The Truth About Cholesterol, Part II
In the last issue of HealthBeat we talked about cholesterol, discussing what it is and what blood levels are most healthful. If you missed that issue, you can review it here: The Truth about Cholesterol, Part I
Here is a quick review before we proceed to Part II:
- Cholesterol is essential to human life - it makes up about 80% of our body's cell walls, and we can't live without it.
- Cholesterol in it's various forms - Low Density Lipoproteins, High Density Lipoproteins, Very Low Density Lipoproteins and Triglycerides, each exert various and different effects.
- Science currently "thinks" that LDL is the most dangerous cholesterol and that HDL is protective.
- Medical opinions about cholesterol and it's effects change regularly.
- LDL and TG's appear to be independent risk factors for cardiovascular disease.
- TG's become elevated primarily by excess carbohydrates in the diet, not by high fat or cholesterol.
- HDL levels can be increased by exercise, niacin, and maintaining youthful sex hormone levels.
- Decreased dietary cholesterol often does NOT lower total cholesterol levels; the liver simply manufactures more when it senses less intake from diet.
So, what can be done if you have been told that you have "high cholesterol?"
First, if a conventional doctor has found your cholesterol levels to be "high" (and there is differing opinion on what " too high" really is!), he or she has probably advised you to start taking a "statin" drug. You will likely be sent off with a prescription for the statin-de-jour along with a recommendation to "eat less cholesterol and cut down on the fats!" If you do a little research on your own, you will discover that these statin drugs have some very worrisome side-effects and that there are dozens, maybe even hundreds, of other "natural" remedies - all claiming to be "the best" for safely lowering cholesterol levels. Dr. Myatt and Nurse Mark chuckle when they get questions from Wellness Club members asking if they have heard about the latest and greatest pill or potion or "cure" - they've heard 'em all and then some!
While statin drugs are being marketed as the next best drug since antibiotics, the dangers and expense of these drugs are rarely mentioned. All the while, very well-proven natural remedies exist to reduce LDL cholesterol levels, total cholesterol levels, triglycerides and various other heart risk factors. Along with these well-proven natural remedies come another half-dozen that are seen to be helpful but are not as well researched. And of course, as with all other natural remedies, there are an entire array of poorly-researched, unproven remedies that rely on anecdotal "patient success stories" in their glowingly inflated sales pitches. Beware - these "also rans" aren't known to perform like proven remedies and may leave you sorely disappointed with the results.
So, let's take a look at the remedies for high cholesterol that have been well-researched and proven:
1.) Niacin The most well-studies natural agent for cholesterol improvement is niacin, a B complex vitamin. Niacin's effect on cholesterol has been known since the 1950's when it was found to be a highly effective cholesterol lowering agent. Studies have shown that niacin not only lowers LDL cholesterol, but also Lp(a), triglyceride, and fibrinogen (a blood protein that causes clot formation) levels, while it simultaneously raises beneficial HDL cholesterol levels. The Coronary Drug Project, an intensive and extensive evaluation of cholesterol-lowering drugs demonstrated that niacin was the only cholesterol-lowering agent that actually reduced overall mortality. Its effects were also found to be long lived, protecting patients in the study years after they had stopped taking it.
Like any substance, niacin is not entirely without cautions. It's side effects are well known, the most common being a "niacin flush" - an uncomfortable flushing or hot feeling experienced by some people after taking standard niacin. Niacin can also be toxic to the liver when taken in a "time release" form that was developed to avoid the problem of the "niacin flush" that made some patients reluctant to use it. Niacin can alter blood sugar control and so should be used under medical supervision in people with diabetes. It is also important to monitor both cholesterol levels and liver enzyme levels every three months or so while using niacin, as with a statin drug. Dr. Myatt recommends a form of niacin called inositol hexaniacinate, a No-Flush Niacin that is very well tolerated.
