Written by Dr. Joseph Mercola
Cholesterol is a waxy substance present in almost each cell of your physique and is important to good well being. It performs a task in hormone manufacturing, digestion and the manufacture of vitamin D following solar publicity, and helps shield your cell membranes.
As famous by Zoe Harcombe, Ph.D.,1
“It is virtually impossible to explain how vital cholesterol is to the human body. If you had no cholesterol in your body you would be dead.”
Your liver manufactures most, about 80 %, of the ldl cholesterol your physique requires, which in and of itself suggests your physique can’t survive with out it. The remaining 20 % comes out of your weight loss plan. Nevertheless, dietary ldl cholesterol is absorbed at a fee of 20 to 60 %, relying on the person,2and for those who eat much less, your physique will compensate by making extra and vice versa.
Animals use ldl cholesterol in a lot the identical approach, therefore beef, pork and hen have comparable ranges of ldl cholesterol, averaging 25 milligrams of ldl cholesterol per ounce.Three
Cholesterol has lengthy been vilified as a main explanation for heart problems (CVD), but quite a few research refute this speculation, demonstrating that ldl cholesterol has nearly nothing to do with coronary heart illness — at the very least not in the best way typical drugs presents it.
As famous by Harcombe, the notion that there’s good and dangerous ldl cholesterol can also be mistaken. Low-density lipoprotein (LDL) and high-density lipoprotein (HDL) are not truly ldl cholesterol; they’re carriers and transporters of ldl cholesterol, triglycerides (fats), phospholipids and proteins.
“LDL would more accurately be called the carrier of fresh cholesterol and HDL would more accurately be called the carrier of recycled cholesterol,” she says.four
What’s extra, dietary ldl cholesterol has no impression on the ldl cholesterol degree in your blood, so how might dietary ldl cholesterol pose a well being danger?
- 1 Does Excessive Cholesterol Trigger Cardiovascular Illness?
- 2 Stress Will increase Your Cardiovascular Illness Danger
- 3 For Cardiovascular Illness to Happen, There Have to be Arterial Wall Injury
- 4 The Thrombogenic Principle
- 5 Elements That Increase Your Cardiovascular Illness Danger
- 6 The Position of Irritation in Cardiovascular Illness
- 7 Extra Proof Cholesterol Is Not the Enemy
- 8 Why Statin Medicine Are Unwell Suggested for Most
- 9 Essential and Beneficial Dietary Dietary supplements if Taking a Statin
- 10 Newer Cholesterol Medicine Are Not Safer
- 11 Assessing Your Coronary heart Illness Danger
- 12 The way to Keep away from Coronary heart Illness
Does Excessive Cholesterol Trigger Cardiovascular Illness?
In an April 16, 2018, podcast (embedded on the prime of this text), Christopher Kelly with Nourish Stability Thrive interviewed Dr. Malcolm Kendrick, a British doctor and writer of “Doctoring Data: How to Sort Out Medical Advice from Medical Nonsense,” “The Great Cholesterol Con,” and “A Statin Nation: Damaging Millions in a Brave New Post-Health World.”
An outline5 and transcript6 of the interview could be discovered on the Nourish Stability Thrive web site. On this interview, Kendrick discusses the true explanation for heart problems and “the specific environmental and psychosocial factors that cause the most harm.” You may also view the video above, through which Kendrick delivers a half-hour lecture on “Why Cholesterol Does Not and Cannot Cause Heart Disease.”
Briefly, probably the most regarding danger elements for heart problems are truly insulin resistance, Sort 2 diabetes and the continual irritation related to these circumstances. Nevertheless, Kendrick argues there are different elements at play as nicely, comparable to the way you eat.
People are infamous for dashing by way of their meals, whereas another nations, comparable to France, encourage a slower, extra leisurely tempo throughout meals, which can have an effect on how the meals is metabolized.
“I still think that probably is partly the case because clearly if you eat in a rushed fashion and you gobble it down and then you rush around immediately afterwards, your body is not in the correct metabolic rate to digest your food,” Kendrick says,7 including:
“I was looking at some studies8 from Japan where they got people to eat a meal whilst being read a boring lecture and asked to eat the same meal whilst a comedian was telling jokes. And when the comedian was telling jokes, the blood sugar level was considerably lower.”
Stress Will increase Your Cardiovascular Illness Danger
Kendrick additionally notes the hyperlinks between stress and elevations in insulin ranges (as insulin is counteracted by stress hormones) and blood clotting elements, and cites knowledge displaying that demise charges from heart problems parallel nerve-racking occasions that have an effect on a whole nation.
