Statins and Your Brain Health

well hey there welcome back to eye care for your brain with board certified neuropsychologist Dr Karen Sullivan that is me tonight we have a very important very controversial topic that we're going to be doing for our free brain health lecture and that is statins and the Brain statins elicit a reaction in my patients uh unlike any other drug even just hearing the word statins can make people have a very strong reaction people are concerned people are confused they're not informed people don't have enough information to make the decision about whether or not this is a good idea for them in many instances there's a lot of misunderstanding not just about statins but about cholesterol and ldlc the supposed bad cholesterol I have researched this topic for hours every day for the last two weeks and I have learned so much even having a PhD in a brain health science there was still many many things that I learned that I'm excited to hand over to you today statins are in a class of medications you probably know this that reduce low density lipoprotein cholesterol that we call ldlc the stuff that is most associated with atherosclerosis so the first message I want you to get out of this time with me tonight is that LDL cholesterol is not the enemy okay the atherosclerosis is the enemy that is the problem this is what happens when blood vessels get all clogged up with Gunk that we're going to Define tonight and narrow the blood flow to the degree that the amount of oxygen glucose and other micronutrients cannot get through to cells including brain cells this is the cause of cardiovascular disease or cerebrovascular disease including heart attacks and strokes we call this CBD this is the leading cause of disability and death in the United States with about 40 percent of us dying from some type of atherosclerosis disease okay in 2020 4.5 million deaths were attributed to this CBD and that's actually up 19 from 2010. okay and that's according to the American Heart Association so that makes you a little concerned if we are supposedly doing better with heart disease why is it that more people are dying well it's just a numbers game there's just more people so what's interesting uh is that 50 of men will have their first cardiovascular event like a heart attack or stroke uh before the age of about 65 but 25 percent of men before the age of 54 will have some type of cardiovascular event for women the biggest risk seems to be pushed back by about 10 years we're about 10 years behind men with the same amount of heart disease we don't seem to get symptoms for about 10 years more than 200 million people worldwide take a stat in the first one Lovastatin was approved in 1987 and they've been gaining popularity ever since then in the U.S Statin users across all age groups increased by 80 percent from 2002 to 2013. Lipitor also called atorvastatin is the most commonly prescribed prescription in the entire world Statin use increases as we get older so between 45 and 64 years of age about 17 percent of people take a Statin from 65 to 74 it goes up to about 42 percent and then we see a little bit of a decline after 75 41 of the world population takes a Statin so both the widespread use and the Public's concern really put upon us as doctors to be well informed so we can engage our patients in high quality education this topic is also personal for me I recently learned that I have a genetic lipid disorder passed down from one of my parents that makes LDL cholesterol in my body a lot more dangerous now within the disorder that I have there's a range of abnormal lab values and mine aren't awful but they're also not great and so it does put me at Future risk for heart attack and stroke so this is this is where it came in for me so I have had what they call a cardiac calcium scan and luckily there's no build up in my heart yet but at the age of 49 early intervention is very important to me so I have been sitting on this prescription of Crestor five milligrams of resovastatin for about six months and I have not been able to make a decision after I have put in the this time to doing my research for our lecture tonight I have come to a decision about what I want to do so at the end of this lecture I'm going to share that decision with you will I be reaching for the five milligrams of Crestor or might I pick something like this this is a packet of plant sterile gummies a supposed natural alternative to reducing cholesterol so at the end of our time together I'm going to tell you what I've decided to do for me so this lecture is uh was very complex to put together probably the one I've spent the most time on in five years I couldn't possibly explain everything about statins in this time so my focus is going to be on brain health and statins as a neuropsychologist this is my Lane this is what I get asked about this lecture is intended to make you a better informed consumer so you can advocate for yourself and collaborate with your doctor that is key do not make any personal medical decisions based on what I say a board-certified neuropsychologist on the internet okay 40 at least of people get their medical information and make Health Care decisions based on things they learned on social media do not be one of those people okay please do not make any changes in your cholesterol regimen based on what I tell you tonight go to your doctor with this information and have a more informed conversation okay so ready we have a deal