Alternative Treatments for High Cholesterol
There are many alternative treatments for lowering cholesterol. But before you add any supplements or alternative therapies to your diet, talk to your health care provider. Some supplements may interact with other medication you may be taking or have dangerous side effects.
Supplements for Lowering Cholesterol
Some of the herbal and nutritional supplements that may lower cholesterol include:
· Garlic: According to some studies, garlic may decrease blood levels of total cholesterol by a few percentage points. Other studies, however, suggest that it may not be as beneficial as once thought. It may also have significant side effects and/or interaction with certain medications. Garlic may prolong bleeding and blood clotting time, so garlic and garlic supplements should not be taken prior to surgery or with blood-thinning drugs such as Coumadin.
· Guggulipid: Guggulipid is the gum resin of the mukul myrrh tree. In clinical studies performed in India, guggulipid significantly reduced blood levels of total cholesterol and LDL cholesterol. The enthusiasm for using guggulipid as a cholesterol-lowering herbal agent, however, diminished after the publication of negative results from a clinical trial in the U.S. Further research is necessary to determine the safety and efficacy of this herb.
· Red yeast rice: Red yeast rice has been found to lower cholesterol in studies and was previously found in the over-the-counter supplement Cholestin. However, in 2001, FDA took Cholestin off the shelf because it contained lovastatin, a compound found in the cholesterol prescription medication Mevacor. Reformulated "Cholestin" no longer contains red yeast rice. Other red yeast rice-containing supplements currently available in the U.S. contain very small amounts of lovastatin. Their effectiveness is questionable.
· Policosanol: Produced from sugar cane, policosanol was found to be effective in lowering LDL cholesterol in several studies. Most policosanol supplements found in the U.S., including the reformulated Cholestin, contain policosanol extracted from beeswax and not the sugar cane policosanol. There is no evidence that policosanol extracted from beeswax can lower cholesterol. Additional studies on sugar cane policosanol are needed to determine its effectiveness in lowering cholesterol.
· Other herbal products: The results of several studies suggest fenugreek seeds and leaves, artichoke leaf extract, yarrow, and holy basil all may help lower cholesterol. These and other commonly used herbs and spices -- including ginger, turmeric, and rosemary -- are being investigated for their potential beneficial effects relating to coronary disease prevention.
Dietary Approaches to Lowering Cholesterol
Increased consumption of dietary fiber, soy foods, omega-3 fatty acids, and plant compounds similar to cholesterol (plant stanols and sterols) can significantly reduce LDL cholesterol, or bad cholesterol.
· Fiber: Only plant foods (vegetables, fruits, legumes, unrefined grains) contain dietary fiber. The soluble fiber found in foods such as oat bran, barley, psyllium seeds, flax seed meal, apples, citrus fruits, lentils and beans are particularly effective in lowering cholesterol.
· Soybeans: Substituting soybeans or soy protein for other proteins have been shown to prevent coronary heart disease by lowering LDL cholesterol and triglycerides. Soy protein is present in tofu, tempeh, soy milk, soy yogurt, edamame, soy nuts, and many other food products made from soybeans.
· Phytosterols: Phytosterols (plant sterol and stanol esters) are compounds found in small amounts in foods such as whole grains as well as in many vegetables, fruits, and vegetable oils. They decrease LDL cholesterol, mostly by interfering with the intestinal absorption of cholesterol. Phytosterols can be found in spreads (like the cholesterol-lowering margarines Benecol, Promise, Smart Balance, and Take Control), dressings for salads, and dietary supplements. Additional phytosterol-fortified foods include Minute Maid Heart Wise orange juice, Nature Valley Healthy Heart chewy granola bars, CocoVia chocolates, Rice Dream Heartwise rice drink, and Lifetime low-fat cheese.
· Omega-3 fatty acids: Eating foods rich in omega-3 fatty acids may also help lower cholesterol. Omega-3 fatty acids decrease the rate at which the liver produces LDL cholesterol and triglycerides. They have an anti-inflammatory effect in the body, decrease the growth of plaque in the arteries, and aid in thinning blood. Aim for at least two servings of fatty fish like salmon, mackerel, herring, tuna, and sardines per week. Other dietary sources of omega-3 fatty acids include flax seed and walnuts. Supplement sources include fish oil capsules, flaxseed and flax seed oil. If you are considering taking omega-3 fatty acids, first discuss with your health care provider if omega-3 fatty acid supplements are right for you, especially if you are currently taking blood-thinning medication.
Nutritional Supplements for High Cholesterol: 1) Niacin (Vitamin B3) Niacin, also called vitamin B3, is used to lower cholesterol. Specifically, it appears to lower LDL cholesterol and increase HDL cholesterol.
