# Atherosclerosis

Category: Conditions

Also known as: arterial plaque, cardiovascular disease

Atherosclerosis is an inflammatory condition of the blood vessels, not a disease caused by cholesterol accumulation. Peat argued that the cholesterol found in arterial plaque is a defensive reaction to protect injured tissue, acting as a protective bandage over areas damaged by…

11 passages · 4 authors · 1973–2025 · Most-cited: [Ray Peat](https://bioenergeticoracle.com/md/voices/ray-peat/index.md)

Canonical page: https://bioenergeticoracle.com/concepts/atherosclerosis

## Synthesis

**Atherosclerosis** is an inflammatory condition of the blood vessels, not a disease caused by cholesterol accumulation. [Source 1, 5] Peat argued that the cholesterol found in arterial plaque is a *defensive reaction* to protect injured tissue, acting as a **protective bandage** over areas damaged by oxidative stress. [Source 1, 3] The initial insult driving this inflammation is the breakdown of unstable **polyunsaturated fats** (PUFAs) into free radical products and **lipofuscin** (age pigment), which can be extracted from every arterial plaque. [Source 3, 5] This process is accelerated by stress hormones like cortisol, estrogen, and growth hormone, which are activated by energy deprivation and further promote the release of damaging free fatty acids. [Source 8]

The foundational driver of the metabolic dysfunction underlying atherosclerosis is **hypothyroidism**. [Source 1, 10] Research from the 1930s demonstrated that thyroid supplementation was sufficient to prevent the condition while simultaneously lowering cholesterol. [Source 1] Broda Barnes’ review of over 70,000 autopsies in a goiter region confirmed that thyroid deficiency causes arterial damage to begin earlier and progress faster, though paradoxically, the incidence of fatal heart attacks dropped when coronary sclerosis increased, suggesting the plaque itself is not the primary killer. [Source 10] Georgi Dinkov has extended this view, noting that **mitochondrial dysfunction** is a major causal factor in cardiovascular disease, generating the oxidative stress that guarantees a structural pathology will develop. [Source 11]

The composition of the plaque confirms the inflammatory, protective model. The majority of the plaque is composed of dead and alive white blood cells, indicating an active immune reaction, with cholesterol rushing in to limit the inflammation. [Source 4] Chemical staining reveals the plaque is full of breakdown products from PUFAs, while the saturated fats remain intact. [Source 5] Dinkov notes that adequate **vitamin K status** is crucial, as it can reverse calcification of blood vessels, whereas the drug warfarin, a vitamin K antagonist, is known to cause calcification. [Source 4] Peat similarly highlighted that vitamin K, along with substances that increase **carbon dioxide** like baking soda or niacinamide, helps keep calcium in bones and out of arteries. [Source 9]

Therapeutic interventions focus on opposing the inflammatory and calcifying cascade. Vitamin E, in a human-equivalent dose of about 5mg/kg daily, can reduce established atheroma and improve cardiac function, primarily by acting as a *PUFA antagonist* and inhibiting inflammatory enzymes like COX/LOX. [Source 7] Aspirin in doses of 800mg+ daily has also been shown to reduce plaque. [Source 7] Peat recommended ensuring adequate calcium and vitamin D intake to suppress **parathyroid hormone**, as elevated PTH is linked to degenerative, inflammatory diseases and bone loss. [Source 9] Iodine injections have a historical precedent for use in atherosclerosis. [Source 6] The condition can manifest extremely early; Danny Roddy referenced a study showing atherosclerotic plaque in the arteries of three-year-old children, illustrating that the metabolic injury accumulates over a lifetime. [Source 2]

## People also ask

### What role does hypothyroidism play in causing atherosclerosis?

Peat argued that hypothyroidism is the foundational driver of the metabolic dysfunction behind atherosclerosis, and research from the 1930s showed thyroid supplementation could prevent the condition while lowering cholesterol.

### Why is cholesterol considered protective rather than harmful in arterial plaque?

The corpus describes cholesterol as a defensive reaction that acts like a protective bandage over tissue injured by oxidative stress, rushing in to limit inflammation within the plaque.

### How can vitamin K help with arterial calcification?

The entry notes that adequate vitamin K status can reverse calcification of blood vessels, while substances like baking soda or niacinamide that increase carbon dioxide also help keep calcium in bones and out of arteries.

