Dr Craige Golding: The Highs and Lows of Cholesterol

Based in South Africa,  globally trained Dr. Craige Golding is a physician and pioneer who routinely adopts and implements functional, integrative, and anti-aging therapies to help people live longer and healthier.

“I believe it’s crucial to look at the whole person, not just the disease they have. This holistic approach helps identify the root causes of health issues. That’s where the functional medicine model is so effective – it recognizes the complex web of interconnections in the body, considers environmental factors, supports detoxification, and incorporates various healing modalities to improve overall patient health.”

In focusing less on the sickness paradigm and instead on the connection between nutrition, hormones, stress, genetics, detoxification, and the microbiome, his attention has recently shifted to cholesterol, which is often portrayed as the biggest villain of health. With that, we recently spoke to Dr. Golding, who believes that cholesterol isn’t evil, but essential for longevity.

Cholesterol: Longevity Villain or Healer?

“Cholesterol is a healing molecule, not the root cause of heart disease.”

Speaking of cholesterol, Dr. Golding explains how it is one of the body fats that health practitioners measure alongside triglycerides,

“Triglycerides are a combination of fatty acids and glycerol,” he shares,

“Generally, when you do a lipogram, you’re getting total cholesterol, LDL, HDL, and triglycerides. I’ve found that when people undergo wellness checks, the higher their cholesterol level, the more likely they are to be prescribed a statin to lower it. This is due to the misconception that cholesterol is the root cause of heart disease or cardiovascular disease, and that the lower your cholesterol, the better.”

Cholesterol is not the villain we think it is

However, this couldn’t be further from the truth, explains Dr. Golding, who argues that cholesterol isn’t the health villain we think it is,  but rather a healing molecule,

“We need it to make all of our neurosteroid hormones – your adrenal, ovarian, and testicular hormones,” he reveals, adding that all of these steroid hormones, which are so crucial for brain health and cellular health in general, are made from cholesterol: “As is vitamin D – we know that steroid hormones and vitamin D are essential for brain health.”

Also, hormonal imbalance, especially in perimenopausal and menopausal women, plays a significant role in elevated cholesterol. Dr. Golding mentions that when progesterone drops and estrogen follows, cholesterol often rises – not because it’s harming you, but because your body is trying to make more hormones.

Similarly, low thyroid function, common in women, can elevate cholesterol, leading to misdiagnosis and unnecessary statin prescriptions. Thus, it’s better to treat the hormones or thyroid, not the cholesterol, as it is trying to heal you.

Statins: Help or Hurt?

Whilst statins are portrayed as drugs that can manage high cholesterol, Dr Golding reveals that there are studies that suggest that statins may increase the risk of conditions like diabetes, motor neuron disease, and even heart disease itself.

“Often, I find that people are on very high doses of statins, as they are told their cholesterol has to be as low as possible. But what about the consequences of that? If you lower your cholesterol, your LDL, down to one, which is the target for many cardiologists, how are you going to produce any of your adrenal or sex hormones? How will your brain function properly?”

Cholesterol and your brain

While this may sound very controversial, more recently we have witnessed more active and open debate on this subject. Indeed, the side effects of statins are often underplayed.

We’re composed of cells, and improved cellular health requires the cell membrane to be permeable, allowing nutrients in and toxins out. Yet, one of the risks of reducing cholesterol levels, especially if you’re on a statin, is that the cell membrane can become stiff, and this means you can’t get nutrients in or toxins out of your cells.

 “So, if your cellular health becomes impaired, your overall health suffers,” says Dr. Golding, “You experience body aches, pains, cognitive decline, mood issues, libido problems-all sorts of problems.”

So what happens if you want to use a statin?

Dr. Golding  recommends supplementing with coenzyme Q10,

“I am starting to see cardiologists use it more, and in fact, some statins are now being formulated with coenzyme Q10, which is important. If you’re going to use a statin, at the very least take coenzyme Q10, and also consider the other nutritional deficiencies caused by statins.”

Metabolic Syndrome: The True Longevity Villain

According to Dr. Golding, metabolic syndrome is defined by a waist circumference of more than 102 cm in men and more than 88 cm in women. Waist circumference is likely more important than total cholesterol level.

“Insulin resistance, high blood pressure, low HDL, and high triglycerides usually accompany metabolic syndrome. This is important because HDL and triglyceride levels can be seen directly on your lipidogram,” says Dr. Golding. He further adds that the risk factors that correlate with cardiovascular risk are:

• Cholesterol divided by HDL – this should be less than 4.
• Triglycerides divided by HDL – this should be less than 2.

So if these ratios are off, meaning your triglycerides are high and your HDL is low, this is what correlates with an increased risk of cardiovascular disease.

“As I mentioned, insulin resistance can be identified in your blood work. If you undergo a fasting glucose and fasting insulin test, the lab can run a test called HOMA-IR. That’s the Homeostatic Model Assessment, and the lab will then indicate whether you’re mildly, moderately, or severely insulin resistant. And that’s what correlates with cardiovascular disease.”

