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Seven Tips to Fix Your Cholesterol Without Medication

Seven Tips to Fix Your Cholesterol Without Medication

THE SINGULAR FOCUS on treating cholesterol as a means to prevent heart attacks is leading to the deaths of millions of people because the real underlying cause of the majority of heart disease is not being diagnosed or treated by most physicians.

For example, I recently saw a patient named Jim who had “normal” cholesterol levels yet was taking the most powerful statin on the market, Crestor. Despite this aggressive pharmaceutical treatment, this man was headed for a serious heart attack.

Jim’s doctors had missed his real disease risks by focusing on and treating his cholesterol levels. All the while they were ignoring the most important condition that put him at dramatically higher risk of heart attacks, diabetes, cancer, and dementia. In a moment I will explain what this condition is and what you can do about it.

This craze for treating cholesterol has lead to an onslaught of pharmaceuticals designed to “lower cholesterol.” Statins are now the number one selling class of drugs in the nation and new cholesterol medications are produced every day.

The latest in a new class of “super” cholesterol drugs, CETP inhibitors, now in the drug approval pipeline from Merck (anacetrapib) burst into the news recently with exclamations from typically restrained scientists. Data on this new drug was recently published in the New England Journal of Medicine and presented at the American Heart Association conference in Chicago.

The study found a 39.8 percent reduction in LDL (or bad cholesterol) and a 138 percent increase in HDL or good cholesterol.(i) Sure, the medications lowered cholesterol. However, the study was not large enough or long enough to answer the most important question: Did the drug results in fewer heart attacks and deaths.

Despite this glaring omission, the scientists reporting on these results used words such as “spectacular”, “giddy”, “enormous”, “most excited in decades” to describe their enthusiasm over the medication. Of course, the researchers (as I described in a recent post “Dangerous Spin Doctors”) were on the payroll of Merck who funded the study.

Metabolic syndrome is the leading cause of heart disease, diabetes, and a variety of other chronic illnesses in this country.

Why Lowering Cholesterol May Not Lower the Risk of Death

Unfortunately, these scientists seemed to have short-term memory loss. Just three short years ago in 2007, another new “wonder” drug from Pfizer (torcetrapib) which worked on the same mechanism that anacetrapib does, was found to dramatically lower LDL and raise HDL cholesterol, just like this new drug from Merck.

There was only one small problem—in those taking the drug, deaths from heart attacks increased 25 percent, deaths from heart disease increased 40 percent and overall deaths increased 200 percent.(ii) After spending $800 million in development Pfizer had to walk away from the drug.

Oops. How can a drug that does all the right things (dramatically lowering bad cholesterol and raise good cholesterol) actually cause MORE heart disease and deaths?

The answer is simple. Drugs don’t treat the underlying causes of chronic illness. It is not our genes which haven’t changed much in 20,000 years, although they may predispose us to environmental and lifestyle triggers of illness. The causes of chronic disease are rooted in what we eat, how much we move, how we face stress, how connected we are to our communities, and toxic chemicals and metals in our environment.

A wry editorial in the New England Journal of Medicine many years ago remarked that doctors should use new drugs as soon as they come on the market before side effects develop. Perhaps that’s what the authors of this study are proposing what we do with anacetrapib.

At best this new “super cholesterol” drug will lower cholesterol numbers without killing too many people while increasing health care costs by billions of dollars as millions of new prescriptions are written. Worse it may end up in the same garbage dump Pfizer’s drug from 3 years ago did. Even worse scenarios exist … and the reason is startling simple …

These drugs do not address the fundamental underlying cause of heart disease. Heart disease is not a Lipitor, Crestor or even an “anacetrapib” deficiency. It is a complex end result of multiple factors driven by our diet, fitness level, stress, and other lifestyle factors such as smoking, social connections, and, increasingly, environmental toxins.

Taking a pill won’t fix these problems that push our biology steadily along the trajectory of disease. The idea of putting statins at the check out counter of MacDonald’s is the epitome of reductionist thinking. The problem isn’t cholesterol — it’s all the stuff we are putting in our mouths!

Jim, my patient, is a perfect example of how doctors treat the symptoms, not the cause of disease. As I have written about, in a previous blog, most doctors focus on the wrong target for preventing and treating heart disease.

Abnormal cholesterol levels are just a downstream problem that is mostly a result of “diabesity” or the continuum of blood sugar and insulin imbalances that range from pre-diabetes to full-blown end stage diabetes.

Taking a statin or a CETP inhibitor cannot reverse this change in our biology. We cannot use a drug to correct what happens to our biology because of a high sugar and refined flour, low fiber, processed diet, a sedentary lifestyle, excessive stress, lack of sleep, or the harmful effects of pollution.

Let’s take a closer look at Jim. On 10 mg of Crestor, the most powerful statin on the market, his total cholesterol was a beautiful 173, and his LDL was a respectable 101. But the good news ended there. His triglycerides were 176 (normal is less than 100), and his HDL was 37 (normal is greater than 50).

Jim’s numbers belie a deeper truth about cholesterol that most conventional doctors are ignoring today: Given the current state of scientific understanding, the cholesterol numbers doctors measure today are increasingly irrelevant.

The Real Cause of Heart Disease

Instead of looking just at the cholesterol numbers, we need to look at the cholesterol particle size. The real question is: Do you have small or large HDL or LDL particles? Small, dense particles are more atherogenic (more likely to cause the plaque in the arteries that leads to heart attacks), than large buoyant, fluffy cholesterol particles.

Small particles are associated with pre-diabetes (or metabolic syndrome) and diabetes and are caused by insulin resistance. Recent research (see my blog “Do Statins Cause Diabetes and Heart Disease”) indicates that statins may actually increase diabetes.

While measuring cholesterol particle size is a simple blood test that can be done at Labcorp, most doctors do not look at it, even though it is the only meaningful way to evaluate cholesterol numbers. You can have a LDL cholesterol that looks normal, like Jim did at 101, but you may have over 1,000 small LDL particles which are very dangerous.

On the other hand, you can have the same LDL number of 101, and it may be made up of  400 large particles which cause no real health risk. Your health risk has less to do with your cholesterol numbers than it does the quantity and size of your cholesterol particles.

Again, we can take Jim as an example. His cholesterol particles were all small and dense because he had severe pre-diabetes. This is also not hard to diagnose. Jim was obese at 285 pounds with a BMI (body mass index) of 36. You are considered obese if your BMI is greater than 30. His waist-to-hip ratio was 1.04 (normal is less than 0.9 for men).

He had very high insulin and blood sugar levels after we gave him a test drink of glucose (sugar). All this added up to tell us he had severe pre-diabetes or metabolic syndrome. As I mentioned before, he also had high triglycerides and low HDL — another clue that he had metabolic syndrome. We also found he had very low testosterone and growth hormone, further symptoms of pre-diabetes or metabolic syndrome.

Jim reported that despite working with a trainer he kept losing muscle and he was always hungry. This is why.

Let me reiterate: These are measurements and tests that can be done in any doctor’s office, but are rarely done. These are not esoteric or expensive labs that can only be done at specialty clinics.

The condition that Jim suffered from, metabolic syndrome, is the most common medical condition in America, but the most rarely diagnosed. It affects over half the population. It is the major cause of heart disease, diabetes, and aging, and it is one of the major causes of dementia and cancer, not to mention infertility and sexual dysfunction.

Yet it is mostly ignored by doctors. Why? The answer is simple and tragic: There are no drugs to treat it effectively, and doctors tend to focus on what they can treat with medications, even if it is the wrong target. This is one of the reasons statins are so popular in America despite the vast research against them.

Seven Tips to Fix Your Cholesterol and Reverse Metabolic Syndrome without Medication

Luckily, this doesn’t mean you are doomed, even if you are already suffering from metabolic syndrome and heart problems. High cholesterol and pre-diabetes, or metabolic syndrome, can be successfully diagnosed and treated. I have reviewed this in previous blogs but here are 7 tips to help you get large, fluffy cholesterol particles and reverse metabolic syndrome.

  1. Get the right cholesterol tests. Check NMR particle sizes for cholesterol by asking your doctor for this test at Labcorp or LipoScience. You want to know if you have safe, light, and fluffy cholesterol particles, or small, dense, artery damaging cholesterol particles. A regular cholesterol test won’t tell you this.
  2. Check for metabolic syndrome.
    • Do you have a fat belly? Measure you waist at the belly button and your hips at the widest point—if your waist/hip is greater than 0.8 if you are a woman or 0.9 if you are man, then you have a problem
    • If you have small LDL and HDL particles, you have metabolic syndrome.
    • If your triglycerides are greater than 100 and your HDL is less than 50, or the ratio of triglycerides to HDL is greater than 4, then you have metabolic syndrome.
    • Do a glucose insulin challenge test. This is very important and most physicians do not test for insulin and glucose.
    • Check your hemoglobin A1c, which measures blood sugar over the last 6 weeks. If it is greater than 5.5, you may have metabolic syndrome
  3. Eat a healthy diet. Eat a diet with a low glycemic load, high in fiber, and phytonutrient and omega-3 rich. It should be plant based, and you should consume plenty of good quality protein such as beans, nuts, seeds, and lean animal protein (ideally organic or grass fed). I have described specific diets that abide by these parameters in my book UltraMetabolism.
  4. Exercise. Enough said.
  5. Get good quality sleep. Sleep is essential for healing your body, maintaining balanced blood sugar, and your overall health.
  6. Use supplements to support healthy cholesterol particle size. These include:
    • A multivitamin including at least 500 mcg of chromium, 2 mg of biotin, and 400 mg of lipoic acid. For most you will take 3 capsules twice a day.
    • 1000 mg of omega-3 fats (EPA/DHA) twice a day.
    • 2000 IU of vitamin D3 twice a day.
    • 1200 mg of red rice yeast twice a day.
    • 2-4 capsules of glucomannan 15 minutes before meals with a glass of water.
    • Broad-range, balanced concentration of plant sterols. You will usually take 1 capsule with each meal.
  7. Consider using high dose niacin or vitamin B3. This can only be done with a doctor’s prescription. It is useful to help raise HDL cholesterol, lower LDL cholesterol and triglycerides, and increase particle size.
  8. Use low-dose statins ONLY if you have had heart disease or are a male with multiple risk factors, while carefully monitoring for muscle and liver damage.