Well-designed studies have found that niacin lowers LDL cholesterol by approximately 10%, lowers triglycerides by 25%, and raises "good" HDL cholesterol by 15% to 30%. Niacin also appears to significantly lower levels for another risk factor for atherosclerosis, lipoprotein A.
Niacin is available in prescription form and as a dietary supplement. The American Heart Association cautions patients to only use the prescription form of niacin.
Because of side effects, niacin should not be used to lower cholesterol unless under the supervision of a qualified health practitioner.
Niacin can increase the effect of high blood pressure medication or cause nausea, indigestion, gas, diarrhea, gout, and worsen peptic ulcers, or trigger gout, liver inflammation, and high blood sugar.
The most common side effect of high-dose niacin is skin flushing or hot flashes, which is caused by widening of blood vessels. Most people only notice this when they initially start taking niacin. The flushing may be lessened by taking niacin with meals.
Although high doses of niacin showed promise in combination with drugs to lower cholesterol (called "statins"), there are concerns that combining them could result in a potentially fatal condition called rhabdomyolysis. They shouldn't be combined unless under the close supervision of a physician.
Find out more about using Niacin supplements.
2) Artichoke Leaf There is some research suggesting that artichoke leaf extract (Cynara scolymnus) may help to lower cholesterol. Artichoke leaf extract may work by limiting the synthesis of cholesterol in the body.
Artichokes also contain a compound called cynarin, believed to increase bile production in the liver and speed the flow of bile from the gallbladder, both of which may increase cholesterol excretion.
A double-blind, placebo-controlled German study found that 1,800 mg of artichoke extract per day for six weeks significantly lowered total cholesterol by 18.5% compared to 8.6% in the placebo group and lowered LDL cholesterol by 22.9% compared with 6% in the placebo group. The ratio of LDL to HDL decreased by 20% in the artichoke group compared with 7% in the placebo group. There were no adverse effects associated with artichoke use.
A meta-analysis looked at randomized controlled trials for artichoke extract for high cholesterol. Two trials involving a total of 167 people met the quality criteria. One trial found artichoke significantly reduced total cholesterol after 42 days of treatment. The other study found artichoke significantly reduced total cholesterol in a subgroup of patients with total cholesterol levels of more than 230 mg/dl. Adverse events were mild, transient and infrequent. Larger clinical trials over longer periods are needed.
High Cholesterol
What is high cholesterol?
High cholesterol is a well-known risk factor for heart disease. Cholesterol itself is a waxy, fat-like substance that is primarily made by the liver, although some comes from the diet. It is an essential component of cell membranes and is used by the body to produce hormones and vitamin D.
Cholesterol is carried through the bloodstream attached to two different compounds called lipoproteins: low-density lipoproteins (LDL) and high-density lipoproteins (HDL). LDL is commonly known as the "bad" cholesterol because it transports cholesterol from the liver throughout the body, and potentially allows it to be deposited in artery walls. HDL, known as the "good cholesterol," picks up cholesterol from the blood and delivers it to cells that use it, or takes it back to the liver to be recycled or eliminated from the body.
Too much cholesterol in the blood builds up on artery walls causing hardening of the arteries (atherosclerosis). The buildup of cholesterol narrows arteries, slowing or blocking the flow of oxygen-carrying blood to the heart, which can manifest as chest pain. If blood flow to the heart is cut off because of clogged arteries, the result is damage to the heart muscle - a heart attack.
What are the symptoms of high cholesterol?
High cholesterol itself does not cause symptoms, so there are no outward signs that your levels are too high and thereby posing a risk to your heart.
What are the causes of high cholesterol?
The tendency toward high cholesterol appears to be genetic although diet also influences cholesterol levels. Other factors that can influence cholesterol levels include being overweight and being physically inactive. The older you get, the more likely your cholesterol levels are to rise. Before menopause, women tend to have lower cholesterol levels than men of the same age, but after menopause, women's LDL levels often increase.
There is considerable controversy over whether high cholesterol is in itself a cause of heart disease (the lipid hypothesis), or a symptom of an inflammatory condition that is the true cause of heart disease (the inflammation hypothesis). According to the latter theory, chronically high levels of inflammation creates small lesions on arterial walls; the body sends LDL to heal those lesions, but it ultimately accumulates and oxidizes, causing blockages. From this perspective, the best lifestyle approach to lower cardiovascular disease risk is to lower inflammation in the body rather than LDL levels.
The two theories are not mutually exclusive; they may both be true to some extent.
How is high cholesterol diagnosed?
