Cholesterol Doesn’t Always Count

Five natural substances that protect the heart

by Christiane Northrup, M.D.

Heart Health Women's Health


Lowering cholesterol isn’t the best or the only way to protect the heart.

Heart disease (including hypertension and stroke) is the most frequent cause of death in women today. AHA¹ More than one in three women has some form of cardiovascular disease. AHA2² Cardiovascular disease results, in part, from an accumulation of oxidized fat in blood vessels that calcifies and eventually causes blood vessel and heart damage. The risk of cardiovascular disease can be quickly and easily lowered by diet, exercise, and other lifestyle changes, but most doctors focus primarily on lowering cholesterol. They do this with statin drugs, which ironically weaken the heart and cause other side effects that increase your risk for heart disease. And lowering cholesterol isn’t the best or the only way to protect the heart.

Ever increasing evidence shows that the consumption of too much sugar (in all its many guises) and not enough nutrients is actually the root cause of heart disease—not fat or cholesterol. You heard me. Dietary fat is not the cause of heart disease as so many of us have been led to believe. Inflammation is! And sugar causes inflammation. The huge increase in sugar consumption in the United States parallels the rise in obesity and diabetes—both of which are risk factors for heart disease. To get a handle on your sugar consumption, read The Belly FatCure by Jorge Cruise or The Perfect 10 Diet: 10 Key Hormones That Hold the Secret to Losing Weight and Feeling Great-Fast! by Michael Aziz, M.D.

Better Than Statins

Nowadays, people are told to take cholesterol lowering drugs if their total cholesterol level is as low as 200. This is ridiculous! The body, and brain in particular, need cholesterol to function properly. Without enough cholesterol, you are at increased risk for depression—another independent risk factor for heart disease. I believe that if your cholesterol level is lower than 240–275 mgs and your HDL is 60 or above, you certainly don’t need a statin. (And, quite frankly, you might not need one even if your total cholesterol is higher than that.)

I won’t go into great detail here about the dangers of statins, but you can learn more by reading “Buyer Beware.” For now, know that the serious side effects resulting from statins include muscle weakness and fatigue, liver damage, brain and nerve damage, and depression. Statins may also promote cancer and even heart disease! This is because of the way they work. Statin drugs block cholesterol production by inhibiting the enzyme HMG-Co-A reductase, but in so doing, statins also block production of two vital nutrients—coenzyme Q10 and substances called dilochols, both of which are absolutely essential for proper cell health and heart health.

Instead, focus on other ways to protect your heart, like diet, exercise, and expressing your emotions freely. For the record, fully 50% of heart attacks are in individuals with healthy cholesterol levels—so obviously there’s far more to this than cholesterol alone. And there are many natural substances that help your heart far more than any statin. Here are five of my favorites:

  • Magnesium. Among its many roles in the body, magnesium helps stabilize electrical conduction in the cardiac muscle. It also helps relax the smooth muscle in blood vessels, Witteman³ contributing to maintenance of normal blood pressure and vascular tone, and assists insulin in transporting glucose into cells, fighting glycemic stress. Because it helps all muscles relax, it’s very effective in helping prevent cardiac damage and even death after a heart attack. In fact, up to 40 to 60 percent of sudden deaths from heart attack are caused by spasm in the arteries—not blockage from clots or arrhythmias! Eisenberg4 Magnesium deficiency is much more common than you would think due to commercial farming practices, which rob the soil of nutrients. Certain medications also cause depletion of magnesium.

    Magnesium comes in many forms. You can take magnesium oxide, chloride, or chelated magnesium. Capsules usually contain 250–500 mg of magnesium. If you have cardiovascular challenges, you should aim for 500 mg per day in divided doses. Read the “Magnificent Benefits of Magnesium” for more information on this mighty mineral.

  • Omega-3 Fats From Fish. The well-known Nurse’s Health Study found that women who ate fish once per week cut their risk of stroke by 22 percent, while those who ate fish five or more times per week cut their risk by 52 percent. iso5 Studies have also shown that 3 g per day of fish oil containing both EPA and DHA is cardioprotective because it makes platelets more slippery and decreases cellular inflammation. leaf6 The evidence that the omega-3 fats in fish are heart healthy is now so compelling that the American Heart Association now recommends that all adults consume fish at least twice per week. Fatty cold-water fish such as wild Alaskan salmon contains the most omega-3 fats.