Prevention is always better than cure

Now, lowering cholesterol can be counterproductive because it may interfere with the healing role that cholesterol plays; therefore, Dr. Golding opts to focus more on ratios, insulin resistance, and other criteria of metabolic syndrome.

Speaking more about prevention markers, Dr. Golding shares that many physicians overlook fasting homocysteine levels, vitamin D levels, and inflammation markers such as CRP, IL-6, and oxidative stress. He further explains that inflammation and oxidative stress are responsible for damaging cholesterol, and once cholesterol becomes oxidized and inflamed, it then contributes to arterial pathology. Thus, he encourages doctors to check vitamin D, fasting insulin, fasting glucose, and other ratios he mentioned.

Furthermore, he suggests examining particle size, as he always requests an APOB (apolipoprotein B), which combines LDL and VLDL, as well as lipoprotein(a), also known as lipoprotein A, the smallest and densest cholesterol molecule associated with high cardiovascular risk. 

“That’s why I say there’s a big difference between the sickness paradigm, where many physicians mostly use pharmaceuticals, and the health paradigm, where we look for the underlying cause. If you’re looking for a cause, it’s not total cholesterol. It’s low HDL, high triglycerides, inflammation, insulin, homocysteine, low vitamin D, oxidative stress, and waist circumference – all of which are much more important than total cholesterol.”

With that, Dr. Golding adds that when you go for a wellness check and they tell you your total cholesterol is high and that you need a statin, don’t listen, as he doesn’t believe that is good advice. Instead, you need the HDL and triglyceride numbers, which is why he checks his patients’ oxidative stress.

“If it’s high – and their cholesterol is high – I’d rather give them vitamin C than a statin. Because it’s not their total cholesterol that’s linked to coronary artery disease – it’s the oxidative stress…The real problem is inflammation and oxidative stress.”

Polypharmacy – A Modern Chronic Disease

Yes, aging is inevitable, but the way we’re aging isn’t exactly normal. According to Dr. Golding, our DNA is not programmed to age, as our cells regenerate all the time— even our brain cells, liver cells, skin cells, and bone cells. Yet, thanks to a societal kind of indoctrination that makes us believe we must get old, accompanied by symptoms like weight gain and cognitive decline, we believe those things are going to happen as we get older. However, Dr. Golding says that it all comes down to thoughts, which then influence our actions and our dependency on Big Pharma.

“If you believe you’re getting old, and you accept all of these symptoms as normal, then you’ll likely resort to pharmaceutical ‘band-aids’ to manage them. And that’s considered the right thing to do, because your physician says so. However, this often causes more problems. This leads to even more pharmaceuticals, resulting in polypharmacy,” says Dr. Golding.

Revealing chronic pharmaceutical use as the third leading cause of death in the world, Dr. Golding explains that once you’re on multiple medications, you may start experiencing drug-drug interactions, drug-herb interactions, and impaired drug elimination.

“You’re hit with side effects, and then you’re prescribed more drugs to manage those side effects. This compromises your cellular health and leaves you riddled with even more symptoms, being patched up with more and more medications,” he says.

“I think as humans, we tend to be a little lazy, and over decades, it’s become the norm to just run to pharmaceuticals to fix problems, rather than rely on the body’s inherent healing capacity. The human body is a divine creation. It’s designed to heal, not to be sick.”

Nutrition: A Healing Plate

“Eating is one of the most inflammatory things we do, so you want to avoid foods that cause inflammation or trigger autoimmunity.”

Speaking on the various eating styles adopted worldwide, Dr. Golding shares a somewhat unexpected opinion on the carnivore diet,

“The carnivore diet is gaining traction worldwide, and I’ve had many patients adopt it with impressive results,” he reveals, “Their metabolic markers have significantly improved-diabetes is better controlled, insulin resistance is reduced, and inflammation markers are down. Triglyceride levels drop while HDL levels rise.”

He admits that while a diet featuring red meat may not be suitable for everyone, many people respond well to incorporating red meat into their diet. With that, he adds that the genuine concern with red meat isn’t the meat itself, but rather the additives, like antibiotics and pesticides, that come with it.

“I always tell people: if a food exists in nature, it’s generally not harmful; it becomes problematic when humans interfere, especially through ultra-processed products.”

Take, for instance, the growth of plant-based meats, which are advertised as a healthier alternative to red meat, yet this couldn’t be further from the truth.

“Figures are promoting plant-based ultra-processed meats, which are full of questionable compounds. In contrast, a grass-fed Argentinian steak is a far better option.”

The reality is that an eating plan is not a one-size-fits-all matter, yet mindlessly eating anything without consideration is also not the way to go. With ample information available, Dr. Golding advises that you find a diet that works for you, but also monitor your nutritional, metabolic, and hormonal markers to prevent any deficiencies due to your dietary choices.

