Philip J. Goscienski, M.D.
For 150 bucks you can measure your blood cholesterol at home with your very own monitor, but is that a good investment? These devices measure what is known as total cholesterol but some can also measure fractions of cholesterol that are probably more indicative of a person's risk of heart disease. The sophistication of medical instrumentation makes it likely that we'll soon be able to test for multiple conditions on a drop or two of blood — or perhaps without the discomfort of a blood test at all, a la Star Trek.
Since the 1970s physicians have generally recognized that as one's blood cholesterol rises, so does the risk of heart attack. The normal level should be about 150 (expressed in milligrams per deciliter). Many Americans have levels above 200, especially those who are obese or diabetic. A few unlucky families have a genetic defect that allows cholesterol to reach very high levels in spite of a healthy diet and lots of physical activity.
Modern hunter-gatherers who still live the Stone Age lifestyle eat about as much cholesterol as we do but their blood cholesterol levels are in the range of about 150. That's because their meat sources have almost no saturated fat, which is the main cause of high cholesterol levels in modern societies.
If you ate no cholesterol-containing foods and hardly any saturated fat your body would make all it needs. Even a diet that is high in cholesterol doesn't really raise blood cholesterol levels more than about 10 or 15 percent. We need it to make sex hormones (estrogen, progesterone and testosterone) and cortisol, the stress hormone. Without cholesterol as a barrier, too much water would evaporate through our skin. Most of the cholesterol that we manufacture is turned into bile salts, which make it possible for us to digest fat.
There are at least nine different forms of cholesterol. The total cholesterol includes forms that are attached to protein and that are better predictors of heart disease. High levels of low-density lipoprotein (LDL) and very low-density lipoprotein (VLDL) are important risk factors and so is a too-low level of high-density lipoprotein (HDL). The plain fact is that there are numerous factors that affect one's risk of heart disease and stroke and it's pointless to rely on just the total cholesterol.
It's possible to have a cholesterol level that is too low. Low total cholesterol levels are associated with depression, aggressive behavior and a higher risk of suicide.
Some physicians aggressively prescribe statin drugs, which do help to lower both cholesterol levels and the risk of heart attack and possibly, cancer. The occasional severe side effects of statins should make patients consider changes in lifestyle so that they can either avoid the medication altogether or to get by with a lower dose A healthy diet and proper exercise cost absolutely nothing and the results in the long term are at least as good for many people.
Should you invest in a cholesterol monitor? Frequent checks are pointless and normal fluctuations cause unnecessary anxiety. Spend the money on a good pair of walking shoes instead. It's a better buy.
Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at email@example.com.