    The benefits of eating fish have been confirmed over and over again, and continue to make the headlines. For example, a recent review of 97 clinical studies on the effects of lipid-lowering agents (statins, fibrates, resins, niacin, and fish oils) showed that fish oils provided the greatest reductions in total mortality and cardiac morbidity. Studer7 For those of you who don’t like fish, there are some excellent omega-3 supplements available. Take 1,000–5,000 mg of omega-3 fats per day from fish oil, flax oil, hemp oil, or an algae-derived product.

  • Natural Progesterone Cream. Evidence that progesterone protects the heart is becoming more prevalent than ever. I predict that clinical trials in this decade will show without a doubt that progesterone decreases the magnitude and duration of coronary artery constriction. Don’t be fooled into thinking that all progesterones are created equal, though. A recent research paper reviewing the cardiovascular effects of MPA versus natural progesterone suggests that there is a minimal level of progesterone necessary for normal cardiovascular function in women. Hermsmeyer8 Perimenopause is the time when a progesterone deficiency is likely to make coronary arteries most susceptible to damage. I urge you to research this issue for yourself. And then, before turning to potentially harmful drugs or synthetic hormones, ask your healthcare practitioner to prescribe transdermal natural progesterone instead.

    My past clinical experience certainly bears this out. Though a well-designed, substantial clinical trial is needed for proof of the cardiovascular benefits of progesterone, smaller studies have shown that angina can be treated effectively by as little as 20 mg of natural progesterone applied to the skin of the chest, hands, or abdomen once or twice per day. (This is available over the counter in many pharmacies. Emerita or ProGest are good brands.) Taking progesterone orally doesn’t work nearly as well.

  • Red Yeast Rice. A number of compelling studies in recent years have shown that red yeast rice is as effective at reducing cholesterol, especially LDL (bad) cholesterol, as statins. One reported a reduction in total cholesterol of 18 percent and LDL cholesterol of 22 percent over a 12-week period. Red yeast rice, a fungus grown on a form of rice prevalent in Asia, contains a naturally occurring lovastatin. (Lovastatin is also the generic name for Mevacor, a statin manufactured by Merck.) As mentioned previously, synthetic (non-naturally occurring) statins come with many side effects, including severe muscle pain. One reason that red yeast rice has been gaining in popularity is it confers similar benefits without the associated muscle pain. Becker29

    Some doctors who are already against statins are also opposed to red yeast rice, saying a statin is a statin, and statins come with the same risks, regardless of the source. One risk (mentioned above) is the depletion of CoEnzyme Q10, a critical energy source for the heart. So if you decide to supplement with red yeast rice, make sure to also supplement with 30–100 mg of Coenzyme Q10 every day.

    There have also been some concerns that red yeast rice isn’t safe and that it isn’t appropriate for people with very high cholesterol levels. It’s true that some products have had toxins and contaminants in them, so be careful what you buy. You get what you pay for when it comes to nutritional supplements. When you purchase from a company that manufactures according to pharmaceutical grade standards or is sold in a physician’s office, it’s unlikely that you will be buying a tainted product. I recommend 600 mg of red yeast rice 2 or 3 times a day.One of my colleagues, a cardiologist well versed in alternative treatments, doesn’t recommend red yeast rice for patients who have very high cholesterol levels. He believes that statins are better for them, despite the risks.

    I was encouraged to read a study pairing fish oil and red rice. Researchers gave 74 people either 40 mg of simvastatin (a statin) a day or the combination of fish oil (containing EPA of 2,106 mg a day and DHA 1,680 mg from an oceanic source) plus red yeast rice (containing a total monacolin content of 5.3 mg, with 2.53 mg in the form of monacolin K [lovastatin]). After 12 weeks, participants taking the fish oil and red yeast rice combination experienced a 42.4 percent drop in LDL cholesterol. The statin group had similar results with a 39.6 percent reduction in LDL cholesterol. Becker310 This combination may well turn out to be an excellent alternative to statins. I’ll keep you posted as more studies emerge.