## Related concepts

- [Age Pigment (Lipofuscin)](https://bioenergeticoracle.com/md/concepts/age-pigment-lipofuscin/index.md)
- [Aldosterone](https://bioenergeticoracle.com/md/concepts/aldosterone/index.md)
- [Arachidonic Acid](https://bioenergeticoracle.com/md/concepts/arachidonic-acid/index.md)
- [Calcium-to-Phosphorus Ratio](https://bioenergeticoracle.com/md/concepts/calcium-to-phosphorus-ratio/index.md)
- [Cheese](https://bioenergeticoracle.com/md/concepts/cheese/index.md)
- [Cholesterol](https://bioenergeticoracle.com/md/concepts/cholesterol/index.md)

## Cited passages

Passage numbers match the `[Source N]` markers in the synthesis above.

### Source 1 — Ray Peat Full Interview: Cholesterol, PUFA, Coconut Oil, Thyroid, and the Metabolic Truth

Ray Peat · Interview · Jul 12, 2025 · https://www.youtube.com/watch?v=lQB95tLW7eE

> **Ray Peat:** But when the petroleum chemists learned how to use petroleum, that freed up the soybean market for pigs, and their production was great enough. They wanted to... find new markets to replace the paint and plastics market. And so they started promoting the health idea of their soy oil, cotton seed oil, safflower seed oil, and so on. And the only biological effect other than sterility and dementia that were established for these seed oils was that they lowered blood cholesterol and for several decades people had been noticing that cholesterol accumulated in the walls of blood vessels atherosclerosis and although the first person who discovered that in rabbits had dissolved the cholesterol in unsaturated vegetable oil, he realized that cholesterol by itself wasn't causing the disease. But there had been these experiments that gave a basis for the seed oil people to say cholesterol is found in the hardened arteries. and in the blood and their oil lowers the level in the blood so they argued by guilt by association that if it's in the blood vessel and the blood then you can lower it in the blood and prevent the disease but the very people who had made those discoveries had realized that It wasn't so. And in fact, in the 1930s, people had found that thyroid was enough to prevent the atherosclerosis. And at the same time, it lowered cholesterol. Over the last 10 or 15 years, a Swedish doctor named Uffe Ravenskov has gone through the literature and shown just beautifully that there is no connection between atherosclerosis, heart disease, and the triglycerides and cholesterol in the blood. They are associated, but it isn't causal. And the experiments that have been done in the 30s showed that hypothyroidism and the associated changes caused by the lack of thyroid and metabolism were what caused the atherosclerosis. And the cholesterol seems to be there as a defensive reaction to protect the injured blood vessels.

### Source 2 — #220 - Toxic diet culture with Danny Roddy

Danny Roddy · Interview · May 22, 2023

> **Danny Roddy:** I can back that up for a second. There's a paper, I think it's in Japan, and they say, this is like in the 1960s. The details on this, people are probably going to look up this paper. I'm kind of paraphrasing. Anyways, the kids at three years old, I think it's in the 60s, so people are significantly healthier. Uh, the, the Japanese kids at three years old had, most of them had atherosclerotic plaque in their arteries at three years old. Okay. And then when they measured them at 20, like everybody had it. Okay. So, so it's an idea of like how early the health problems are manifesting. Like, so when a 21 year old thinks like, oh man, I have a health problem now. It's been, it could, could have been ostensibly happening since they were three years old, you know, or even earlier than that. And so, so anyways, Craig, go ahead. Sorry.
>
> **Craig:** That's really interesting. I've completely lost what I was going to say. That's crazy. I need to have a look at that.
>
> **Danny Roddy:** I need to find it. I'm probably butchering all the details.
>
> **Craig:** It's interesting that they were measuring that back in the 60s, though.

### Source 3 — Sugar Myths 1 – Sugar and the Link Between Cholesterol.

Ray Peat · Transcript · 2011

> **Andrew Murray:** But didn’t the Japanese come out with a study, just recently too that showed that when they took off an atherosclerostic plaque it had a cholesterol bandage over oxidised rancid vegetable oil?
>
> **Ray Peat:** Yeah cholesterol protects every cell. It is increased in the location that is being injured, especially. It is necessary for healthy cell division, DNA replication, nerve function, and learning. It’s our most basic anti-stress protective substance.
>
> **Andrew Murray:** So those oxidised vegetables oil were damaging the arterial wall and if the cholesterol wasn’t there, it couldn’t have stopped the rancidity and oxidation and it could’ve caused more problems right?
>
> **Ray Peat:** Yeah and what starts the inflammation in the artery wall and everywhere else, is the breakdown of the essential fatty acids into the free radical products and lipofuscin. You can extract lipofuscin from every arterial plaque, every degenerative tissue you find the breakdown product, but you don’t find fresh polyunsaturated fats because they’re unstable. They break down quickly and what you find is the cholesterol that is there repairing the tissue, the saturated fats that didn’t break down and the lipofuscin which is the EX essential fatty acids.