we're gonna shake on it so the first thing I want to say is that cholesterol really gets a bad rap cholesterol is essential to life every cell in our body makes and synthesizes cholesterol without cholesterol there would be no me there would be no you cholesterol is not a fat it is in the lipid family it's kind of a soft waxy substance it is the main ingredient in cell membrane so it is what gives cell membranes its flexible structure it's its ability to let things in and out right cells can't just be blobs that have no walls they have to have a structure in in human beings that cell membrane is largely made up of cholesterol cholesterol is an essential building block in the production of many hormones if we didn't have cholesterol we couldn't have estrogen we couldn't have testosterone we couldn't have cortisol and respond to stressors it is essential for the synthesis of vitamin D and the creation of bile acids that wrap around our food especially if anything food and help us digest them and break them down cholesterol is also responsible for transporting different types of molecules across the cell so bringing glucose into cell and also antioxidants this is where the coenzyme Q10 issue comes in that we will talk about tonight because it is so needed and not every cell can make enough of its own cholesterol there has to be somewhere else in the body that can be called in if we need it for cell maintenance and production and this is where the liver comes in so the liver is actually the organ in the brain that makes more than it needs and this is because it dulls it out across the biological system we make more cholesterol when we are stressed now keep that in mind when we start talking about recommendations remember cholesterol is a lipid right so think of putting oil into water right so imagine this is trying to move in the blood the plasma which is mostly water it's repelled right imagine oil going into a cup of water it doesn't smoothly really move right it kind of has its own bubble and it goes in its own Direction so cholesterol needs a vehicle to help it move throughout the blood okay the vehicle is called lipoproteins now you might not have heard of this type of molecule yet but in the next five to ten years this is going to be the thing that we talk about instead of LDL or HDL or good cholesterol or bad cholesterol we're really focusing on lipoproteins now so lipoproteins do allow the LDL the not so great uh cholesterol to attach to receptor sites on the surface of the cells and basically once it's attached then it's either able to hold on to or break down the cholesterol okay so we can either up take it and use it or we can put it in a package and get rid of it so this is where our second misconception comes in okay so LDL cholesterol that is in our body does not come from the foods we eat okay only 10 to 15 percent of the cholesterol that we eat so think about things like eggs and meats right they have very high cholesterol the molecules are too large for us to actually absorb so they get moved to the liver packaged and bio and excreted this is not the problematic cholesterol that we think of when we think about cholesterol building up in Our arteries and blood vessels it's from the inability or the lack of efficiency in clearing out naturally produced cholesterol in the these lipoproteins okay so it's a whole different way of thinking about it so high cholesterol does not come from the cholesterol that you eat in food now saturated fat right which we kind of put saturated fat and cholesterol in the same category when they're separate so yes saturated fat does raise the bad LDL and increases the risk risk of atherosclerosis but what you have to remember is it's not the cholesterol that is the enemy per se right it's what causes it to build up and form these plaques in our blood vessels that then narrow it and make not enough oxygen get through so we have two main types of cholesterol we've got the LDL which we talked about which is low density lipoprotein and this can contribute to the clogging of arteries and is a major cause of heart disease but it's really not the end-all be-all and if you get anything of our time together tonight it's that we need to not focus as much on LDL there's a whole panel of lipids that have to be understood together to really understand our risk and how we can be proactive against heart disease so if we just focus on LDL and we talk about the good and the bad the reason that researchers don't like to call it good and bad anymore is it creates this incredible oversimplification lipids are actually extremely complex So within Cardiology you know you've got your Specialists your electrician sometimes you got your plumber well we're going to add a new one in and that's the lipid ologist okay and this is the type of doctor that is going to be up to date on having these kind of conversations with you so when your body has too much LDL cholesterol due to lipoprotein dysfunction okay this is what contributes to all of that stuff building up in the cell wall so the big issue is when you start to get enough of the cholesterol building up it basically causes a plaque that ultimately blocks a blood vessel which causes ischemia okay the ischemia can cause a heart attack so part of the heart muscle doesn't get oxygen and dies or a piece of the plaque can break off and this is what causes ischemic Strokes then we have HDL this is the high density lipoprotein often called the good cholesterol