Shoul I Worry About My High Cholesterol?

Shoul I Worry About My High Cholesterol?

By Dr Joe

My cholesterol is high. Help!
Should I worry about my high cholesterol? With all the conflicting messages on you tube, blogs, twitter and facebook, it’s not surprising that people get confused about cholesterol levels.

You go to your doctor who requests lipid profile on your behalf or you order some blood tests online (you know you can do that now, don’t you?). Results come back. And voilla, your cholesterol level is high and you are not sure what to do.

You’re confused. Worse still, your doctor is not giving you straight advice because he too is confused about the significance of high cholesterol.

Why is your doctor confused?

It’s because there’s so much conflicting medical publications out there that it just gets even more confusing for us in the medical world.

Well, relax. Because on this page I am going to try and clear the confusion for you. At the end of this article, you should know what to do. Hopefully feel more reassured too.

I will give you an explanation as to why some folks have heart attacks despite normal cholesterol levels. The last word on cholesterol on the basic level…

should i worry about my high cholesterol


So, should I worry about my high cholesterol?

Good question. Now it’s not a straight Yes or No answer. It’s a little more nuanced than that.

It’s high cholesterol level concern a myth?

First of all, where’s the high cholesterol concern coming from. It’s mainly from the potential damage that high cholesterol can cause on the walls of our arteries.

The ultimate damage being atherosclerosis and plaque formation on the arteries. That’s the concern. And with heart disease and stroke causing so much deaths and disability, it makes sense to know what to do with your cholesterol numbers.

But that is not always an easy thing to do. In fact, it is a challenge in itself.


The Challenge of the Cholesterol confusion

Everyone is an expert these days. Even more worrying is everyone is an expert on cholesterol these days. That’s fine.

What is not fine is; how everyone is chest-puffing about how much they know about cholesterol. The cholesterol fight has become inextricably tied to the polarity of the diet world.

In one corner, we have the meat-lovers. These folks are transfixed on hovering up as many animal products as possible.

On the other corner are the vegans. Naturally, these are plant-based eaters. It’s just that veganism is an extreme form of plant eating.

What is clear is that in the majority of meat lovers, there seem to be a problem with their bodies handling cholesterol in one form or another. Either they have problems with Total cholesterol, or problems with LDL Cholesterol (the bad cholesterol) or even their triglycerides or a combination of those parameters.

The vegans on the other hand seem to do fairly well, within reason, that is. Because not all vegans are healthy eaters.
There’s a perception out there that all vegans are healthy. Nope.

There are lots of unhealthy vegans about and some of them do have issues with cholesterol too.

Yes, both groups may end up with cholesterol issues but the meat lovers win hands down in the poor cholesterol performance stakes.

So, to defend their corner, the animal food loving Gurus tell their crowd not to worry about their cholesterol numbers. They reassure their followers that cholesterol does not cause heart disease or strokes. They should go to bed and sleep well. Nice!

The only group that seem to point out a cautious message to their followers are are the vegans. If your cholesterol numbers are abnormal, do something about it. Seems reasonable to me…

Obviously those in the middle between veganism and carnivorism would want to pay attention to that warning too.

But is it right to tell people not to worry about your cholesterol numbers?
Would that be an ethical thing to do?


Some Cholesterol background information

Okay let’s delve into some background information regarding cholesterol because it will help us understand where we stand better.

The concern is; atherosclerosis, right? Yes, it is.

The truth is; there are many factors involved in the development of atherosclerosis. One of them is cholesterol. That should not be in question.

What is in question is whether cholesterol is there in the beginning, the orginator, an active participant or just there as a byestander.
What’s cholesterol’s contribution to the development of atherosclerosis?

Few facts:

1. Not everyone with high cholesterol will develop atherosclerosis and consequent build up of plaque. Meaning not everyone with high cholesterol will suffer a heart attack and or a stroke.

2. On the flipside, people with life long very low cholesterol levels hardly develop plaques in their arteries leading to heart attack and strokes.

Those 2 facts do leave you with a conundrum, right?


Some Basic Cholesterol Biochemistry

Okay, let’s do some basic biochemistry as it relates to cholesterol.

Fats are insoluble in water. I’m sure you know that from your kitchen dealings already.

Unfortunately, blood is 90% water. But we need to move our cholesterol from one part of the body to another.

To do that knowing that cholesterol is fat and it wouldn’t dissolve in water i.e blood, then, we are going to need a transport system. We need a solution…fast.

Cue, Proteins. Hurray!

Yes, proteins are going help us move our cholesterol fats in blood from one place to another. Around the body, that is. Proteins are going to be the “taxi” that will ferry our cholesterol from one tissue to another. I like that.

These proteins are called carrier proteins. These proteins will be moving fats like Cholesterol, Triglycerides and Phospholipids around the body for us. Perfect.

So, the combination of Fat plus its carrier protein is called Lipoprotein.

And Lipoproteins are what’s going to interest us when it comes to cholesterol and it’s potential problems.

why are lipoproteins important


Why do the Lipoproteins interest us?

Here’s the reason why lipoproteins are significant to us. It’s because lipoproteins may have their greasy hands in the causation of these killer diseases.

Lipoproteins (remember they are a combination of fat and proteins) are the molecules that interact with the walls of our arteries to trigger a cascade of events that cause inflammation.

Finally, that word. Inflammation. I know you have been waiting to hear it. Or should I say, read it.

Yes, inflammation is what leads to atherosclerosis and subsequent plaque build up.

And lipoproteins carrying cholesterol are involved in that inflammatory process. Cholesterol is not alone in that inflammatory process. there other agents too – white blood cells, macrophages, inflammatory mediators, platelets, T-cells etc.

Where opinion is divided is whether the presence of the cholesterol kicks the whole inflammatory process off or cholesterol comes in later on in the process.

That debate will go on for a while. Some of us believe that small particle dense cholesterol is the trigger for the inflammation.

Some other people believe in theory that, there some microtears or physical injury that occur on the arterial wall and cholesterol latches on to the tears and it all kicks off after that.

Yet, there are also the animal lovers who believe that just because cholesterol is there doesn’t mean it was involved. These folks believe cholesterol is just a byestander in that ‘scene of crime’. Interesting concept, huh?