For instance, in 1989, the guts illness price skyrocketed in Lithuania, the identical yr the Soviet Union collapsed. This sample may also be seen in different European nations. In the meantime, the LDL speculation has failed to carry in a variety of research.
As only one instance, Kendrick cites a BMJ research the place they checked out LDL ranges in individuals over 60, discovering that these with the very best LDL ranges truly had the bottom general mortality, together with CVD mortality.9
For Cardiovascular Illness to Happen, There Have to be Arterial Wall Injury
Kendrick has written an in depth collection of articles on the heart problems course of. A abstract of this voluminous work could be present in “What Causes Heart Disease — Part 59,”10 posted on his weblog November 27, 2018. In it, he dissects the fallacies inherent within the typical LDL/ldl cholesterol speculation, and explains the thrombogenic principle of heart problems as a extra dependable counterhypothesis. He writes partially:11
“For the LDL speculation to be right, it requires that LDL can journey previous the liner of the artery, the endothelial cells, and into the artery wall behind. That is thought-about the start line for atherosclerotic plaques to type.
The issue with this speculation is that LDL can’t get into any cell, not to mention an endothelial cell, until that cell needs it to. We all know this, for sure, as a result of the one approach for LDL to enter any cell, is that if the cell manufactures an LDL receptor — which locks onto, after which pulls the LDL molecule inside. There isn’t a different passageway. That is an inarguable reality …
Others have argued that … the LDL merely slips via the gaps between endothelial cells and that’s the way it will get into the artery wall. Once more, that is unattainable. There are no gaps between endothelial cells. Endothelial cells are tightly sure to one another by robust protein bridges, referred to as ‘tight junctions.’
These tight junctions can forestall the passage of single ions — charged atoms — which makes it unattainable for an LDL molecule to slide via, as it’s many hundreds of occasions greater than an ion. This, too, is an inarguable reality.
Ergo, the initiation of an atherosclerotic plaque (the underlying drawback in heart problems) can’t be triggered by LDL leaking into an undamaged artery wall. Which signifies that, if you wish to get LDL (or anything) into the artery wall, you first should injury the endothelium/lining of the artery.”
The American Nationwide Coronary heart, Lung, and Blood Institute admits that injury of the inside layers of your arteries precedes coronary heart illness, and that this injury may be induced by a lot of elements, together with smoking, hypertension, elevated blood sugar, irritation and, as Dr. Zach Bush and Stefanie Seneff, Ph.D., promote: glyphosate. As soon as the artery is broken, cholesterol-rich plaque begins to construct up as a protecting mechanism.
“However, it is what happens next, where we rapidly diverge in our thinking,” Kendrick writes.12 “The mainstream believes that, after injury has occurred, it’s LDL, and solely LDL, leaking into the artery wall that triggers an entire collection of downstream reactions that result in plaques forming.
Nevertheless, after you have broken the endothelium there isn’t a longer a barrier to cease something stepping into the artery wall. So, why decide on LDL? You even have proteins, pink blood cells, platelets and Lp(a) and VLDL. Certainly, something within the bloodstream now has free entry.”
The Thrombogenic Principle
Kendrick presents the thrombogenic concept — initially prompt by Karl von Rokitansky in 185213 — as a counter-theory to the flawed LDL/ldl cholesterol speculation. In abstract, the thrombogenic concept goes as follows:
- Endothelial injury happens, ensuing within the formation of a blood clot
- The ensuing blood clot is minimized in measurement by plasmin, an enzyme that breaks up blood clots
- A brand new endothelial layer grows over prime of the remnants of the blood clot, thereby incorporating it into the artery wall
- Macrophages (white blood cells specializing in restore) break down and digest any remnants of the blood clot. The macrophages are in flip damaged down together with their contents, and eradicated out of your physique by means of your lymph glands.
Whereas this course of results in irritation, it’s a wholesome response and never a illness state per se. Issues solely come up “when the rate of damage, and resultant blood clot formation, outstrips the ability of the repair systems to clear up the mess,” Kendrick explains.
So, whereas endothelial injury and ensuing blood clotting is on the coronary heart of heart problems, the one time this pure restore course of will trigger issues is when injury outstrips restore.