For the vast majority of people this approach is better than simply taking a cholesterol medication. To reduce your risk of heart disease you need to address metabolic syndrome, and that can ONLY be done effectively with a comprehensive diet and lifestyle approach like the one outlined above.

Now I’d like to hear from you …

Have you taken statins? What has been the effect and do you have muscle pain or any neurologic side effects?

Do you think metabolic syndrome is an important factor to address to reduce the risk of heart disease? Why or why not? Has your doctor ever said, your sugar is a little high and we will watch it? Watch for what — until it is so bad you are eligible to take diabetes medication?

What do you think of conventional medicine’s tendency to prescribe medications over dietary and lifestyle change for chronic health conditions?

I would love to hear your thoughts. Share them by leaving a comment below.

To your good health,

Mark Hyman, MD


(i) Cannon, C.P., Shah, S., Dansky, H.M. et al. 2010. Safety of anacetrapib in patients with or at high risk for voronary heart disease. N Engl J Med. 363(25): 2406–2415.

(ii) Barter, P.J., Caulfield, M., Eriksson, M. et al. 2007. Effects of torcetrapib in patients at high risk for coronary events. N Engl J Med. 357(21):2109-2122.

Mark Hyman MD is the Medical Director at Cleveland Clinic’s Center for Functional Medicine, the Founder of The UltraWellness Center, and a ten-time #1 New York Times Bestselling author.

Comments (107)

  • Just left the doctor’s office. This was the first time I had met the guy (I switched doctors because I wasn’t happy with the last one). I had seen the nurse practitioner two weeks before. She sent me for blood work. The test came back that my cholesterol is high and my tryglcerides are high. My HDL is low and I have hypertension. This is the third time with these results in the last year and a half. Until then, I had never had cholesterol problems. I do not eat unhealthy, but I have fibromyalgia, osteoarthritis, herniated discs and bone spurs, which keep me from being as active as I need to be. The doctor said I am obese (which really upset me); I am only a size 12. (He said that my BMI was high, but I’ve always weighed 20lbs heavier than what I look like. Even as a child when I was solid muscle, the doctors and nurses couldn’t believe I weighed as much as I did. I don’t think you can accurately know someones fat content just because of what they weigh.) I have a family history of heart disease and diabetes so the cholesterol thing has me worried. I think the doctors are missing the mark. They have me on a statin drug that I’ve been on for over a year now and it’s not doing anything. I agree with your article; I believe that doctors are so busy prescribing every new pill that comes along to treat a symptom, that they are completely missing the cause, which is being left untreated and people are dying or physically deteriorating because of it. I’m at a loss; I need a doctor that will actually figure out whats going on instead of throwing pills at me to take. It’s the same scenario with the other conditions that I have – no help. I keep scouring the internet for answers. Thank you for your article.

    • I recently had some blood work done. My ldl-p is 2271 with hdl 54 ldl119 and total cholestrol 178. I am 71 years of age 5’9″ and 178 lb. Can this be brought under control with diet only.I am active and fast walk 2 miles per day.

      • Hi Morris,
        Diet and lifestyle will have a significant impact on your cholesterol management. Unfortunately Dr. Hyman cannot provide you personalized medical advice in this forum. In order to provide you the proper care you need we hope you will seek the attention of a local qualified Functional Med practitioner soon. To locate a doctor near you who practices functional medicine like Dr. Hyman, go to and scroll down to where it says “locate a practitioner” and enter your location. Progress accordingly from there.
        Wishing you the best of health,
        Dr. Hyman Staff

  • I am very interested in this article as I’ve been on 20 mg of Lipitor daily for about 3 years now. Eighteen months ago I had a vertical sleeve gastrectomy and, to date, I’ve lost about 87 pounds. I still have about 50 more to go to goal. Prior to having the VSG, I was diagnosed with diabetes. Currently all of my blood tests are normal. My A1C was 5.8%, blood pressure was 112/60, total cholesterol 3.72, HDL 1.85, LDL 1.23 for a ratio of 2; triglycerides 1.41 at a weight of 238 lbs. I would like to stop taking the lipitor, as I believe my diet and exercise is doing more to control it than the lipitor is. I will be approaching my doctor asap to request that I be allowed to stop taking the lipitor and follow your recommendations. I am also taking PGX which I understand may be contraindicated if I am on lipitor?? I am looking forward to seeing my results without the lipitor.

    • Thank you for your message and your interest in Dr. Hyman’s work. Please check with your physician for information on contraindications.

      Wishing You the Best of Health!

      Dr. Hyman Staff

      • My total cholesterol is 286, Hdl-c 79, triglycerides 59, Hdl-p 44.8, small ldl-p 796, ldl size 21.5.

        I’m 71, do cardio 45 min 4x week, yoga 1 day and have a bmi of 21. I eat only organic and mostly vegan. Blood pressure usually 117/73.

        My dr wants to put me on Crestor but I’m opposed to taking any drugs but vitamins. I did have a clogged carotid surgery several years ago and have osteoporosis. Otherwise excellent health.

        I’m going to follow your advise regarding supplements but do you think I should take a statin, also?

        • Hi Dianne,

          Thank you for your message and your interest in Dr. Hyman’s work. Your question and constellation of symptoms represents a complex medical condition. Questions regarding conditions like these cannot be answered in a responsible manner via the Internet.

          Wishing You the Best of Health!

          Dr. Hyman Staff

  • I have low testosterone,i went to my drug store to check on a gel replacement and found the cost way out of my buget.$479 to $539 a month.Is there a suupplement i can take to raise my testosterone.JImmy Lascola

    • Hi James,

      The best way to raise your testosterone is by understanding what is causing it to be low in the first place… Simple things like adjusting your diet to a low glycemic diet helps improve insulin sensitivity which actually boosts testosterone! In Dr Hyman’s The Blood Sugar Solution, he discusses which foods and supplements to eat to help men naturally (and affordably!) boost testosterone. Check it out: and for supplements:

      For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to: OR call (800) 892-1443 to get started.

  • I have tried lipitor and livalo, both have caused me tremendous muscle and joint pain… I don’t know what else to try…. I eat a healthy diet, walk a mile a day, I am 5ft. 3” and weigh 138 lbs. Help!!!!

    • Hi Marie,

      There are so many tools you can try in your “food as medicine” toolkit and supplements you can try. I would suggest you look into Dr Hyman’s The Blood Sugar Solution for specific diet and supplement suggestions for improving your cholesterol profile. But also remember that not all “high” cholesterol is necessarily bad…That is why Dr Hyman suggests having an NMR profile run so you can see the quality of your cholesterol. Also you may want to consider supplements to help with cholesterol. For example, have you tried PGX? For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to: OR call (800) 892-1443 to get started.

    • You should supplement your Lipitor or any statin drug that you take to control your cholesterol level with COQ10. Statin drugs leach your blood and cause lots of muscle problems. The COQ10 should replace what your blood needs. Good luck.

      • You’re absolutely right Ruth, I’m surprised that Mark did not mention CoQ10 in the article, especially since he recommends Red Yeast Rice (a natural statin) as a supplement to lower cholesterol.

  • I too like many of the commenters have cholesterol that won’t budge. i have high blood pressure and pre diabetic. My total cholesterol was 204 at the first of the year. I started walking every day, cut out all bread and foods high on the glycemic index, started eating nuts, avacados, raw veggies like crazy. Only eat good fats. My total cholesterol has gone up to 220! It the bad kind too. My blood sugar remains the same too,too high. I am discouraged. What could I possibly be doing wrong? I am under a tremendous amount of stress. Is that a factor?

    • Thank you for your message and your interest in Dr. Hyman’s work. Your question and constellation of symptoms represents a complex medical condition. Questions regarding conditions like these cannot be answered in a responsible manner via the Internet.

      Wishing You the Best of Health!

