Maguire G Justin, Nov2022.

Presents

Cholesterol and its influence on behaviour

Introduction – historically misinformed cholesterol

Cardiovascular disease has historically been associated with cholesterol, leading the public into demonizing this protective sterol, resulting in the misappropriate use of statins and fibrates[1]. Pharmacology is by no means an evil entity, and in some cases, the use of drugs is essential to enable health to flourish. Tackling high or low cholesterol should however be approached through a broader lens, one in which underlying immunological and endocrinological activity is considered. Additionally, suppressing cholesterol may insight unwanted outcomes of psychological distress, this article serves to enlighten intricacies that otherwise may not be considered in the role cholesterol plays within the management of both molecular and psychological health.

What is cholesterol

Cholesterol is a sterol biosynthesized by all animal cells, providing structure to cell membranes[2].  Cholesterol was first discovered by François Poulletier de la Salle in 1796 and later between 1913-1929 lipoproteins were identified by Nikolay Anichov, accelerating studies of cardiovascular lipid studies into full swing with contributions respectively by Joseph Goldstein and Michael Brown in 1974[3].

There is but one type of cholesterol with different types of protein carriers, each of which plays a role in maintaining biological processes in the body. Most of our cholesterol is synthesized by our bodies, with only one-third coming from dietary sources[4]. Cholesterol has a wide range of functions, including:

  1. The structural component of cell membranes
  2. Raw material to produce bile acids to enable absorption of fat-soluble vitamins
  3. Raw material (precursor) to the production of steroid hormones
  4. A component of myelin, which protects our nerves
  5. Aids thermoregulation at a cellular level
  6. Involved in Vitamin D absorption from the skin

Thyroid and cortisol impact on mitochondria – impact on cholesterol

The state of the immune system dramatically impacts cholesterol synthesis and transport. Immunological compromise impacts cholesterol health, often leading to initial elevation and in some cases depletion[5]. Compromised mitochondria function has been associated with different pathologies[6] linked to dysregulated cholesterol levels. Thyroid hormones play a crucial role in the regulation of mitochondria activity[7], enabling mitochondrion to support the production of adrenal hormones[8] thus modulating communication between both the peripheral and central nervous systems. Thus, we need to understand the activity of metabolic hormones when we are looking into the causative factors of poor cholesterol profiles.

Cortisol dominance is often expressed in cases of hypothyroidism[9], given that cortisol instigates elevated levels of oxidative stress[10], increases in LDL (low-density lipoprotein) can closely be associated with both elevated cortisol and poor thyroid hormone levels. Common causes for elevated cortisol[11] and insufficient thyroid hormone levels[12]can be traced back to both hepatic and gastrointestinal health.

Microbiome diversity and our nervous system develop at the same pace[13], thus alterations to our gut flora due to stress directly influences reactivity in the nervous system to stress. Poorly modulated stress leads to dysregulation of thyroid and cortisol function, resulting in mitochondria dysfunction which leads cholesterol metabolism to focus on repairing micro-abrasions caused by oxidative stress, resulting in atherosclerosis and eventual cardiac health compromise.

Recommended testing

  • Omnos Thyroid panel
  • DUTCH – omnos
  • Stool tests – omnos

Low cholesterol and the dangers of poor mental health

Much focus is given to elevated cholesterol, yet low cholesterol is neglected as a major cause of disease[14]. Causes of low cholesterol could be linked back to ongoing immunological compromise, leading the body into a position of exhaustion, and not being able to synthesize enough cholesterol. Other factors that may induce low cholesterol include:

  • Hyperthyroidism – linked to hepatic compromise of sulfation pathways
  • Liver disease
  • Gastritis
  • Intestinal hyperpermeability
  • Malnutrition
  • Manganese deficiency
  • Genetic enzyme disorders
  • Iron overload – hemochromatosis

ASD (Autism spectrum disorder) impacts the way in which a person is able to learn, communicate and interact with the world. Ranging from anger to social isolation, ASD impacts the way in which a person is able to fully express themselves in a safe and productive manner. Low cholesterol was found to in 19% percent of ASD cases within a meta-analysis of this condition[15]. Improving how the body is able to manage and produce cholesterol in those affected by ASH may provide relief from inflammatory conditions commonly associated with the condition.