Your cholesterol levels can be measured by a blood test done after you've fasted for nine to 12 hours. Results will reveal your total cholesterol level, your LDL and HDL levels as well as levels of triglycerides, the most common type of fat in the body. Some doctors also obtain tests for LDL particle size and number.
Desirable levels of total cholesterol are 200 mg per deciliter of blood or less; levels between 200 mg/dL and 239 mg/dL are considered borderline high; 240 mg/dL or higher is considered high cholesterol and raises your risk of heart disease to twice what it would be if your total cholesterol were 200 mg/dL or lower.
A desirable level of heart protective HDL cholesterol is 60 mg/dL or higher; levels below 40 mg/dL for men and less than 50 mg/dL for women increase the risk of heart disease. According to the American Heart Association, the mean level of HDL cholesterol for American adults age 20 and older is 54.3 mg/dL.
A desirable level of LDL ("bad") cholesterol is less than 100 mg/dL - the lower your LDL, the better in terms of heart disease risk. Levels between 139 and 150 mg/dL are borderline high and those between 160 to 189 mg/dL are considered high, while LDL levels above 190 mg/dL are classed as very high. According to the American Heart Association, the mean level of LDL cholesterol for American adults age 20 and older is 115.0 mg/dL.
Normal triglyceride levels are considered 150 mg/dL or lower; those from 150 to 199 mg/dL are considered borderline high while those from 200-499 mg/dL are considered high, and those above 500 mg/dL are deemed very high. The American Heart Association reports that the mean triglyceride level for American adults age 20 and older is 144.2 mg/dl.
What is the conventional treatment of high cholesterol?
Treatment of high cholesterol usually begins with lifestyle changes geared toward bringing levels down. These include losing weight if you're overweight, and changing your diet to emphasize vegetables and fruits, fish, particularly cold water fish such as wild Alaskan salmon, mackerel, herring and black cod that provide heart healthy omega-3 fatty acids. If lifestyle changes don't help or if you're unable to make the changes your doctor recommends, cholesterol-lowering drugs may be prescribed. These include statins, which effectively lower LDL cholesterol; bile acid sequestrants that may be prescribed along with statins to lower LDL; nicotinic acid to lower LDL cholesterol and triglycerides and raise HDL; drugs called fibrates that may be prescribed to lower cholesterol and may raise HDL; and a drug called Ezetimibe to lower LDL by blocking the absorption of cholesterol in the intestine.
What therapies does Dr. Weil recommend for high cholesterol?
Dr. Weil recommends making the following lifestyle and dietary changes in order to lower high cholesterol levels:
1. Lose weight. Even a modest amount of weight loss can lower cholesterol levels.
2. Reduce the amount of sugar and flour in your diet. Recent evidence indicates that added sugar - in the form of table sugar (sucrose) or high-fructose corn syrup - is probably a greater contributor to heart disease than is consumption of saturated fat. This suggests that the inflammatory hypothesis may in fact have more validity than the conventional lipid hypothesis, although the debate is far from settled. As a general rule, Dr. Weil advises against consuming foods with added sugars, particularly soft drinks and highly processed snack foods, which can cause rapid spikes and dips in blood sugar levels. The result can be overeating, obesity and heart disease.
3. Avoid trans-fatty acids. These heart-damaging fats can reduce HDL ("good") cholesterol levels and raise levels of LDL ("bad") cholesterol. The tip-off that trans-fatty acids are present in foods is the listing of "partially hydrogenated oil" on a food's ingredient list. Trans-fats are found in many brands of margarine and in most heavily processed foods, as well as in snack foods such as chips, crackers and cookies, and in the oils used to cook fast-food French fries, doughnuts and movie popcorn.
4. Exercise. Daily aerobic exercise can help increase HDL levels.
5. Don't smoke. Smoking itself is a risk factor for heart disease. It can also significantly lower HDL cholesterol.
6. Relax. Emotional stress may prompt the body to release fat into the bloodstream, raising cholesterol levels. Counter stress by practicing daily breathing exercises and other stress-reduction techniques such as yoga, meditation, guided imagery ortai chi.
Nutrition and Supplements
Dr. Weil recommends the following dietary changes that may help lower cholesterol levels.
1. Eat some nuts every day. Choose almonds, walnuts and cashews, all of which contain heart-healthy monounsaturated fat.
2. Substitute whole soy protein for animal protein. Soy protein such as tofu, tempeh, soy milk, whole soy beans and roasted soy nuts has been shown to lower cholesterol levels. Choose organic products where possible.
3. Use fresh garlic regularly. Garlic has been shown to lower both cholesterol levels and blood pressure. Use one or two raw or lightly cooked cloves a day.