It is these individuals that will tell you not to worry about your cholesterol numbers. Because cholesterol is an innocent byestander. Of course they hold on to the argument that not veryone with high cholesterol ends up having a heart attack or stroke.

That’s true but they are mistaken and I shall give you an explanation as to why shortly.


Back To Cholesterol Biochemistry

Okay, I went off on a tangent there. But an important one, you have to admit.

So, where was I? Oh, yes, I was talking about Lipoproteins.

You know 2 of them already because we never stop talking about them. There are actually 5 different types of lipoproteins. And they are:

  1. High Density Lipoprotein (HDL cholesterol) – The Good cholesterol
  2. Low Density Lipoprotein (LDL cholesterol) – The Bad cholesterol
  3. Intermediate Density Lipoprotein
  4. Chylomicrons
  5. Very Low Density Lipoprotein (VLDL cholesterol) – carries Triglycerides

The 2 most popular ones are the bad cholesterol (LDL cholesterol) and the good cholesterol (HDL cholesterol). Popular because everyone keeps talking about them. That’s a good thing because the awareness is there.

Of the other 3 lipoproteins that aren’t so popular, the most important one is the VLDL cholesterol. You can ignore the chylomicrons and intermediate density lipoproteins because they aren’t so important clinically.

But VLDL cholesterol is one you need to be familiar with because this is the lipoprotein that carries triglyceride fats. And this is very important.

As for the HDL cholesterol, the so-called Good Cholesterol, it is named that for a reason. The HDL cholesterol is a scavenger cholesterol. It carts away cholesterol from the walls of our arteries. Takes it to the liver for processing and possible excretion.

what type of cholesterol should be treated


So, what cholesterol should you worry about?

Now that we are done with our basic knowledge of cholesterol and their carrier proteins. Let’s turn our attention to the cholesterol that should concern you and your health.

Should you worry about your cholesterol numbers?

Here’s the truth.

Your total cholesterol (the sum total of your cholesterol parameters) only gives you an overview of your cholesterol status. It is okay to look at this cholesterol figure but note this:

Your total cholesterol is a poor predictor of your risk of having a heart attack or stroke. High or Low Total cholesterol doesn’t mean a lot in terms of predicting if you are at risk of a heart attack or stroke.

Interesting, right?

So, if your total cholesterol doesn’t tell you a lot, what does?

How about we talk about the bad cholesterol i.e LDL cholesterol. They don’t call it “bad” for nothing.

This one is important but even then LDL cholesterol is only important up to a point.
What do I mean by that? I’ll tell you now.


Does Cholesterol size matter?

Oh yes, the old well worn out debate. Does size really matter? Actually it does when it comes to LDL cholesterol.
Cholesterol particle size matters…a lot.

Here is the thing:

LDL cholesterol comes in 2 different sizes – Large particle LDL cholesterol and Small particle LDL cholesterol.

The large particle LDL cholesterol is fluffy and cotton wool-like whilst the small particle LDL cholesterol is dense.

Studies have shown that the small dense particle LDL cholesterol is one cholesterol to worry about. Because people whose cholesterol is predominantly small particle dense cholesterol are 3 times more likely to have Coronary Heart Disease.

And guess what. There’s a suggestion that the large particle LDL cholesterol could be protective of Coronary Heart Disease. Are you following?

So, LDL cholesterol can be harmful or beneficial at the same time. But which way it swings depends largely on whether you have a predominance of small particle LDL or large particle LDL.

The predictive value of LDL cholesterol giving a heart attack or stroke is poor unless you break it down to small or large particle. Makes sense?


Can I have a heart attack with normal Cholesterol numbers?

Answer to that question: Yes, you can.

Let me explain:

The reason some people with normal Total cholesterol and normal LDL cholesterol numbers end up having a heart attack is because of the their small particle dense cholesterol concentration.

Oh yes. You can have a normal range of bad cholesterol but if within that normal range, you have a relatively high small dense LDL cholesterol, your risk of a heart attack goes through the roof.

If your risk is high (and you do nothing about it), then it is a question of ‘when’ not ‘if’.

Does that explain why that happens and tends to make people feel bewildered when it happens.

It’s all about how much small dense LDL cholesterol you have. That matters a huge deal.


How about that Pesky VLDL cholesterol?

Should you worry about your VLDL cholesterol?

I’m glad you asked.

Yes, that VLDL cholesterol (remember it carries the Triglycerides) is another cholesterol that should concern us. Why?

The reason is this:

High Triglycerides levels in your blood correlates with a high Small particle dense LDL cholesterol. In the same vein, low levels of Triglycerides floating around correlates with high levels of large fluffy LDL cholesterol.

Meaning your blood Triglyceride level can be a window to knowing your small particle LDL or large particle LDL cholesterol status. Especially in individuals who cannot access Lipoprotein Sub-fraction testing which I shall be talking about shortly.


So, what should you do if you are worried about your cholesterol numbers?

Here’s what you need to do if your cholesterol numbers on the standard lipid panel come back as abnormal.

Do not worry too much about your Total cholesterol number. Poor predictor, remember?

Look at the LDL cholesterol and the Triglycerides. If they are abnormal, request lipoproetin sub-fraction testing from your doctor. It’s called LDL-P testing. Whilst you are at it, also ask for Apolipoprotein B.

LDL-P and Apolipoprotein B are better predictors of your risk of coronary heart disease or stroke. They are way better markers than your LDL cholesterol alone.

Remember LDL cholesterol number is just the total concentration of cholesterol in the LDL. It does not tell you the differential particle concentration within the LDL molecule. That’s why sub-fraction testing which breaks down the particle concentration is the way to go.

Of course, if you want to take things to the next level, then Calcium scanning of your coronary arteries will be a reasonable step too.

Having said that, I also know that there are readers of this article who may not have access to those specialised tests either for reason of cost or test availability in their locality.

If you are one of those people, then you should take your VLDL cholesterol result on the standard lipid panel seriously because of it’s correlation with small particle LDL.

Also in the absence of specialised subfraction testing, you should assume your risk of heart disease to be high if your LDL cholesterol is high especially if your Triglyceride is high too.


Can I have the LDL-P Reference range?