which is thought to be protective and the way it's protective is it basically absorbs cholesterol in the body when there's too much carries it back to the liver and then the liver gets rid of it okay there are no medications on the market to raise HDL statins reduce LDL but they really don't do anything to HDL and in fact they might lower them so low HDL was actually more predictive of heart disease than high LDL according to the Framingham heart study so already you know our mind is kind of changing like okay maybe I haven't really been understanding cholesterol in the way that it's been pitched to me and these super simplified media messages so we've got two different kinds right of cholesterol so this is going to be very important if you take a Statin or if you're considering it you need to know where your Statin is in terms of those categories so we've got the lipophilic right the low density so this is your Lipitor your simvastatin and your Lovastatin then we've got hydrophilic right high density this is your Crestor and this is your pravastatin so keep in mind which one you take or you might take as we start to talk about the brain because it turns out there's a big difference in the way those two different categories are able to travel to the brain and make an impact so like I said it is atherosclerosis what a mouthful huh that is the problem and this disease process has a lifespan the risk of having these blockages is something that accumulates over decades and this is a very important point for tonight this is not just like dementia this is not something that you should care about once you're in your 60s or 70s we need to be having conversations about lipids with people they say starting around your 30s 35 years old okay so this buildup happens over a lifetime so the longer you have it the more likely it is to go from soft plaque to hard and hard is where we get the blockages starts off as fatty streaks of kind of the soft stuff and eventually eventually gets to the point where it's oxidized or calcified and then it's living on the blood vessel wall once it is attached to the blood vessel wall it basically opens up and dumps all of its Gunk and junk into the artery wall which creates an incredible inflammatory process which in and of itself is problematic so basically it is this buildup of these fatty streaks which is very complex and not just related to ldo that is the problem okay heart attacks and strokes don't just happen they're often the result of Decades of slow developing disease so we have got to start to change the way that we think about cholesterol so one of the things I wanted to provide you tonight is what are some optimal numbers right what should your goal be well it turns out this is not as straightforward uh as as it might seem so when you go to get your cholesterol tested by your doctor they are measuring the lipids in your blood that are circulating in your blood right there is no way to really measure the amount of plaque and cholesterol that is in your arteries outside of some very Advanced there's no blood test for example that's going to get you to that number that's really what we need to understand is from that kind of lipoprotein and the clearing perspective how efficient is your system how efficient is my system so the way they really calculate risk now is they take take about 10 years and they say in the next 10 years what is the likelihood this person could have a heart attack or a stroke and they yes are measuring LDL and HDL but I want to share with you the formula that most lipidologists are actually using these days so if you go to your primary care your you know generalist cardiologist they may still be just relying on the very simple very oversimplified LDL and HDL okay there's actually eight different methods for calculating LDL and guess what they all come up with slightly different numbers so there's that also cholesterol fluctuates by about 10 in any given blood draw so it's a little bit of a moving Target but basically what we're generally thinking of is about under a hundred milligrams per deciliter for ldlc and this is especially if you have diabetes heart disease if you've ever had a blockage if you've had a heart attack or a stroke you do want to be a little bit more aggressive Okay so statins can reduce your ldlc by 30 to 50 percent but one thing you need to know is if you stop them the effect completely goes away and you will likely return to the exact same Baseline levels of cholesterol that you had before okay so the 2018 guideline on the management of blood cholesterol from the American College of Cardiology and the American Heart Association basically has put together an algorithm and I thought this was very very helpful this really helped me wrap my head around it so if you're between 40 and 55 the critical things are age and your gender that's it that really seems like the two big influential factors that should be considered when trying to make a decision about future heart disease right you can kind of draw two different lines based on um how old you are based on your gender because there are some differences in men and women now once you get past 55 then there's this whole whole host of variables that have to go into an interpretation so cigarette smoking and increased blood pressure have the strongest biggest influence if you have those two things you're going to have to be treated a lot more aggressively but they are also looking at pre-diabetes