Elements That Increase Your Cardiovascular Illness Danger
As famous by Kendrick,
“For good health, you want to maintain a balance between the blood being too ready to clot, and the blood not clotting when you need it to.”14
So, what elements may result in a state of affairs during which the arterial injury is bigger than your physique’s means to restore it? Kendrick’s “short list” consists of over 30 elements, and there are many others. On this listing are:
- Use of sure medicine, together with oral steroids, omeprazole, Avastin and thalidomide
- Illnesses comparable to Cushing’s illness, Kawasaki’s illness, rheumatoid arthritis, systemic lupus erythematosus, continual kidney illness and acute renal failure, sickle cell illness, malaria and Sort 2 diabetes, in addition to bacterial and viral infections
- Acute bodily and psychological stress, and continual psychological stress
- Heavy metallic publicity, together with lead and mercury
- Sure dietary deficiencies, together with nutritional vitamins B and C deficiencies
Subsequent there are elements that promote blood clot formation and/or inhibit the dissolution of blood clots, all of which additionally increase your CVD danger. Once more, there are many elements that may do that, together with however not restricted to:
- Raised ranges of lipoprotein (a), blood sugar, very low density lipoprotein (VLDL) and fibrinogen (fibrinogen binds tightly to the blood clot, creating a troublesome plug; with extra fibrinogen in your blood, you might find yourself with bigger, extra robust to dissolve blood clots)
- Stress hormones similar to cortisol
- Nonsteroidal anti-inflammatory medicine
- Acute psychological and/or bodily stress
Lastly, there are elements that impair your physique’s restore system, i.e., the formation of a brand new endothelial layer over the blood clot, and the clearing of particles from the blood clot, and these additionally increase your danger for CVD. Elements that forestall new endothelial cells from being shaped embrace however are not restricted to:
- Sure medicine reminiscent of Avastin, thalidomide, omeprazole and any drug that lowers synthesis of nitric oxide (conversely, something that will increase nitric oxide in our physique will scale back your danger of coronary heart illness15)
- Previous age
- Continual kidney illness
- Sort 2 diabetes
- Inactivity (lack of train)
Elements that impair clearance of particles from inside the arterial wall embrace:
- Use of oral steroids, immunosuppressant medicine, sure anti-inflammatory medicine and lots of anticancer medicine
- Continual unfavourable psychological stress
The Position of Irritation in Cardiovascular Illness
In accordance with Kendrick, whereas persistent irritation is acknowledged as a contributing issue for heart problems, not all irritation is dangerous. In reality, using anti-inflammatory medicine (which may impair helpful acute irritation) has been linked to a rise in heart problems danger, “Which suggests that if you interfere with the healing response to arterial injury, you are going to make thing worse — not better,” he says, including:16
“[T]he actual cause why [chronic] irritation is being seen as a attainable explanation for CVD is as a result of inflammatory markers could be raised in CVD. To my thoughts this simply demonstrates that in individuals with CVD, a lot of injury is happening, subsequently there’s extra restore happening, so the inflammatory markers are raised.
Nevertheless, the mainstream has determined to take a look at this from the other aspect. They see rather a lot irritation happening and have decreed that the irritation is inflicting the CVD — moderately than the opposite approach round. Frankly, I feel that is bonkers. However there you go.
Anyway, the place has all this acquired us to? I shall attempt to obtain a fast abstract. The LDL speculation is nonsense, it’s incorrect, and it doesn’t remotely match with some other elements recognized to trigger CVD.
The thrombogenic principle, however, matches with virtually every part recognized about CVD. It states that there are three, interrelated, processes that improve the danger of CVD:
- Elevated price of injury to the endothelial layer
- Formation of a much bigger or harder to take away blood clot at that time
- Impaired restore/removing of remnant blood clot.
Any issue that does one in every of these three issues can improve the danger of CVD … You might want to have three or 4, perhaps extra, after which issues actually get going … All of which signifies that — typically — CVD has no single, particular, trigger. It ought to, as an alternative, be seen as a course of whereby injury exceeds restore, inflicting plaques to start out creating, and develop — with a remaining, deadly, blood clot inflicting the terminal occasion.”
Extra Proof Cholesterol Is Not the Enemy
The Minnesota Coronary Experiment was a research carried out between 1968 and 1973 that examined the connection between eating regimen and coronary heart well being.17 The researchers used a double-blind randomized trial to guage the impact of vegetable oil (excessive in omega-6 linoleic acid) versus saturated fat in coronary coronary heart illness and dying.