To round up, I feel I should let you have a reference range for LDL-P testing if you can access the test through your doctor.

Remember, we are using this test to assess our risk of heart disease and or stroke. So it makes sense to know what the result you get back means.

Here’s how to interprete your LDL-P result:

<1000 – Your Risk is Low
1000-1299 – Your Risk is Moderate
1300-1599 – Your Risk is Borderline High
>1600 – Your Risk is High, Buddy.

Now how was that. I told you this was going to be your last word on your cholesterol concerns. Did I deliver on that promise? Let me know below please…if you can.

Have you checked out how insulin resistance contributes to high blood pressure

Does Insulin Resistance Cause High Blood Pressure?

Does Insulin Resistance Cause High Blood Pressure?

By Dr Joe

There’s always a surprise around the corner when it comes to our health. Insulin resistance and high blood pressure is one. Is there a relationship between insulin resistance and high blood pressure?

Okay, let’s get direct. Does insulin resistance cause high blood pressure? Let’s explore that question on this page. This is very important because it constitutes part of the spectrum of the metabolic syndrome. A syndrome that is making us sick the world over. Worse in the Western hemisphere.


So, does insulin resistance cause high blood pressure?

The simple answer to that question is: Yes, insulin resistance does cause high blood pressure. In fact, the relationship is so strong that some scientists now believe that what we call ‘Essential Hypertension’ should no longer be called that.

Because we now have a cause for that high blood pressure of indeterminate origin. Insulin resistance.
In case you didn’t know, essential hypertension is hypertension (high blood pressure) for which there’s no known cause.

But now we know essential hypertension is not neccessarily without a cause. It has a cause that has been missed all of these years. Insulin resistance is the cause of most essential hypertension cases.

If you have any doubt, ask your doctor the next time you visit him/her, if most people with type 2 diabetes also have high blood pressure. Your doctor will probably smile at you and will answer in the affirmative.

Yes, a relationship exists between hypertension and glucose intolerance without doubt.


What’s the background to insulin resistance and high blood pressure relationship?

Here’s the background.

The first thing to remember is that when you have insulin resistance, your insulin levels in the blood are going to be persistantly high. The reason is that your pancreas will keep pumping insulin into circulation to overcome the resistance of the cells to respond to insulin action.

Insulin’s primary job is to drive glucose out of the blood circulation into the cells of our body where the glucose is needed for energy production. In insulin resistance, the insulin receptors which are the “doorman” guarding glucose entry into the cells become desensitized.

Once desensitized, they are no longer responsive to signals to let glucose into the cells. The result is high blood glucose levels. This triggers further release of insulin from the pancreas as a compensatory mechanism. The idea being to lower blood glucose levels at all cost.

And because the insulin receptors on the cells are not “listening” to these signals, the result is higher and higher levels of insulin in the blood circulation. A sort of reactive hyperinsulinemia, if you like.

Imagine the pancreas as a pump station. It will keep pumping insulin until the blood sugar levels drop. Unfortunately those high levels of insulin in the blood circulation through a cascade of events result in high blood pressure.

This study was able to reproduce the effect of insulin on blood pressure when it observed a rise in blood pressure in patients commenced on insulin therapy. Meaning the presence of insulin through insulin shots is enough to trigger a rise in blood pressure.

There’s even a suggestion that high insulin levels especially high fasting insulin levels play a huge role in the development of high blood pressure independent of weight.

Highlight: Insulin resistance always carries the inescapable misfortune of elevated insulin levels (hyperinsulinemia). It is the hyperinsulinemia that forms the bedrock of the unhealthy relationship between insulin resistance and high blood pressure.


So, how does insulin resistance cause high blood pressure?

There are 3 possible mechanisms. And they are all related to the high insulin levels.


Mechanism #1 – Insulin resistance and the autonomic nervous system

The first is that; high insulin levels in blood drives sympathetic activity. If you have high blood pressure, the last thing you want is high sympathetic activity of your autonomous nervous system. Not good.

The sympathetic nervous system raises blood pressure. That’s a direct response and is bad for your health. Someone with high blood pressure should be hankering for what I decsribe as ‘Parasympathetic Domination‘.

There’s usually a fight between the Sympathetic nervous system and the Parasympathetic nervous system. Nature tries to balance out both systems but every now and again one of them will dominate depending on what’s happening to you or what you are doing.

For instance, if you were confronted by a lion. The sympathetic nervous system will automatically take control. It is needed in that instance to protect you. For self-preservation, if you like. It automatically prepares you for the ‘Fight or Flight response‘.

But there are other instances where the action of the sympathetic become undesirable. High blood pressure is one of them. With high blood pressure, the parasympathetic nervous system is a better friend to you.

When you have insulin resistance, the sympathetic wins the battle. Hence, it is bad news for your BP.

Highlight: The pressor effect exerted through the sympathetic nervous system narrows your blood vessels mainly the arteries resulting in higher blood pressure. Not good!


does insulin resistance cause high blood pressure


Mechanism #2 – Insulin resistance and the kidney effect

High insulin levels has an effect on what happens in your kideneys as urine is being formed. Normally the kidneys have a fine balancing act where they control how much Sodium is retained in the body and how much is expelled out of the body through urine.

This fine balancing act is influenced by a couple of substances in particular Aldosterone. This is done through a well co-ordinated system called the Renin-Angiotensin-Aldosterone System (RAAS).

But it would appear that when insulin levels are high, insulin gets in on the action too. Insulin influences what happens in the kidneys at high levels.

What does insulin do in the kidneys?

Insulin levels when high, facilitates retention of sodium in the body through the RAAS.

The overriding influence of insulin on the Renin-Angiotensin-Aldosterone (RAAS) is extensively reviewed here and here.

In fact, the relationship between insulin resistance and high blood pressure is so close that the class of blood pressure medications called ACE inhibitors like Lisinopril, Ramipril and the ARB medications like Valsartan, Losartan, Candesartan are thought to actually improve insulin sensitivity.

Mainly because those class of medications block the RAAS mechanism at various points which in turn reduces the influence of insulin.

Insulin facilitates reabsorption of sodium in the distal tubules of the kidneys. This is a problem for us.
Because sodium retention leads to water retention. Where sodium goes, water follows.