they're looking at what we call metabolic syndrome if there's any family history of early heart disease or stroke chronic kidney disease if you ever had pre-eclampsia when you were pregnant if you had premature menopause before the age of 40 if you have rheumatoid arthritis psoriasis if your ldlc levels have been chronically elevated to 160 or more if you are triglycerides or consistently over 175 if you're C-reactive protein is over to and incorporating these measures of lipoprotein so the two big ones I want you to know about are APO B and lipoprotein a okay so this is the reason I found out about my lipid disorder is I went to kind of a a concierge medicine who did a broader lipid panel and this was discovered I would have never discovered this if I was in a traditional primary care practice now if you were to fast forward five to ten years I guarantee you lipoproteins are going to be in every single lipid panel because the science is already there the clinical practice just hasn't caught up so all of this goes into a big pot and then a lipidologist really should be deciding based on multiple very sophisticated calculations what is your specific risk for future heart disease okay so this is very important to me that you understand this it's not just HDL it's not just LDL now generally speaking we're trying to raise hdlc to above about 40 milligrams right so this is the one that we think packages the cholesterol and is able to actually remove it from the system so these these tests for lipoprotein a and APO B are available now you can actually just go on Google and order them yourself now I'm not going to post any online options because I have not had the time to figure out who I would endorse who is reputable but you should this is they do it in Europe they do it at these concierge medicine practices do not hesitate especially if you have a family history of any type of early cardiovascular disease you need your lipoproteins tested okay lipoprotein a and a PO B uh in about 10 years like I said this is going to be very very standard so that's basically what I want you to know in terms of laboratory tests the story is way more complicated than LDL statins are mostly working on LDL I mean primarily but that's not it that's an oversimplification to say that if you reduce your LDL you're going to reduce all of your risk of heart disease or stroke because that's just not true there's so many other variables it is not something I want you to try to figure out on your own I honestly don't even want you in your primary care doctor to figure it out alone I want you to find a lipidologist as close to you as possible to give them a blood sample and have them counsel you on what is the very best match for you the next section of this lecture tonight is that fat in the brain is very different than fat in the body okay so in the brain we are protected by the blood-brain barrier and this basically prevents the uptake of bad cholesterol here in our body to getting through into the brain okay when you have high cholesterol here it does not mean that you have high cholesterol up here okay yes it can narrow the blood vessels the carotid arteries that feed the brain but actually in the brain it's two different worlds okay 60 of the human brain is made of fat the brain also contains the highest amount of cholesterol in the whole body about 20 percent of all your cholesterol is right here in the brain cholesterol is essential to brain function we don't want to remove cholesterol from the brain it helps us uh with so many different things but we're just going to focus on brain cells communicate educating to each other which is how it all happens from breathing to making new memories to finding our words so basically communication from brain cell to brain cell happens because we have an insulator around different parts of the brain cells called the myelin sheath and this propagates electrical impulses and basically this little brain cell has something to say and it's going to shoot it down this long tail that's going to be wrapped in myelin which is 70 cholesterol and that's how it's going to get its message to the next one okay so when we start messing around with cholesterol in the brain this is where we start to get concerned and I think that's at the heart of why some of you are with me tonight so I had to give you the back story before I could get into the meat of it okay so the last thing I want to say about the lab stuff is um you you really need to be focused on you know lowering circulating total cholesterol yes lowering LDL lowering triglycerides lowering HDL lowering APO B and lowering lipoprotein a if you have a genetic predisposition to have it okay so now we have set the stage on all that good stuff now we're going to get into the actual brain so remember before I said we've got lipophilic and hydrophilic right lipophilic basically means that it's much more dissolvable it absorbs is much faster okay so remember you got your lipophilic over here basically the lipophilics can enter into cells a lot easier and affect the cell membrane okay hydrophilics are higher density so they struggle or can't get into brain cell pardon me into any cells as quickly so remember your personal Statin right so lipophilic is the Lipitor the Zocor the Lovastatin these are more absorbable you got to keep that in mind okay and they are mostly metabolized by the liver the hydrophilic ones the Crestor the pravastatin these are mostly excreted by