ADHD (Attention deficit hyperactivity disorder ) ranges in 3 broad classes of expression, all of which limit a person’s ability to feel calm and peaceful within moments of emotional and intellectual challenge. ADHD often leads those affected by the condition into impulsive and at times destructive behaviour. Disruptive and aggressive behaviour has a close association with children impacted by ADHD. Through investigative analysis across the United States of America, children with low cholesterol levels were threefold more likely to have been suspended or expelled compared to those with higher cholesterol[16]. Identifying causative factors which may compromise innate cholesterol metabolism may provide relief to aggression/frustration often experienced in those with ADHD.

Through case series retrospective analysis, it was found that patients with lower cholesterol had a higher tendency to attempt to commit suicide[17]. Cholesterol plays a contributing role within the available concentration of serotonin in cerebral spinal fluid, thus improving symptoms of depression and lowering the likelihood of suicide. 

Through retrospective analysis, it was found those addicted to cocaine had low cholesterol profiles[18]. An investigative analysis of both genetic vulnerability and current physiological function may provide insight into what additional preventative measures could be incorporated in the fight against addiction, namely restoring immunological reactivity and the associated impact on cholesterol.

Improving cholesterol requires focus on not only the intake of cholesterol but the functionality of physiological and immunological systems both of which play an integral role within a homeostatic balance of cholesterol metabolism. For those with low cholesterol consuming enough cholesterol from dietary sources may prove beneficial in supporting the body’s need for this sterol.

Foods that are  high in cholesterol include the following:

  • Eggs – 2 yolks = 500mgs of cholesterol
  • Brain – 3oz = 1000mg cholesterol
  • Liver – 3oz = 372mg

Conclusion

Cholesterol gives the body the ability to regulate and repair. Dysregulated cholesterol metabolism not only leads one into possibly cardiac disease but also may instigate a whole host of behavioural disorders. Approaching the reformation of cholesterol needs to consider more than just incorporating statins or fibrates (although they are also useful in specific situations), rather restoring cholesterol function entails looking into the whole body and cellular metabolism. Through the identification of internal environment disruptors (heavy metals, toxins, pathogenic flora, mycotoxins, candida, etc..) we can support, remove, detoxify and restore cellular health, in particular, that of the mitochondria, thus providing a greater opportunity for lipid health renewal and lowered incident of mood or behavioural disorders.

Kris Gethin testimonial


[1] Soliman, GA. 2018. Dietary cholesterol and lack of evidence in cardiovascular disease. Available at: https://pubmed.ncbi.nlm.nih.gov/29914176/ (Sourced: 28 October 2022)

[2] National library of medicine: National center for biotechnology information. Oct 2022. Compound summary: Cholesterol. Available at: https://pubchem.ncbi.nlm.nih.gov/compound/5997 (sourced 28 October 2022)

[3] Kuijpers, P. 2021. History in medicine: the story of cholesterol, lipids and cardiology. Available at: https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-19/history-in-medicine-the-story-of-cholesterol-lipids-and-cardiology#:~:text=Fran%C3%A7ois%20Poulletier%20de%20la%20Salle%20(1719%2D1788)%20first%20identified,cholesterol%20for%20the%20first%20time. (sourced 28 October 2022)

[4] Kapourchali, R F. Surendiran, G. Goulet, A. Moghadasian, H M. Oct 2016. The Role of Dietary Cholesterol in Lipoprotein Metabolism and Related Metabolic Abnormalities: A Mini-review. Available at: https://pubmed.ncbi.nlm.nih.gov/26055276/#:~:text=Cholesterol%20plays%20a%20vital%20role,the%20body%20(endogenous%20cholesterol). (sourced 28 October 2022)

[5] Anderson, J C. 2018. Impact of dietary cholesterol on the pathophysiology of infectious and autoimmune disease. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024721/ (sourced 28 October)

[6] Naviaux, K R. Mitochondrion. 2019. Perspective: Cell danger response biology – the new science that connects environmental health with mitochondria and the rising tide of chronic illness. Available at: https://www.sciencedirect.com/science/article/pii/S1567724919302922 (sourced 28 October 2022)