This the second mechanism through which insulin resistance causes high blood pressure.

Highlight: The net effect of sodium and water retention in the body is high blood pressure.


Mechanism #3 – Insulin resistance and your arteries

Persistent high insulin levels almost ineveitably leads to lipid dysfunction. Dyslipidemia is one of the hallmarks of metabolic syndrome.

Why is this?

Quite simply; insulin is a fat storing hormone. Insulin facilitates the storing of fat both viscerally and underneath the skin too. Along with that is the elevation of triglycerides and LDL cholesterol.

Over time, high lvels of LDL cholesterol (the bad cholesterol) and triglycerides, results in hardening of arteries. When arteries are hardened, they become inelastic.

If your arteries are in elastic, they are less stretchy, less relaxed. Blood pressure goes up because of the inelasticity. Obviously if the situation is allowed to prgoress unchecked, plaques will form in the arteries making the situation worse.

At the cellular level, insulin induces harmful vascular effects through the promotion of various growth factors. These growth factors cause narrowing of blood vessels and plaque formation.

Highlight: High insulin level is bad for the health of the walls of your arteries. Insulin is in fact, atherogenic.



What should you do?

As I stated in the video above, if you have high blood pressure, it makes sense to screen yourself for insulin resistance. The relation between insulin resistance and high blood pressure is so strong that screening yourself is best thing you can do for your health.

You should assume that if you have high blood pressure, then you probably have insulin resistance until proven otherwise. Act on the basis of that premise.

Ideally you would want to check your blood fasting insulin levels but such a test is beyond the reach of most of us.

So the best alternative is to check your fasting blood sugar levels. It’s very simple to do. All you need is a blood sugar monitor.

Get a blood glucose monitor here from and if in the UK, get it here from UK Amazon.

Test yourself. Make sure it is a proper fasting blood sugar. So nothing to eat or drink in the morning before you do the test.

As a guide, your readings should be below 5.6 mmol/l (100 mg/dl).

Make sure you test yourself at least twice on 2 separate mornings. If in doubt, do a 3rd test.

If your tests are high, then make an appointment to see your doctor both for confirmation and starting a management plan.

The essence of this self-screeing is this. Screen yourself for insulin resistance which translates as Pre-diabetes or Type 2 diabetes. It is a wise thing to do.

Got any experience with both conditions, do let leave me a comment below please.

You may also be interested in => Should I worry about my high cholesterol level?

Does Drinking Water Reduce Blood Pressure? What About Dehydration & BP?

Does Drinking Water Reduce Blood Pressure? What About Dehydration & BP?

By Dr Joe

One of the queries I get often on this blog is: does drinking water reduce blood pressure? If we flip that question on its head, the question can be framed differently.

What will that be? It will be: does dehydration affect blood pressure?

I shall answer both questions for you on this page and you shall know the truth regarding water and blood pressure reduction.

Plus, you also get to know briefly the importance of water to our bodies, why we need water, how much water to drink and the effect of over-consumption of water on blood pressure too.

And you get my recommendation on the best drink for high blood pressure.


The Plan

The way I am going to approach the subject is this. I will discuss the effect of dehydration on blood pressure first, then talk about how drinking water (rehydration) affects your blood pressure afterwards.

Kinda make sense to do it that way.

But if you’re in a hurry and only want to know if drinking water reduces blood pressure, then you can scroll towards the later part of this article for an answer straightaway.

Using water as a blood pressure remedy can seem a little far fetched but there’s some truth in it, within reason.

I know that some people do take it a little too far. I have read some people claim that drinking just water only without any medications whatsoever lowered their blood pressure and now they live life happily ever after.

We live in a world where anyone can make any claim regarding anything. This is worse online. After all, people make all sorts of claims about diabetes and cancer online. These claims range from the sublime to the ridiculous.

So, it’s not surprising we have people making ridiculous claims about blood pressure treatment at home…and even low blood pressure.

does drinking water reduce blood pressure


Before I delve into the possibility of dehydration causing high blood pressure and the fact that drinking water is one way you can lower your blood pressure naturally, let’s talk about the importance of water to our bodies briefly first.


How important is water to our bodies?

Well, make no mistake about it. Water is very important to our very survival. Without water we won’t be here on this planet.

This is exemplified in the fact that the average adult body is made up of 55 – 60% water. Babies have even more water content in their bodies. Babies are made up of 75% water until they are 1 year old when their water content drops to 65%.

Water plays a huge role in our bodies. From joint lubrication to keeping our brain well hydrated. Your brain is 75% water, believe it or not. Our brains have the same amount of water as you’ll find in ripe bananas. Our lungs are to a large extent a wet organ too.

Let’s not forget body temperature regulation. Water plays a major role in heat generation for our bodies.
In fact, without water, there will be metabolic mayhem in our bodies. Undoubtedly so.


Why do we need to drink water daily?

We need to drink water daily because some of our body functions mean we lose water every day. We lose water through urine. We lose water through bowel movement. We lose water through sweat. We lose water through our breathe.

All of that water loss needs to be replaced.

If we fail to replace the water lost through those bodily functions, dehydration will result.
But there has to be a fine balance between how much we are losing and how much we replace.

This fine balance prevents dehydration and over-hydration. Both over-hydration and dehydration are bad for our health.

Indeed, too much water in the body from over-hydration is just as bad for our blood pressure as dehydration is.

So, does dehydration affect blood pressure?

Yes, it does. And dehydration does affect blood pressure through 3 different mechanisms.
Dehydration is a potent trigger for a whole host of metabolic events.

Let’s just talk about hormonal events that occur when you are dehydrated. Because this is how dehydration can affect your blood pressure.


The 1st Dehydration-BP Elevation Mechanism

Dehydration leads to renin secretion. Renin is an enzyme produced in the kidneys in response to low blood volume or low salt levels in the blood.

When renin is released, it triggers the conversion of another pro-enzyme called angiotensinogen to angiotensin 1.

A chain of events follows. I don’t want to bore you with the details. All you need to know is that; the end result of that chain of events is the production of another hormone called aldosterone.

The job of aldosterone is to conserve the mineral called sodium. Of course, wherever there’s sodium, water follows. Aldosterone raises blood pressure as a result.