### Source 4 — A Bioenergetic View of Heart Disease and Stroke [Generative Energy #22]

Danny Roddy · Interview · Feb 25, 2016 · https://www.youtube.com/watch?v=WF5LJMCuGn0

> **Georgi Dinkov:** Yeah, sure. I mean, I guess as I started, as I said at the beginning, let's split them into two main kinds. One of them is the heart failure type of heart disease, which is really like the weakening and the destruction, the myopathy of the heart muscle. And I'm saying muscle, I'm emphasizing muscle because we'll see how this parallels with other conditions like muscular myopathy of the skeletal muscle. And then there's also the cardiovascular disease triggered by atherosclerosis. And let's start with atherosclerosis process. Basically, even though the mainstream view and everybody thinks that cholesterol is the cause, in fact, even the mainstream view, if you look at the actual textbooks, will tell you that that's not the case. The majority of the plaque that's actually lining up these vessels is composed of dead and alive white blood cells. So it does seem to be an actual immune reaction. There is a guy in Germany who has proposed to look at atherosclerosis as an autoimmune disease of the vascular system. Basically, the process is the same. It looks like, for whatever reason, if you don't know any better, it looks like the white blood cells are attacking the lining of the blood vessels. And what happens is that basically as these white blood cells accumulate, they form basically the innermost layer. As the cells along the wall of the vessel start to die, basically calcium accumulates as well. And finally, cholesterol rushes in. And originally, the claim was that cholesterol was the cause of the outermost layer of the plaque. But now it seems that cholesterol is going there to actually try to limit the inflammation and protect the vessel. Over time, basically what you have is this increased immune reaction attracts to itself cholesterol and also the calcium from the dying cells. And eventually, this is what forms the plaque. And there are studies that show that all of these issues are virtually absent when vitamin K status is adequate.

### Source 5 — One Radio Network: Ray Peat with Patrick Timpone — April 18, 2022

Ray Peat · Interview · Apr 18, 2022

> **Ray Peat:** No, I'm very skeptical that that would improve heart disease.
>
> **Patrick Timpone:** Mm-hmm. Heart disease, as you know it, it's more of something going on right with the heart muscle rather than atherosclerosis, correct, is what we're thinking?
>
> **Ray Peat:** Oh, no. Atherosclerosis is an inflammatory condition that affects your heart at the same time as the blood vessels. But people have removed the plaque and chemically stained it and found that it's full of breakdown products from polyunsaturated fat.
>
> **Patrick Timpone:** Poofers again. Age pigment, basically. Poofers. The culprits again? Poofers. Yeah. Wow. Do we get too many poofers more than we want just by eating fish?
>
> **Ray Peat:** Yes, you eat too much fish. That's why I advocate only the low-fat fish.
>
> **Patrick Timpone:** Low-fat fish, which are, what are some of your low-fatters?
>
> **Ray Peat:** Cod and sole.
>
> **Patrick Timpone:** Cod and sole are the best ones, called cod and sole. That's why the salmon, they've got a lot of poofers in there, right?
>
> **Ray Peat:** Mm-hmm.
>
> **Patrick Timpone:** Yeah, good old poofers. Let's see, here's someone... I don't understand this one. Sorry. I read that it takes about 40 to 56 days for skin cells to turn over from stem cells to disquamination off the surface of a follicular hypokeratosis, and I started supplementing vitamin A for it. I'm sorry, did you understand those words? Yeah. Okay. In Dr. Peat's experience, how does vitamin A supplementation, how long does it take to clear skin problems like follicular hypokeratosis?