      Dr. Hyman Staff

    • I know this is an old post but will comment for anyone new reading it. Background: I was supplimenting with 10k of D3 a day and my cho kept rising higher every month while I ate a very low carb diet. I am diabetic, T2 and have high BP, etc. Metabolic syndrom, in other words. My A1C is kept at low normal levels. I read lots of medical reports, blogs, etc. and in my reading I came across the fact that BP and Cho is lower in Summer than Winter. This led me to wonder about why the Medditeranian diet seems to work for lowering BP,etc. Then it dawned on me that sunshine was the common denominator. I learned that the body makes D via the skin using sunshine (Beta rays though, not the ones that burn) and the raw material that was used with the sunshine to produce D with the skin is….. LDL WOW!!!! I stopped my D3 suppliments and began to get 15 minutes of pure sunshine a day. Within a month my LDL had gone to normal ranges (99) but my HDL remained at 58. A second month saw my LDL fall to 70. Research this with a websearch! Older folks do not get much sunshine and have more problems with Deficiency, BP, etc. too. Not much clinical reaearch on this subject, though there is some, cause NO one will make any money off sunshine instead of drugs. I live in Texas with lots of good sun, but when winter rolled around I bought a reptile light to get my beta rays. Remember the beta rays do not cause burn and it is the beta rays that use the LDL to make D. Lowered my LDL and got my D with $0 and stopped my D3 supplements (which IMO had caused me to have a surplus of LDL) By calculation, my LDL are large and fluffy too— 😉

  • I’m thinking of changing doctors as all doctors Ive seen so far through out another pill and awhile later you see an attorney sueing the pharmaceuticles for too many people dying or having other problems besides the original one. I have a pacemaker that was put in in 2008. I have not used it since then. I’m losing weight but very slowly as I am on a cane and walker after hurting my back lifting cases of water and degenerative osteoarthritis. I exercise very little a d when I could walk normally I exercised up to two hours a day 5 days a week. I now have metobolic syndrome but my numbers are coming down with watching for food intolerences and eating 50 percent fruits and veggies. I decided to take matters in my own hands when I was given blood pressure medication 3 years ago and went to emergency with my blood pressure too low and almost died. I wonder now if the pacemaker is something I needed as well. They wanted to give me Lipitor when it came out but I lowered my pressure and cholesterol with foods and less stress in my life. Now since Lipitor is recalled they want to give me Crestor and I won’t take that either. I e gone on a juice and veggie fast for 10 days, eat e en more veggies in the hopes of losing more quickly. My blood pressure goes up when I have too much salt. My blood pressure is usually 115/68 to 140/80. I was to go for a stress test and knew they were going to inject me with some chemical and was scared so my pressure went to 178/80. Minutes later it was 140/84. I don’t know what to do anymore so I’m eating more organic and no dairy or gluten. I’ve lost 4 pounds in 14 days trying to reset my metabolism. I have to lose 85 pounds, but have minor sleep apnea until I lose more weight. The doctors want me on cymbalta, Crestor, and I am on a diretic and potassium. They just want to give me pill after pill. Any they have given me have caused side effects or not fixed the problem. I am on the Internet constantly trying to heal myself or go to A doctor I can trust. I had one doctor I saw for the first time snd he wanted to give me knee surgery on both knees at the same time. I wasn’t asked what I felt about it. I’m not egoed or trying to tell S doctor what to do I just think they are pill happy. They don’t spend enough time on you to see what your problem is. I had one doctor tell me I have copd and asthma just because I had a sinus infection. Also when I have bronchitis I don’t breath very well. Like most people. I haven’t had that for 5 years or more. I’m getting better on my own and doing what I’m doing. Any suggestions!

    • Hi Cheryl,

      Thank you for your message and your interest in Dr. Hyman’s work. If you are interested in a different approach you might consider a practitioner of functional medicine. To locate one in your area see the “Find a Functional Medicine Practitioner” link at the Institute of Functional Medicine website:

      Wishing You the Best of Health!

      Dr. Hyman Staff

  • I realize this is an older article but I just want to say you almost had me convinced. That is until I read your recommendation to take 1200 mg of red rice yeast twice a day. I encourage all other readers to do their due diligence and research red rice yeast on their own.

  • So my ldl wasn’t low enough so my doctor doubled my crestor dosage. Now my perception of crestor is that I get heady from the pills in the first place and real muscle pain, god knows what it must do to my heart. So I doubled my exercise, no fat in my diet, lots of veggies. Also found I could buy red rice from the local shop (which crestor is fabricated on), with much fewer side effects. Also I could regulate the dosage by consumption. I see clients who had bypass surgery 30 years ago, and are in good shape, not sure about these coated and uncoated stents, wonder why they haven’t developed a device for reaming out an artery, like a waterpick effect, laser, highfrequency flush out, guess they don’t involve a pharmaceutical product

  • Can we request Dr. Hyman to post a topic of how he would treat a patient with Takayasu Arteritis- an autoimmune disease. What diet they should have?

  • I was taking Red Yeast Rice for my high LDL. Until it was no longer effective. I was put on Lipator by my doctor. It caused liver function problems. No bile production.
    I have been eating a low fat, no meat diet for years. No hamburgers, french fries, etc. I am a chicken and fish guy. Grilled or baked only. Lots of fresh veggies. My total cholesterol was 229 at my last test.
    So, I eat right, cannot take statins. What do I do?

  • I was liking what was being recommended until I hit the Red Rice Yeast line..and I lost all respect for you and your railing against Statins..

    Red Yeast Rice contains the same ingredient as lovastatin.. what a crock! Worse, you don’t have any clue what you are buying because the FDA goes out of its way to make sure you are not getting something worth buying.. if you are going to take Red Yeast Rice.. just get the $4/month statin at your local Walmart or competitor.. and at least you will be getting a known dose.. lame..

    I am deeply suspicious of statins and have elected to take Slow Release Niacin with good results.. but this is not something I see here.. mmmm.. and yea.. don’t bother with that so called “No Flush” Niacin.. you are just risking liver damage for no benefit.. whats the point?

    • Hi David,

      Thank you for sharing your concerns about RYR. The truth is that not all RYR in the states has the active constituent (statin-like monacolin constituents) which you are expressing concern about. Actually, RYR contains a plethora of healing constituents (healthy monounsaturated fats, sterols and isoflavones) which might be responsible for its cholesterol-lowering and anti-inflammatory effects. We hope you will reconsider the healing attributes of this traditional medicine carefully suggested by Dr. Hyman!

      For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to: OR call (800) 892-1443 to get started.

      In good health,
      The Nutrition Coaching Team

  • I’m off my Lipitor (20mg) for 5 weeks due to muscle soreness in the upper arms and will be exploring options with my cardiologist when he returns from vacation.

    I had tried Niaspan but had side effects (waking up on fire) so I dropped that.

    I would like to start following your recommendations but am having a very difficult time finding a multivitamin with the right formulation – Lipoic Acid, Biotin, etc. Any recommendations?

  • My lipid tests came back and I heard a nurse scream to the telephone: We need you here ASAP!!! You LDL has gone up by 60 points from 110 to 175. My total # was 235. She didn’t even bother to go over the other #’s. But I did.They were as follows: blood sugar: 72, triglycerides: 75, HDL: 55. So what’s the big deal, I asked? She agreed further into going over these #’s that there’s really to reason for alarm because based on those #’s there’s very little indication of chronic inflammation.

  • Started on statins,(simvastatin), for approx 3 yrs. when I first went on them I began having headaches. Dose was increased to 40mg. Began having headaches all the time. Other side effects, cognitive problems,can’t remember things can’t concentrate. Feeling depressed and anxious all the time. Would love to get off statins.

    Hello I’ve been diagnosed with high cholesterol last summer. I was so disappointed as I am the kind who eats health foods,i visit Mac Donnalds twice a year, because I was born to a family of farmers, I have been taught that cooking our own meal is the best for our health,dispite the blood tests for liver profile recently and endoscopic and other imaging tests in the past,not showing abnormalities, my liver does not agree with fat foods
    (so naturally I tend to eat healthy)! since my diagnostic I’ve been fighting this tendency as I exppected it to go away on itself once I assumed that was only a storm going on inside my body which would soon calm down.There was no much i could do as i had health lifestyle already;i forgot to mention that my work is very physical, on top of that I swam once or twice a week and do belly dancing once a week.EVEN THOUGH I STARTED PILLING ON WEIGHT! shocking!
    3 weeks ago on the 26th of April i was put on Simvastatin 40mg because the bloody thing was still increasing
    The very next day I sick in the morning,spent the day light headed and just could’n bring my self to concentrate on my studies, those symptons improved but on Wednesday last week new symptons appeared : Back pain that goes and comes back,My back got stiff on wednesday,sunday and yesterday again
    I still have trouble concentrating on my studies,I am forgetful and my urine is much darker and I’m also tired,beyond the normal
    I’m so pleased I’ve found these informations here because I pretty much believe there must b reasons rather than bad diet and lack of exercise that lead to high levels of bad cholesterol.the science should focus more on that
    I am expecting a phone call from my GP today to discuss the side effects of the tablets and either or not to stop taking it

  • I don’t know whether it’s just me or if everyone else experiencing problems with your website.
    It appears like some of the written text within your posts are running off the screen.
    Can somebody else please provide feedback and let me know if this is happening to them as well?
    This may be a issue with my internet browser because I’ve had this happen previously. Cheers

    • It sounds like an issue with your browser, please clear the cache.

      Wishing You the Best of Health!

      Dr. Hyman Staff

  • I had been taking Lipitor for nine years and had severe muscle cramps which my doctor ignored,so I took myself off for five weeks and the muscle pain levels have increased again and he put me on 10mg.of zocor about a month ago and the muscle pain is back,he does not believe that it has anything to do with the. Medication,what else can it be?please help I am a caregiver for my husband I am 73 years old,what else can I do for my health.