the kidney and again they have a harder time getting in they're both pretty darn good at removing the plaque and the LDL but the lipophilic ones are much more easily going to slip through the blood brain barrier and get into skeletal muscles you see where I'm going with this so already we're starting to think Hmm maybe it's not that all statins are bad maybe it's that there's differences within statins that aren't a good match for some people we also think about statins as belonging to Generations first second or third but that's kind of neither here nor there so the two things that increase the risk of a Statin going from your blood into your brain are the dose okay and how lipophilic it is so according to brain health according to the lecture in November 2022 that we know right now what the the literature would tell us is that the lipophilic Statin is more readily going to get into your brain because statins are so darn good they're so effective the theory about why there could be cognitive symptoms with high-dose lipophilic statins is because they lower cholesterol below the level required for normal cellular transmission and in this way we can have trouble with memory which is the the primary symptom people are concerned about so the good thing about these memory symptoms that have been more associated with lipophilic and higher doses is you have to remember statins only work as long as you use them so when people come off of them these memory syndromes are thought to be reversible when the satin is stopped okay so how did we ever even start to worry about statins and brain and memory well that's really interesting because the first clinical trials for the lipitors of the world didn't include any cognitive test they didn't even it wasn't even on their radar that there could be Memory effects it was only from what they call post-marketing surveillance where patients started telling their doctor I don't know ever since I've been taking the Statin I just I'm not thinking right as something wrong like there's a disconnect so the FDA heard this enough times that in 2012 they issued a warning to statins basically saying that we have a concern we have an alert that there there could be a rare side effect of memory loss they also included an increased risk of diabetes and muscle pain but the FDA was very clear and they said these risks are very small compared to the benefits of reducing cardiovascular disease and we don't want you to stop your Statin we want you to talk to your doctor about it okay so then the question is did the FDA do the right thing what did they base their information on or did they cause some of the hysteria that we are still seeing today about statins well it was controversial because basically scientists looked into it and said what was this evidence we we really can't okay you took people's word for it that's good but that's usually not how the FDA works so a group of scientists basically went back and tried to look at the data differently to see if there was anything to this and what they found was a non-statistical trend towards reversible cognitive impairment and this is basically what we worked on for years it really wasn't a good answer it's kind of like well maybe but it doesn't seem like it sticks around for too long another group of researchers then came in and they said you know what let's get the data but also try to look at other medical records and see do these people go to the doctor and complain about dementia do they uh work complain about memory loss and basically uh what they found is that they they weren't too worried there didn't seem to be any strong statistical uh correlation but what they acknowledged is that they didn't really use people on high dose statins because in clinical trials they were prescribing at a much lower rate than it turned out people needed clinically in real life so the clinical trials were based on let's just say five milligrams but in real life people were getting like 40. so they conceded that maybe we just haven't really done the the proper research so it kind of goes on and on and on like this for years so finally we get a group of researchers that start to look at it a little bit of a different way and this is where we start to see The Divide in the road that yes lipophilic statins at high doses so specifically atorvastatin and simvastatin compared to hydrophilic and less lipophilic statins do come along with more cognitive complaints okay and then even when you do cognitive tests looking at these lipophilic statins we do see that people who take them at high doses in double-blind placebo-controlled Studies have worse attention working memory and mental processing okay in another study they also looked at um the impact of simvastatin and that group was not able to learn from prior experience as much as people on a placebo so there was some good and bad about these studies the good was that the design of the study was good it was randomized it was controlled but they had a small population so more and more research Searchers started to try to look into this and basically what is the conclusion and what is accepted now in the literature is that about 50 percent of people who take lipophilic statins will note some cognitive symptoms within the first two months or when they have an increase in dose and almost all of them said it improved when the Statin was discontinued okay but what we were still waiting for was we really wanted to know what hap