Hormones & Your Cholesterol
Cholesterol is the building block of hormones such as testosterone, estrogen, progesterone, cortisol (stress hormone), and aldosterone (responsible for our salt/water balance).
Cholesterol is comprised of a number of particles that each serve a function. These include:
- Low-density lipoprotein (LDL), often referred to as 'bad' cholesterol, isn’t really that bad because it helps deliver cholesterol to our cells. The real question is what predisposes it to oxidizing in a way that causes damage to the body.
- High-density lipoprotein (HDL) or the so-called 'good' cholesterol transports cholesterol molecules to the liver to get metabolized. While an HDL level of 60 mg/dL is often recommended, do take note that over 75mg isn’t so good as elevated levels can be an inflammatory marker for most people.
- Triglycerides, a marker of sugar/carbohydrate intake, are all the calories your body doesn’t use right after you eat. They’re stored in your fat cells and released later for energy between meals.
There are a few more cholesterol markers such as particle sizes and ratio, but these three are the main ones that will show up in a typical lipid profile.
Why cholesterol levels matter
Healthy cholesterol levels are commonly seen in premenopausal women since estrogen is in proper balance. However, LDL tends to increase while HDL decreases as women enter perimenopause and menopause due to a decline in estrogen.
First, let’s take a look at how various hormones affect our cholesterol levels as we approach middle age.
Estrogen not only helps blood vessels expand and contract; it also cleans up free radicals (pro-inflammatory molecules) that can damage arteries and other tissues. However, too much of a good thing can also be harmful. Elevated estrogen hinders thyroid function leading to hypothyroidism where cholesterol levels climb as metabolism slows down. In addition, constipation is a common concern among individuals with an underactive thyroid. As a result, toxins and estrogens recirculate in the body due to inefficient elimination. This creates additional stress on the body which further throws off hormone balance.
Progesterone helps balance the effects of estrogen and assists in improving cholesterol markers like HDL and LDL. Actual progesterone therapy, however, can raise triglyceride levels.
In men, a healthy testosterone level is the main player in keeping optimal cholesterol numbers and mitigating risk factors for cardiovascular disease, stroke and heart attack. But testosterone replacement therapy in the case of low testosterone may actually have the opposite effect (i.e. lower HDL and raise LDL). In other words, too high or too low levels are never a good thing.
A note on cholesterol-lowing medications
We must keep in mind that healthy levels of cholesterol are imperative for optimum cellular function and all-around health. Another matter worth considering is that cholesterol-lowering medications such as statins decrease the formation of the cholesterol we need to manufacture hormones. Decreased cholesterol formation can actually exacerbate heart disease risk in women and contribute to low testosterone levels in men.
Statins also deplete the body of Coenzyme Q10 (CoQ10), an antioxidant and vital nutrient which the body produces naturally for growth, energy and maintenance. CoQ10 levels diminish as we age and further depletion can result in muscle and joint soreness or pain.
Statins have also been shown to mess up blood sugar levels (they can particularly raise certain lab values associated with diabetes) and even place some individuals at even more risk for a cardiovascular event!
Side note: If you're taking a CoQ10 supplement with a statin, it does NOT reduce your risk for heart disease. You're simply just replacing a nutrient and we know our body is so much more complex than working with a 'quick fix.'
Getting to the bottom of things
I suggest you be wary when interpreting the usual symptoms associated with high cholesterol levels. Who knows, you may not really have high cholesterol – in most cases, it’s typically a combination of an unhealthy diet, a sedentary lifestyle, stress, inadequate sleep, and hormonal imbalance. It’s also worth looking into other causes such as low vitamin D levels, an underactive thyroid, or blood sugar issues.
All that being said, there’s some good news behind all these – your body is simply telling you that something isn’t quite right. There are so many ways to figure things out and understanding everything from your diet and lifestyle to your bloodwork is a great place to start in coming up with a comprehensive plan towards better hormonal and overall health.