    • Thank you for your message and your interest in Dr. Hyman’s work. Your question and constellation of symptoms represents a complex medical condition. Questions regarding conditions like these cannot be answered in a responsible manner via the Internet. Please consult with your physician on this matter.

      Wishing You the Best of Health!

      Dr. Hyman Staff

  • I don’t mind discussing this openly as I hope it will help someone.

    I’m a post-menopausal woman. I had an inkling last year that something was seriously up with statins when my primary care provider told me that if I didn’t comply with her request to take statins at the dose she recommends, that she would be financially penalized by my insurance company. My jaw hit the floor.

    When this occurred, I hadn’t been taking the statin prescription because I was on the max dose of Vicodin (max dose of Tylenol!) pending double knee replacements and had been for more than 1.5 years. I just didn’t want to hit my liver that hard by adding the statins. I figured it was safer to risk not taking them than taking them. (I had the replacements nearly a year ago and am pain free, very mobile, and Vicodin free. 🙂 ) Also, I’ve been hovering around being a borderline Type 2 for four years (stable) after having RNY, before which I’d been Type 2 for nearly a decade (metabolic syndrome). I don’t want to do ANYTHING to go back to that place! I’d been hearing about the statin-diabetes connection.

    So then I found The Great Cholesterol Myth book, and what Dr. Hyman and others have written. And I’ve been eating really well and exercising. Went in for my annual yesterday and got read the riot act to the point that it sounds like she may quit me if I don’t comply, because of my LDL number and total cholesterol. Never mind that my ratios are excellent, as is my CRP. Never mind that my HDL shot up 30 points and is AWESOME! (I suspect my LDL and total cholesterol went up from the healthy coconut oil I’ve been consuming.) She also won’t authorize the tests to find out what size my particles are as she doesn’t believe in it.

    I feel so much better without the statins. I really don’t think the evidence is there to take them, especially someone like myself who is so close to that Type 2 boundary. However, I have requested through the contact form to go see Dr. Hyman and/or his staff since I’m in MA. Can’t wait to talk to them about it.

    Thanks for the info, Dr. Hyman! Hope to see you soon!

  • You should update your recommendations for red rice yeast. In the US it no longer contains but trace amounts of the cholesterol lowering substance, due to disputes between the pharmaceutical industry and the FDA on whether it is a drug or a supplement. So far, the pharmaceutical industry has won.

  • In July of 2012, my weight was 146 (I’m 5’4″), HDL 98, LDL 107, Triglycerides 45, Fasting glucose 89. I developed a foot injury and when my numbers were rechecked in Jan of 2013 my wt had increased to 154 lb (secondary to decreased activity), but b/c I was still eating reasonably well my cholesterol #’s were still good: TC 237, HDL increased to 105, LDL up to 120, Trig up to 58, Glucose still good at 88.

    I had surgery on my foot which improved the pain, however in the spring I switched to a 5d/wk job. (I’m still seeing a pain mgmt doc for compensatory hip/back pain r/t the foot injury.) I foolishly thought I’d be able to be more active b/c of the better hours, but instead. found myself stressed and too tired to cook. As such, we began eating “garbage” most of the time. I switched PCP’s in July and we ran fresh labs for my initial physical. After only FOUR months of junk food I had gained another 6 lbs (total 1 yr gain was 14 lbs!) and my TC was 245, HDL had dropped to 95 (yeah, I know that’s still a great #, but that’s a 10 pt drop in FOUR months!); LDL had increased to 131, Trig increased to 93! The only good thing was that I finally got someone to measure VLDL and it was 19.

    I have now quit working and we are back to eating “real” food (read: home cooked). So, I figure that I can bring my LDL and Trig back down fairly quickly, however w/the SVT, most exercise is out until we figure out what is going on. (All I have to do is stand up and HR pops up to 130-140’s. Echo was perfect. I’ve turned in my event monitor last week. Treadmill showed some EKG changes w/activity but my HR did level off in the 180’s. What I had assumed were panic attacks from my crazy stressful job is actually SVT. Great. I don’t have a plumbing problem, I have an electrical one!)

    (For those who fall for the “statin” solution, it really is possible to turn your numbers around just by changing diet/activity. I know this b/c in 1996 my TC was 221, HDL was 46, LDL was 133 and Trig were 212! I was 35 yr old at that time, I’m 52 now. My husband and I did “Body for Life” in the early 2000’s which totally changed how we ate and our numbers have been better ever since. We eat real butter, eggs, bacon (an occasional treat!), mostly lean meats and/or salmon/tuna or shrimp, tons of veggies–esp the low glycemic ones, lots of beans, and limited whole grains. We use canola oil 90% of the time, and olive oil the other 10%. We do allow ourselves some junk, but w/the exception of veggies, we eat pretty much everything else in moderation. Outside of the crazy job-induced months long fast food binge, we eat very few refined or pre-packaged foods and we avoid margarine and trans-fats. Of course, exercise is important.)

    So now my question: I noticed when I saw my “new” doc (the cardiologist), that he dx’d me w/mixed hypercholesteremia. Seriously? I mean, yeah…my LDL is 131, but my HDL of 95 and VLDL of 19 kind of balances that out, doesn’t it? All of my ratios are still well WNL and the rest of my lab work (CBC, Chemistries) w/the exception of a low Vit D level (now corrected) are also WNL. It just seemed odd to me (an RN) to be dinged w/that dx since the most important numbers are all good. At the same time, I will take great pleasure in reversing my LDL just to show him it can be done!

  • My PCP has tried me on Lovaza, Niaspan, Crestor, lipitor, pravastatin. The Lovaza and Niaspan were not effective. I had immediate side effects from the statins. At my last office visit, I asked for the particle size test. I will find out the results this Thursday. I have come to the conclusion that I am statin intolerant. My doc gets impatient with me, but I am a nurse and I see a little more than the general public. I don’t think we see all the negative data on statins. Big pharma only has the bottom line in their sights. I take a bp med. my pressure is normal when I am not working. I work 12 hour shifts 3 nights a week. I know that my schedule has a lot to do with my health. I am due to retire in the next few years. I expect my general health, which is good, to be optimal at that time. I don’t believe in jumping on the band wagon of some drugs. I am now going to purchase your book. I have the book “the cholesterol myth”; in it, the authors do not give statins women, children or men who have not had a cardiac event. I have come to the conclusion, after reading and listening to the doctor authors, that sugar and the inflammation due to it are the big culprits. I have been doing MEGA amounts of research regarding cholesterol and related issues. I apprise my PCP of my findings. He is willing to listen, though, I suspect somewhat skeptical. My gut tells we “RUN” when statins are suggested, but, as stated, I have given a few a test drive. I know my body. I detested the muscle cramping, the foggy thinking, the spectator-in-my-own-life feeling that I experienced within a day or day and a half of initiating each one. I was thrilled to find your website to add to my arsenal. Keep up the good work. There are legions of people like myself looking for solutions.

  • Does Dr. Hyman take patients from out of state? I have been researching on line for my husband who has hereditary cholesterol. We do not like the crestor which he is currently on which is causing heart palpitations as a side effect. He travels to MA on business every once in a while. Does the Dr. believe what he is saying as far as vitamin supplements apply to those with hereditary cholesterol?

    • Thank you for your interest in Dr Hyman’s work. Unfortunately Dr Hyman cannot provide personal medical advice in this forum. For more personalized nutrition advice, Dr Hyman’s nutrition coaching team would be happy to work with you on an individual level to help you reach your goals. To work with the nutrition coaching team please go to: OR call (800) 892-1443 to get started.

  • I like the helpful info you provide in your articles.
    I will bookmark your blog and check again here regularly.
    I am quite certain I’ll learn many new stuff right here! Best of luck for the next!

  • I am a 54 year old female in fairly decent health leading a fairly active life and attending the gym at least 2-3 times a week. I have been told for years that I have hereditary high cholesterol that requires a drug intervention or I will be at a much higher risk for heart disease. I cannot take any of the statin drugs without experiencing most of the identified side effects in a harsh way. I even tried red rice yeast, which lowers the cholesterol levels without so many harsh side-effects, but is only suggested to take no longer than three months. Your article above makes so much more sense to me than what my medical doctors have told me. I honestly feel like they are always treating just a small symptom or result of my overall issue. I have grown tired of the medical society, and so I took classes and began educating myself on my body, proper nutrition, a daily movement program, and my zen health by reducing the toxins (environmental, stress, etc.) in my daily life. I go for blood work again tomorrow, we will see if my strategy has had an effect on my numbers, because I know I am starting to feel better with more energy and clarity than ever before.

  • I just got the call from my doctor that I need to come see her about high cholesterol on recent blood test results. I’m obese (wow, it’s hard to use that word to describe myself- I’m definitely in denial!) and am certain I have metabolic syndrome based on the symptoms you discuss in various blogs. I also have a leaky gut. I’m glad to know that I can address cholesterol without taking drugs like so many other people I know. In fact, I consider this a much-needed wake-up call.

    Thank you for all the information you provide on the internet, free of charge. I’m glad our society is starting to take the principles of functional medicine more seriously – I know I do! I don’t know why so many of us would rather take drugs than do the ultimately pretty simple things that would give us better health overall.

    Thanks, Dr. Hyman!