4. Drink green tea daily. The antioxidants it contains help lower cholesterol and prevent the cholesterol in your blood from oxidizing.
5. Eat plenty of soluble fiber. Beans and lentils, apples, citrus fruits, oats, barley, peas, carrots and ground flax seed are all good sources of soluble fiber, which has a powerful cholesterol-lowering effect.
6. Limit refined carbohydrates. These include cookies, cakes, crackers, fluffy breads, chips and sodas, all of which can worsen cholesterol levels by lowering HDL and also increase triglyceride levels.
7. Take coenzyme Q10 (CoQ10). This powerful antioxidant benefits heart health by protecting LDL cholesterol from oxidation and by re-energizing the mitochondria in the heart cells, which is where energy metabolism occurs. CoQ10 may also help lower blood pressure.
8. Take fish oil. Fish oil contains an abundance of essential omega-3 fatty acids (omega-3s) that have been shown to lower triglyceride (blood fat) levels, minimize inflammation and clotting, and increase HDL ("good") cholesterol. Research indicates that omega-3s may help reduce the risk and symptoms of a variety of disorders influenced by inflammation, including heart attack and stroke. You can add omega-3s to your diet by eating more cold water fish such as wild Alaskan salmon, sardines, herring, mackerel and black cod. If that's not possible, Dr. Weil recommends taking two grams daily of a fish oil supplement that contains both essential omega-3 fatty acids, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). When choosing a supplement, look for one derived from molecularly distilled fish oils - these are naturally high in both EPA and DHA and low in contaminants. Also choose a supplement brand that has been independently tested and guaranteed to be free of heavy metals such as mercury and lead, and other environmental toxins including polychlorinated biphenyls, also known as PCBs.
Cholesterol-lowering supplements: Lower your numbers without prescription medication By Mayo Clinic Staff
If you're worried about your cholesterol level and have already started exercising and eating healthier foods, you might wonder if adding a cholesterol-lowering supplement to your diet can help reduce your numbers. Although few natural products have been proven to reduce cholesterol, some might be helpful. With your doctor's OK, consider these cholesterol-lowering supplements and products.
Cholesterol-lowering supplement
What it does
Side effects and drug interactions
Artichoke extract
May reduce total cholesterol and LDL, or "bad," cholesterol
May cause gas or an allergic reaction
Barley
May reduce total cholesterol and LDL cholesterol
None
Beta-sitosterol (found in oral supplements and some margarines, such as Promise Activ)
May reduce total cholesterol and LDL cholesterol
May cause nausea, indigestion, gas, diarrhea or constipation
May be ineffective if you take ezetimibe (Zetia), a prescription cholesterol medication
Blond psyllium (found in seed husk and products such as Metamucil)
May reduce total cholesterol and LDL cholesterol
May cause gas, stomach pain, diarrhea, constipation or nausea
Fish oil (found as a liquid oil and in oil-filled capsules)
May reduce triglycerides
May cause a fishy aftertaste, bad breath, gas, nausea, vomiting or diarrhea
May interact with some blood-thinning medications, such as warfarin (Coumadin)
Flaxseed, ground
May reduce triglycerides
May cause, gas, bloating or diarrhea
May interact with some blood-thinning medications, such as aspirin, clopidogrel (Plavix) and warfarin (Coumadin)
Garlic extract
May reduce total cholesterol, LDL cholesterol and triglycerides
May cause bad breath, body odor, heartburn, gas, nausea, vomiting or diarrhea
May interact with blood-thinning medications, such as warfarin (Coumadin)
Green tea extract
May lower LDL cholesterol
May cause nausea, vomiting, gas or diarrhea
May interact with blood-thinning medications, such as warfarin (Coumadin)
Oat bran (found in oatmeal and whole oats)
May reduce total cholesterol and LDL cholesterol
May cause gas or bloating
Sitostanol (found in oral supplements and some margarines, such as Benecol)
May reduce total cholesterol and LDL cholesterol
May cause diarrhea
Another popular cholesterol-lowering supplement is red yeast rice. There is some evidence that red yeast rice can help lower your LDL cholesterol. However, the Food and Drug Administration has warned that red yeast rice products could contain a naturally occurring form of the prescription medication known as lovastatin. Lovastatin in the red yeast rice products in question is potentially dangerous because there's no way for you to know what level or quality of lovastatin might be in red yeast rice.
Sometimes healthy lifestyle choices, including supplements and other cholesterol-lowering products, aren't enough. If your doctor prescribes medication to reduce your cholesterol, take it as directed while you continue to focus on a healthy lifestyle. As always, be sure to tell your doctor if you decide to take an herbal supplement. The herbal supplement you take may interact with other medications you take.