“Most deficiencies can be addressed with supplements; for instance, vegetarians can use pea protein and iron supplements without abandoning their diet. The key is sustainability-diets should be a lifestyle, not a temporary fix.”

He further refers to Peter J. D’Adamo, whose book, ‘Eat Right 4 Your Type,’ which introduced the blood type diet and explained how gut health, home to 80% of our immune system, is influenced by what we eat. Because foods can trigger immune responses, including those from healthy foods, Dr. Golding believes in nutrigenomic testing to guide personalized nutrition and promote longevity.

Food Testing

“You can’t just guess your nutritional type or ideal food choices. Testing is necessary to know what’s right for you.”

In terms of food tests, Dr. Golding frequently uses NutriSmart. This finger-prick test identifies foods that cause IgG-related chronic inflammation (which requires a temporary elimination) or IgE allergies (which require permanent elimination).

For Dr. Golding, the typical culprits regarding food inflammation and autoimmunity are sugar, processed foods, dairy, and gluten, all of which contain casein that can trigger an inflammatory response.

He further explains that genetic tests can reveal valuable insights about your nutritional needs: “For instance, if you have glutathione SNPs, you should increase your sulfur intake through cruciferous vegetables, whereas someone else without those SNPs may not need as much sulfur.”

Nightshades and Autoimmune Conditions

With the rise of autoimmune conditions like Hashimoto’s thyroiditis, Dr. Golding has noted how the wrong foods may worsen the condition, especially inflammatory foods like gluten, dairy, and nightshades.

“I often recommend avoiding nightshades such as aubergine, potato, tomato, and even tobacco. Yes, tobacco is also a nightshade. These foods are considered inflammatory in people with autoimmune disorders.”

Interestingly, he references cardiologist-turned-functional-medicine-expert Dr. Steven Gundry, who once condemned tomatoes but later reversed his stance after observing how much Italians enjoyed them, yet continued to live long and healthy lives. The secret? They boiled the tomatoes, removing their skins and seeds,

“The Italians don’t appear to suffer from high rates of autoimmune disease or obesity.”

Speaking more on dietary habits, Dr. Golding shares the story of a woman who received a breast cancer diagnosis whilst following a raw vegetarian diet. Following her diagnosis, she began steaming some of the vegetables, and she’s now completely healthy. Now, while raw isn’t always ideal, some nutrients, like lycopene in tomatoes and glucosinolates in broccoli, are better absorbed after cooking,

“So, while I’m not against raw vegetables, it’s important to strike a balance that works for your body and ensures proper nutrient absorption.” 

Stress and Cortisol

In addition to cholesterol, another hormone that has caught Dr. Golding’s attention is cortisol, also known as the stress hormone.

“If you live with high cortisol, particularly after the age of 40, for example, when your cortisol starts going up, you will have weight issues.” 

Thus, he believes that managing our cortisol more effectively would lead to a reduction in cases of metabolic syndrome and cardiovascular disease. As such, he recommends adaptogens such as ashwagandha, phosphatidylserine, and vitamin C to help manage stress naturally.

One way to monitor your stress levels is through the use of wearable devices, which can track various aspects of your lifestyle and make adjustments accordingly.

“You don’t have to guess anymore,” says Dr. Golding, “Data-driven lifestyle changes are here – and they’re cheaper than disease.”

Empowered Medicine for Longevity

For Dr. Golding, modern medicine is about examining everything from the root level, rather than immediately turning to the closest pill. For him, proper health begins when you take control of your body, before falling ill.

“While I’m not against pharmaceuticals and prescribe them when necessary, I believe they should be a last resort, not the first option. Too often, doctors reach for the prescription pad before considering essential lifestyle factors like sleep, stress, and diet, when in reality, those are the true building blocks of lasting health.”

Dr Golding always points out up front in his interviews with Longevity, that all patients must consult their medical specialists and that this platform is intended for educational purposes, and the information shared here is to raise awareness,  not a substitute for an individual’s particular healthcare needs.

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References

Al-kuraishy, H.M., Jabir, M.S., Sulaiman, G.M., Mohammed, H.A., Al-Gareeb, A.I., Albuhadily, A.K., Jawad, S.F., Swelum, A.A., and Abomughaid, M.M. (2024). The role of statins in amyotrophic lateral sclerosis: protective or not? Frontiers in Neuroscience, 18. doi:https://doi.org/10.3389/fnins.2024.1422912.

‌Reith, C., Preiss, D., Blackwell, L., Emberson, J, et al. (2024). Effects of statin therapy on diagnoses of new-onset diabetes and worsening glycaemia in large-scale randomised blinded statin trials: an individual participant data meta-analysis. ˜The œLancet. Diabetes & endocrinology (Print), 12(5). doi:https://doi.org/10.1016/s2213-8587(24)00040-8.