Category: Nutrition

Cholesterol as Antioxidant

Cholesterol – Fundamental for Life

As fate would have it, one of the most important chemicals in human physiology to sustain life is cholesterol. Yes, this is the same cholesterol that has been so vilified over the past several decades as being the cause of everything from heart disease to global warming.

Let’s take a step back and embrace the understanding of the critical role of cholesterol in keeping you healthy:

  • Cholesterol is a fundamental component of every cell membrane in the human body including brain cells.
  • Cholesterol is the raw material from which your body is able to manufacture vitamin D in the sunshine.
  • Cholesterol is a brain antioxidant – protecting brain cells against the ravages of free radicals.
  • Cholesterol is the raw material from which we manufacture the sex hormones including estrogen, progesterone, testosterone and even cortisol as well.

So it comes as no surprise that an extensive study of 3572 adults demonstrated that in those whose had the lowest levels of life sustaining cholesterol, the risk of mortality during the 20 year study was increased by an incredible 65%! This is what peer-reviewed science is telling us, and we must listen to these findings.

  • TechnoTriticale

    “This is what peer ”

    It appears that your remarks got cut off.

    • David Perlmutter

      Thanks for pointing that out. Gone ahead and fixed that now.

  • Dawn Furman Gordon

    My 80 year old father just told me that the cardiologist said his caroided artery (sp) is 40% blocked and put him on a very high dose of a staton drug. What do you recommend instead? He has low blood pressure and has been having mild headaches. Thank you so much!

    • Not advice, but Dr P is talking much about the brain in this post, anyone considering statins should understand HOW they work – which is basically by snipping off one of the most important enzyme pathways to fuel the heart, liver, and kidneys (not to mention the brain, which is what many people take CoQ10 supplements for).

      –> http://highsteaks.com/cholesterol/#statins

    • pbdoc

      You will find your answer there on how to reverse his blockage.

      • Ambivalent

        The Framingham heart study was mentioned in one of the comments. As I recall, it showed that no one with a total cholesterol 150 or under had a heart attack over the several decades of the study. I’ve been wondering how to reconcile this with Dr. Perlmutter’s advice that high cholesterol is not a problem for the heart or arteries. Just asking.

        • Funny thing about that, below 150 cholesterol people tend to die of malnutrition or a simple communicable disease long before their heart gives out.

          • alan

            Dr. P, What is your cholesterol number, if I may ask?

          • Ambivalent

            It’d be nice to hear responses to this and other questions raised by
            Dr. Perlmutter himself. Does high cholesterol lead to plaque build up
            and therefore to heart attacks or not?

          • Doesn’t matter who you ask, there’s no evidence of such BS. Never has been, never will.

  • ann

    same question as Dawn. What do you recommend if Carotid arteries have plaque buildup?

    • Malua Fever

      Change of diet remove wheat and sugar and any processed food and replace with plenty of organic whole foods include plenty of raw vegetables even include fruit and vegetable juicing and smoothies (keeping the fibre) include kifer or sourkrout (healthy gut bacterior) full fat organic yoghurt plenty of clean filtered water replace table salt with sea salt or Himalayan salt eat organic grass fed meat get a clean omega 3 supplement like salmon oil and flaxseed try and get some sun on your body about half an hour a day around midday and take good vit D supplement up to 5000iu a day and exercise daily for about 20 minutes include walking and some light weight resistance
      Usually high cholesterol means we have high inflammation usually diet related and the body manufactures the cholesterol to combat the affects of chronic inflammation in our system

      • ann

        thank you Malua. I guess I forgot to mention that I am on a very healthy diet. All organic, grass fed meat, chicken, eggs, wild fish, raw milk homemade yogurt, nuts, seeds, berries, fermented cod liver oil, 16 oz green juice daily, kombucha, low salt (himalayan), chia seeds, gluten free, low carbs, vit D supplement and levels are sufficient >96. I exercise daily. I am concerned because C reactive protein is elevated which relates to inflammation and waiting for carotid artery results.

        • Mathieu Gagné

          Sounds great! If you have ben low carb for a long time, try some resistant starch.