· Other herbal products: The results of several studies suggest fenugreek seeds and leaves, artichoke leaf extract, yarrow, and holy basil all may help lower cholesterol. These and other commonly used herbs and spices -- including ginger, turmeric, and rosemary -- are being investigated for their potential beneficial effects relating to coronary disease prevention.
Disclaimer
The articles and information given in the publication of this web site are not intended to replace a one on one relationship with a qualified health care provider and are not intended or to be interpreted as medical advice. They are more so intended in the sharing of information and knowledge from experience and research in the field of health care alternatives.
These statements and products shown on this website have not been evaluated by the United States Food and Drug Administration (FDA). These statements and/or products are not intended to diagnose, treat, cure or prevent any disease. Those seeking treatment for a specific disease should consult a qualified integrative physician prior to using these products if possible. Nothing stated here should be considered as medical advice for dealing with a given problem, or to diagnose / treat / prevent / cure any disease. All information posted on this web site is provided for educational purposes only. It is not to be construed as medical advice. Only a licensed medical doctor can legally offer medical advice in the United States. Consult your health care professional for individual guidance for specific health problems. The information on this site is presented strictly for informational and educational use only. Information conveyed herein is based on pharmacological and other records, both ancient and modern. No claims whatsoever can be made as to the specific benefits that might result from their use. Anyone with knowledge of additional information on any of the medical information on this site is highly encouraged to e-mail that information to me, so that it can be shared with others who may be interested.
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There are many alternative treatments for lowering cholesterol. But before you add any supplements or alternative therapies to your diet, talk to your health care provider. Some supplements may interact with other medication you may be taking or have dangerous side effects.
Supplements for Lowering Cholesterol
Some of the herbal and nutritional supplements that may lower cholesterol include:
· Garlic: According to some studies, garlic may decrease blood levels of total cholesterol by a few percentage points. Other studies, however, suggest that it may not be as beneficial as once thought. It may also have significant side effects and/or interaction with certain medications. Garlic may prolong bleeding and blood clotting time, so garlic and garlic supplements should not be taken prior to surgery or with blood-thinning drugs such as Coumadin.
· Guggulipid: Guggulipid is the gum resin of the mukul myrrh tree. In clinical studies performed in India, guggulipid significantly reduced blood levels of total cholesterol and LDL cholesterol. The enthusiasm for using guggulipid as a cholesterol-lowering herbal agent, however, diminished after the publication of negative results from a clinical trial in the U.S. Further research is necessary to determine the safety and efficacy of this herb.
· Red yeast rice: Red yeast rice has been found to lower cholesterol in studies and was previously found in the over-the-counter supplement Cholestin. However, in 2001, FDA took Cholestin off the shelf because it contained lovastatin, a compound found in the cholesterol prescription medication Mevacor. Reformulated "Cholestin" no longer contains red yeast rice. Other red yeast rice-containing supplements currently available in the U.S. contain very small amounts of lovastatin. Their effectiveness is questionable.
· Policosanol: Produced from sugar cane, policosanol was found to be effective in lowering LDL cholesterol in several studies. Most policosanol supplements found in the U.S., including the reformulated Cholestin, contain policosanol extracted from beeswax and not the sugar cane policosanol. There is no evidence that policosanol extracted from beeswax can lower cholesterol. Additional studies on sugar cane policosanol are needed to determine its effectiveness in lowering cholesterol.
· Other herbal products: The results of several studies suggest fenugreek seeds and leaves, artichoke leaf extract, yarrow, and holy basil all may help lower cholesterol. These and other commonly used herbs and spices -- including ginger, turmeric, and rosemary -- are being investigated for their potential beneficial effects relating to coronary disease prevention.
Dietary Approaches to Lowering Cholesterol
Increased consumption of dietary fiber, soy foods, omega-3 fatty acids, and plant compounds similar to cholesterol (plant stanols and sterols) can significantly reduce LDL cholesterol, or bad cholesterol.
· Fiber: Only plant foods (vegetables, fruits, legumes, unrefined grains) contain dietary fiber. The soluble fiber found in foods such as oat bran, barley, psyllium seeds, flax seed meal, apples, citrus fruits, lentils and beans are particularly effective in lowering cholesterol.
· Soybeans: Substituting soybeans or soy protein for other proteins have been shown to prevent coronary heart disease by lowering LDL cholesterol and triglycerides. Soy protein is present in tofu, tempeh, soy milk, soy yogurt, edamame, soy nuts, and many other food products made from soybeans.
