Why Do Cholesterol Levels Increase?
Cholesterol levels are regulated by a complex combination of various physiological functions including liver function, hormonal balance, genetic makeup, diet, lifestyle, and inflammation. Here are the reasons and mechanisms that contribute to high blood cholesterol:
1. Liver Dysfunction
The liver produces 70–80% of your cholesterol and is responsible for dividing and releasing it as lipoproteins like LDL and HDL, as well as clearing it from the blood via cholesterol recycling.
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When the liver is fatty (NAFLD), inflamed, or overloaded, it struggles with regulating cholesterol.
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Conditions such as alcoholic liver disease, hepatitis, and exposure to toxins or medications can lead to increased VLDL and LDL production while reducing cholesterol clearance.
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An unhealthy liver also reduces bile production, impairing cholesterol elimination via digestion.
2. Genetics and Inherited Lipid Disorders
Some individuals carry genetic mutations that directly impact cholesterol regulation. This is why a family history or high cholesterol and heart disease should never be overlooked.
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Familial Hypercholesterolemia (FH): A mutation in the LDL receptor gene reduces the body’s ability to remove LDL from circulation, resulting in extremely high LDL-C levels from birth.
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Polymorphisms in genes like APOE, PCSK9, and LDLR affect how cholesterol is absorbed, produced, and cleared.
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Lipoprotein(a) levels, which are largely genetic, are also an independent risk factor for heart disease.
3. Hormonal Imbalances That Elevate Lipids
Hormones control everything in the body and significantly influence fat metabolism, liver function, and cholesterol transport:
Hormonal Condition |
Mechanism |
Effect on Lipids |
|---|---|---|
| Hypothyroidism | Reduces LDL receptor activity | ↑ LDL |
| Menopause | ↓ Estrogen → alters fat distribution | ↑ LDL, ↓ HDL |
| High Cortisol (stress) | Promotes gluconeogenesis and central obesity | ↑ LDL, ↑ TG |
| Insulin resistance / PCOS | Promotes VLDL and small LDL | ↑ TG, ↓ HDL |
| Low testosterone (in men) | Alters lipid metabolism | ↑ LDL, ↓ HDL |
4. Diet
While saturated fat has long been blamed for high cholesterol, it’s a bit more complicated than that:
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Saturated fats (from red meat, dairy, coconut oil) can raise LDL-C.
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Trans fats (found in margarine, fried foods) increase LDL and lower HDL—a highly dangerous combination.
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Excess refined carbohydrates and sugars are converted into fat in the liver and converted into VLDL, which becomes LDL in circulation.
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Low-fiber diets impair cholesterol elimination, since soluble fiber binds bile acids and helps remove excess cholesterol via feces. In fact, including more fiber in your diet is one of my preferred remedies for reducing high cholesterol levels.
5. Chronic Inflammation and Oxidative Stress
Even if cholesterol levels are “normal,” inflammation can make them dangerous:
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Inflammation oxidizes LDL particles, increasing their ability to stick to the artery walls.
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High-sensitivity C-reactive protein (hs-CRP) is a marker of inflammation that correlates with heart disease risk—even when LDL is normal. It is crucial to have this tested when trying to monitor heart health and cardiovascular risk factors.
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Conditions like gum disease, autoimmune disorders, and obesity increase systemic inflammation, worsening lipid profiles.
6. Physical Inactivity and Sedentary Living
A sedentary lifestyle has been found to lead to:
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Reduced HDL production
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Increased triglycerides
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Worsening insulin sensitivity
Regular exercise helps stimulate enzymes that clear triglycerides, raise HDL, and enhance LDL receptor activity in the liver. Keep in mind that if your daily activities and work involve extensive periods of inactivity, it is far more important to get multiple bouts of exercise over the course of the day. The human body is meant to be active. When we go against this, metabolic disease develops.
7. Medications That Alter Lipid Metabolism
Some commonly used drugs have the side-effect of raising cholesterol:
Medication |
Effect on Lipids |
|---|---|
| Beta-blockers | ↑ Triglycerides, ↓ HDL |
| Corticosteroids | ↑ LDL and TG |
| Oral contraceptives | ↓ HDL, ↑ LDL |
| Immunosuppressants | Alter lipid metabolism |
| Antipsychotics | Promote weight gain and insulin resistance |
8. Gut Health and Bile Recycling
The gut microbiome plays a significant role in cholesterol balance:
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Dysbiosis (imbalance in gut bacteria) can impair bile acid recycling.
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If bile isn’t properly bound and excreted, it’s reabsorbed and sent back to the liver, promoting a cholesterol feedback loop.
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Certain probiotics and prebiotics have been shown to improve cholesterol metabolism (see study). Probiotics alone is one of the most simple remedies for reducing high cholesterol.