Aldosterone raises blood pressure by preventing the kidneys from losing sodium in urine. Conserve as much sodium as possible.

And because water follows the sodium saved by the aldosterone (don’t forget that sodium is salt), our blood pressure gets elevated when we are dehydrated.

Blood pressure rises when salt and water are retained in the body.

This chain of events caused by dehydration is initiated by renin. In fact, this research tells us a 24-hour episode of dehydration induced a 3-fold increase in renin activity in the body.

That’s the power of water deprivation with a ripple effect on our blood pressure.
That’s one mechanism.

does dehydration affect blood pressure

The 2nd Dehydration-BP Elevation Mechanism

A second mechanism of how dehydration can affect our blood pressure is via another hormone called Anti Diuretic Hormone (ADH).

ADH is released from the hypothalamus in our brain when dehydration signals are received by the brain.

Anti Diuretic hormone as the name implies stops you losing water in urine. Meaning ADH will concentrate your urine to conserve water in the body.

By reducing the amount of urine excreted by the kidneys, blood volume increases and blood pressure rises as a conseqence. This is a protective mechanism to prevent the fatal consequences of dehydration on your body.

This action in turn will elevate your blood pressure too.


The 3rd Dehydration-BP Elevation Mechanism

There’s a 3rd mechanism through which dehydration elevates your blood pressure. It involves a direct effect on the tiny vessels we call capillaries.

Dehydration causes these capillaries to “narrow up”. When these tiny vessels become narrow, the pressure inside them rises causing a blood pressure elevation.

So, whereas initially dehydration leads to a lower blood pressure, compensatory mechanisms move things in the opposite direction leading to high blood pressure.

That’s how our body protects itself from harm caused by dehydration.


So, does drinking water reduce high blood pressure?

Yes, drinking water does reduce high blood pressure but with a caveat. You only need to drink what your body requires for the effect of water on blood pressure to be within the safe margins.

You just need to stay well hydrated. Nothing more.

The reason water does cause a reduction in blood pressure is the reverse of the events I discussed above.

Staying well hydrated by drinking plain water, mineral water or decaffeinated tea means you suppress renin release. Inhibiting the release of renin means you avoid elevated aldosterone levels.

Remember I said, aldosterone causes blood pressure elevation, so we don’t want to trigger its release.

We also want to suppress Anti Diuretic Hormone release by drinking enough.

Drinking enough water staves off those hormonal events that lead to blood pressure rise. Meaning drinking adequate water helps us lower high blood pressure naturally.

The effect of drinking water to lower or reduce blood pressure may not be as dramatic as eating foods that lower blood pressure quickly, but it helps a great deal.

What about over-hydration…


Does drinking too much water cause high blood pressure?

If you remember, I did say, to use water as a natural blood pressure remedy, you only need to drink enough to stay well hydrated.

This means you don’t need to go over-board because drinking too much water can actually cause high blood pressure.

It’s got to be finely balanced.

What’s the fine balance?


How much water should I drink a day?

Well, conventional teaching has always been that we should aim to drink 8 glasses of 8-oz glass per day.

But that advice is changing.

The amount of water we need to drink a day largely depends on our weight and our environment.

The recommended daily water intake does vary but it ranges from 2.5 liters – 3.7 liters for men and between 2 liters – 2.8 liters for women.

Obviously, that recommended daily water intake is not set in stone. Our daily water intake can be dialled up or down depending on how healthy we are, how old we are, how active we are and how hot the environment we are located is.

So, drink enough water or decaffeinated beverage like tea or mineral water or even coconut water to stay hydrated but don’t overdo it.

Because when you drink too much water especially within a short time interval, you can cause salt dilution in the body.

This is called hyponatremia.

This happens accidentally with athletes as they are physically active and feel they need to drink more and more.


How Water Intoxication comes about and the effect on your Blood Pressure

Whereas the dehydrated brain compensates by releasing that pesky Anti Diuretic Hormone (ADH), over-consumption of water is also sensed by the brain. Over-consumption inhibits the release of the ADH.

The inhibition of Anti Diuretic Hormone causes dilution of sodium and water retention occurs. Because the kidneys can’t keep up with the resulting amounts of dilute urine.

The net result is water intoxication and a direct effect of this water retention is high blood pressure.

So, please do not drink water in excess in the hope that that would lower your high blood pressure instantly and naturally. It won’t.

what's the best drink for high blood pressure


What’s the best drink for high blood pressure?

Whatever you do when considering the best drink for high blood pressure, do not think for one second that alcohol will help you lower your blood pressure. It won’t.

I have written extensively about alcohol and blood pressure here.

Next drink you really do not want to be hydrating yourself with is coffee. Quite apart from the fact that coffee does make the body acidic, the caffeine in coffee does cause a rise in blood pressure.

So, coffee is not the best drink for high blood pressure.

In its place, you can consider drinking herbal teas for high blood pressure. The herbal teas have phytochemicals in them that will help you lower your blood pressure naturally.

Herbal teas do not have caffeine in them; hence they are ideal for BP control. Visit this page for a complete list of herbal teas that reduce high blood pressure.

A very good drink to consider is cacao drink but make sure you make the drink from original cacao powder. Make your cacao drink from unprocessed cacao not the processed sugar-loaded variety.

When also thinking about the best drink for high blood pressure, coconut water is an excellent drink to consider. You can consume coconut water for high blood pressure because it is mineral-rich.

Coconut water contains lots of potassium just like bananas. Foods and drinks high in the mineral potassium are one of the best things to consume to control high blood pressure.

Let me know what you think about what you have read here. Leave your comments below anything relating to water and indeed high blood pressure.

Suggested further reading:
Drink THIS 2 Hours Before Bedtime to Sleep Better

Does Coffee Break a Fast?

Does Coffee Break a Fast?

By Dr Joe

Does coffee break a fast? A very good question. Some people just cannot get on with their day, if it doesn’t start with a regular morning routine that includes a coffee drink. That’s a habit of a lifetime for them and it’s pretty hard for them to change it.

And with all the rave about intermittent fasting as one of the healthiest things you can do for your health, you don’t want to miss out. You know the drill. Fear of missing out (FOMO). So you join in the fun of intermittent fasting.