  • Niacin. Niacin, known commonly as vitamin B-5, is also a naturally occurring “statin.” Doctors often recommend it to help increase HDL (good) cholesterol, reduce inflammation, and lessen arterial constrictions. Studies show that niacin may work by keeping the liver from eliminating HDL cholesterol. Zhang11

    Recently, Zetia (ezetimibe), a prescription statin drug given to help lower bad cholesterol, was studied and compared to niacin’s affects. Zetia is often given in addition to a regular statin for patients who have very high cholesterol or are at a high risk for heart attack and/or stroke. After the 14-month trial, niacin reduced plaque buildup significantly in patients, whereas the Zetia actually increased it. Additionally, nine people taking Zetia died during the trial compared to two deaths for patients on niacin. The kind of niacin used in the study is not available over-the-counter; it’s a time-released prescription. However, the results of this study led researchers to conclude that, in high risk patients, adding niacin to the patients existing treatment for high cholesterol carried a much greater benefit than adding the Zetia. Zhang212

Listen to Your Heart

In addition to arteriosclerotic plaque deposits and oxidized LDL cholesterol, emotions such as depression, anxiety, panic, and grief have been shown to cause constriction in blood vessels, thereby impeding the free flow of blood. Over the years, I have seen happy, joyful women with high cholesterol levels live healthy lives into their eighties and even nineties, while much younger women whose lives were characterized by depression, anxiety, or hostility might have their first heart disease symptoms in their early fifties despite normal cholesterol levels. That’s why the one-size-fits-all answer of a statin drug doesn’t really get at the heart of the matter—pun intended.

The core issue when supporting your heart’s health is having the courage to open your heart to the possibility of living joyfully. If you have cardiovascular disease, start by opening your heart to yourself. Feel all of your emotions fully—even the yucky ones, like anger and sadness. Know that your emotions are your inner guidance system, letting you know whether or not your needs are being met. I also highly recommend you protect your heart with fish oil every day and consider adopting some of my other holistic options instead of taking a statin. These options just make more sense.

Learn More — Additional Resources


  1. American Heart Association Web site, 2010.
  2. American Heart Association, Heart Disease and Stroke Statistics–2010 Update, Circulation.
  3. Witteman, J.C., et al., 1994. Reduction of blood pressure with oral magnesium supplementation in women with mild to moderate hypertension, Am J Clin Nutrition, 60 (1), 129–135.
  4. Eisenberg, M.J., 1992. Magnesium deficiency and sudden death, American Heart Journal, 124, 2, 544–9; Turlapaty, P. D., & Altura, B. M., 1980. Magnesium deficiency produces spasms in coronary arteries: Relationship to etiology of sudden death ischemic heart disease. Science, 208, 4440 (April 11, 1980), 198–200; Altura, B.M., 1979. Sudden death ischemic heart disease and dietary magnesium intake: Is the target site coronary vascular smooth muscle? Medical Hypotheses, 5, 8, 843–8.
  5. Iso, H., et. al., 2001. Intake of fish and omega-3 fatty acids and risk of stroke in women, JAMA, 285(3):304–12.
Last Updated: January 20, 2010

Christiane Northrup, M.D.

Christiane Northrup, M.D., is a visionary pioneer and a leading authority in the field of women’s health and wellness. Recognizing the unity of body, mind, and spirit, she empowers women to trust their inner wisdom, their connection with Source, and their ability to truly flourish.


Add comment
  1. Jane Hallstrom
    5 years ago

    I love you! Niacin is B-3 (not 5). I know this because I used a powdered niacin product 50 years ago to flush out toxins at the advice of an orthomolecular psychiatrist my mother found to treat some nasty psychotic symptoms I was dealing with in my early 20’s. Thank you for your excellent advice and all the attendant links and references. XOXO

  2. Emily Akins
    7 years ago

    Which nician product do you recommend?

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