If niacin is so great, why don't the drug companies sell it, and why doesn't my doctor tell me to take it you ask? Well, though the studies strongly supports the use of niacin, it has also been victim of a lot of misinformation - your doctor may be ill-informed about it's benefits, while he or she has certainly been told all about the "benefits" of statins. Niacin is a widely available "generic" substance, meaning it cannot be patented, and the drug companies do not stand to make from it the massive profits that the other cholesterol-lowering drugs have generated for them. As a result, one rarely sees niacin advertised in the way that the expensive statin drugs are. Still, niacin should be considered as the first choice in a cholesterol-lowering treatment.
2.) Red Rice Yeastis next in importance. This substance is actually the result of a fungus that grows on white rice, turning it a red color. It has been known for centuries, and used as a colorant in oriental cuisine, and to make a form of red sake (rice wine). The active component in Red Rice Yeast is a compound called mevinolin, which is identical to the prescription drug, lovastatin. The drug companies created lovastatin in the laboratory in 1987 also using a fungus, Aspergillus terreus. The active ingredient in Red Rice Yeast was discovered and isolated a decade earlier. Red Rice Yeast has been proven to be just as effective as the modern statin drugs at lowering LDL cholesterol. Taken in high doses, it can have some of the same risks as the modern statin drugs - namely a risk of liver damage and also of rhabdomyolysis, a condition that includes muscle deterioration. Anyone taking this or any statin drug should have a baseline liver enzyme check and have their liver enzymes checked periodically thereafter. Both risks are small (about 2%) but present. The good news is that it is thought that there is a synergistic effect obtained from other related compounds in Red Rice Yeast which allows much smaller doses to be effective. A typical dose of statin drug would be in the range of 20-80mg/day while a typical dose of Red Rice Yeast would be about 2.5-10mg/day. Neither Red Rice Yeast or statin drugs should be taken with grapefruit juice, as this can cause a dangerous buildup of the statin compounds in the body.
Due to drug company pressure on the FDA, many Red Rice Yeast products have been taken off the market because they contained--- guess what?--- the active ingredient for lowering cholesterol! The FDA said that this made them a drug. Statin drugs are now a 10+ billion dollar a year business for the drug companies (statins are the biggest selling drug of all time), and Dr. Myatt believes they do not want any competition from a natural remedy, especially one that works successfully, has far less negative side effects, and can be taken for about 1/4 the monthly cost of the drug versions.
3.) Garlic is another well-known cholesterol-lowering agent is with a wide spectrum of additional beneficial effects including blood pressure regulation, effective antibiotic scope and potent immune stimulant. Here however we are interested in garlic's proven ability to lower LDL cholesterol when taken in appropriate doses of preparations that contains the the ingredient allicin. Allicin is the product of the substance alliin and the enzyme alliinase, and is fragile, dissipating quickly and easily during processing. A minimum therapeutic intake of allicin is considered to be about 4000 mcg. That is the equivalent to about one to four cloves of whole fresh garlic (depending on the size of the clove.) It is true that simply eating garlic (and it's cousin onion) can have an excellent effect for lowering LDL cholesterol, blood pressure, and blood fibrinogen levels. Please remember that this effect is lost when garlic or onion is cooked, as cooking quickly destroys the active ingredient allicin.
Anyone looking to buy garlic supplements should be aware of the German Commission E, a panel of experts which sets standards for dosage requirements to allow for therapeutic claims. Check the label to make sure the supplement you are considering meets their standards for strength and purity.
4.) Policosanol is a "new kid on the block" in terms of cholesterol control, but it looks promising. "Policosanol" refers to a group of eight solid alcohols derived from sugar cane wax. Octacosanol is the major constituent of policosanol and proponents of this substance claim that Octacosanol is remarkably safe and effective at reducing cholesterol levels, and at reducing platelet aggregation. Dr. Myatt and her team are actively researching this substance, and if it proves to be everything that it claims to be, look for it to be made available through the Wellness Club just as soon as "The Dragon Lady" - oops, I mean Dr. Myatt - ("The Dragon Lady" is what our supplement suppliers call her because of her exacting quality standards) - pins down the very highest quality product. For now, it appears that policosanol is more expensive than it should be because the main source of supply is the sugar cane fields of Cuba. The leaves and rinds of citrus fruits also contain octacosanol, as does wheat germ oil - these may prove to be an alternate source for this promising substance. If you are interested in giving Policosanol a try give us a call here at the Wellness Club and we'll give you the latest updates on it's availability and price.