Now you have a clash of concepts in your hands. I’m supposed to be fasting and I like my coffee. How do I marry the two ideas. Hence, you have to ask the all-important question; does coffee break intermittent fasting?

If you go on this wonderful platform we call the internet to research this, all you get is conflicting opinions and views.


The Plan – What You’ll Get On This Page

You needn’t worry, because you have just landed on the right page where you’ll get the low-down on:

The effect of plain black coffee on intermittent fasting and the effect of bulletproof coffee on fasting (water fast and dry fast). Plain black coffee and bulletproof coffee affect fasting differently. You’ll get to know this.

The science, the effect of coffee on insulin, coffee effect on ketosis, coffee effect on autophagy, ampk enzyme and of course that will include bulletproof coffee as well.

Not forgetting how coffee with cream, stevia, dairy milk, nut milk affects fasting.

Plus, you get my suggested approach to using coffee during your fast.

I’ll clear the confusion for you. You’re going to love this.

does coffee break a fast


First things first…

It makes sense to want to know ‘what a fast is’ and why you’re fasting. Kinda makes sense, right?


What’s a fast?

Our friends at Wikipedia defined it as:

“Fasting is the willing abstinence or reduction from some or all food, drink, or both, for a period of time. An absolute fast or dry fasting is normally defined as abstinence from all food and liquid for a defined period”

So, the fact that you are thinking of drinking coffee in the morning or any time for that matter, during your fast means you are not doing a Dry Fast. Because a dry fast means nothing goes through your mouth. Nothing!

If you are doing a dry fast, and you drink coffee, that means you have broken your fast. Period.

The fact that drinking coffee does break a dry fast is not debatable. Right?

I’m glad we cleared that up…quickly. Now, let’s move on.


What about the more Popular Water Fast and coffee?

Okay, not everyone is suited to a dry fast. I love doing it. You may not.

So, if you’re not doing a dry fast, then you are most certainly doing a Water Fast, right?

And that’s where the question then pops up; does coffee ruin a water fast?

Let’s talk about coffee and water fast then. Because water fast is what we are doing, if we are even considering a coffee drink at all.


Does Coffee break a fast?

As usual with these things, it’s not a straight ‘Yes and No’ answer.

Because coffee comes in various “shapes and sizes”. Not the size of the cup or the shape of the cup. No, not that. I mean coffee is prepared in different ways.

More ways than you can imagine. In fact, I saw an ad the other day on facebook about ‘CBD oil with coffee’. Wow. If that’s not a contradiction in terms, I don’t know what is. But I digress there.

The answer as to whether drinking coffee will ruin your water fast will depend on what type of coffee. I know you are thinking, isn’t coffee just coffee?

Not quite. Because you can have coffee with cream, bulletproof coffee, plain black coffee without sugar or cream or milk, coffee with stevia, coffee with almond milk, coffee with collagen, coffee with monk fruit extract etc. And that’s just a tip of the iceberg when it comes to coffee preps.

Truth be told:

If you are having coffee with any other food added to it, You Are Breaking Your Fast. A true water fast is water only. Drinking anything else muddles the water (no pun intended).

The argument is whether having plain black coffee with nothing else in it breaks your fast or not. And we shall come to that in a minute.

Before then, let me talk about Bulletproof coffee and fasting.

does bulletproof coffee break a fast


Does Bulletproof Coffee break a fast?

It’s funny how we can try and msucle an argument over simple things just to suit our personal circumstances and sometimes to suit our pocket. Beware of commercial intentions behind what advice you are given.

Listening to podcasts about bulletproof coffee, tea break, calories, fats, ketones and healthy living, it’s amazing how we are are even debating if bulletproof coffee breaks a fast or not. Because it’s not debatable…at all. Remember our definition of a fast?

It’s funny that commercial interest will drive a debate in a direction that wants to make you scream at your smart phone or laptop device.


If you want to know the answer to the relationship between bulletproof coffee and fasting. Here it is.

Bulletproof coffee will break your fast. Period.

You can use bulletproof coffee to boost your fitness results if you want to. Nothing wrong with that. In fact, I encourage it. But just know that bulletproof coffee with break your intermittent fasting.

Why is this?

Okay, let’s look at what’s in a bulletproof coffee first of all. In fact, let’s make a cup of bulletproof coffee whilst we are at it.


How to make a bulletproof coffee

Here’s how you make 1 cup of bulletproof coffee

  • Scoop 2 ½ heaping tablespoons of freshly ground Amazonian Coffee Beans made with a French Press. This preserves beneficial coffee oils that paper filters tend to sieve off.
  • You add 1 – 2 tablespoons of Brain Octane Oil.You may use other Medium-chain triglyceride oils like Coconut oil instead.
  • Then add 1-2 tablespoons of grass-fed, unsalted butter or grass-fed ghee butter. Ensure the butter is unsalted. The last thing you want is Salty coffee. Not nice!
  • You may add a scoop of Collagen Powder. This is optional.
  • Then blend all of these mixture for about 30 seconds or thereabout. Stop the blender when you have a foamy latte.

This is how you make a lovely, creamy coffee that will send your energy stores through the roof. Think endurance.

So, you have 1 – 2 tablespoons of Brain Octane oil fetching 125 – 250 calories and the butter bringing another 100 – 200 calories making a total of 225 – 450 calories. This is liquid food, by all accounts.


Liquid food like Bulletproof coffee breaks your fast

If you are consuming anything with calories in it, you’re by definition breaking your fast. It’s that simple.

We can argue as to whether consuming bulletproof coffee is a good thing or bad thing, and I’ll clarify that in a minute. But what’s not up for argument is; if bulletproof coffee breaks your fast or not.

Because let it be known here; bulletproof coffee breaks your fast. It sure does.

If you’re potentially consuming those amounts of calories in bulletproof coffee, then you’re techically eating and indeed you are breaking your fast.

I think the question we should be answering is; does it matter at all that you break your fast with bulletproof coffee?


What about Collagen and fasting?

Before I get to that, let me quickly answer the question, does collagen break my fast? If you want to know if collagen will break your fast or not, the answer is; yes, it will.

Collagen will break your fast because it is protein and it contains calories. In fact, 1 gm of Collagen powder will furnish you with 4 Calories.