        • Malua Fever

          Ok well that throws that theory out the window Lol

        • susan henderson

          Late answer but do you take K2? That will put calcium in your bones and out of your blood stream. I had high calcium for 10 years, plus and started taking K2 and 6 weeks later my calcium level was normal once again.

          • Malua Fever

            Where did you get your K2 from, other than dairy

          • David Perlmutter

            Egg yolks, chicken liver, chicken breast, ground beef, and fermented foods are all additional sources of K2.

          • Malua Fever

            Thank you

      • pbdoc


        Cholesterol does not increase to “combat the effects of inflammation”. Too much cholesterol causes the inflammation itself, in the arterial wall.

        • Malua Fever

          So you are telling me our bodies create more cholesterol so it can cause inflammation in our bodies?
          My understanding is cholesterol in the arteries stops bleeding on the arterial walls, which is caused by inflammation when the inflammation is under control and the bleeding has stopped the body then sends the what we call good cholesterol to flush out the arteries but if inflammation persists then we have a problem because the artery will begin to be closed off by the cholesterol because the bleeding is continuing unabated in the arterial wall, I’m no Dr and I could be wrong but if I am give me a link so I can see the science in what you are saying please

    • pbdoc


      If you want to reverse your plaque build up and prevent a heart attack, alzheimer’s, etc, then set aside animal products. It doesn’t matter if its grass fed, seriously. Look up Dean Ornish and Caldwell Esselstyn

      • Debra Libby

        Well said Ann!!

        • nomoregrain

          I believe APO-e 3/4 or 4/4 blood type (genetic testing) from the northern european lineage should not consume animal. Just stick to white fish and shell fish. That was the results of my husbands Berkley lab test and his heart doc surgeon, says no animal including dairy. http://www.drgundry.com

      • Malua Fever

        I’ve read about raw vegans dying of heart attacks one was a famous raw vegan advocate and Dr I believe who died at 60 of a heart attack after being a raw vegan for 30 years, the Afro American actor who’s name escapes me at the moment who played the part of the gifted prisoner in the movie Green Mile became a vegan then died 2 years later of a heart attack so I don’t think abstaining from meat is the answer, but hey I maybe wrong

        • Carla

          My husband had a massive heart attack after being on a diet of mostly carbs and very little fat, no cholesterol for 3 years. Half his heart died and he was in the hospital for two months.
          His cardiologist told me he was sending my husband home to die, but he lived 15 more years until the age of 82. While he was in the hospital, I read Weston A Price’s book, Nutrition and Physical Degeneration, and completely changed our diet. The book was enlightening. My husband was thrilled that we were eating grass fed meats, pastured eggs, raw dairy homemade soups and sauerkraut. And I got to have his company much longer and improved my health as well.

  • Simona

    What about people with low weight, wouldn’t a katogenic diet be danegerous for them?

  • Rika

    I agree that our brain needs cholesterol to function properly. I think it’s a little misleading having the butter sticks and saying its healthy. There are other great sources to get your cholesterol and healthy fat intake from that haven’t been processed. Ie. nuts, avocados, eggs, chia, and flax seeds.

    • Sol

      Cholesterol only comes from animal products. The only one on your list is eggs. I suppose vegetarians can get cholesterol from eggs and dairy although lots of folks don’t do well with dairy.

  • Lori Miller

    My cholesterol is 135. I guess I’m living on borrowed time.

    • HealthWealth

      My cholesterol is 250 so I guess I’m living on borrowed time too. This is timely because I went to the doctors yesterday and said Ihink I have low thyroid because I have several symptoms and he said, it’s just old age–I’m 68. He also said I should be more concerned with my high cholesterol, because it. Will cause clogged arteries. I don’t think he appreciates the fact that I don’t listen to him as he wants me to get a mammography and Ihad to sign a paper that it was offered and I refused. Then I said, “Did you ever hear of Dr. Perlmutter, the famous neurologist?” To that he said, “Everyone goes online and becomes their own doctor.” Iwished my insurance covered holistic doctors, but I guess until then, I’ll do my own research.