  • Just met with my doctor to review my NMR blood test results. He said pretty much what you said while reviewing the importance and danger of small cholesterol particles. My small particle count was very high and he really stressed diet changes. Not so much the good night’s sleep — I’m terrible at that — or vitamin supplements. But he really hammered at the diet changes, with a class from a nutritionist if necessary, and preferred it over medication as a first step.

  • My current HDL is 254 and my LDL is 80. After reading your article on cholesterol, I had a particles test last Oct. which indicates HDL-P (total) of 40.8; small LDL-P of 647. Under the “interpretative information” it indicates HDL-P of 34.9 and small LDL-P of 117. Not sure what the numbers indicate. My triglycerides are 97 mg. I’m 72 yrs. old and take 88 mcg of Levothyroxine, omega 3, vitamin D and Citracal.

    I would appreciate your opinion.

  • “His triglycerides were 176 (normal is less than 100)” I thought normal was 150-300? and 100 or below is optimal?

    • Hi Mark,
      You are correct. Most labs reference <150 mg/dl as the normal range, however Dr. Hyman recommends <100 mg/dl as optimal.
      Wishing you the best of health,
      Dr. Hyman Staff

  • and HDL normal for men is 40 and above 60 optimal. guess it depends on the testing lab.
    I live in Japan and my doctor wanted to put me on Lipitor.
    non fasting levels.

    HDL 45
    trigycerides 106
    LDL 155-

    I have a BMI of 25 but I am very muscular and wast is 33

    I am 43

    He looked at the LDL and immediately wanted to put me on sterols. He was curious why I didnt want to be on drugs.

    I have a pre-med degree but I can read the research but it seems doctors don.t read the research fro the last 20 years. I just dont trust general practitioners anymore. They always give me advice based on oversimplified tests that apply to the norm. They always say I am overweight based on height and weight despite being very muscular. Its really scary how ignorant they seem

  • I have been fighting with my doctors for year since I was 40 I am now 50, everytime they have put me on statins I have muscle pain my brother is the same, I am not obese I am 5’5″ and a uk 10 dress size, I have high colestrol I do not want to take tablets for this and I know that if i am stressed my colestrol is higher, I am going to ask my doctor about the test you recommend on my next appointment

    thank you for this information on your site


  • My husband & I have never been on any pills at all until we move from one province to another (Canada). Before we knew it we both were put on Statin and myself on high blood pressure pills. I was shocked! Yes there is muscle pain etc. and I told my GP that I reduced the mg. from 30 to 10!
    In my frustration a friend recommended “The Blood Sugar Solution” since myGP. figured I am borderline diabetic. Yes I am a little overweight, yes I smoked as well. After reading the book I quit smoking and have gone strictly by Dr. Hyman’s book. Within the first week I have lost 6 lbs. and feel fantastic. I want to prove to my GP that there are options and not just pills which I don’t believe in anyway.
    Thank you, Dr. Hyman, for the book.

  • Hi, I’m a 54yr old man started a graphic design company and have been in the business since 1984 I have always lived life to the full and stress and worry is an occupational hazard. I have had a 10yr gap in my carreer where I went through a divorce and loss of everything in my life suffering depression and a mini stroke I should actually be dead.. my company is now failing and the bills are piling up despite working 24-7 7days a week I have just had my blood tests back from the doctors and surprise everything is off the scale .. I am a diabetic type 2 have a high colesteral and I smoke (due to the stress and worry) I am currently perscribed Atorvastin 40mg Metformin 500mg Levothyroxine 50mg Aspirin one a day and omeprazole to stop my stomach from exploding I guess! I haven’t realised till I just read about them that these drugs are causing me to live less of a life than I would like, for instance I know now why I have less than a normal sex drive, and when I did get the chance I couldent do anything about it….I want off these drugs and want to do everything to give myself the chance of a few more year, I am willing to do all it takes.. can you help me? I have two kids and I’d like to stay around to see theirs.. help? Steve

    • Hi Steve,

      It sounds like you are ready to start taking charge of your health and getting back on the path to feeling great! It sounds like you have a lot of challenges in your life, but you are by no means doomed. Sometimes taking the first step is the hardest and by doing research and taking ownership over your health you are starting the right track, so great job! Following the tips outlined in the article can help you manage your cholesterol but you may want to look into the 10 Day Detox to help reform your lifestyle, lose some weight and help break some unhealthy habits. The book can be found and the website provides community, tools and resources to help you to start feeling great again.

      Thank you so much for sharing your story and contributing, good luck on your journey to health!

  • My family cardiac history is horrific! My Mom was 47 had her 1st triple CABG, and has since under gone a second single CABG, my Dad also had triple CABG with a 90% blockage in the widow maker? My Moms two Brothers & Sister all under went CABG & my Maternal Grand Mother died from heart disease. My Brother has been on two statins since the age of 38. Ok I, enough about my family. I’m 45 & was a lacto-ovo vegetarian from the age of 12 till 35 then started eating fish. I was exercising twice a day mostly cardio for a total of 5 miles and my cholesterol was perfect. Then I hurt my back was out of exercise for almost a year. When I could go back basically I didn’t because all I had worked to achieve was gone & I was frustrated. Then at the age of 40 I started eat g chicken after my MD said he thought I was having GI issues with gluten and wanted me to stop eating white flour for awhile to see if it helped. I’ve always had my cholesterol levels checked yearly. Last year I decided to start trying to lose some weight as I’d put in 30 lbs over the previous year and my GYN reminded me I was on a straight coarse to the CABG table. So, I started. working out again pretty regular 3-4 times a week & started taking Organic virgin coconut oil in April, May, then had my yearly cholesterol done in June with a total cholesterol of 201 highest it’s ever been, triglycerides 187 and weighing in at 186 lb@ 5′ 7″. So I stopped the coconut oil and increased my workouts to up to 2 hrs a day. And improved my diet some what. Aug I had blood work again cholesterol increased to 210. Continued with my increased cardio workouts, takin 500 mg Niacin twice a day and less fatty intake of food. January had my blood work done again my cholesterol is still @ 210. continued on the same path, May had my yearly blood work done cholesterol 212. Go see a cardiologist who looks at me like I’m obsessed but entertains my concerns agrees to 1at do a lipo-profile and if it comes back bad to do a calcium marker test that will cost $200.00 and insurance won’t pay for it. So, his Nurse calls me and says my LDL is Mod to High risk he wants me to go on a station 10 mg a day. Of coarse I said absolutely not, that’s NOT what we discussed I will be into see him on July 2nd.
    In the mean time my own Brother @ 54 years under went cardiac catheterization for chest pain to find 5 blockages 1 @ 50% 2 @ 40% & 1 @ 30% the worst one @ 80% in the widow maker & a stent placement. This of coarse has terrified me and my one Sister and I’ve become extremely stringent on what I consume eating mostly fruits & vegetables with some all white albacore tuna and only white meat chicken. I also began taking fish oil, flaxseed oil, niacin again, RYR, CQ-10, a chewable fiber supplement and probiotic every other day. I’ve set up an appointment with a Certified Nutritionist who has a specialty background in herbal medicine. I truly don’t want to go on statins. But, I also don’t want to have a zipper put in my chest or worse DIE before I see my Grand Children’s Graduate or get married. Is there anything more I can do naturally? Thank You for taking the time to read and answer my questions a he’d of time.

  • 48 y.o. Male – What number is considered low enough to use bio-identical testosterone. The range on the tests just done is 262 ng/dl – 1593 ng/dl. Mine, taken 9am after 12 hrs fasting was 288 ng/dl. I’ve been following Blood Sugar Solution for nearly 2 yrs and still have excess belly fat despite cardio and diet. Blood sugar is 95. HDL somewhat low, LDL somewhat high. NMR Lipid Profile is normal. I take many of the supplements recommended in BSS for energy, but sitll have low energy/apathy. Have unresolved depression after 9 mos. on 100mg Wellbutrin. I meditate and do yoga for stress.

    The doctor refused to write the testosterone before trying something else. They prescribed 10mg DHEA and pumpkin seeds.

    I’ve seen bio-identical testosterone mentioned in BSS and numerous articles, but never a blood level stated at which it should be prescribed. Can you tell me that and how a long a course is recommended to see if levels increase w/ follow up blood work?

    • Hi Steve,
      Thank you for your interest In Dr. Hyman’s work. Unfortunately he cannot provide you personalized medical advice in this forum. In order to provide you the proper care you need we hope you will seek the attention of a local qualified Functional Med practitioner soon. To locate a doctor near you who practices functional medicine like Dr. Hyman, go to and scroll down to where it says “locate a practitioner” and enter your location. Progress accordingly from there.

      You can also make an appointment to be a patient at Dr.Hyman’s UltraWellness Center in Lenox, MA. Please go to:
      Wishing you the best of health,
      Dr. Hyman Staff

  • I wasn’t looking for personal advice. I was looking for a number or consistent range of numbers at which Dr. Hyman or other Functional Medical doctors who are familiar with the benefits of short-term use of bio-identical testosterone would consider its use with a patient. In the same way that in BSS regarding TSH Dr. Hyman writes that the American Society of Endocrinology now thinks that TSH below 3.5 should be considered low, but that the ranges produced by labs have not been adjusted to reflect this new understanding. I am looking for similar range or number from someone who has the latest information. While I appreciate your suggestion that I visit Dr.Hyman’s clinic as one who has been unemployed for a year as $1300 office visit is not possible. So I’m trying to find the information that I need through other means.