How Saturated Fat Raises LDL Cholesterol
While cholesterol consumption is often blamed for elevated cholesterol levels, this is not entirely accurate. As I mentioned earlier, the body makes cholesterol on its own. When we consume cholesterol, the body simply makes less in order to maintain a healthy amount. On the other hand, certain foods have the ability to raise cholesterol levels due to their saturated fat content.
Saturated fat raises LDL by:
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Suppressing LDL receptor activity in the liver (leading to poor clearance of cholesterol)
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Increasing production of VLDL, which becomes LDL
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Promoting ApoB-containing lipoproteins, the building blocks of LDL
Additionally, not all saturated fats are the same. For example, saturated fats like lauric and myristic acid (found in coconut oil and dairy fat) raise LDL more than stearic acid (found in cocoa and beef), which is somewhat neutral.
It is also important to note that saturated fat often raises large, buoyant LDL, which is less harmful than small, dense LDL. However, total LDL still increases.
Why the Carbohydrate + Fat Combo Is Bad
The modern diet—rich in refined carbs AND fats—creates a perfect storm for cardiovascular disease:
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Refined carbs spike insulin, which promotes fat storage
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Fats slow digestion, keeping glucose and insulin elevated longer
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This combo leads to non-alcoholic fatty liver disease (NAFLD), insulin resistance, and inflammatory lipid profiles (high TGs, low HDL, small dense LDL)
These metabolic disturbances precede arterial plaque buildup, even before cholesterol becomes elevated on a blood test.
Ultra-Processed Foods: The True Villain
Ultra-processed foods (pastries, chips, soda, fast food) combine:
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Refined carbs
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Processed fats (including trans fats)
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Excess salt (sodium) and synthetic additives that are also connected to impaired metabolic health
These foods:
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Are hyper-palatable and addictive
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Lack fiber and micro-nutrients
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Often lead to overeating and inflammation
This refined carb + trans fat + high salt combination drives obesity, metabolic syndrome, and atherosclerosis.
These problems are not typically seen when consuming a diet rich in high quality, fresh, whole foods.
The Role of Insulin Resistance in Heart Disease
Chronically elevated insulin levels (hyperinsulinemia) trigger:
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An increase in triglycerides
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Smaller, denser LDL particles (the more harmful type)
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Endothelial dysfunction
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Arterial inflammation
This insulin-driven connection to heart disease may explain why certain individuals with normal LDL levels still suffer heart attacks—because their underlying metabolic health is impaired, leading to the above-mentioned risk-factors.
Not All Carbs and Fats Are Bad
Nutrient |
Source |
Impact on Health |
|---|---|---|
| Healthy carbs | Vegetables, legumes, oats | High fiber, stabilize blood sugar |
| Refined carbs | Sugar, white bread, soda | Spike insulin, promote fat storage |
| Healthy fats | Olive oil, fatty fish, nuts | Anti-inflammatory, raise HDL |
| Trans fats | Fried fast foods, margarine | Raise LDL, lower HDL, pro-inflammatory |
Balanced, whole-food diets that emphasize fiber, healthy fats, and minimally processed carbs consistently show cardioprotective benefits.
Remedies For Reducing High Cholesterol
Diet
It is important to understand that the development of heart disease isn’t just fat or cholesterol—it’s the modern combination of refined carbohydrates and unhealthy fats, especially when consumed in processed, nutrient-lacking forms. It is also the lack of activity and increased amounts of stress.
Therefore, remedies for reducing high cholesterol and supporting heart health requires several factors:
- Consume whole, unprocessed foods
- Whole fruits, vegetables, and meat products
- Reduce or remove refined carbs and added sugars
- Breads, pastas, cookies, pizza, candy, etc.
- Get healthy fats from natural sources
- Avocado, Olive Oil, Nuts & Seeds, Organic Pasture-Raised Eggs, etc.
- Stay physically active
- Resistance exercise, Cardio, Yoga
- Manage stress
- Yoga, Meditation, Vacations, Relaxation
- Support liver & gut health
- Consume milk thistle tea and probiotic rich foods
- Eat more fiber
- Fruits, Vegetables, beans, legumes, and konjac root
Herbs & Supplements
Amla has similar results to that of Simvastatin (a common cholesterol-lowering medication) for lowering cholesterol (see study)
Black Seed reduced blood cholesterol, improves liver function, and reduced blood sugar levels (see study)
Pomegranate juice is extensively studied and found to reduce cholesterol, blood pressure, and improve endothelial function (see study)
Berberine, a plant compound, has been found to reduce cholesterol (see study) and blood sugar with similar results to metformin (see study)
Niacin, also known as Vitamin B3, has been found to reduce cholesterol via a similar metabolic pathway to that of anti-cholesterol drugs (see study)
I strongly recommend speaking with a professional that specializes in utilizing herbs, supplements, and diet for managing health conditions, such as an Ayurvedic doctor or Functional medicine doctor. This should be done in addition to working with your Primary Care doctor or Cardiologist.
To book an Ayurvedic consultation with me, click here
(Always use medicinal herbs under the supervision of a doctor)
by Dr. Nishal R.
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