      • Cherryl

        We must go to the same Dr. though mine is a thoroughly modern miss. I expected better of her. She is pushing the flu shots, mammogram, colonoscopy, and the pap smear agenda, even though I’m a 68 year old celibate grandmother having no risk factors that warrant mammograms, am widowed, and have been an avocado and coconut oil eating vegan all my life. My weight is low, my BMI is low, my blood pressure is vampire-like, I backpack weekly and hike daily. As I told her, I worked for big pharma’s so I know it is a business, not “health care”. I wanted to say I also know she’s not getting any commissions for promoting all this stuff, as she’s affiliated with an HMO. So what the heck?

      • I’m 72 and I have had the same experiences over and over with physicians. The last one who told me he didn’t want me going on the Internet to do research received the response that I was in charge of my body and I decide what I will allow or not. I also worked in health care administration and was married to a physician when he was still in med’ school. I remember being given the birth control pill and two others to counteract the nausea and the water retention and I said to my then husband, “Something is seriously wrong with the idea that you take one pill to do one thing and two others to counteract the side effects.” More and more I seek other alternatives, especially homeopathy, acupuncture, QiGong, etc.

  • Dan Thomas

    Have any studies been done on the relationship of Alzheimer’s and cholesterol? It makes sense that if you reduce cholesterol through statins or diets that are extremely low in fat, that there would be no raw materials to repair brain cells.

    • pbdoc

      Some statins cross the blood brain barrier, so they could adversely effect cholesterol production in the brain which is not good. But lowering blood cholesterol does not effect your brain cholesterol. So those on plant based diets with naturally low cholesterol do not have an increased risk of alzheimer’s.

      • nomoregrain

        My husband tried every statin until he met (below) Dr. Gundry.The statins made him feel so ill. He is APO-e 4/4 blood type (genetic testing) from the northern european line and should not consume animal. Just stick to white fish and shell fish. That was the results of my husbands Berkley lab test and his heart doc surgeon, says no animal including dairy (no salmon).www.drgundry.com

        • GNewman

          I’ve read Gundry’s book. I’m APO-e 3/4 so have questions about Dr. Gundry’s plan for e 4’s. Does he recommend fish oil supplements? If so, how much? Any other supplements he suggests for e 4’s? Does he allow European & goat dairy/cheese. What about eggs (if yes, I assume pastured or omega 3)? Red wine? 85% chocolate. What inflammation tests does he run? What are his targets for an e 4? Thanks!!

      • Di

        I wish I could believe what you are saying, but what about the case of my mother, who has been on a low fat, non junk food, low sugar, vegetarian, plant based diet for about 30 years and now at age 66 has been diagnosed as being in the third year of having Alzheimer’s?

        • Dr. K

          You just stated she was on a “low fat” diet, probably being low in cholesterol as well. This would explain exactly why she has Alzheimers.

          • Di

            I’m afraid I have to agree with you on that. If you look at her lifestyle, she ticks all the boxes that conventional wisdom says will lower your risk of developing AZ – but it hasn’t worked.

          • pbdoc

            There are factors in addition to diet. Environmental toxicity, aluminum, copper, zinc, etc. Sorry to hear about your mom.

          • Lisa Lee Quenon

            Doc…have there been any studies of adding a cholesterol-rich diet reversing any of the symptoms of either Alzheimer’s or memory loss in general? (Once it’s set in … been diagnosed, etc?)

          • David Perlmutter

            Lots of studies on the site relate to those subjects, take a look: http://www.drperlmutter.com/learn/studies/?study_tag=cholesterol

          • Lisa Lee Quenon

            In this study, “Cognitive
            Function and Brain Structure in Persons With Type 2 Diabetes Mellitus
            After Intensive Lowering of Blood Pressure and Lipid Levels: A
            Randomized Clinical Trial,” A1c levels were quite high…and from what I, a non-medical person, can tell, not in any way altered/changed as a part of the study. From what I’ve been learning/reading this past year or two, one of the very significant markers for the combined diagnoses (diabetes, heart-related, metabolic syndrome, etc.) is the lowering of A1c. (I realize it was NOT a part of this study, merely being noted.) Would you concur with what I am thinking/discovering?

        • Barbara Hickman

          If the diet was also very low in fat the vitamin & mineral absorption from even a great diet may have been very low because the fats are needed for absorption& use.

  • karen nichols

    My son has severe seizures and very low cholesterol, despite being on a keto diet for the past 4 years ( but he is allergic to dairy and eggs so we don’t do those). The diet has helped seizures a bit, but not a lot. I think there is a link between the low cholesterol and his seizures, but I am sure what else to do….Ideas?