  • hi this is robyn just had a test done on my cholesterol and it was high my ldl so i just looked up this site so i can better myself on what is cholesterol.

  • NoFlush Niacin 500 mg – I don’t understand – I bought it over the counter here in South Africa in the health / supplement section? Because I’d read so much on it I decided to pour out bits fromthe capsule and take a tiny bit at a time (I AM a trully allergic person) and nothing happened so I’m taking 500 m in the morn and 500 at night with food. I am also looking for Lipostabil Forte (which was the very first drug for people with HeFH in the early 80’s. I am quite certain that the statin companies squashed it out of the market. Can’t find it in South Africa at all and we have the MOTHERLOAD of people with HeFH. None of my family can tolerate statins any longer (my son has had quintuple bypass surgery – he was the youngest patient ever to undergo heart bypass at this heart hospital. A keto diet halved my numbers, but I don’t promote it. I did it for myself and it worked. I cannot force my children (both have the disease) to do the same. I think I am the only person in the universe with the disease who went onto LCHF 2 years ago and my doctors were astounded with my results. People of my ilk are simply too frightened, so they stick to low fat foods and still get bypass. Oh well…. Thanks for the article.

  • Hi there,

    My fairly healthy husband, 37 years old was put on Crestor a few years ago and then went off. 3months ago he was tested and his results were pretty bad.
    Triglycerides 205
    Cholesterol 228
    LDL 154
    HDL 31

    New results after following most of the above supplements for 3months and eating well the last year are:
    Triglycerides 51
    Cholesterol 220
    LDL 160
    HDL 36

    He has always been active and eats quite well. When he first had high cholesterol the doctor was quite surprised since it didn’t make sense that it should be because of his lifestyle and age. I cannot tell if his new results are better or not. Or if we should continue with supplements of if he should consider taking statins again.

    Any insight will be appreciated.

    • Hello Tahi,
      Thank you for your interest In Dr. Hyman’s work. Unfortunately he cannot provide you personalized medical advice in this forum. In order to provide your husband the proper care he needs we hope you will seek the attention of a local qualified Functional Med practitioner soon. To locate a doctor near you who practices functional medicine like Dr. Hyman, go to and scroll down to where it says “locate a practitioner” and enter your location. Progress accordingly from there.

      You can also make an appointment to be a patient at Dr.Hyman’s UltraWellness Center in Lenox, MA. Please go to:

      Did you know you can work with Dr. Hyman’s nutritionists virtually? For personalized nutrition coaching where you can receive 1:1 support with Registered Dietitians, please see:
      Wishing you and your husband the best of health,
      Dr. Hyman Staff

  • A question on this recommendation below.

    A multivitamin including at least 500 mcg of chromium, 2 mg of biotin, and 400 mg of lipoic acid.For most you will take 3 capsules twice a day

    Is he suggesting the above as total quantity…so 3 capsules should add up to 500mcg of chromium and 2 mg of biotin etc or take 2 mg and 500mcg of chromium 3 times a day.

  • Red rice yeast…is another statin. Just not in a pill. From consumer reports: “Red yeast rice (rice extract fermented with a strain of red yeast) really does reduce cholestero­l, not surprising since it contains the same active ingredient as a real statin drug called lovastatin (generic, Altoprev, Mevacor – ). In 1998, the Food and Drug Administra­tion ruled that red yeast rice products were unapproved drugs, not supplement­s, and therefore illegal, but it’s still easy to purchase the products online. Our experts say that taking red yeast rice exposes you to all of the risks of taking a prescripti­on drug, with dubious benefits. First, you really won’t know how much you’re taking. As with all supplement­s, there’s no guarantee that what you buy will contain what the label says it does, since the FDA doesn’t regulate the manufactur­ing quality for supplement­s as it does for drugs. Second, you may be taking a powerful drug with the same potential side effects as the prescripti­on counterpar­t but without proper medical supervisio­n” Niacin can have pretty severe side effects…­beyond the red face rash and flushing, it can also trigger a gout attack. There are many plant sources of beta-sitos­terol, but the most important are wheat germ, rice bran, flax seeds, peanuts, soybeans, pumpkin seeds and corn oil. Muli and co-workers showed that a plant-base­d diet, rich in fibre, soy and flax seed, can increase serum levels of beta-sitos­terol.

  • I am interested too in not taking statins. I took Crestor, Lipitor, Livilo, and generic ones. All gave me muscle pain so bad I could hardly walk. Many were so expensive that I couldn’t afford them either. My doctor is on my case all the time about how high it is. It runs in my family and hear disease is there too. I had open heart in 2000 and took meds faithfully after that. None helped. I am going to try your way of lowering my cholesterol. Thanks for posting them.

  • Some background. I worked a sedentary, high mental stress IT job for a couple decades. I tried to move as much as possible and eat what was, at the time a recommended healthy diet, but of course there were exceptions, and my weight is about 15-20 pounds over where it really should be. And sugar. Yes, many times I have not been able to resist the sugary treats.

    Because there were always layoffs pending, I never went to the doctor because I didn’t want to have a pre-existing condition in case I had to get private insurance ( this was before ACA) and sure enough it worked, I ended up getting a private plan for a period of time. Then I got another job, but after a couple more years I somehow knew it was killing me and I quit last March. Now I am retired.

    Finally have insurance through ACA so I went to the Dr. and got the blood work done. I feel great, I exercise, don’t smoke or use alcohol or other drugs, don’t ever drink soda or sugary juices, eat what I thought was a quality diet, but what a shock when my cholesterol was 252, my triglycerides were 400 (!) and my small LDL particle number was 329. I couldn’t believe it.

    My doctor suggested statin but I wanted to read up on it first and I found this (and other) websites. It doesn’t sound to me like you can just take a statin, go on with business as usual and everything will be fine. So I have completely revamped my diet according to the suggestions on this & other websites. I’m taking a fish oil supplement (Norwegian Gold EPA 1000 and when that is finished I’m switching to Super Critical Omega). I’m getting a private lipid panel on Dec 6 just to see if I can move the needle down on the triglycerides and the total cholesterol by then, and based on those results will set a date to retest on the particle size.

    I have backed off from all processed foods, wheat, and most dairy (haven’t given up the nonfat milk) and have not eaten in a restaurant, and I am constantly shopping and cooking! There’s a reason all those processed food manufacturers got their hooks into us — convenience.

    It seems to me that already after only a week I have more energy? Anyway, we will see how it goes and thank you so much for providing this information, Dr. Hyman.

    • Many thanks to Dr. Hyman and the other courageous doctors and writers who have provided this invaluable information that allows people to read carefully and optimize their health.

      update: First lab was October 2014 second was February 2015. In the meantime I cut out sugar, nontraditional fats, wheat, all flours, and all dairy. I added fish oil and Vitamin D supplements. Changed to eating a lot of fresh and fermented vegetables, some fruit, and properly raised eggs and meat. I prepare whole grains according to the Sally Fallon cookbook (acid ferment overnight before cooking). Got a fitbit and log 10K steps pretty consistently in addition to other activity. I have lost 30 pounds without ever feeling hungry and have more stamina than before. My digestion has improved (you could have called it IBS it was that bad).

      Since February I have experimented with adding foods back in and I can tolerate goat milk and sourdough bread (fermented) made with einkorn flour.

      Triglycerides 401 to 103
      Total cholesterol 252 to 178
      HDL 52 to 65
      Non HDL cholesterol 200 to 113
      LDL particle number 1476 to 928
      LDL Peak size 210 to 221
      LDL Pattern B to A
      HDL Large 7251 to 5902
      LDL small 329 to 133
      LDL medium 259 to 171

  • Good day doctor.
    my good friend Martie.whittekin CCN.
    emailed the article above.
    I found it to be very informative.
    I have a question I’ve been on hemodialysis 11 years and it was caused by mercury fillings which is been removed.

    I’ve never been predisposed to diabetes and my ideal weight im active,I take supplements and I’m more careful with my diet than most people.

    Recently in the last year after having two NMR cholesterol profiles at LabCorp, it revealed my small LDL particle size has doubled, my HDL particles are in the lower range under 30%,my total cholesterol is 205, my triglycerides are 43 and my last hgb a1c test was under 5.

    I currently do not urinate but a few drops in the morning there for some of the tests used in determining mercury not available until there is an increase in urination.
    I have worked with a handful of holistic doctors I met through my work as a manager of the nutrition network and have improved in several areas but still would like to increased urination there for cleansing my body and while re gaining my natural kidney health.

    I’ve had a couple of close calls when receiving a kidney transplant but still would much prefer to do the natural option and avoid medications including anti rejection medicines in the future.

    Dr.Hyman in your experience do you believe that any residual mercury that can be in my system could be causing this problem with a particle size in relation to cholesterol?

    Thank you
    James Michael

    • Hi James,
      Thank you for your interest In Dr. Hyman’s work. Unfortunately he cannot provide you personalized medical advice in this forum. In order to provide you the proper care you need we hope you will seek the attention of a local qualified Functional Med practitioner soon. To locate a doctor near you who practices functional medicine like Dr. Hyman, go to and scroll down to where it says “locate a practitioner” and enter your location. Progress accordingly from there.