The outcomes have been left unpublished till 2016, once they appeared within the BMJ. An evaluation of the collected knowledge revealed decreasing your levels of cholesterol via dietary intervention didn’t scale back your danger of demise from coronary coronary heart illness. In response to the researchers:18
“Out there proof from randomized managed trials exhibits that alternative of saturated fats within the food plan with linoleic acid successfully lowers serum ldl cholesterol however doesn’t help the speculation that this interprets to a decrease danger of demise from coronary coronary heart illness or all causes.
Findings from the Minnesota Coronary Experiment add to rising proof that incomplete publication has contributed to overestimation of the advantages of changing saturated fats with vegetable oils wealthy in linoleic acid.”
The researchers discovered that for each 30-point drop in complete ldl cholesterol, there was a 22 % improve within the danger of dying from cardiac illness. Upon post-mortem, the group consuming vegetable oil and the group consuming saturated fats had the identical quantity of atherosclerotic plaques of their arteries, however the group consuming saturated fats skilled almost half the variety of coronary heart assaults because the group consuming vegetable oil.
Equally, a scientific evaluation19 of three giant evaluations revealed by statin advocates (which tried to validate the present perception that statin remedy helps forestall heart problems) concluded the three research in query did not fulfill standards for causality and drew defective conclusions. Particularly, the authors discovered:20
- There was no affiliation between complete ldl cholesterol and the diploma of atherosclerosis severity
- Complete levels of cholesterol are usually not predictive of the danger of coronary heart illness and could also be absent or inverse in lots of research
- In lots of research LDL was not related to atherosclerosis and in a big U.S. based mostly research of almost 140,000 sufferers who suffered an acute myocardial infarction, LDL ranges on the time of admission have been decrease than regular
- Adults over the age of 60 with greater LDL ranges usually stay longer
- Few adults who expertise familial hypercholesterolemia die prematurely
The researchers concluded that prime levels of cholesterol can’t be the primary reason for coronary heart illness as these with low ranges have almost the identical diploma of sclerosis as these with excessive ranges, and the danger of getting a coronary heart assault is identical or greater when levels of cholesterol are low.
They consider the speculation has been stored alive by reviewers utilizing deceptive statistics and excluding outcomes from unsuccessful trials whereas ignoring quite a few contradictory observations.21 For an outline of different research debunking the saturated fats fantasy, typically linked intently to growing levels of cholesterol, see my earlier article, “The Cholesterol Myth Has Been Busted — Yet Again.”
Why Statin Medicine Are Unwell Suggested for Most
Whereas the dietary tips for People not concentrate on decreasing dietary ldl cholesterol to guard your coronary heart, and U.S. ldl cholesterol remedy tips have stopped utilizing complete ldl cholesterol as a measure of coronary heart illness danger, honing in on elevated LDL ldl cholesterol as an alternative, we’re nonetheless far off the mark when it comes right down to methods to greatest forestall coronary heart illness.
Refined sugar and processed fructose are actually the first drivers of coronary heart illness, in order that’s the place the main target must be — not on driving down your ldl cholesterol with assistance from a statin drug (and/or avoiding wholesome saturated fat in your weight-reduction plan).
The one subgroup which may profit from a statin are these born with a genetic defect referred to as familial hypercholesterolemia, as this makes them immune to conventional measures of normalizing ldl cholesterol.
There are many essential explanation why you shouldn’t take a statin drug until you’ve got this genetic defect, together with however not restricted to the next. For extra details about every of those, see “5 Great Reasons Why You Should Not Take Statins.”
1. They don’t work as marketed — A 2015 report22 revealed within the Professional Evaluate of Medical Pharmacology concluded that statin advocates used a statistical software referred to as relative danger discount to amplify statins’ trivial useful results. For those who take a look at absolute danger, statin medicine profit simply 1 % of the inhabitants. Which means out of 100 individuals handled with the medicine, one individual may have one much less coronary heart assault.
One other systematic evaluate23 revealed that very same yr concluded that in research the place demise was the first prevention endpoint, statins taken for as much as six years postponed dying by 5 to 19 days. In secondary prevention trials, dying was postponed by 10 to 27 days.
Median postponement of demise for main and secondary prevention was three and 4 days respectively. When you think about the various well being hazards related to these medicine, this minuscule profit hardly warrants statin remedy.
2. They deplete your physique of CoQ10 — Statins block HMG coenzyme A reductase in your liver, which is how they scale back ldl cholesterol. This enzyme additionally makes CoQ10, which is an important mitochondrial nutrient that facilitates ATP manufacturing.
