High Cholesterol

Cholesterol is needed for normal cell membrane function and as a precursor to steroid hormones, bile acids, and vitamin D. Metabolism of cholesterol, which is both produced in the liver and obtained through diet, is carefully controlled in the body. In some circumstances, however, cholesterol metabolism becomes dysregulated, leading to high blood cholesterol levels, accumulation of cholesterol in tissues and immune cells, and increased risk of atherosclerosis and heart disease.¹

Cholesterol circulates in several types of fatty complexes, which have different effects on vascular health and function. In simplest terms: very low-density lipoprotein (VLDL)-cholesterol is made in the liver and released into the bloodstream; VLDL is converted into low-density lipoprotein (LDL)-cholesterol, which delivers cholesterol to tissues and cells, promoting atherosclerotic plaque formation; high-density lipoprotein (HDL)-cholesterol retrieves excess cholesterol from circulation and from cells in the blood vessel lining and returns it to the liver for storage or excretion, possibly inhibiting plaque formation. The amounts of total cholesterol and each type of cholesterol are measured to assess cardiovascular risk. High levels of VLDL- and LDL-cholesterol (sometimes referred to as non-HDL cholesterol) and low levels of HDL-cholesterol are associated with heart disease.^1,3 Importantly, while LDL-cholesterol-lowering therapies have been shown to reduce cardiovascular events (like heart attack and stroke), therapies that raise HDL-cholesterol levels have so far failed to improve cardiovascular outcomes.⁴

The American Heart Association recommends total cholesterol levels should stay under 200 mg/dL, although the optimal level is likely to be closer to 150 mg/dL.⁵ They also recommend a target LDL-cholesterol level of 100 mg/dL or lower, and a target HDL-cholesterol level of 60 mg/dL or higher. Target cholesterol levels in individuals with a high cardiovascular risk or a history of a cardiovascular event, such as known cardiovascular disease, diabetes, or a previous heart attack, are more stringent, especially regarding LDL-cholesterol.^5,7 Healthy cholesterol levels, however, are not a guarantee of good heart health, as some people with lipid profiles considered to be healthy can still have atherosclerosis and an increased risk of heart attack.^8,9

The following discussion is limited to information about improving cholesterol levels using natural approaches. People with high cholesterol levels may also want to learn more about atherosclerosis and cardiovascular disease.