      You can also make an appointment to be a patient at Dr.Hyman’s UltraWellness Center in Lenox, MA. Please go to:
      Wishing you the best of health,
      Dr. Hyman Staff

  • Dear Dr. Hyman, my bad cholesterol is high and the good is low. I had a blood test several years ago and the doctor told me the results were that my cholesterol was like sand, the particles very small and if I didn’t go on Crestor he would not visit me in the cardiac ward. He fired me as a patient. He was the only doctor that sent off my blood test and told me about the size of my cholesterol, so I have no hard feelings over being fired. He also said that it is genetic and you can’t do anything about that but take the medicine. My current doctor just put me on Prevastatin, I would much rather go with the vitamin, exercise and good eating route. Which I do eat pretty good but could add a lot more exercise. One question do genetics trump everything else? Good news is I live in Cleveland so maybe I could come and see you one day myself.
    Thank you so much for posting this because it has been hard to find information on how to puff up your cholesterol!

  • I don’t think Kaiser will do this type of test. I simply asked for it and didn’t get it. It only shows
    me how low/high my cholesterol is. They do the lipo fasting type and not sure if that’s the same thing.
    I’ve never seen size particles on the test.

    • Terri, my mother requested the particle size test at Kaiser. It took her a while, because she was told it didn’t exist, but her spouse knew it did (works in healthcare), so my mother kept asking. She finally received it. She can’t remember the name of it, but don’t let that stop you. I am actually going to be asking for it myself this week.

  • I was put on a statin and was ok for about 6 months, then my legs started giving me pain at night. Eventually I couldn’t put my knees against one another without experiencing pain. I went online and read about others having the same symptoms. I reflected back to when she prescribed the drug and she had said that leg pain could happen and if it did to call her. Well I quickly weaned myself off the drug and went in to see her. She tried to prescribe another cholesterol drug and I said, no way. So now my cholesterol is 246, I’m pre diabetes and will try your diet and supplements. We’ll see. I hope it works. Thank you for the information.

  • 13/1/15

    I read with interest and mounting horror the article “Study could boost the use of statins” (the Age, Jan 10). I am 71 with a family history of heart attacks, but no problems myself.

    Somewhere around 15-20 years ago I was prescribed statins, as a preventative I assume. Recently, I ran out of the statin; a fortnight later, I saw a doctor new to my practice to get a script. Her first question was “Statin X? How are you managing the muscle pain?” My jaw dropped. For the first time in many years I was relatively muscle pain free – and it had happened in the last fortnight.
    So I stayed off them, and felt a lot better.

    “Potential hazards of the drugs include muscle damage and diabetes…” says the article but insisted it was still better to take it than risk a heart attack.
    These studies always work from an unprovable point – if you do X (take our pill) then Y (a heart attack) won’t happen. But we don’t know if Y was ever on the cards nor do we know when. It’s all guesswork, probability, chance.

    Looking back over the last 15-20 years, I started to add up the cost to me of taking statins, not in monetary terms, although that is considerable.

    I used to be a happy walker, not necessarily long walks, but certainly one to two hours on a regular basis, and longer walks when appropriate. Then I started getting severe muscle pain in my calves, causing me to stop walking every 10 minutes; over the years, the muscle pain spread to my lower back, further restricting me. Finally I was in a wheelchair, and resorted to a laminectomy, an operation on my spine, with little success. The muscle pain persisted – lower back, midback, calves, thighs, and I now use a walking frame whenever I leave the house. Now I walk very little because it hurts.

    That “potential… muscle damage” – did these people ever consider just how much damage, or how debilitating, or how irreparable this damage would be? And no, I do not have rheumatoid arthritis or other causes of the pain.

    Second problem – I started putting on weight around about the same time. This is a known side-effect of statins, but nobody told me. Instead, they criticise me for being fat and tell me I have to lose weight.
    Third problem – I was diagnosed as being diabetic – again, a known side effect of statin use. People working in the diabetics industry seem to be trained to blame the victim.
    Fourth problem – my blood pressure started to rise – so we up the blood pressure pills and keep the statins going.

    Now I have one lot of scientists/doctors telling me to take a drug that causes pain, stops me from exercising, makes me fat, and turned me into a diabetic all to stop me having a heart attack that I might never have anyway. Then I have another lot of scientists/doctors telling me I will have a heart attack because I am obese, have high blood pressure and am diabetic. They tell me that my fat causes my diabetes, that I should exercise more, eat less, and they prescribe more pills. Nobody questions that the fat might have a cause other than my sheer laziness or greediness.

    The pills that might stop me from having a heart attack have caused other illnesses that will cause me to have a heart attack. There must be some logic there, but I cannot see it.

    So, three months ago, I stopped taking Statin X, and immediately some of the worst of the muscle pain disappeared – but not all. Perhaps that muscle damage is irreversible. I doubt I will ever recover.

    A month ago, I had my regular blood tests. My HBA1C reading (for diabetes) was normal for the first time in years. My ALT reading (liver – consistently high) again normal. My weight – well, I have lost 5kg without changing my diet. And my blood pressure is down a little.

    Oh yes, my cholesterol levels are up, but there are a third group of scientists who believe that the recommended levels were set far too low – “Eight of the nine doctors on the panel that developed the new cholesterol guidelines had been making money from the drug companies that manufacture statin cholesterol-lowering drugs” (

    So, if you are taking statins, or your doctor suggests you start, think very carefully. They might, just might, stop you having a heart attack at some time in the future, but at what cost in the meantime? What about quality of life now? And if you do decide to take them, keep an eye on the many possible side effects. Remember, it’s your body, your life, not the doctor’s nor the drug company’s – they just make money out of you.

  • I have been taking Crestor for 5 yrs 10mg. now
    developed terrible aches and pains, all over,
    seems to be in muscles.
    stopped meds. but due to previous hert attack
    6 yrs ago Dr. said dangerous to stop
    Dont know what to do .I am diabetic for 15 yrs,on

  • I’m wondering about the effectiveness of your protocol for those of us with familial hypercholesterolemia. I don’t doubt it would have some positive effects, but I wonder if it has proven to be sufficient for those of us with the genetic predisposition? I was diagnosed by a traditional medical doctor with familial hypercholesterolemia at the age of 11. I was put on a statin for the first time at the age of 14 (mevacor) and at the age of 39 this is still an issue. Even when I am a very clean eater and exercising consistently my results are still high. Therefore, my medical doctors keep me on a statin. I’ve never seen anything specific to those of us whose bodies are creating a much higher ratio of LDL than HDL. Are there case studies specific for this condition coming from the functional medicine community? Thanks, Dr. Hyman.

    • Hi Jennifer,
      Thank you for your interest In Dr. Hyman’s work. Unfortunately he cannot provide you personalized medical advice in this forum. In order to provide you the proper care you need we hope you will seek the attention of a local qualified Functional Med practitioner soon. To locate a doctor near you who practices functional medicine like Dr. Hyman, go to and scroll down to where it says “locate a practitioner” and enter your location. Progress accordingly from there.
      You can also make an appointment to be a patient at Dr.Hyman’s UltraWellness Center in Lenox, MA. If you would like information on becoming a patient at The UltraWellness Center, please see “How to Become a Patient” at You may also feel free to call The UltraWellness Center at (413) 637-9991.
      Wishing you the best of health,
      Dr. Hyman Staff

  • I had two stents Putin my grion and stomach for blood clots they said my cholesterol was high but never told results they put me on Lipitor 10mg then my family doc did blood test and said my triglicerides were high and switched me to Creator 20mg after a few months I could hardly walk and told my doc about this she told me this was all in my head and not to worry But after reading the different post I took myself off the Creator and within a few weeks was feeling much better and was able to walk. I have a appointment coming up and will be making sure I get the results

  • I’m in my 50’s been taking b/p meds since my 30’s, and been on statins since my 40’s. I am fit, I run marathons, triathlons, 50 mile runs and ultramarathon canoe races. But have had belly fat. My dr. has mentioned my blood sugar being a little high. Everytime I go into my dr. I can feel my b/p shoot up…Drives me crazy. and I hate being on every med trying to control my b/p

  • I am 46 years old and have had cholesterol levels in the high 400’s since I was a teenager. At 5’7″ and 125lbs, I have never been overweight, pre-diabetic, hypertensive etc. My diagnoses is familial hyperlipidemia (small particle). I eat an organic diet and exercise …but have been frightened into taking statins for over 25 years now. (Both my father and brother died of sudden heart attacks in their 30’s.) What do you recommend for someone w/ my diagnosis? Thank you.

    • Hi Jenna,
      Thank you for your interest In Dr. Hyman’s work. Unfortunately he cannot provide you personalized medical advice in this forum. In order to provide you the proper care you need we hope you will seek the attention of a local qualified Functional Med practitioner soon. To locate a doctor near you who practices functional medicine like Dr. Hyman, go to and scroll down to where it says “locate a practitioner” and enter your location. Progress accordingly from there.

      You can also make an appointment to be a patient at Dr.Hyman’s UltraWellness Center in Lenox, MA. Please go to:
      Wishing you the best of health,
      Dr. Hyman Staff

  • I have the skeletal muscle breakdown problem with the statins, on both lipitor and pravachol. I was taking 1200 mg of red yeast Rice 2 times a day for 1 year, and it took 1 year, but developed the same problem as with the lipitor and the pravachol.
    My total Cholesterol is 276, my HDL is 56, and Triglycerides are 165. My doctors are now trying me on Welchol which only lowers the cholesterol but does nothing to prevent a heart attack.

