe episode 56 off the top of my head, it really helps you implement what I've taught you before, what I've talked to you about all the time in terms of how to eat and making sure you stay on track with them.

Without a plan, we're less likely to hit our goals or eat in the way that we want to. That is true. And if you, if you don't like meal planning, if you don't want to do it, then PerimenoGO ready made nutrition plan for you. Four weeks of breakfast, lunch, and dinner planned out, make it super easy for you to get in the habit of eating in this particular style or way and learning the principles and the basics, my guiding principles around nutrition so that you then don't have to stick with the plan forever, but what to do and you've got yourself in that habit because we know it takes 21 days to change habits, but we need, I think we need an extra week to cement that in that change. In terms of lifestyle, really it's about your stress management here and working with your body exercise and movement like yoga and Pilates and stretching and things like that can really help with your bowel motions as well.

But we're talking about boosting our resilience within when it comes to stress and working with our body. So we're going to nourish it with food. Avoiding calorie restriction, avoiding skipping meals, even avoiding those long intermittent fasts. If you're a busy or stressed woman, intermittent fasting is not your friend.

It's just going to encourage cortisol release. And as I said, gentle resistance training, yoga, Pilates, walking, swimming, weights, really lovely ways to help remove cortisol and adrenaline from your body and help reduce your cortisol levels helps keep our blood sugar level balanced and sleep, sleep deprivation.

Even one night of sleep deprivation increases our insulin resistance, which means a higher blood glucose level, which means higher cholesterol levels are imminent for us there as well. So you see that it's actually the, those basics that I'm always talking about are really fundamental to a great perimenopause experience, but also great health now and into your future as well.

Because perimenopause is a, it's more than just a metaphorical fork in the road of what do we want. It's a physiological fork in the road. There's so much change happening in our bodies. How we eat, what we do at this time really influences how we age and how we live in the long term. What work we do now helps ensure that we have a strong old woman body, that we are still mobile and active into our eighties and nineties.

And we're not living the last 15 years of our life unwell and on lots of medication and stuck inside. And I don't want that for me. I don't want that for you either. And I think even though humans live longer, the last 15 years or so of most people's life, the quality of it is not great. And I think that's what we are thinking about.

Now we have the opportunity to strongly influence how that pans out for us. Okay. Winding up takeaways from today, cholesterol is really important in your body for your hormones, digestion, lots of other stuff for your cell function. And especially, no different in perimenopause and menopause understanding its importance and the process of how it might end up inside your arteries is really important for you to be able to confidently manage it naturally and maintain your health and wellbeing, I think.

If you're concerned about heart disease, focusing on reducing your triglycerides is more crucial. Like I said, and your blood sugar level and your insulin levels, they are the driver of that elevated LDL. So really want you to take home today that cholesterol is a symptom of other problems. And it's a response, cholesterol on your artery walls is a response to inflammation and damage to the arteries.

It's a repair mechanism. Your bodies will make what it's going to make based mostly on your hormones and genetics. Diet has a smaller part, but also your physiology there is important to like your digestive function, your liver function, if you have fatty liver, like liver damage, it's going to impact your cholesterol levels.

Also your thyroid impacts your cholesterol levels too. So if you have an undiagnosed thyroid condition, then that's going to elevate your cholesterol levels too. So it's really important to have your blood tests, have them done and have full thorough thyroid panel included in that. All right. So, like I said, diet is still important, even though it has a smaller part to play, because when, from my perspective, we're thinking about diet as having that long term influence, like a fuller, broader picture.

It's not just about the cholesterol, it's about your overall health and function. So focus on your fats, your phytoestrogens, your plants and your protein at every single meal. And as I mentioned earlier, if you'd like some help in implementing the food changes, having a meal plan, then check out PerimenoGO, it's a program that helps you understand the principles of nutrition for peri and post menopause has a beautiful, tasty four week nutrition plan with recipes that are really simple, like my teens make them as well.

And having that plan done for you is really helpful in getting you to take action and implement the training and knowledge that I provide about the principles of how to eat for your best health in peri and post menopause. PerimenoGO works with your body to help it better adjust to the changing hormones.

So you can feel amazing in your body, mind and clothes again. So there's certainly no calorie restriction or skipping meals or fasting involved in it. Now I'll put links in the show notes to my freebie, the blood test decoder to PerimenoGO and to those other episodes that I mentioned there today on insulin and cortisol.

Thank you so much for listening and sharing your time with me. I'm looking forward to actually exploring in more depth, my nutrition principles, my guiding principles for peri and post menopause in the next episode to help keep your perimenopause experience moving from chaos to calm.

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