Hence, if you consume collagen during your fast, you are also technically eating. Because you are consuming calories. Fasting should be a calorie-free endeavour. Adding collagen powder to any drink would mean you are administering calories during your fast.


What about coffee with cream, dairy milk and Nut milk and fasting?

The same thing applies to having your coffee with cream or dairy milk or any nut milk like almond milk. If you consume coffee with cream, dairy milk, almond milk, hazelnut milk, hemp milk, cashew nut milk, goat milk, you are breaking your fast for the same afore-mentioned reason.

But you won’t be breaking your fast if you add calorie-free sweetner instead. So, if you drink your coffee with Stevia, monk fruit extract, erythritol or yacon syrup, you won’t be breaking your fast.

What about plain black coffee.


Does plain black coffee break a fast?

No, plain black coffee without any added sugar does not break your fast. Indeed, you may even add a calorie-free sweetner as stated above, if you like and you still will not break your intermittent fasting schedule with black coffee.

The reason is; plain black coffee has no calories. It might have some influence on insulin but that effect is sub-clinical, so long as you don’t have added sugar, added cream, added nut milk or added dairy milk.

Plain black coffee will not stimulate insulin secretion significant enough to blunt the hormonal benefits of intermittent fasting.


So, does breaking your fast with Coffee really matter?

It depends.

Let’s start with bulletproof coffee. One reason bulletproof coffee became popular and indeed the reason we are talking about it now is because of Dave Asprey.

He was hiking in the Tibet mountainous regions and he was served coffee with Yak butter during his hiking escapades.

He noticed that he could hike for longer, his endurance was so much better and he wasn’t hungry for hours on end. He felt so much better and naturally when he got back home, he publicized this discovery and here we are.

We’re talking about bulletproof coffee as a standalone concept in fitness. Thanks to that serendipity.

The point is, yes, you’ll break your fast with bulletproof coffee but the fitness benefits are so much more.

You would fast for longer because the fat in the coffee keeps hunger at bay and you’ll still burn fat. Indeed, the longer you fast, the more the benefits especially when it comes to autophagy.

Fat does not stimulate insulin much, so that effect is negligible. And if you are already deep in ketosis, bulletproof coffee will not kick you out of ketosis. You should be fine staying in ketosis with bulletproof coffee.

Some people will argue that you’ll burn more fat if you didn’t have the bulletproof coffee at all. That may be true but there’s a way around that that I’ll tell you shortly.


What about coffee effect on AMPK enzyme?

Well in case you don’t know about AMPK, it is Adenosine monophosphate-activated protein kinase (AMPK). This is an enzyme you want to upregulate if you want to burn fat.

AMPK promotes fat burning whilst inhibiting fat storage. The good news is that the caffeine in coffee actually upregulates this enzyme which works in your favour. It not only does that. The caffeine in coffee is also involved in repair activities like blood vessel wall damage repair through this AMPK enzyme.


Chlorogenic acid in Coffee does what?

Coffee is one food that has chlorogenic acid in it. Guess what chlorogenic acid does?

Chlorogenic acid is involved in the delay of glucose absorption from the intestines and promotes the entry of glucose inside the skeletal muscle cell. The net effect is; lowering of blood glucose. That’s what you want.

By the way, chlorogenic acid is also found in caffeinated tea.

does coffee affect autophagy


Will Coffee affect Autophagy?

Did you know that we all have cancer cells in our bodies every now and again. The reason these cancer cells don’t progress is because of the process called autophagy.

Autophagy is a physiological process whereby our bodies eat up these ‘bad, disordered cells’ that potentially can lead to cancer. This is what this scientific paper that confirmed coffee does promote autophagy in mice said about autophagy.

“Autophagy preferentially targets damaged macromolecules (such as unfolded and aggregated proteins) and organelles (such as dysfunctional mitochondria), it contributes to ridding the cytoplasm of aged structures and hence potentially “rejuvenates” non-nuclear portions of the cell”

That quote above might be too geeky for you but the take home message from that research is that coffee does not interfere with Autophagy. This is good news because autophagy is one of the selling points of intermittent fasting.

It will be a tragedy if drinking coffee inhibited autophagy. I particularly love this because it means drinking coffee will not ruin a water fast.


What about coffee effect on insulin?

Opinion is divided as far as the effect of coffee on insulin and insulin sensitivity is concerned. This paper talks about that.

Looking at all the research, it is clear that there may a short-term reduction in insulin sensitivity when you take coffee. But that may not matter much if tissues like your brain that prefer to use glucose as its energy source metabolize the glucose quickly.

This effect actually applies to people who do not drink coffee often. Because for habitual coffee drinkers, coffee actually increases insulin sensitivity.


Will coffee kick you out of ketosis?

I know this is always a concern for individuals on the ketogenic diet doing intermittent fasting as part of the ‘package’. Well be rest assured that drinking coffee (even bulletproof coffee) will not kick you out of ketosis.

Why, because caffeine in coffee actually increases plasma ketones. So, rather than worry about possible negative effect of caffeine in coffee or tea on ketone production, you should celebrate it because the opposite is true.

This reasearch tells us that caffeine drunk at breakfast actually stimulated ketone production by a whopping 88%. Nice!


What I suggest you do:

Use your coffee if you want to regardless of the fact that you are doing intermittent fasting. Don’t let it bother you.

If you are so concerned about any negative effect, be reassured by what you have read here on this page. I am telling you that it is okay to drink coffee while fasting.

==> Use black coffee if you are still dubious about it. Do not add any other ingredient, although a calorie-free sweetner should not cause any disruption to your fasting plans.

==> If you want to use bulletproof coffee, you may want to delay it until the last hour before your workout. That way any calories arising from using the bulletproof coffee will be used up during your workout. Cool!

Remember, Dave Asprey who “invented” bulletproof coffee used to drink it and then go for his energy-sapping hikes. He didn’t drink it and went sedentary. He moved…a lot. He didn’t sit around doing very little.

Hence, I will recommend you do the same and you shouldn’t have to worry about the calories in bulletproof coffee. Not one bit should you be worried if you adopted this approach.

Let me know what you think about this piece. Have I done justice to this all-important topic. Please leave your comments below. I’ll appreciate it.