    I do take 2000 iu of vitamin d-3 daily, but will increase it to twice daily. I take 1200MG of fishoil 2 times day, and take 200mg of krill oil once daily. Not sure where I can find the other supplements you have listed. Any vitamin store should have something called Plant Sterols, or Glucomannan,

    Where do you find a multi-vitamin that can be taken 3 times day, that is not a one-a-day or centrum which are huge pills and have a full-day supply of vitamins and minerals.

    If I took 3 Centrum multi-vitamins or 3 one-day woman’s vitamins a day, I would be so constipated that I would probably be hospitalized.

  • Great article!

    Rather than Red Yeast Rice which acts like a statin, I take Garlic, Plant Sterols and Policosanol [at bedtime 20mg]. Great results.

  • I am a 54 year old femal, 5′ 8″ 175 pounds. After taking low doses of Lipator I have noticed feet problems the past five years. My heels bother me and I have tingling numb toes. I also have developed Lichen Plano Pilanis which causes perminant hair loss. I often wonder if these have been a result of the a lipator. I have been tested for diabetics and told my sugar is fine. I will be asking for clarification next time.

  • I just wanted to say that after drastically reducing sugar, eggs, and milk because of my leaky gut and food intolerances my cholesterol drooped on its own 40 points and my BP also normalized… this with not much exercising but I’m working on that too 🙂

  • Dr. Hyman – read your article with interest. As a invasive caridologist I deal directly with heart attacks, plaques etc. I do have a question. I don’t mean to be a contrarian but but would like to understand this from a Functional Medicine Standpoint.

    In my experience, since the Statins – incidence of acute heart attacks has gone down (although not of heart disease). I spend more time with stable patients in the office than in the Emergency Room or the Cath lab. Infact, although I see more more patients now, I actually do a lot less invasive interventions. I think a loto f this can be attributed to Statins and newer antiplatelet agents.

    More importantly, on a macro scale – Statins have been studied inside and out. Most studies have validated the benefit of Statins from a reduction in acute coronary syndromes. If indeed the target is wrong, why do we consistently see a benefit in statin utilization? (Of note, I am not refuting your comments about metabolic syndrom and LDL-P – I am onboard with that and that awareness can only help us get better outcomes)

    In my opinion combining statins and treating Metabolic syndrome is possibly the best way to go.. Look forward to your comments

  • Great article! I have long been frustrated with the leaning toward medication in this area. I would like to get more background information, though: I’d like to know the references for studies on the work showing the relevance of HDL and LDL size, as well more on metabolic syndrome. I didn’t see references listed for those at the end of the article.

  • Great article. My husband is 42 and just had basic labs drawn and he is a little worried. Let me tell you some background, he and his mother and siblings all have LOW total cholesterol. So low a local university has been studying them for years. During these studies there has not been any concerns brought forward to any of them. He is the youngest of ten. So recently after his new md received his labs the office called to tell him the results. They were a little surprised I think. His total cholesterol is 72 with his HDL only 19 which is up from 13 in the past. At onetime his total cholesterol was in the 40’s. His fasting blood glucose was 105. He does have a family history of diabetes and hypertension. He is on a small dose of lisinopril. Instead of adding a prescription of niaspan I wanted to explore other options for him. We recently went grain free and are trying to eat clean. Where should we go from there? I am going to see if the doctor’s office will order the special cholesterol test you mentioned as well. Thank you.

  • I enjoyed and learned from your article, thank-you. I was wondering if you could go into a little detail as to why supplements are a part of your plan. Eating the right foods and exercising makes sense…but that isn’t enough? Is it simply the fact that I would have to eat a WHOLE lot of beef livers to get adequate amounts of CoQ10!? 🙂 I am definitely interested in the most natural approach to keeping my body in its healthiest state. I am in my 40’s and my HDL has been consistently low, LDL high, and triglycerides high since my 20’s. I have always been thin and have a low BMI. I am a low energy, sedentary person, and I am learning how different the American diet should be. Thanks again for the information you have shared.

  • Heart transplant 5yrs post doing everything right and yet cholesterol is continue to rise they say “due to immunosuppressants” recent heart cath now showing 60% blockage. Your discussion is very interesting would love to have some help and advice, am an open book , want to correct this if a all possible.With a grateful heart, Jeff

  • Hi, I am wondering if you can send me links to studies done on the work showing the relevance of HDL and LDL size, as well more on metabolic syndrome. I am not sure why you would not be providing those, if such studies have been done.
    Thank you,
    Raelin Mariel

  • I’m a 28 year old female with a strong history of early heart disease on my father’s side. My paternal grandmother dropped dead of a heart attack at 44 and my dad had his first heart attack at 32 (4 bypass surgeries since then, he’s now in his 50’s). I’m paranoid about heart disease but make terrible lifestyle choices considering this fear and genetic predisposition. My LDL is 143, my triglycerides are 136, my total cholesterol is 197, but my HDL is a disturbing 27! I’m seriously considering switching to a plant based diet because I don’t want to continue on the genetic legacy of early CAD.

    Can you tell me your thoughts on having such a low HDL at such an early age? It causes me debilitating fear and I’m always terrified that I’m going to have a heart attack at any moment (manifesting as panic disorder). I know that I’m heading down a bad road if I don’t change my lifestyle, but I guess what I’m wondering is how severe are my cholesterol issues for my young age and gender? Is there still time for me to undo the damage? Thanks for answering my (possibly irrational) questions.

  • sir my serum cholesterol is 279 and serum triglyceride is 319 my serum hdlc is70 my serum ldlc is 145 sir this is my request please sir help me to control my cholesterol I will be greatfull to you thank you sir

    • Thank you for your interest In Dr. Hyman’s work. Unfortunately he cannot provide you personalized medical advice in this forum. In order to provide you the proper care you need we hope you will seek the attention of a local qualified Functional Med practitioner soon. To locate a doctor near you who practices functional medicine like Dr. Hyman, go to and scroll down to where it says “locate a practitioner” and enter your location. Progress accordingly from there.
      Wishing you the best of health,
      Dr. Hyman Staff

  • Hi Dr Hyman,

    I am 26 years old, I am very active I eat very well but I have high cholesterol. The first time I checked it was 330- with my HDL over 100 and triglycerides below 40.

    I have checked again and it is 290 with my Hdl in the 90s. I don’t smoke, drink and as i said I exercise almost every day. My doctor has put my on a high dose of omega 3 fish oils but says if my numbers dont improve in 3 months he will put me on statins.

    That is the last thing I want to do. How would you recommend I lower my cholesterol naturally as i am such an unusual case.

    • Hi Maryam,
      Thank you for your interest In Dr. Hyman’s work. Unfortunately he cannot provide you personalized medical advice in this forum. In order to provide you the proper care you need we hope you will seek the attention of a local qualified Functional Med practitioner soon. To locate a doctor near you who practices functional medicine like Dr. Hyman, go to and scroll down to where it says “locate a practitioner” and enter your location. Progress accordingly from there.
      Wishing you the best of health,
      Dr. Hyman Staff

  • Dear Doctor,

    I am 40 year old female. I do not drink or smoke, I am pure vegetarian. My blood profile was never this bad. Last month I had my blood tests and report came quite contrast to the previous one (I can’t remember the last units correctly). This time, Cholesterol- 5.24; Triglycerides- 2.67; HDL- 1.47; LDL- 2.55; non HDL cholesterol (calc)- 3.77; Hs CRP- 5.0; Ferritin- 6 (12-125); TSH- 4.43; free T4- 12 (12-22); Hb- 111.
    Earlier my Doctor used to put me in low risk group, this time after 3 months I should go for another test and if results don’t come normal then she can put me on therapy to mainly lower the triglyceride levels. I reminded to her that these tests are done after I have started contraceptives (taking cyclen from last 5 months) but she doesn’t think that contraceptives can suddenly affect my blood profile. Earlier she never raised any issue. I am very afraid.

    Whats your kind opinion; is contraceptive the main culprit?


    • Thank you for your interest In Dr. Hyman’s work. Unfortunately he cannot provide you personalized medical advice in this forum. In order to provide you the proper care you need we hope you will seek the attention of a local qualified Functional Med practitioner soon. To locate a doctor near you who practices functional medicine like Dr. Hyman, go to and scroll down to where it says “locate a practitioner” and enter your location. Progress accordingly from there.
      Wishing you the best of health,
      Dr. Hyman Staff

  • Dr. Hyman,

    I have read that you need to be very careful about stopping your statin medications – some places even state if you’re on these meds, you should be on them for life. What is your opinion about getting off statins and the risk associated and what is the best approach or process for getting off of them?

    Thank you,

    • Hello Jerry,
      It is best to work with your doctor to structure a plan for reducing and eliminating your medications, and it is recommended to assess your cholesterol levels more frequently to monitor and adjust as needed.
      Wishing you the best of health,
      Dr. Hyman Staff

  • Hello. I am 34, weight 68kgs and height is 5’8″.I am a vegetarian and from India. My lipid profile reads total cholesterol 217,ldl 153, triglyceride 143 and hdl 42..what is your advice for me. Plz suggest veg sources of omega 3.