· Phytosterols: Phytosterols (plant sterol and stanol esters) are compounds found in small amounts in foods such as whole grains as well as in many vegetables, fruits, and vegetable oils. They decrease LDL cholesterol, mostly by interfering with the intestinal absorption of cholesterol. Phytosterols can be found in spreads (like the cholesterol-lowering margarines Benecol, Promise, Smart Balance, and Take Control), dressings for salads, and dietary supplements. Additional phytosterol-fortified foods include Minute Maid Heart Wise orange juice, Nature Valley Healthy Heart chewy granola bars, CocoVia chocolates, Rice Dream Heartwise rice drink, and Lifetime low-fat cheese.
· Omega-3 fatty acids: Eating foods rich in omega-3 fatty acids may also help lower cholesterol. Omega-3 fatty acids decrease the rate at which the liver produces LDL cholesterol and triglycerides. They have an anti-inflammatory effect in the body, decrease the growth of plaque in the arteries, and aid in thinning blood. Aim for at least two servings of fatty fish like salmon, mackerel, herring, tuna, and sardines per week. Other dietary sources of omega-3 fatty acids include flax seed and walnuts. Supplement sources include fish oil capsules, flaxseed and flax seed oil. If you are considering taking omega-3 fatty acids, first discuss with your health care provider if omega-3 fatty acid supplements are right for you, especially if you are currently taking blood-thinning medication.
Nutritional Supplements for High Cholesterol: 1) Niacin (Vitamin B3) Niacin, also called vitamin B3, is used to lower cholesterol. Specifically, it appears to lower LDL cholesterol and increase HDL cholesterol.
Well-designed studies have found that niacin lowers LDL cholesterol by approximately 10%, lowers triglycerides by 25%, and raises "good" HDL cholesterol by 15% to 30%. Niacin also appears to significantly lower levels for another risk factor for atherosclerosis, lipoprotein A.
Niacin is available in prescription form and as a dietary supplement. The American Heart Association cautions patients to only use the prescription form of niacin.
Because of side effects, niacin should not be used to lower cholesterol unless under the supervision of a qualified health practitioner.
Niacin can increase the effect of high blood pressure medication or cause nausea, indigestion, gas, diarrhea, gout, and worsen peptic ulcers, or trigger gout, liver inflammation, and high blood sugar.
The most common side effect of high-dose niacin is skin flushing or hot flashes, which is caused by widening of blood vessels. Most people only notice this when they initially start taking niacin. The flushing may be lessened by taking niacin with meals.
Although high doses of niacin showed promise in combination with drugs to lower cholesterol (called "statins"), there are concerns that combining them could result in a potentially fatal condition called rhabdomyolysis. They shouldn't be combined unless under the close supervision of a physician.
Find out more about using Niacin supplements.
2) Artichoke Leaf There is some research suggesting that artichoke leaf extract (Cynara scolymnus) may help to lower cholesterol. Artichoke leaf extract may work by limiting the synthesis of cholesterol in the body.
Artichokes also contain a compound called cynarin, believed to increase bile production in the liver and speed the flow of bile from the gallbladder, both of which may increase cholesterol excretion.
A double-blind, placebo-controlled German study found that 1,800 mg of artichoke extract per day for six weeks significantly lowered total cholesterol by 18.5% compared to 8.6% in the placebo group and lowered LDL cholesterol by 22.9% compared with 6% in the placebo group. The ratio of LDL to HDL decreased by 20% in the artichoke group compared with 7% in the placebo group. There were no adverse effects associated with artichoke use.
A meta-analysis looked at randomized controlled trials for artichoke extract for high cholesterol. Two trials involving a total of 167 people met the quality criteria. One trial found artichoke significantly reduced total cholesterol after 42 days of treatment. The other study found artichoke significantly reduced total cholesterol in a subgroup of patients with total cholesterol levels of more than 230 mg/dl. Adverse events were mild, transient and infrequent. Larger clinical trials over longer periods are needed.
High Cholesterol
What is high cholesterol?
High cholesterol is a well-known risk factor for heart disease. Cholesterol itself is a waxy, fat-like substance that is primarily made by the liver, although some comes from the diet. It is an essential component of cell membranes and is used by the body to produce hormones and vitamin D.
Cholesterol is carried through the bloodstream attached to two different compounds called lipoproteins: low-density lipoproteins (LDL) and high-density lipoproteins (HDL). LDL is commonly known as the "bad" cholesterol because it transports cholesterol from the liver throughout the body, and potentially allows it to be deposited in artery walls. HDL, known as the "good cholesterol," picks up cholesterol from the blood and delivers it to cells that use it, or takes it back to the liver to be recycled or eliminated from the body.
