Women's International Pharmacy E-Newsletter

The Complexities of Cholesterol

Cholesterol NewsletterWhat do we really know about cholesterol? The lower the better, doctors have told us since the 1960s, when the “cholesterol hypothesis” became widely accepted as fact, and millions reluctantly gave up bacon and eggs for cereal with skim milk.

Despite shaky science, Americans were quick to accept the thinking that high cholesterol foods were the chief villain in the disease of atherosclerosis—the process whereby fatty deposits build up in arteries, hardening and narrowing them, eventually starving the heart of blood.

If we could just reduce our intake of cholesterol, less of it would build up, we were told. It made sense; if you avoid dumping grease down the kitchen sink, your pipes are less likely to clog.

Finally, cholesterol is getting a closer look.

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The Magic of Cholesterol Numbers by Sergey A. Dzugan, MD, PhD
Reviewed By Carol Petersen, RPH, CNP - Women's International Pharmacy

The Magic of Cholesterol Numbers by Sergey A. Dzugan, MD, PhDDr. Dzugan may just turn the medical industry upside down with this book. He sets the stage by explaining that—fueled by pictures of seriously clogged arteries—we have bought into the delusion that elevated cholesterol levels signal that cholesterol is on the warpath to attack our arteries. Statins aim to reduce cholesterol levels by interfering with the production of cholesterol, and to do so in a limited fashion; hence, they are currently the most commonly prescribed drug. Dr. Dzugan contends that this approach is not viable, and asks the question: Why does cholesterol get such a bad rap?

First of all, he says it is because cholesterol is a steroid, which in and of itself carries negative connotations. We immediately think of the synthetic testosterone-like hormones abused by body builders. Or maybe we think about prednisone, which is close enough to hydrocortisone and cortisone to relieve inflammation but does so at the cost of other severe side-effects. Dr. Dzugan believes that there is no place in the human body for these man-made hormone mimics. Cholesterol, on the other hand, is so prevalent in and important to the brain that it is formed independently in the brain. Thankfully, statin drugs cannot pass the blood brain barrier to interfere with that process!

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Homocysteine, Hormones and Heart Disease
Written by Kathy Lynch, PharmD - Women's International Pharmacy

High levels of homocysteine have been associated with an increased risk for heart disease and other chronic medical conditions. While age, gender and kidney function are the primary factors that determine homocysteine levels, the B vitamins also play an important role in keeping homocysteine in check, particularly among the elderly.

The role that hormones play in the regulation of homocysteine is less clear. However, it turns out that the same B vitamins that keep homocysteine in check also help the body “methylate” or metabolize and excrete estrogens. And a high homocysteine level also typically reflects a lack of methylation, which can be a significant source of hormone imbalance.

Research suggests that higher estradiol levels in pre-menopausal women may be keeping homocysteine in check. Preliminary studies suggest that testosterone may play a role as well. Further research is needed to fully understand the relationships among homocysteine and hormone levels.


"Homocysteine: The Amino Acid with Life or Death Implications" by Kimberly Pryor. Available at http://www.vrp.com/heart-health/homocysteine-the-amino-acid-with-life-or-death-implications as of January 2, 2013.   

"Testosterone Regulation of Renal Cystathione B-synthase: Implications for Sex-dependent Differences in Plasma Homocysteine Levels" by Vitvitsky V, Prudova A, Stabler S, Dayal S, Lentz S, and Banerjee R;  American Journal of Physiology - Renal Physiology; 2007 Aug; 293(2): F594-F600.    



Staff at Women's International Pharmacy



In This Issue
Book Review: The Magic of Cholesterol Numbers
Homocysteine, Hormones and Heart Disease

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