happen when you put these groups together in terms of dosage so this is a huge body of literature and they're what they found out is for some people it wasn't so much a high dose in anyone it was a high dose in certain population so basically people with liver disease struggle a lot more with statins because that's basically where the lipophilic ones are metabolized processed and excreted so basically if you have any type of liver disease fatty liver in particular it's going to make statins stick around more and again they're so good at what they do they become more potent they also found that people who had alcohol abuse were more susceptible to developing cognitive symptoms again the liver is involved with alcohol so I thought those two things were very helpful to know because it's it's really a public health problem that we think broadly negatively about all statins okay it's really it's it's much more nuanced than that I really think the concerns with the brain are more related to the lipophilic and the higher dose one myth I've heard repeatedly is do statins cause Alzheimer's disease and I don't believe that I don't think there's any evidence that statins cause Alzheimer's or any type of Dementia in fact there's research that it might actually prevent different types of dementia especially vascular dementia so could statins actually be neuroprotective so yes I just went over some research where some people think that cognitive impairment can be seen in these high-dose lipophilics but we also have other people that actually say that they're helpful for the brain and the truth is both can actually be true so I want to summarize for you what is the data on statins and dementia okay it started to get attention in 2013 because Tuesday studies came out that said people who take statins for over a certain amount of years have a reduced risk of dementia that got a lot of people thinking and it kind of makes sense that a Statin would prevent the buildup of that atherosclerosis which we know can ultimately cause brain cells in particular to die because they don't have enough oxygen that is is there's enough good evidence to say it supports brain health and there's enough good evidence to say it has no effect so that I'm kind of null on that one there's also been reports that maybe statins slowed down Alzheimer's disease once it started again I would say the evidence on this has just not been really great um we I don't feel like we have a great answer on that but certainly many people have mixed Dementia in which there is Alzheimer's and a vascular issue and if that's the case if we identify that there is vascular disease in the body and the brain that is hurting cognition or brain cells then we are going to want to be more aggressive about reducing it now I want to talk about the most common side effects in statins because this is what keeps people off them five to twenty percent of people will report what they call Statin related Adverse Events and the most common is called Sam's this is Statin Association Associated muscle symptoms five to twenty percent of people so over 80 percent of people with Sam's talk about muscle pain and they may or may not have uh they're they're creating kinase may or may not go up that that kind of changes the way you know that it's related to statins is it happens within weeks of taking a Statin or increasing and it's bilateral it's on both sides and it's typically in the thighs and the hips and the symptoms go away when you stop the statins okay so once again Sam's the statin-associated muscle symptoms are also different between the two types of statins with lipophilic again being worse right and it's because they diffuse the lipophilic the the molecule is smaller and less dense and it can get into skeletal muscles easier and pull out the cholesterol it's a very simplified way of saying it but I think you get my point p people who get these muscle aches typically have other things that are also exacerbating it untreated hypothyroidism is number one low body mass index so if you're kind of small petite alcohol use and vitamin D deficiency they all lower the threshold for statin-associated muscle symptoms the way doctors handle it is they don't just say well you failed the stat and that's it life goes on what they do is they take you off of it and they try you on a different type of Statin and almost always this works to get rid of the muscle symptoms the big thing you want to watch out for here is muscle weakness now weakness is different from aches and pains if people have statin-induced weakness that's a whole other ball of wax a very rare side effect that would be a medical emergency I did talk about new onset diabetes with statins earlier so I did just want to raise that we see that with both lipophilic and hydrophilic it appears to be more frequent in older folks and in people on those higher doses so this typically the people we watch out for is if you already had you were basically already on your way you hadn't been quite diagnosed with diabetes the Statin seems like it can kind of tip people over the edge um I want to address natural supplements because I know this is very important to you in 2020 market research Americans spent an estimated 50 billion dollars on dietary supplements and many of them just like we've got the whole brain Fitness industry we've got heart protection cholesterol management interestingly just this week people were sending me this the American Heart