### Source 6 — Iodine Injections

Ray Peat · Newsletter · 1986

> ## Iodine Injections
>
> **Ray Peat:** *Editor*: You mentioned in the July Letter that iodine injections have been used in atherosclerosis. An old PDR described the use of iodide in atherosclerosis. Could you tell me who has studied the iodine injections? I liked your comments on Chelation. Ray Peat P.O. Box 3427 Eugene, OR 97403
>
> **Alan Gaby:** *Editor’s Reply*: Some of the references on iodine and cardiovascular disease are listed below: - Stern, FH: *Psychosomatics*, July, 1968, p. 229 - Fani, K: *Res Commun Chem Pathol, Pharmacol*, 1970; 1: 169 - Feinblatt, TM, et al: *Med Times*, 1956; 84(7) - Abrahamson, JA, et al: *EENT Digest*, 1968; 30:48 Alan Gaby, M.D.

### Source 7 — Vitamin E reverses atherogenesis/CVD, independently of its antioxidant effects

Georgi Dinkov · Article · Aug 25, 2024 · https://haidut.me/?p=2669

> Mainstream medicine claims that once cardiovascular disease (CVD) is established, there is no way to reverse it. All one can do is try to inhibit further plaque formation in the hope of delaying the inevitable (vessel blockage/rupture, followed by heart attack and/or stroke). I have already found studies demonstrating that aspirin, in doses of 800mg+ daily can reduce already established atheroma (plaque) and prevent future CVD event. The study below found that vitamin E, in a human-equivalent dose of about 5mg/kg daily, also reduces atherogenesis and improves cardiac function, without displaying antioxidant effects. The role of vitamin E as PUFA antagonist is probably the main mechanism of action, together with its role as an inhibitor of the inflammation producing enzyme COX/LOX, and its inhibitory effects on the release of other inflammatory mediators such as TNF-a, IL-1 and IL-6.
>
> [references]

### Source 8 — Ray Peat Full Interview: Cholesterol, PUFA, Coconut Oil, Thyroid, and the Metabolic Truth

Ray Peat · Interview · Jul 12, 2025 · https://www.youtube.com/watch?v=lQB95tLW7eE

> **Josh Rubin:** So, guys, what he just said the past couple minutes, write that down. That's some really good stuff to educate yourself on the differences. and why saturated fat is so important, the right type for humans, and why unsaturated fats can be actually quite detrimental. Now, you were talking about atherosclerosis. It's not the easiest word to say. You know, most Western literature, Western medicine literature doctors, they always talk about cholesterol and heart disease. You know, and if you even read the side of, like, Lipitor and stuff, it even says this medication has not been approved to prevent heart disease, but they still promote it for that. What do you feel? I know your thoughts on intracellular calcium and fibrosis and all that. Can you elaborate on what your thoughts are around atherosclerosis and heart disease and stuff like that?
>
> **Ray Peat:** Yeah, the polyunsaturated fats that we unavoidably get in our diet, they're constantly breaking down, producing free radicals. and tending to cause inflammation and tissue injury. And if anything is disturbing the metabolism of a cell, that's more likely to happen. For example, the normal healthy oxidation through the mitochondrion keeps the electrons tightly controlled while they're being transferred from, say, a glucose molecule to an oxygen molecule. But if you take away some of the oxygen, the electrons in the mitochondrion will have no place proper to go, and they will escape as free radical potentiators. And so the cell becomes more oxidized in the absence of sufficient oxygen. So any stress of a cell puts out these electrons that can attack the exposed electron bonds in unsaturated fats. But the saturated fats aren't open for stray electrons. So every time you're limited in your delivery of oxygen to a cell you're putting the unsaturated fats in the way of these stray electrons and those will then start chain reactions that at the extreme they form lumps of material called age pigment or lipofuscin and these the free radical oxidized fat fragments attached to proteins, and they collect bits of iron and other breakdown products from the free radical attacks on whatever is around in the cell. And these lumps of H pigment, because of their iron and fat fragments, are able to catalyze the consumption of energy and deliver energy from the enzymes to oxygen. So they can create a false mitochondrial effect, consuming energy and wasting oxygen. And then that accelerates the process because the real mitochondrion is further deprived of oxygen by these age pigment lumps. But before that happens, that tends to be at the end of the life. You get degrees of that happening in which oxygen deprivation and stress cause lower degrees of damage and inefficiency. signals go out changing the conditions of the organism.

