Cholesterol: Why Your Body Needs It

Cholesterol has often been vilified as a primary cause of heart disease, but the truth is, cholesterol is essential for life. Without it, our bodies wouldn’t function properly. While high cholesterol levels can pose health risks, having too little cholesterol can also cause serious health issues [1].

What is Cholesterol?

Cholesterol is a waxy, fat-like substance found in every cell of the body. It is primarily produced by the liver but can also be obtained through food. There are actually five major types of lipoproteins that transport cholesterol and other fats through the bloodstream:

• Chylomicrons – Carry dietary fats (triglycerides and cholesterol) from the intestines to tissues.

• Very Low-Density Lipoprotein (VLDL) – Transports triglycerides produced by the liver to various parts of the body.

• Intermediate-Density Lipoprotein (IDL) – A transitional form between VLDL and LDL, carrying both cholesterol and triglycerides.

• Low-Density Lipoprotein (LDL) – Often called “bad cholesterol,” it delivers cholesterol to cells but can contribute to plaque buildup in arteries, often due to an inflammatory process [2].

• High-Density Lipoprotein (HDL) – Known as “good cholesterol,” it helps remove excess cholesterol from the bloodstream and transports it to the liver for excretion [3].

Our bodies can make it's own cholesterol in the liver from the foods we eat. Healthy sources of fats include avocados, nuts, seeds, coconuts, salmon, eggs, and olive oil.

The Essential Functions of Cholesterol

Cholesterol plays a critical role in several bodily functions, including:

• Cell Membrane Integrity: Cholesterol is a crucial component of cell membranes, providing structural stability and fluidity [4].

• Hormone Production: Cholesterol is the building block for steroid hormones, including estrogen, progesterone, testosterone, cortisol, and aldosterone [5].

• Vitamin D Synthesis: When the skin is exposed to sunlight, cholesterol is converted into vitamin D, which is crucial for bone health, immune function, and calcium absorption [6].

• Bile Production for Digestion: Cholesterol is a key ingredient in bile, a digestive fluid produced by the liver that helps absorb fat-soluble vitamins (A, D, E, and K) [7].

• Brain Function and Nervous System Health: The brain contains about 25% of the body’s cholesterol. It is essential for neuron function, synapse formation, and myelin production, which insulates nerve fibers [8].

What Happens When Cholesterol Levels Are Too Low?

While cholesterol levels are often considered a risk factor for cardiovascular disease, having cholesterol levels that are too low can also cause serious health issues:

• Hormonal Imbalances: Low cholesterol can lead to deficiencies in estrogen, testosterone, and cortisol, resulting in irregular cycles, fatigue, poor stress response, or low libido [5].

• Increased Risk of Stroke: Very low cholesterol has been linked to weakened blood vessel walls and a higher risk of hemorrhagic stroke [9].

• Cognitive Decline and Mental Health Issues: Cholesterol is vital for brain function, and excessively low levels are associated with depression, anxiety, and increased dementia risk [8,10].

• Weakened Immune System: Cholesterol supports immune cell production; low levels impair the ability to fight infection [11].

• Digestive Issues: Without cholesterol, bile production suffers, reducing the absorption of dietary fats and fat-soluble vitamins [7].

Maintaining Healthy Cholesterol Levels

Maintaining cholesterol at an optimal level is crucial for overall health:

• Eat a Whole-Foods Diet: Include healthy fats (avocados, nuts, olive oil) while avoiding processed foods and refined sugars.

• Exercise Regularly: Physical activity boosts HDL and regulates overall cholesterol levels [12].

• Manage Stress: Chronic stress increases cholesterol production due to higher cortisol demands [13].

Synopsis

Cholesterol is an essential substance that supports numerous bodily functions, from hormone production to brain health. While high cholesterol levels can pose health risks, low cholesterol can be equally concerning. Achieving balance through proper diet, exercise, and medical guidance is key to maintaining optimal health.

If you’re already taking cholesterol-lowering medication or have concerns about your levels, schedule a consultation today. We’ll work with you to make sure your cholesterol supports—not harms—your health.

References

1. Ravnskov U, de Lorgeril M, Diamond DM, et al. The LDL paradox: higher LDL-cholesterol is associated with greater longevity. Expert Rev Clin Pharmacol. 2018;11(10):959–970. https://meddocsonline.org/annals-of-epidemiology-and-public-health/the-LDL-paradox-higher-LDL-cholesterol-is-associated-with-greater-longevity.pdf

2. Ference BA, Ginsberg HN, Graham I, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease. Eur Heart J. 2017;38(32):2459–2472. https://doi.org/10.1093/eurheartj/ehx144

3. Rader DJ, Hovingh GK. HDL and cardiovascular disease. Lancet. 2014;384(9943):618–625. https://doi.org/10.1016/S0140-6736(14)61217-4

4. Simons K, Ikonen E. Functional rafts in cell membranes. Nature. 1997;387(6633):569–572. https://doi.org/10.1038/42408

5. Payne AH, Hales DB. Overview of steroidogenic enzymes in the pathway from cholesterol to active steroid hormones. Endocr Rev. 2004;25(6):947–970. https://doi.org/10.1210/er.2003-0030

6. Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266–281. https://doi.org/10.1056/NEJMra070553

7. Russell DW. The enzymes, regulation, and genetics of bile acid synthesis. Annu Rev Biochem. 2003;72:137–174. https://doi.org/10.1146/annurev.biochem.72.121801.161712

8. Björkhem I, Meaney S. Brain cholesterol: long secret life behind a barrier. Arterioscler Thromb Vasc Biol. 2004;24(5):806–815. https://doi.org/10.1161/01.ATV.0000120374.59826.1b

9. Iso H, Jacobs DR Jr, Wentworth D, Neaton JD, Cohen JD. Serum cholesterol levels and six-year mortality from stroke in 350,977 men screened for the Multiple Risk Factor Intervention Trial. N Engl J Med. 1989;320(14):904–910. https://doi.org/10.1056/NEJM198904063201405

10. Muldoon MF, Manuck SB, Matthews KA. Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials. BMJ. 1990;301(6747):309–314. https://doi.org/10.1136/bmj.301.6747.309

11. Tall AR, Yvan-Charvet L. Cholesterol, inflammation and innate immunity. Nat Rev Immunol. 2015;15(2):104–116. https://doi.org/10.1038/nri3793

12. Kelley GA, Kelley KS, Roberts S, Haskell W. Comparison of aerobic exercise, diet, or both on lipids and lipoproteins in adults: a meta-analysis of randomized controlled trials. Clin Nutr. 2012;31(2):156–167. https://doi.org/10.1016/j.clnu.2011.11.011

13. Steptoe A, Brydon L. Emotional triggering of cardiac events. Neurosci Biobehav Rev. 2009;33(2):63–70. https://doi.org/10.1016/j.neubiorev.2008.04.010