[7] Sinha, R H. Singh, B. Zhou, J. Wu, Y. Farah, L B. Ohba, K. Lesmana, R. Gooding, J. Bay, BH. Yen, M P. Autophay 2015. Thyroid hormone induction of mitochondrial activity is coupled by mitophagy via ROS-AMPK-ULK1 signalling. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590606/ (sourced 28 October 2022)

[8] Lam, M. Lam, C. mitochondria’s impact on adrenal gland diseases. Available at: https://www.drlamcoaching.com/adrenal-fatigue/complications/mitochondria-impact-on-adrenal-gland-diseases/ (sourced 28 October 2022)

[9] Gassama, S. Ndoye, O. Mbodj, M. Akala, A. Cisse, F. Niang, M. Ndoye, R. 2000. Serum cortisol level variations in thyroid diseases. Available at: https://pubmed.ncbi.nlm.nih.gov/14666786/#:~:text=Excessive%20catabolism%20can%20lead%20to,often%20allow%20normal%20cortisol%20values. (sourced 28 October 2022)

[10] Simsek, S. Yuksel, T. Kaplan, I. Uysal, C. Aktas, H. ‘Pyschiatry Investigation 2016’. The levels of cortisol and oxidative stress and DNA damage in child and adolescent victims of sexual abuse with or without post traumatic stress disorder. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5128349/#:~:text=It%20was%20reported%20that%20oxidative,axis%20dysfunction%20and%20mental%20disorders.&text=It%20was%20also%20reported%20that,production%20of%20reactive%20oxygen%20species. (sourced 28 October 2022)

[11] Panduro, A. Iniguez, R I. Sepulveda-Villegas, M. Roman, S. Genes, emotions and gut microbiota: The next frontier for gastroenterologist. Available at: https://www.researchgate.net/figure/Gut-brain-axis-and-dysbiosis-A-The-gut-microbiota-maintains-a-two-way-communication_fig1_317093451 (sourced: 28 October 2022)

[12] Knezevic, J. Starchl, C. Berisha, T A. Amrein, K. Thyroid-gut-axis: How does the microbiota influence thyroid function? Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7353203/ (sourced 28 October 2022)

[13] Yahfoufi, N. Matar, C. Ismail, N. 2020. Adolescence and aging: impact of adolescence inflammatory stress and microbiota alterations on brain development, aging, and neurodegeneration. Available at: https://pubmed.ncbi.nlm.nih.gov/31917834/ (sourced 28 October 2022)

[14] Budzynski, J. Tojek, K. Wustrau, B. Czerniak, B. Winiarski, P. Korzycka-Wilinska, W. Banaszkiewicz, Z. 2018. The cholesterol paradox among inpatients – retrospective analysis of medical documentation. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374572/ (sourced 28 October 2022)

[15] Tiery, E. Bukelis, I. Thompson, E R. Ahmed, K. Aneja, A. Kratz, L. Kelly, I R.  Am J of Med Genetics Part B: Neuropsychiatric genetics Vol 141B, Issue 6, Pg 666-668, 2006. Abnormalities of cholesterol metabolism in autism – spectrum disorders. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2553243/ (sourced 28 October 2022)

[16] Zhang, J. Muldoon, F M. McKeown, E R. Cuffe, P S. Am J Epidemiol. 2005. Association of serum cholesterol and history of school suspension among school-aged children and adolescents in the United States. Available at: https://pubmed.ncbi.nlm.nih.gov/15781958/ (sourced 28 October 2022)

[17] Modai, I. Valevski, A. Dror, S. Weizman, A. J Clin Psychiatry. 1994. Serum cholesterol levels and suicidal tendencies in psychiatric inpatients. Available at: https://pubmed.ncbi.nlm.nih.gov/8071280/ (sourced 28 October 2022)

[18] Buydens-Branchey, L. Branchey, M. Psychosom Med. 2003. Association between low plasma levels of cholesterol and relapse in cocaine addicts. Available at: https://pubmed.ncbi.nlm.nih.gov/12554819/ (sourced 28 October 2022)

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