Is Cholesterol Good or Bad for Alzheimer's Disease and Cognition?

The brain is 60% fat and 25% of the body's cholesterol is in the brain. But the brain's blood brain barrier blocks the uptake of cholesterol into the brain. So cholesterol is made by the brain to satisfy its enormous needs. HMGCoA reductase inhibitors (statins) block the liver and brain's production of cholesterol. Is that bad? Some say yes! Some aren't all that concerned!

So there is no consensus yet. Though the "leaning" would be to keep cholesterol low by a whole food diet and exercise, and not by the use of statins for brain health.

A lot of my integrative medicine colleagues are against trying to lower cholesterol by any means, especially with statins, because there have been some cases of statin-induced cognitive dysfunction. This could occur not just from the cholesterol lowering ability of the statin, but the statins s ability to reduce mitochondrial energy production in every cell, including the brain. So it might NOT be the cholesterol lowering ability of the statin that causes the problem with statins but the reduction in cellular energy that causes the cognitive decline in the brain cells because statins block CoQ10 production.

So here is my point. You will read/watch in the links below regarding the concerning role of elevated cholesterol in Alzheimer's disease and the vascular disease link to Alzheimer's disease. My take is this. I wouldn't take a statin drug to lower cholesterol, especially if cognitive decline was an issue. But if I had to take a statin I would surely take at least 200-400 mg of ubiquinol (CoQ10) daily with food when taking the statin AND I would get my CoQ10 level measured to make sure it was at least 2.5 μg/ml.

That said, I do believe in lowering cholesterol by a whole food, UNPROCESSED, FIBER RICH, phytonutrient and antioxidant dense, mostly plant based diet which I believe gives the best of all worlds in reducing cholesterol without using a statin, and, has been shown to reverse proven atherosclerosis which affects not only the blood vessels to the heart but everywhere blood vessels go, including the brain! Also elevated cholesterol might increase beta amyloid deposition in the brain a hallmark of Alzheimer's disease.

I do believe in good fats, but they should be obtained mostly, if not all, in whole foods. Eat olives, avocado, raw nuts and seeds, especially flax or chia, and GREENS for brain health. Take a DHA rich omega-3 fatty acid product getting at least 200-300 mg of DHA from algal (algae) oil. They are less contaminated than getting the oil from whole fish and helps maintain fish stocks.

I probably confused you more than I helped..but it is not a clear topic and a work in progress with very strong feelings on both sides.

Here is an outstanding video by Dr. Greger on the topic of "Cholesterol and Alzheimer's Disease".

"Can Low Cholesterol Keep the Brain Healthy" (article WebMD)

"Cholesterol, the Mind, and the Brain" (article Harvard Health Publishing)

Be and Stay Well,

Kirk
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