Cholesterol has a bad reputation. Most of us only hear about it when a blood test comes back "high". But your body makes most of its own cholesterol for a reason. Without it, you couldn't make hormones, build cells or keep your nerves working.
In a recent interview, Dr. Gerald H. Smith (@drgeraldhsmith) put it simply: "You couldn't survive without it." He explains how your adrenal glands rely on cholesterol to make dozens of hormones, and why he thinks the full picture often gets lost in the cholesterol conversation.
In this guide, we look at what cholesterol actually does, how statins affect your body's own production of CoQ10, and what you can do to support your heart and energy every day.
Video credit: Dr. Gerald H. Smith, interview via ICNR.com. Shared with credit. The views in the video are his own.
Why does the body need cholesterol?
Cholesterol is a waxy fat that sits in every cell in your body. Your liver makes most of it, and only part comes from food. Here is what it does.
1. It is the starting point for your hormones
Your steroid hormones are all built from cholesterol. That includes:
- Cortisol, which helps you respond to stress
- Aldosterone, which helps balance salt and fluid
- Oestrogen, progesterone and testosterone, your sex hormones
Dr. Smith points to the adrenal glands as an example. Their two parts, the medulla and the cortex, produce what he describes as "over 60 different hormones", and the cortex uses cholesterol as the base for its steroid hormones. His point: if you lower cholesterol artificially, your body has less raw material to work with.
2. Your body uses it to make vitamin D
When sunlight hits your skin, it turns a form of cholesterol into vitamin D. This is why cholesterol and vitamin D are so closely linked. In the UK, sunlight is too weak to make enough vitamin D from October to March.
3. Your brain and nerves depend on it
The brain holds about 20% of the body's total cholesterol, more than any other organ (Orth & Bellosta, 2012). Much of it sits in myelin, the protective coating around nerves that helps signals travel quickly. As Dr. Smith says in the interview, "the nerves need cholesterol".
4. It holds your cells together
Every cell membrane contains cholesterol. It keeps membranes stable but flexible, so nutrients can get in and waste can get out.
5. It helps you digest fat
Your liver turns cholesterol into bile, which is stored in the gallbladder. Bile helps you absorb fats and fat-soluble vitamins like A, D, E and K.
How statins work, and the CoQ10 link
Statins are among the most prescribed medicines in the UK. They work by blocking an enzyme in the liver called HMG-CoA reductase. This enzyme controls the first steps of the pathway your body uses to make cholesterol.
That same pathway also makes coenzyme Q10 (CoQ10). CoQ10 sits inside the mitochondria, the "power stations" of your cells, where it helps turn food into energy. Organs that use the most energy, like the heart and muscles, hold the most CoQ10.
Because statins slow this shared pathway, they can lower CoQ10 too. A 2018 meta-analysis of randomised controlled trials found that statin treatment reduced CoQ10 levels in the blood (Qu et al., European Journal of Medical Research).
Natural CoQ10 production also falls as we get older. That is one reason CoQ10 has become a popular part of many longevity routines.
Good to know: The same researchers said CoQ10 supplements "may be a promising complementary approach" for statin-related muscle symptoms. Other studies have found less benefit, so the evidence is still mixed. If you take a statin and want to try CoQ10, speak to your GP or pharmacist first.
Statins: the balanced picture
Dr. Smith is openly critical of statins, and he isn't alone. But statins also have strong evidence behind them, so it's worth seeing both sides.
What the evidence supports: The British Heart Foundation says statins are effective at preventing and managing heart and circulatory disease. That conclusion rests on a 2023 NICE review of 52 randomised trials (BHF).
Known side effects:
- Muscle pain or weakness. The BHF estimates about 11 extra reports per 1,000 people in the first year.
- Blood sugar. Statins can cause a small rise in blood sugar. People already at high risk may develop type 2 diabetes sooner.
- Memory problems. The NHS lists these as an uncommon side effect (NHS).
The bottom line: Never stop or change a prescribed statin on your own. If you have side effects, the NHS advises speaking to your doctor, who may change your dose or switch you to a different statin.
How to support your heart, hormones and energy
Healthy ageing starts with the basics. Supplements work best on top of them, not instead of them.
Start with daily habits
- Eat for your heart. Fill up on oily fish, nuts, olive oil, beans, oats and colourful vegetables.
- Move every day. Walking, strength training and anything that raises your heart rate all count.
- Protect your sleep. Aim for 7 to 9 hours, as poor sleep affects hormones and blood sugar.
- Know your numbers. Ask your GP about a full picture, not just total cholesterol: HDL, triglycerides, blood pressure and blood sugar.
Then add the right nutrients
Liposomal CoQ10 100mg Our CoQ10 uses liposomal delivery, wrapping the CoQ10 in tiny fat-based bubbles. It's made in the UK and third-party tested, with 60 capsules per pot. If you take a statin, check with your GP or pharmacist before you start.
Vitamin D3 + K2 Spray Since your body makes vitamin D from cholesterol and sunlight, UK winters leave many people short. Vitamin D contributes to the normal function of the immune system and the maintenance of normal muscle function. Vitamin K contributes to the maintenance of normal bones. Prefer drops? Try our Essentials D3K2 Drops, a full year's supply.
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Frequently asked questions
Why does the body need cholesterol?
Your body uses cholesterol to make steroid hormones like cortisol, oestrogen and testosterone. It also uses it to make vitamin D and bile, and to build cell membranes and the myelin around your nerves.
Is all cholesterol bad?
No. Cholesterol is essential. What matters is your overall heart health picture, including HDL, triglycerides, blood pressure, blood sugar and lifestyle. Your GP can help you understand your results.
Do statins lower CoQ10?
Statins block part of the pathway the body uses to make both cholesterol and CoQ10. A 2018 meta-analysis of randomised trials found that statins reduce CoQ10 levels in the blood.
Can I take CoQ10 with a statin?
Many people do, but always check with your GP or pharmacist first, especially if you take other medicines such as blood thinners.
Should I stop my statin?
No, not without medical advice. If you have side effects, speak to your doctor. They may change your dose or switch you to another statin.
Sources
- Dr. Gerald H. Smith, interview via ICNR.com (@drgeraldhsmith)
- Orth M, Bellosta S (2012). Cholesterol: Its Regulation and Role in Central Nervous System Disorders. Cholesterol.
- Qu H et al. (2018). The effect of statin treatment on circulating coenzyme Q10 concentrations: an updated meta-analysis of randomized controlled trials. European Journal of Medical Research.
- British Heart Foundation. Statins
- NHS. Side effects of statins