  • pbdoc

    Dr. Perlmutter,

    You post without ever mentioning or acknowledging the fact that there were several comments in the lancet basically debunking the Schatz et al study. Are you intentionally misleading your audience, or just not doing your research? Re: the links under “comment in” heading: http://www.ncbi.nlm.nih.gov/pubmed/11502313

    The links to the comments that accurately explained the low cholesterol phenomenon are here:
    1. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2801%2906906-9/fulltext
    2. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2801%2906909-4/fulltext
    3. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2801%2906905-7/fulltext
    4. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2801%2906907-0/fulltext

    Dr. Perlmutter, as explained in the above links and in many many articles in your beloved “peer reviewed” literature, low cholesterol is associated with increased risk of all-cause mortality in the elderly because of REVERSE CAUSATION. Meaning death promoting diseases like cancer, liver disease, infection, and general frailty of the elderly result in lower cholesterol production (among other things). NOT the other way around. Furthermore, as Tilvis et al. stated, “Low cholesterol concentration does not cause death, but is rather a
    consequence of metabolic changes in the liver and intestine associated
    with senile devitalisation and decline.”

    Schatz et al., are “unable to explain their results” yet they then say their results cast doubt on lowering cholesterol. But if they just did a cursory review of the literature, they’d see this was not a new phenomenon and realize it is a NON-causal relationship.

    Folks, lowering your cholesterol through diet does not cause alzheimer’s, death, low testosterone, depression, cancer, or any of the other untruths that are promoted on low carb pages like this one. In fact, if done with a plant based diet, you dramatically decrease your risk of all these diseases. In fact, the traditional okinawans ate mostly carbohydrate from yams, sweet potato and rice, while rarely eating meat on festival occasions and they are the culture with the highest number of centenarians (without heart disease, alzheimers, etc). Yet, they ate mostly CARBS. But they were wholefood carbs, which Dr. Perlmutter seems to lump together with junk food carbs, categorically stating that “Dietary carbohydrate lead to Azlheimer’s Disease” (Mercola interview)

    Dr. Perlmutter, your low carb high fat diet promotes heart disease, diabetes, early death, alzheimer’s, cancer, and the list goes on. It’s also completely out of step with the totality of the scientific literature. You, along with your low carb paleo friends are doing incalculable harm to the public with your misinformation. I expect more from a licensed physician.

    As a neurologist, you should have the basic understanding that serum cholesterol DOES NOT cross the blood brain barrier, and so has basically no effect on the cholesterol level in your brain (which produces its own cholesterol de novo). Thus, eating high fat foods to increase ones total cholesterol does not help your brain! Unless they are essential fats, which saturated fat is not.

    For those reading this, check out:
    1. Is avoiding grains a mistake?
    2. Brains, Brawns, and Grains of Truth
    3. http://www.nutritionfacts.org
    4. Dr. Neal Barnard, “Power Foods for the Brain”

    • Lori Miller

      @pbdoc:disqus , I’m donating $1 to Heifer International for every troll comment I read. Heifer International provides needy people with livestock and training to care for the animals so they can have more foods like milk, eggs, and meat and more income.

      BTW, Neal Barnard told a whopper in The Power of your Plate when he said that Richard Leakey concluded we evolved on a mostly vegetarian diet. http://relievemypain.blogspot.com/2013/05/paleo-vegetarianism.html

      • pbdoc

        Haha, “telling a whopper”, my troll vocab does not include such witty sayings. Im glad for your mom. Yes, LC temporarily provides relief, but never addresses the cause of dm2 which is insulin resistance. IR is caused by intramyocellular lipid and bcaa. So while ur mothers blood sugar, a1c improve, she continues to blunt her insulin receptors, decrease her flow mediated arterial dilation, promote cvd, and other life ending diseases.

        • Lori Miller

          She’s been temporarily improving for over four years. Her kidney function has improved such that she was able to go back on metformin.

          “…ur mothers blood sugar [sic]”? Been to college much?