As famous in a 2010 research,24 “Coenzyme Q10 is an important factor in mitochondrial respiration,” and “Primary and secondary deficiencies of coenzyme Q10 result in a number of neurologic and myopathic syndromes.” Since they impair your mitochondrial perform, they might probably have an effect on any variety of well being issues, as with out well-functioning mitochondria, your danger for persistent illness will increase considerably.
Three. They inhibit the synthesis of vitamin K2, a vitamin that protects your arteries from calcification.
four. They scale back ketone manufacturing25 — In case you take CoQ10 whereas on statins you continue to haven’t solved the issue, as the identical enzyme (HMG coenzyme A reductase) additionally inhibits your liver’s capacity to supply ketones, water-soluble fat that are important to maintain your physique metabolically versatile. Ketones are additionally necessary molecular signaling molecules. So, statins make it nearly unattainable to realize dietary ketosis.
5. Due to 2, Three and four, statins improve your danger for different critical illnesses, together with:
- Coronary heart failure — Primarily because of statin-induced CoQ10 deficiency26,27
- Most cancers — Analysis28 has proven that long-term statin use (10 years or longer) greater than doubles ladies’s danger of two main kinds of breast most cancers: invasive ductal carcinoma and invasive lobular carcinoma.
- Diabetes — Statins have been proven to extend your danger of diabetes by way of a variety of totally different mechanisms, two of which embrace growing your insulin resistance, and elevating your blood sugar.
- Neurodegenerative illnesses
- Musculoskeletal issues and motor nerve injury — Analysis29 has proven that statin remedy lasting longer than two years causes “definite damage to peripheral nerves.”
- Liver issues30,31
Essential and Beneficial Dietary Dietary supplements if Taking a Statin
Should you determine to take a statin, ensure you take CoQ10 or ubiquinol (the lowered type) with it. One research evaluated the advantages of CoQ10 and selenium supplementation for sufferers with statin-associated myopathy.32
In comparison with these given a placebo, the remedy group skilled considerably much less ache, decreased muscle weak spot and cramps, and fewer fatigue. A vitamin K2 complement can also be extremely really helpful. MK-7 is the shape you’ll need to search for in dietary supplements; it’s extracted from the Japanese fermented soy product referred to as natto.
Newer Cholesterol Medicine Are Not Safer
Additionally, watch out for a more moderen class of ldl cholesterol absorption inhibitors referred to as PCSK9 Inhibitors.33 PCSK9 is a protein that works with LDL receptors that regulate LDL within the liver and launch LDL ldl cholesterol into the blood. The inhibitors block that protein, thus decreasing the quantity of LDL circulating in your blood; in medical trials, these medicine lowered LDLs by about 60 %. Nevertheless, as mentioned earlier, LDL has no direct bearing in your CVD danger.
What’s extra, whereas these medicine are being touted as the reply for many who can’t tolerate a few of the unwanted side effects of the opposite medicine, akin to extreme muscle ache, trials have already found that PCSK9 inhibitors can produce “neurocognitive effects,” with some sufferers experiencing confusion and a spotlight deficits.34 There’s proof suggesting these medicine may very well be much more harmful than statins.
Assessing Your Coronary heart Illness Danger
As you consider your danger of heart problems, there are particular ratios and blood degree values that may inform you rather more than your complete ldl cholesterol quantity. For instance, an NMR LipoProfile, which measures the dimensions of your LDL particles, is a much better evaluation of your danger of coronary heart illness than complete ldl cholesterol or complete LDL. The next exams will even offer you a greater evaluation of your potential danger for coronary heart assault or CVD:
• Cholesterol ratios — Your HDL/ldl cholesterol ratio and triglyceride/HDL ratio is a robust indicator of your danger. In your HDL/ldl cholesterol ratio divide your HDL by your complete ldl cholesterol and multiply by 100. That proportion ought to ideally be above 24 %. On your triglyceride/HDL ratio divide your triglyceride complete by your HDL and multiply by 100. The perfect proportion is under 2 %.
• Fasting insulin degree — Sugar and carbohydrates improve irritation. As soon as eaten, these chemical compounds set off a launch of insulin, selling the buildup of fats and creation of triglycerides, making it harder so that you can reduce weight or keep your regular weight. Extra fats round your midsection is among the main contributors to coronary heart illness.35
Your fasting insulin degree might be decided by a easy, cheap blood check. A traditional fasting blood insulin degree is under 5 microunits per milliliter (mcU/ml), however ideally, you’ll need it under Three mcU/ml. In case your insulin degree is larger than Three to five, the simplest approach to optimize it’s to scale back internet carbs.