Association had their scientific sessions their in-person conference and we finally finally had a high quality study that actually put the six most widely used dietary supplements head to head against a Statin for 28 days they did a comparison in a study called sport in 199 adults ages 40 to 75 who had no personal history of cardiovascular disease and they basically tracked them over time so they either took Crestor five milligrams which is what I've got here a placebo or a sugar pill or one of these six so there was Nature Made fish oil at two thousand four hundred milligrams nutroflare brand cinnamon also 2400 garlic 5000 micrograms turmeric 4 500 milligrams Nature Made cholestoff plus which was a thousand six hundred milligrams of plant sterols and nutrition brand of red yeast rice 2400 milligrams so what they found after 28 days was in the Statin group 38 of the people who took the statins had a significant change in their cholesterol okay so this was 24 reduction in overall cholesterol people who took the Crestor also had a 20 decline in blood triglycerides and this was compared to all of the dietary supplements and all of the placebos that resulted in absolutely no change not nothing no how now the author did conclude that maybe 28 days isn't enough for the natural stuff to work and that's still a definite possibility but it was the first time ever this just happened and we haven't even seen the full-length paper this is just a poster at a conference where we actually for the first time have looked at so-called natural remedies versus a prescription so I I don't make conclusions about that for you I just want to say that that is something that happened so I didn't know much of the brand I didn't know much about these sterols um they come in gummies you can get them in their food but basically what are they and why are they so popular for cholesterol well they're natural compounds that are found in plants that can lower your cholesterol directly and indirectly so indirectly by reducing obesity diabetes cancer but the key that I found in my research is it's really preferable that these things come from food and there is even concern about the supplements the gummies that you might be getting too much and too much can actually backfire and cause issue with plaque buildup I know that that seems counter-intuitive but I'm just telling you what I heard so some studies show that when you eat plant sterols in food form that you can reduce your LDL on average by eight to fourteen percent okay a lot of the articles I found that looked at supplements are in not very reputable Medical Journal so they're either industry sponsored they're paid to print they're not undergoing that same rigorous editorial kind of oversight that we like to see in science so where you find these compounds in food is fruits vegetables whole grains and nuts they're so important that actually a lot of foods are fortified with them and the idea is for public health to reduce risk so basically how they work is they stop cholesterol absorption right so remember the cholesterol that you eat is basically passing through you the cholesterol that's the problem is endogenous our own cells make it but we wind up creating too much and we can't package it and excrete it and there's this buildup so the idea is that these should be able to help us absorb in our digestive system more of this kind of runoff cholesterol so I feel very good about saying and the FDA has said that the foods that contain these compounds so the goal is to eat at least 0.65 grams per serving twice a day with meals so your total daily intake should be about 1.3 grams you do want to focus on a low saturated fat diet I don't think cholesterol straw necessarily makes that big of a difference now that I understand it a little bit different but most of us are only getting 160 to 50 milligrams which is in comparison to that 1.3 gram so what foods can you start to take in that will help your blood vessels be better well low or no processed food and I always say that fruits nuts vegetables sesame oil wheat germ oil pistachios yay olive oil Sage oregano thyme paprika cocoa almond butter sesame seeds and macadamia nuts okay we also see lentils dried peas dried beans when you get a food that has these phytosterols plus fiber plus protein that seems to be the superfood that is most helpful in keeping our blood vessels nice and open so the blood bringing the oxygen and the glucose and the micronutrients the American Heart Association came out and said yes we want you to be eating more of these foods but the concern we have is in the supplements you don't know reliably about what the dosage is of them sometimes we don't even know everything that it's actually in there and in fact like I was saying before you can actually overdo it with these um compounds and actually wind up giving yourself a bigger problem so if you do want to go natural the most support there is is for increasing fiber fiber is a very important food for the body and the Brain two different kinds soluble insoluble when you take it in soluble fibers basically dissolve into kind of like a gel that moves slowly throughout your intestines and it's grabbing up all sorts of cholesterol along the way that reduces its ability to absorb in the bloodstream okay so the foods that are most helpful that have been connected to lower LDL are legumes and vegetables so you can get this through um this is one where supplements are I actually feel comfortable