Too much cholesterol in the blood builds up on artery walls causing hardening of the arteries (atherosclerosis). The buildup of cholesterol narrows arteries, slowing or blocking the flow of oxygen-carrying blood to the heart, which can manifest as chest pain. If blood flow to the heart is cut off because of clogged arteries, the result is damage to the heart muscle - a heart attack.
What are the symptoms of high cholesterol?
High cholesterol itself does not cause symptoms, so there are no outward signs that your levels are too high and thereby posing a risk to your heart.
What are the causes of high cholesterol?
The tendency toward high cholesterol appears to be genetic although diet also influences cholesterol levels. Other factors that can influence cholesterol levels include being overweight and being physically inactive. The older you get, the more likely your cholesterol levels are to rise. Before menopause, women tend to have lower cholesterol levels than men of the same age, but after menopause, women's LDL levels often increase.
There is considerable controversy over whether high cholesterol is in itself a cause of heart disease (the lipid hypothesis), or a symptom of an inflammatory condition that is the true cause of heart disease (the inflammation hypothesis). According to the latter theory, chronically high levels of inflammation creates small lesions on arterial walls; the body sends LDL to heal those lesions, but it ultimately accumulates and oxidizes, causing blockages. From this perspective, the best lifestyle approach to lower cardiovascular disease risk is to lower inflammation in the body rather than LDL levels.
The two theories are not mutually exclusive; they may both be true to some extent.
How is high cholesterol diagnosed?
Your cholesterol levels can be measured by a blood test done after you've fasted for nine to 12 hours. Results will reveal your total cholesterol level, your LDL and HDL levels as well as levels of triglycerides, the most common type of fat in the body. Some doctors also obtain tests for LDL particle size and number.
Desirable levels of total cholesterol are 200 mg per deciliter of blood or less; levels between 200 mg/dL and 239 mg/dL are considered borderline high; 240 mg/dL or higher is considered high cholesterol and raises your risk of heart disease to twice what it would be if your total cholesterol were 200 mg/dL or lower.
A desirable level of heart protective HDL cholesterol is 60 mg/dL or higher; levels below 40 mg/dL for men and less than 50 mg/dL for women increase the risk of heart disease. According to the American Heart Association, the mean level of HDL cholesterol for American adults age 20 and older is 54.3 mg/dL.
A desirable level of LDL ("bad") cholesterol is less than 100 mg/dL - the lower your LDL, the better in terms of heart disease risk. Levels between 139 and 150 mg/dL are borderline high and those between 160 to 189 mg/dL are considered high, while LDL levels above 190 mg/dL are classed as very high. According to the American Heart Association, the mean level of LDL cholesterol for American adults age 20 and older is 115.0 mg/dL.
Normal triglyceride levels are considered 150 mg/dL or lower; those from 150 to 199 mg/dL are considered borderline high while those from 200-499 mg/dL are considered high, and those above 500 mg/dL are deemed very high. The American Heart Association reports that the mean triglyceride level for American adults age 20 and older is 144.2 mg/dl.
What is the conventional treatment of high cholesterol?
Treatment of high cholesterol usually begins with lifestyle changes geared toward bringing levels down. These include losing weight if you're overweight, and changing your diet to emphasize vegetables and fruits, fish, particularly cold water fish such as wild Alaskan salmon, mackerel, herring and black cod that provide heart healthy omega-3 fatty acids. If lifestyle changes don't help or if you're unable to make the changes your doctor recommends, cholesterol-lowering drugs may be prescribed. These include statins, which effectively lower LDL cholesterol; bile acid sequestrants that may be prescribed along with statins to lower LDL; nicotinic acid to lower LDL cholesterol and triglycerides and raise HDL; drugs called fibrates that may be prescribed to lower cholesterol and may raise HDL; and a drug called Ezetimibe to lower LDL by blocking the absorption of cholesterol in the intestine.
What therapies does Dr. Weil recommend for high cholesterol?
Dr. Weil recommends making the following lifestyle and dietary changes in order to lower high cholesterol levels:
1. Lose weight. Even a modest amount of weight loss can lower cholesterol levels.
2. Reduce the amount of sugar and flour in your diet. Recent evidence indicates that added sugar - in the form of table sugar (sucrose) or high-fructose corn syrup - is probably a greater contributor to heart disease than is consumption of saturated fat. This suggests that the inflammatory hypothesis may in fact have more validity than the conventional lipid hypothesis, although the debate is far from settled. As a general rule, Dr. Weil advises against consuming foods with added sugars, particularly soft drinks and highly processed snack foods, which can cause rapid spikes and dips in blood sugar levels. The result can be overeating, obesity and heart disease.