          • pbdoc

            Great. Im assuming her current low carb diet is healther/ based mostly on whole foods relative to the diet that she was eating prior to switching. You’ll find that those who address the IR w/ mostly plant foods reverse the condition rapidly, often taking <3 mo without the need for metformin any longer. Again, the carbs are not causing the IR. But, judging by your low carb blog, it seems like you've made up your mind on the subject, along with extremely witty comebacks and ad hom remarks. So engaging in discussion with u (yes, u read that right) would be like giving medicine to the dead, totally pointless. Have a gnight ma'am. 🙂

          • Debra Libby

            No need for such sarcasm!

    • Mike W

      PcDoc even forgot to comment on the initial benefits of
      Cholesterol mentioned at the top of the post..in his mad haste to start typing..that sort of figures.
      Anyway..the framingham study,THE WORLDS LONGEST STUDY which Pcdoc would know about but dare not mention its name 🙂 have tried to fudge their results a few timses) but the data is what counts .
      I you choose veg or omnivore diets and eliminate processed carbs/suger etc from our diets..you will improve your health.
      So don’t try and segue to your own obsession.
      There is zero proof that an all veg diet increases lifespan..
      And, I hate to tell you this but, the MAJORITY of our ancestors..survived on an omnivorous diet..quite adequately.
      And for our poorly read troll..Denise Minger dissection of their favourite study..The China Study.
      Dont chastise others for your own obvious sins and bias sins tiger..
      Never bring a pop gun(carrot) to a sword fight PsDoc:)

  • Carrie

    Dr. P-Just got test results back with super low cholestral , super low vit D, low progesterone and too low cortisol- what plan do I follow diet wise to raise levels in a healthy way? I just began taking supplements for support: vit c, B complex, vit d and cod liver oil capsules. Do need to loose weight but don’t want to stress adrenals by excercise-need help .any advice?

    • David Perlmutter

      The Grain Brain lifestyle is meant to help your body healthfully achieve those goals. However, consult your physician before implementing these changes.

      • Skattabrain

        Good luck finding a Dr onboard with Dr Perlmutter’s research. At some point you need to make up your own mind because conventional schooling/medicine is pumping out herd followers by the metric ton… In all due respect to those in the profession… But the pharm funded school model has to go. I think we are about 10 years away from the Titanic of cholesterol attitudes to turn course before it sinks and people stop destroying brain cells in vain… Trying to do the right thing!

        That’s is the frustrating piece of trying to do the right thing with health… First you have to find the truth, then you have to swim up stream until the money and trends correct themselves. Nora Gedaudas and Dr Perlmutter deserve awards and recognition… So we wait…

  • Virginia

    My cholesterol is above 300,and I never going to use any statins!

  • Craig

    Dr. Perlmutter,

    I have read Grain Brain and it makes a lot of sense and then you have Dr. Esselstyn which talks about taking meats, butter and oils out of the diet. Can you comment on the your approach vs. his as my cholesterol without statins jumps about 100 pts and LDL up over 100 pts.

    Thank you

  • Kristi

    So what if you have naturally low cholesterol? How can you raise it?

  • Mark

    Doctor, just wondering about your thoughts on this, understanding that “might” is in the headline http://www.scientificamerican.com/article/cholesterol-might-be-linked-to-breast-cancer/

  • Carol Ann Gillespie

    My total cholesterol is 300 and I eat Grain Brain way. High HDL and LDL is also up there. Calcium scan shows CAD but no blockages. What to do? Only 63 years old.

  • Jo Ha

    dr.perlmutter, you are so dead wrong with everything. the fear in humans is the problem of everything. a mind which is always on the run destroys itself… think about it!

  • Doctor(s), How do I resolve the conflict between needing Cholesterol for a healthy brain but needing to reduce my cholesterol to keep my heart healthy? I am taking a statin as prescribed by my cardiologist but i’d like to STOP taking it because I’ve heard about its negative side effects. Should i stop taking the Statin? If so will diet changes be enough to protect my heart?

    • Wenona Rbe Makeit-happen

      High cholesterol causing heart disease has been proven wrong. I don’t have a link, but you can probably find it online with a search. With some medications, you have to stop a certain way so you should work with your doctor to be sure. If Dr. Perlmutter hasn’t posted info on diet changes, supplementation which will support heart health, look up what Dr. Joel Wallach says on the subject. I’m a distributor for his high quality supplements and he does have a pak specifically for heart health.