with like Metamucil for example okay people add that to their coffee they add it to their smooth smoothies all it is is basically this husky fiber that that kind of helps pull the cholesterol through people also take pectin or guar gum these have also been shown in well-controlled intervention studies to help with overall cholesterol the problem is we don't get nearly enough five to ten grams or more a day is what we need to impact cholesterol so you know what you eat for it's usually easiest to start off with breakfast like oatmeal or oat bran now you're already three to four grams in you know you're 25 percent there um 25 grams is the goal for Optimal Health so once you get up to 10 now you're helping your heart but if you actually go to 25 you're doing an even better job an easier way to work increase fiber into your diet is also flaxseed flaxseed is a soluble fiber that has that protein that goes along with the fiber that is kind of the essential Powerhouse so after all this information 44 minutes oh my gosh I want to know what your opinion is do you feel any different about cholesterol LDL do you take a Statin how do you feel about it how has what I shared with you tonight impacted your thinking so now I'm going to get back to my promise okay I told you I was going to tell you my personal decision on statins so my LDL is considered borderline okay but now knowing when I was first told about my genetic lipid condition the the doctor basically said you know we want you to take it just jumped out of my hands the anti-statin ghosts are here with me in my house um the the doctor basically said you know take this and and because the LDL is going to be more dangerous in your body well I did research I wanted to understand and basically what I found out is that might not actually be the case Crestor might actually not be the best choice for me so what I have decided to do is I'm not going to rely on the plant sterol gummies what I am going to do is find a lipidologist in my community I have already made a meeting with a nutritionist for a week from next Thursday if that's not Thanksgiving that's what I'm doing it I Now understand a little bit more about diet and how important certain things are to reduce my bad cholesterol lipid profile but what I'm going to do is I'm literally giving myself six months it takes about six months for any lifestyle intervention to make a difference in your labs when it comes to cholesterol if I have not gotten my LDL down to about 100 120 mark my words I will if the lipidologist tells me that you need to take that Crestor I will start taking it I will have no anxiety about taking it if I have muscle aches from it I will go back to the doctor we will rework it my goal would be to choose a hydrophilic Statin and to be on the lowest possible dose that I need in order to get my lipid profile into a healthy therapeutic dose that reduces my risk of having a heart attack or stroke that is just my personal decision what I I think you should do is maybe something similar so at the end of all of this I really believe that statins reduce heart disease and stroke I think that evidence is pretty clear I overall think that there's more positive than negative about statins I could just see the YouTube haters coming for me now I do think statins lower death rates if you have a cholesterol problem but I also think it's vastly under poorly understood I don't think we know enough as much as a lipidologists know so I'm not going to make this decision on my own I am going to seek out a specialist that is going to advise me on what I should do if their advice is that that bottle of Crestor that just jumped out of my hand is what I should do then I really will take it with a clean conscience I'm just not going to rush into doing something because I feel that I don't even have myself never remind my doctors have a full understanding of what my condition is and it's pretty complex and I imagine maybe yours is complex too so conversation has been very valuable for me so I appreciate someone bringing it up to me that they would like me to hear because as you see this is personal I do feel overall that we're very lucky to live in a time where we have these powerful interventions I know some of you are anti-farma anti-doctor I am a Scientist practitioner I do believe in good solid medicine and clinical trials and the conclusion that I have come to is that I would avoid a lipophilic Statin at a high dose in myself or someone I cared about due to the concern about it crossing the blood-brain barrier and interfering with the normal cholesterol supports and Transmissions that happen in the brain that's where I'm at so if you got value out of this free brain health lecture I would love nothing more than for you to leave me a comment share what you've learned let me know where you're at and please do subscribe to our YouTube channel if you haven't done so already I will be back very soon talking about the science of adult attention deficit hyperactivity disorder it's a very common thing that we see as neuropsychologists and I bet there's some things that we'll talk about that will absolutely surprise you thank you guys so much for listening and take care bye-bye

Channel: I CARE FOR YOUR BRAIN with DR. SULLIVAN

Views: 636,153

Keywords: dr karen d sullivan, neuropsychology, brain, brain health, cholesterol, statins, i care foryourbrain

Id: EyBWayCWVcQ

Length: 49min 31sec (2971 seconds)

Published: Thu Nov 10 2022