Other Cholesterol-Lowering Agents
5.) Vitamin C C has a well-studied positive effect on lowering total cholesterol and triglyceride levels while raising beneficial HDL levels. Vitamin C supplementation is valuable for many other reasons - it is an powerful antioxidant, and an immune enhancer. If you are considering using higher doses of vitamin C, use buffered vitamin C to avoid stomach upset. Also remember that Dr. Myatt's Maxi-Multicontains 1,200 mg of this important vitamin when taken in the recommended daily dose.
6. Fiber has a time-honored place in any cholesterol-lowering regimen. High intakes of soluble fiber have been shown to lower both overall and LDL cholesterol levels. Unfortunately, such high intakes of fiber can cause gastrointestinal upset in many people, and this causes them to not take effective doses. Psyllium and oat bran are two of the most-studied, and are easily available to add to the diet. You should NOT take psyllium at the same time you take the prescription drugs carbamazepine, lithium, digitalis or nitrofurantoin because psyllium will decrease their absorption and effectiveness. Another form of fiber that is demonstrating great promise as a cholesterol-lowering aid is chitosan which is a substance made from the shells of shellfish. Chitosan has the effect of binding fat and cholesterol in the digestive tract. It is so effective at this that it will absorb as much as seven to eight times it's own weight in fat and bile which are then passed through the bowel and excreted. Because of it's fat-binding ability, chitosan is valuable as a weight loss aid as well as a cholesterol-normalizing agent. There are just a couple of caveats regarding chitosan: first, like any other fiber, chitosan can interfere with the absorption of certain nutrients and trace minerals. These should be taken at times other than when the chitosan is taken. Secondly, because chitosan is derived from the exoskeletons (shells) of shellfish, people with seafood allergies should use caution.
That is the top half-dozen, proven, tested, effective cholesterol-lowering supplements and agents. They are not the only things in our armamentarium (that's a medical word for "bag of tricks"!) though. Some of the "lesser lights" are not as well proven, or not as specifically effective at lowering cholesterol, but they may still be very valuable as a part of a coordinated cholesterol-lowering and health improving plan. Some of those include:
Artichoke has been studied since the 1930's and found to have excellent effects on both atherosclerotic plaque and cholesterol and LDL levels. It is also highly protective, and may even be regenerative to the liver. It also possesses antioxidant properties. It is a valuable addition to a person's daily supplementation. Dr. Myatt makes this available in combination with Milk Thistle which is a potent liver protector with regenerative properties and a powerful antioxidant and Turmeric which is a marvelous anti-inflammatory, antioxidant, liver-protective (on a par with milk thistle), anti-tumorgenic herb that also helps maintain normal blood viscosity.
Turmeric has been shown in a number of studies to have cholesterol-lowering effects of it's own. This, in addition to it's other benefits as described above make it a "must do" in any daily supplementation program. Turmeric also inhibits platelet aggregation (med-speak for blood clotting) and serves as a natural cox-2 inhibitor like the prescription drug Vioxx.
Gugulipid is an ancient remedy that is being "rediscovered" by the western medical establishment. Gugulipid is made from the resin of the commiphora mukul tree of north central India and has been used for thousands of years to alleviate problems associated with obesity, acne, viral infections, and other ailments. It has also been shown in some limited but significant studies to reduce cholesterol and LDL levels and increase HDL levels within three to four weeks. It is certainly worth considering adding this to a cholesterol-lowering regimen.