### Source 9 — This interview has a lot of good info and I highly suggest reading it.

Ray Peat · Interview · 2012

> **Sarah Johannesen:** Commonly referred to as hardening of arteries.
>
> **Ray Peat:** Yea, the Japanese have done studies using just vitamin K. And, very high doses of it very effectively rebuild osteoporotic bones, while taking calcium out of arteries in their animal studies. But vitamin K is working on cellular energy and specifically on the handling of carbon dioxide as a group that lets the proteins handle calcium. And things that increase your carbon dioxide work right along with vitamin K in helping to keep the calcium and phosphate in your bones rather than in your arteries. Even baking soda helps to build strong bones. And in the way it's acting, it's the same as vitamin K or niacinamide; it's helping the kidneys to excrete phosphate that you don't need, helping to deposit calcium and phosphate in the bones, while taking it out of arteries.
>
> **Andrew Murray:** Talk a bit about parathyroid hormone, calcium and phosphate.
>
> **Ray Peat:** People who have good thyroid function and get enough calcium in their diet have a pretty low parathyroid hormone activity, towards…it’s the low end of what's now considered the normal range. At the middle of the so-called normal range, people tend to suffer inflammatory diseases, muscle pains, bone loss and so on. And the higher the parathyroid is, the more these degenerative, inflammatory diseases you have. And the first way to suppress excess parathyroid is by eating enough calcium but also vitamin d, that's the next most important thing.

### Source 10 — On the Genesis of Atherosclerosis

Broda Barnes · Article · 1973

> Modern autopsy studies offer convincing evidence that premature deaths from atherosclerosis are occurring in the escapees from deaths by infectious diseases.
>
> Atherosclerosis is not a modern invention; it was present in the Egyptian mummies entombed over 3000 years ago. Its phenomenal rise in the 20th century is again a natural consequence of the reduction in early deaths from infectious diseases. The antibiotic drugs have been a much more potent factor in the rise of heart attacks than all of the other changes in diet or living habits combined. Longer survival has allowed a natural process of aging to continue.
>
> There is little hope of abolishing atherosclerosis; to do so would be the equivalent of discovering perpetual motion. No worse catastrophe could occur. However, concrete evidence is accumulating that we can prevent many of the premature arterial degenerations and allow most persons to attain their "three score years and ten." Why did Parrish (1) observe that, at autopsy, no coronary sclerosis can be found in 8 per cent of males over 70 years of age, yet 27 per cent of fatal heart attacks occur before the age of 65? Obviously there is a difference in susceptibility, and that difference deserves the closest scrutiny.
>
> ## Thyroid Deficiency and Atherosclerosis
>
> The answer was found in the routine autopsies at Graz, Austria, where about 75 per cent of the persons who die in this city of 230,000 are examined post mortem in the largest pathology institute in the world. The protocols from over 70,000 autopsies covering the period 1930-1972 have been personally reviewed (2). This is a goiter region, and the entire population suffers from some degree of hypothyroidism. Iodized salt was not introduced until 1963, at which time goiters were the rule.
>
> Graz was chosen as a study area in order to see the influence of thyroid deficiency on atherosclerosis. The autopsies revealed that there is more coronary sclerosis in Graz than in the United States. Arterial damage begins at an earlier age and progresses faster; by age 70 it is hard to find either a male or a female without far-advanced coronary damage. But a paradox appears; Graz has a low incidence of myocardial infarction.
>
> In 1930 the incidence of fatal coronary disease was no greater in the autopsies at Graz than in those among the Bantu of South Africa.

### Source 11 — Mitochondrial dysfunction is a major cause of cardiovascular disease (CVD)

Georgi Dinkov · Article · Feb 12, 2023 · https://haidut.me/?p=2128

> At a first glance, mitochondrial dysfunction (a “functional” problem) has little in common with the build-up of plaque on arterial walls (a “structural” problem). However, as my readers know quite well, structure and function cannot be separated and a functional pathology is perfectly capable (in fact, guaranteed) to ultimately cause a structural pathology. Case in point – as the study below demonstrates, mitochondrial dys-function is a major causal factor in development of CVD, through the mechanism of “oxidative” stress downstream of the mitochondrial dysfunction. Since mitochondrial dysfunction is not addressed by any of the existing CVD treatments currently in clinical use, the authors argue it is not at all surprising that medicine has made zero progress in both preventing and treating this pathology.
>
> [references]

_Generated 2026-07-20 from the Bioenergetic Oracle corpus._