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Is Himalayan Salt Good for High Blood Pressure and Your Overall Health?

Is Himalayan Salt Good for High Blood Pressure and Your Overall Health?

By Dr Joe

Is himalayan salt good for blood pressure? That’s a question I get asked often. Mainly because I do a lot of videos on high blood pressure on my You Tube channel.

My subscribers get bombarded with ads professing the goodness of himalayan salt and the puported benefits of himalayan salt. In modern times, when something appears exotic and himalayan salt is indeed exotic, we automatically assume, it must be good for our health.

That may be true for a lot of products that come from afar. We thank the internet for the globalization that we exeperience today. It’s given us the opportunity to share in the spoils of other regions which hitherto would have been totally unavailable to us.

Making the world one big global village is good for our physical and mental health.


The Plan – Here’s what you’re going to get on this page

In this article, I will answer that question of himalayan salt and high blood pressure, whether himalayan salt is good for you or not, if himalayan salt is iodized and also whether himalayan salt is better than regular table salt.

is himalayan salt good for high blood pressure


Let’s crack on…


Is himalayan salt good for high blood pressure?

The short answer to the question of himalayan salt being good for high blood pressure is; No, it isn’t.

If there was ever a product that literally represents the saying that “all that glitters isn’t gold“, himalayan salt represents that.

Yes, himalayan salt looks pretty because of its distinctive pink hue and it’s easy on the eye. But that’s where the beauty and it’s usefulness to health end.

The beautiful pinkish hue of the himalayan salt is due to the fact that this brand of salt is unprocessed, therefore it retains some traces of iron within it. The presence of the iron and some other minerals is the reason the himalayan salt has become the latest “miracle cure” for all from the East.

No, himalayan salt isn’t a magic cure for all your ailments.

Himalayan salt or Pink salt as it’s also known; is not healthier than any other salt out there.

Indeed, himalayan salt is not good for high blood pressure. If you’re one of those who got caught out with the health benefit claims of himalayan salt being good for hypertension, then it’s time for a thought make-over.

Don’t buy the hype. Terms like organic, natural, unprocessed and healthy salt have all been used to describe the himalayan salt. They all imply a loftier status of this rock salt compared to the regular table salt. Again, don’t buy the hype.


Is Himalayan salt better than regular normal salt?

Answer: No, himalayan salt is not better than regualr normal table salt.

You may argue that himalayan salt is unrefined unlike regular table salt but in the end, the nutritional profile is almost the same. Yes, refined salt is processed which means all the impurities are removed leaving a white crytalline fine powder for us to use as table salt.

But here is the deal.

Himalayan salt retailers may claim superiority because it contains some minerals which regular table salt does not boast of. That’s true.

But the devil is in the detail. When you look closely you’ll realise that ‘all salt is salt’. Period.
Meaning all salt contain Sodium Chloride (NaCl). It is the amount of the sodium chloride in each salt that may vary.

But guess what? They don’t vary that much.


What’s the himalayan salt hype all about?

Yes, himalayan salt contains traces (yes, traces) of calcium, iron, magnesium and potassium compared to our regular white table salt.

But did you know that himalayan salt is actually 98% Sodium Chloride?

Another 0.6% of himalayan salt is calcium and 0.7% being water. That leaves only 0.7% of its nutritional profile being made of the potassium, iron and magnesium. That’s the “mineral idea” the makers of himalayan salt want you to buy into literally; as having superior health benefits over regular white table salt.

Yes, the himalayan salt promoters will tell you your white table salt is bleached and has all the nutrients stripped away unlike himalayan salt, but ask them how much minerals are we talking about?

Is it the 1.4% of the himalayan rock salt that is made up of minerals?
Because the rest of the himalayan rock salt is wholly Sodium Chloride – 98% and 0.6% water.

The so-called minerals you’ll get from himalayan rock salt are so small that we will consider them as negligible. In fact, with a healthy diet which hopefully is what you needed the salt for in the first place, you won’t be lacking those minerals.


Keto and Redmond Real Salt hype similarity

This reminds me of what’s going on the keto community. The keto folks believe so much in Redmond Real Salt (which is basically Sea Salt) as being superior to table salt. So much so that they now carry pocket-sized redmond real salt wherever they go. Ridiculous!

The Redmond Real Salt has the same nutritional profile as the himalayan salt and as expected is marketed to the ketogenic community similarly. And these keto folk have bought into it. Big time.

As for taste, well if you made salt water with himalayan salt and regular table salt, I guarantee you, you won’t notice any difference in taste when you drink both. It’s the same Salt water regardless of the salt in it.

All rock salt whether it’s Sea salt, Himalayan salt, Redmond salt have roughly the same amount of Sodium Chloride and this has been tested in various labs, by the way. Don’t be fooled by the marketing hype and their expensive price tags.

Bottom line: forget those health benefits of organic himalayan salt, sea salt, redmond real salt. They are pure hot air. Not worth your money.

is himalayan salt good for you


Is Himalayan salt iodized?

Himalayan salt may contain the tiniest amount of natural iodine mineral and I mean tiny. So tiny that it’s best ignored. It’s best to say, himalayan salt is not iodized.

If you want to use iodized salt for your cooking to furnish your thyroid gland with supplemental iodine, you are better off buying a manufactured iodized table salt. Don’t rely on the himalayan salt as your source of supplemental iodine.


Is Himalayan salt good for you?

Next question is whether himalayan salt is good for you or not.

Answer: Yes and No.

Himalayan is good for you in so far as any salt is good for you. You need to be careful how much salt you consume daily especially if you have high blood pressure. Recommended daily salt intake is 1500 mg.

Please do not consume lots of himalayan salt in the hope that you are improving your health doing so. You’re not. Use salt to taste whether in a drink or in food.

And No, himalayan salt is not good for your health any more than table salt is.

All the health benefit claims that organic himalayan salt is good for your blood pressure, makes you sleep better, good for your thyroid, relieves headache, improves adrenal function, good for weight management, makes your circulation better etc are all unsupported claims as far as the science goes.

Don’t get sucked in by retailers and their unsubstantiated himalayan salt goodness claims. Your regular table salt is as good as the himalayan salt or redmond real salt and much less expensive.

It’s all hype. Don’t buy into it.

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