Green Tea has also been the subject of some promising and even exciting research. Green tea serves as a potent antioxidant, preventing the oxidation of LDL in the arteries. The cholesterol-lowering effects of Green tea have been shown in numerous animal and human studies. Green tea catechins act to limit the rise in blood cholesterol according to a 1996 Japanese study. Further, Green tea has been shown to elevate HDL, and serves as a natural ACE inhibitor, lowering blood pressure. These benefits can be obtained by drinking up to 10 cups of Green tea daily, or taking one to two capsules of Green tea extract daily.
Fish Oil has been shown to reduce high levels of triglycerides by an average of 35%. It does not appear to reduce cholesterol to that extent, but it does offer benefits when as part of an integrated therapy program. Scientific studies have demonstrated that alpha-linolenic acid (from flax or perilla oil) reduces the incidence of atherosclerosis, stroke, and second heart attacks. One study showed a 70% reduction in second heart attacks in those consuming this type of fatty acid.
Vitamin E protects us from more than 80 diseases and illnesses, including protecting us from the inhibiting the effects of oxidation of LDL and the development of atherosclerotic disease. Studies have also shown it to be effective as some hypocholesterolemic (cholesterol-lowering) drugs. Anyone considering adding vitamin E to their regimen should also add Selenium which works with vitamin E to prevent LDL oxidation. Both of these nutrients are found in Dr. Myatt's Maxi-Multi.
Finally, Soy has been shown to confer numerous benefits through it's isoflavones - genistein, daidzein, and glycitein. According to a study completed in 1997, "Potential mechanisms by which soy isoflavones might prevent atherosclerosis include a beneficial effect on plasma lipid concentrations, antioxidant effects, antiproliferative and antimigratory effects on smooth muscle cells, effects on thrombus formation, and maintenance of normal vascular reactivity." Bottom line: if you want to reduce your risk of heart disease and elevated cholesterol levels, it is worth adding soy to your diet.
So, we've talked about the proven first line remedies and the second line "helpfuls," now let's talk about some substances that have been touted without proof to back them up.
Coral Calcium - promoted as the cure for every thing from cancer to high cholesterol to bad breath to spiritual weakness. Many of it's top promoters are facing criminal prosecution. Avoid it. Not only does coral calcium often contain high lead levels, it is destructive to the coral reefs where it is derived. Calcium alone is not a proven cholesterol-lowering remedy; neither is coral calcium. If you need calcium supplements, consider something pure and proven such as Calmag Amino+Vit D & Boron. This isn't expected do much for your cholesterol levels, but it will help your bones. Also remember that Maxi Multi contains a full day's dose of these bone-protecting nutrients when taken at the recommended daily dose.
Various teas have been touted as total cholesterol cures, no doubt riding on the coattails of accepted Green Tea studies. Don't believe them - Green Tea is an important part of a cholesterol-control program, but teas are not the whole answer!
Cinnamon capsules have recently been promoted as a cholesterol-reducing agent. We are not aware of any solid studies to support this. Cinnamon does seem to have a beneficial effect on blood sugar levels of type II diabetics though. The capsules seem a bit expensive, when you can simply add this spice to your food and beverages - try it in tea!
Vinegar, and most especially apple cider vinegar, have also enjoyed some popularity as folk remedies for high cholesterol. Again, there is no scientific evidence of beneficial effect - though "anecdotal evidence" of the "my best friend's great aunt's late husband used it every day 'till he died" variety is plentiful...
Beyond Supplements of Drugs: Live a "Good Cholesterol Lifestyle"
No cholesterol-lowering program would be complete without a discussion of diet. Instead of dire warnings and restrictive regimes that drastically limit fat intake, Dr. Myatt puts her patients on The Super Fast Diet for cholesterol control. Her patients find this to be a rich, balanced, satisfying diet, and they are pleasantly surprised to find that not only do their cholesterol levels normalize in short order, but so does their weight. This nutrient-rich diet has people feeling better, looking better, and performing better, and their lab results are the proof of it's effectiveness.
Here's to Your good Health and Happy Cholesterol Levels! And remember, cholesterol is your friend :-)
Until Next Time, Be Well!
Editor, HealthBeat Newsletter