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Questions for Dr. Kennedy
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cholesterol and pregnancy
Posted by: Jenny
Date: February 17, 2001 4:53 AM

I am 28 years old and have a cholesterol count of 300. It is hereditary - my father had three heart attacks in his 40's. My doctor wants to put me on a statin, but my husband and I want to have children. Is anything safe to take during pregnancy? Is a very low amount of red yeast rice an option?

RE: cholesterol and pregnancy
Posted by: Ron Kennedy, M.D.
Date: February 17, 2001 11:59 AM

I would double check that diagnosis. Familial hyperlipidemia usually presents with a much higher cholesterol than 300, namely 400 and up even to 800 and above. Diet and lifestyle run in families also and have nothing to do with heredity. In general statins should be used when all else fails. All else includes diet, exercise, stress management, cessation of tobacco, caffeine, etc, use of good digestive enzymes when any cooked food is consumed, avoidance of all cooked fat with substitution of raw fat sources such as avocado or raw goat cheese. Statins are not necessarily safe drugs, but may be indicated in true familial hyperlipidemia to protect from so-called vulnerable plaque. Personally, I would not use them unless all else had failed and the possible dangers and side effects of those drugs would still give me pause. While inositol hexaniacinate is widely used to lower cholesterol, without lifestyle and nutritional changes, it is not much better than the statins which typically lower the count only 10-20 points. The only fraction of the lipid profile which has been shown to be a factor in vascular disease is the VLDL. Most doctors are unaware of that fact and some labs do not even report it. This is part of what has been called, and what I think of as, the "Great Cholesterol Hoax." The other risk factors for vascular disease are at least equally important and it may be a disservice to people for doctors to be so obsessed with controlling a lab study (cholesterol) as it glosses over the fact that there is so much which can be done without drugs. Besides diet and lifestyle, your doctor should be considering the possibility of homocysteine level, lipoprotein(a) level, serum fibrinogen level, and the possible presence of bacteria we now believe can trigger atherosclerosis. We now understand that vascular disease is far more complex than a simple measurement of cholesterol can reflect and that it is very possible to develop vascular disease with a cholesterol of 150 or lower. The triggering mechanism relates to infection, inflammation and hypercoagulability with the formation of a one micron thick fibrin coat on the inside of arteries. Once the vascular intima is broken it can become a festering wound and the repair of that wound is what we know as a plaque. If you happen to be in the acute phase of this festering wound, statins can be of benefit due to their anti-inflammatory activity (not their cholesterol lowering characteristic). If you are not in that acute phase, statins are worthless at best and harmful to your health at worst - my humble opinion. You find out if you are in that acute phase with a cardiac C-reactive protein test. By the way, my cholesterol is 240 and I consider that robust and healthy, despite conventional medical wisdom. Cholesterol happens to be necessary for life. Without it you would soon die. It is the precursor of all the adrenal and sex steroids.



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