• Fasting blood sugar degree — Research have demonstrated individuals with greater fasting blood sugar ranges have a better danger of coronary heart illness.36 Actually, when your fasting blood sugar is between 100 and 125 mg/dl, your danger of coronary artery illness will increase to 300 % greater than these whose degree is under 79 mg/dl.37,38
• Excessive sensitivity C-reactive protein (HS-CRP) — This is likely one of the greatest general measures of irritation and a very good display on your danger of coronary heart illness. Ideally your degree must be under zero.7 and the decrease the higher.
• Iron degree — Iron creates an surroundings for oxidative stress, so extra iron might improve your irritation and improve your danger of coronary heart illness. A really perfect iron degree for grownup males and non-menstruating ladies is between 40 and 60 nanograms per milliliter (ng/ml). You don’t want to be under 20 ng/ml or above 80 ng/ml.
The only and most effective strategy to decrease your iron degree if elevated is to donate blood. For those who can’t donate, then therapeutic phlebotomy will successfully remove the surplus iron. Heavy metallic cleansing may also naturally scale back excessive iron.
The way to Keep away from Coronary heart Illness
In closing, keep in mind that excessive complete ldl cholesterol and even excessive LDL are insignificant when making an attempt to find out your coronary heart illness danger, and dietary ldl cholesterol and saturated fats are not contributing elements.
In all probability the perfect predictor for CVD is your insulin sensitivity. Contemplating how insulin resistance drives persistent illness basically, not simply coronary heart illness, I strongly advocate measuring your fasting insulin regularly and taking quick motion if you end up inching towards insulin resistance.
As for stopping or reversing insulin resistance, the next basic tips will set you heading in the right direction:
- Dramatically scale back your internet carbs and remove processed fructose, as that is what set this cascade of metabolic dysfunction into movement within the first place. Substitute the misplaced energy with greater quantities of wholesome fat, not protein. My optimized dietary plan can information you thru this course of.
- Normalize your omega-Three-to-omega-6 ratio. Most get far too little omega-Three, present in fatty fish comparable to wild Alaskan salmon, sardines, anchovies, fish oil and krill oil, and an excessive amount of omega-6, as it’s plentiful in processed vegetable oils and therefore processed and fried meals.
- Optimize your vitamin D degree by getting common, smart solar publicity. Different vitamins of significance embrace magnesium and nutritional vitamins K2 and C.
- Get eight hours of top of the range sleep every night time to normalize your hormonal system. Analysis has proven sleep deprivation can have a big bearing in your insulin sensitivity.
- Get common train, as it’s a highly effective method to assist normalize your insulin sensitivity.
Learn the complete article at Mercola.com.
1, four ZoeHarcombe.com, We have now acquired ldl cholesterol utterly flawed
2 Consuming Nicely, How a lot does consuming ldl cholesterol in my meals actually have an effect on my blood ldl cholesterol?
Three Berkeley Wellness, September 1, 2011
5 Nourish Stability Thrive April 16, 2018 Interview Define
6, 7, 9, 15 Nourish Stability Thrive April 16, 2018 Interview Transcript
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10, 11, 12, 13, 14, 16 Dr. Malcolm Kendrick, What Causes Coronary heart Illness, Half 59
17, 18 The BMJ, 2016; 353: i1246
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27 Thecholesteroltruth.com Might 30, 2013
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29 Neuro Endocrinol Lett. 2011;32(5):688-90
30 ZoeHarcombe.com March 24, 2015
31 Lipotor Affected person Leaflet
32 Canadian Journal of Physiology and Pharmacology 02/2013; 91(2):165-70
33 Bilazarian S, Sabatine MS. PCSK9 Inhibitors: What to Know If They Come to Market. Medscape. April 28, 2015. On-line (Requires free subscription).
34 Medicine.com. New Drug Class Slashes ‘Bad’ Cholesterol, Assessment Finds. Medicine.com. April 27, 2015. On-line.
35 Crucial Pathways in Cardiology, 2007;6(2):51
36 The American Journal of Cardiology, 2002;89(5):596
37 American Journal of Cardiology March 1, 2002; 89(5): 596-599
38 Fats for Gasoline by Dr. Joseph Mercola
Revealed on December 17, 2018