  • Karen

    I’ve gained a lot of information about a healthy diet through the Weston A Price Foundation, http://www.westonaprice.org.

    • Karen

      We need fats in our diet, but they must be the healthy fats that have not been tampered with by man. The highly processed fats damage our bodies, damage our brains. They do not function properly in the body. Cholesterol comes to the site of inflammatory damage in the arteries (caused by a poor diet) and tries to patch the damaged areas.

  • Clement Sie

    1) Cholesterol is important and no human being will survive without it.

    2) Cholesterol is a waxy oil-based organic substance. About 75% of it is produced in liver while 25% is obtained through consumption.

    3) It cannot be transported in blood stream which is basically a water-based system. In liver, it is packed inside a transporting agent usually termed as lipoprotein (generally categorized into high density DHL and low density LDL).

    4) Cholesterol itself will not cause cardiac disease. LDL is vulnerable to rapture through the process of oxidation by free radicals. Such rapture will cause spillage of cholesterol into blood stream. Spilled cholesterol is also easily subjected to oxidation. Human body treats oxidized cholesterol as alien particle and will initiate series of self defensive mechanism and in turn will result in formation of plaque which cause blockage.

    5) DHL has the function to transport cholesterol and as well as salvage spilled cholesterol back to liver for re-packing or re-cycling.

    6) The most important and effective way to prevent cardiac disease is to avoid foods with high level of free radicals. Good examples of such foods are those which are prepared though deep-fried, bbq or grilled process. Boiled or steamed foods would be considered as ideal diet.

    7) Let take an anology for analysis. If 1000 kg of rubbish is produced in a street daily and while the local council can only carry away 900 kg. So what will happen to the said street? If you understand the facts behind cholesterol, DHL and LHL, then your chances of getting cardiac disease will be slim.

    8) Finally it is important to know that DHL and LHL are not cholesterol. They are merely cholesterol transporting agents. And there are no such things as good and bad cholesterol.

    Please take note that I am not a doctor. The above statements are merely my knowledge obtained from various sources and they should not be treated as medical advice. Viewer discretion is required.

    • Malua Fever

      Thank you great post it has enlightened my understanding of cholesterol and given me some markers to do more research

  • Barbara Hickman

    In reading Dr Bruce Fife’s The Palm Oil Miracle (and his Coconut Oil Miracle) that Statins not only interfere with key pathway for production of cholesterol but also for key pathway for CoQ10 production in the human body. Those with lowest CoQ10 most at risk for heart attack. So while going after cholesterol you ensure you do damage to heart/arteries. What’s usually good for heart is usually good for brain. He cites his studies and point to Pubmed where there are more for anyone on Internet to read. I really value your own work. You do the homework and tell it straight (against the ‘popular’ media misperceptions).

    • David Perlmutter

      Thanks for this endorsement of my work Barbara. It is much appreciated.

  • Emme

    I have a question Dr. I have been reading about the circadian rhythm and chronobiology and I wonder if you have any recommendations on your plan as per the distribution of meals through the day. Thanks.

  • Jason

    My total cholesterol is 149. I have had an unhealthy diet for most of my life (junk food, pizza, soda until two years ago). I’ve never smoked, and I’m in excellent health (according to multiple blood tests) despite this diet. But I’d like to change, and after reading Grain Brain, I’d like to raise my cholesterol. But with all of the misinformation circulating about cholesterol, it’s hard to find a way to RAISE it. Does anyone have any suggestions?

    • Wenona Rbe Makeit-happen

      coconut oil is known to raise HDL, also pastured organic eggs are commonly advised by Dr. Joel Wallach for anyone with cholesterol related problems

  • Amar

    Dear Dr. Perlmutter,
    Would having a high intake of cholesterol but insufficient access to sunlight result in your body not producing vitamin D and disposing of the cholesterol. Can you produce vitamin D in the absence of cholesterol. Would taking vitamin D supplements only be useful when cholesterol is present and, if so, does more present cholesterol mean better absorption and creation of vitamin D through supplements, in addition to, through sunlight. Can your body produce vitamin D through cholesterol without sunlight?

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