3. Avoid trans-fatty acids. These heart-damaging fats can reduce HDL ("good") cholesterol levels and raise levels of LDL ("bad") cholesterol. The tip-off that trans-fatty acids are present in foods is the listing of "partially hydrogenated oil" on a food's ingredient list. Trans-fats are found in many brands of margarine and in most heavily processed foods, as well as in snack foods such as chips, crackers and cookies, and in the oils used to cook fast-food French fries, doughnuts and movie popcorn.
4. Exercise. Daily aerobic exercise can help increase HDL levels.
5. Don't smoke. Smoking itself is a risk factor for heart disease. It can also significantly lower HDL cholesterol.
6. Relax. Emotional stress may prompt the body to release fat into the bloodstream, raising cholesterol levels. Counter stress by practicing daily breathing exercises and other stress-reduction techniques such as yoga, meditation, guided imagery ortai chi.
Nutrition and Supplements
Dr. Weil recommends the following dietary changes that may help lower cholesterol levels.
1. Eat some nuts every day. Choose almonds, walnuts and cashews, all of which contain heart-healthy monounsaturated fat.
2. Substitute whole soy protein for animal protein. Soy protein such as tofu, tempeh, soy milk, whole soy beans and roasted soy nuts has been shown to lower cholesterol levels. Choose organic products where possible.
3. Use fresh garlic regularly. Garlic has been shown to lower both cholesterol levels and blood pressure. Use one or two raw or lightly cooked cloves a day.
4. Drink green tea daily. The antioxidants it contains help lower cholesterol and prevent the cholesterol in your blood from oxidizing.
5. Eat plenty of soluble fiber. Beans and lentils, apples, citrus fruits, oats, barley, peas, carrots and ground flax seed are all good sources of soluble fiber, which has a powerful cholesterol-lowering effect.
6. Limit refined carbohydrates. These include cookies, cakes, crackers, fluffy breads, chips and sodas, all of which can worsen cholesterol levels by lowering HDL and also increase triglyceride levels.
7. Take coenzyme Q10 (CoQ10). This powerful antioxidant benefits heart health by protecting LDL cholesterol from oxidation and by re-energizing the mitochondria in the heart cells, which is where energy metabolism occurs. CoQ10 may also help lower blood pressure.
8. Take fish oil. Fish oil contains an abundance of essential omega-3 fatty acids (omega-3s) that have been shown to lower triglyceride (blood fat) levels, minimize inflammation and clotting, and increase HDL ("good") cholesterol. Research indicates that omega-3s may help reduce the risk and symptoms of a variety of disorders influenced by inflammation, including heart attack and stroke. You can add omega-3s to your diet by eating more cold water fish such as wild Alaskan salmon, sardines, herring, mackerel and black cod. If that's not possible, Dr. Weil recommends taking two grams daily of a fish oil supplement that contains both essential omega-3 fatty acids, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). When choosing a supplement, look for one derived from molecularly distilled fish oils - these are naturally high in both EPA and DHA and low in contaminants. Also choose a supplement brand that has been independently tested and guaranteed to be free of heavy metals such as mercury and lead, and other environmental toxins including polychlorinated biphenyls, also known as PCBs.
Cholesterol-lowering supplements: Lower your numbers without prescription medication By Mayo Clinic Staff
If you're worried about your cholesterol level and have already started exercising and eating healthier foods, you might wonder if adding a cholesterol-lowering supplement to your diet can help reduce your numbers. Although few natural products have been proven to reduce cholesterol, some might be helpful. With your doctor's OK, consider these cholesterol-lowering supplements and products.
Cholesterol-lowering supplement
What it does
Side effects and drug interactions
Artichoke extract
May reduce total cholesterol and LDL, or "bad," cholesterol
May cause gas or an allergic reaction
Barley
May reduce total cholesterol and LDL cholesterol
None
Beta-sitosterol (found in oral supplements and some margarines, such as Promise Activ)
May reduce total cholesterol and LDL cholesterol
May cause nausea, indigestion, gas, diarrhea or constipation
May be ineffective if you take ezetimibe (Zetia), a prescription cholesterol medication
Blond psyllium (found in seed husk and products such as Metamucil)
May reduce total cholesterol and LDL cholesterol
May cause gas, stomach pain, diarrhea, constipation or nausea
Fish oil (found as a liquid oil and in oil-filled capsules)
May reduce triglycerides
May cause a fishy aftertaste, bad breath, gas, nausea, vomiting or diarrhea
May interact with some blood-thinning medications, such as warfarin (Coumadin)
Flaxseed, ground
May reduce triglycerides
May cause, gas, bloating or diarrhea
May interact with some blood-thinning medications, such as aspirin, clopidogrel (Plavix) and warfarin (Coumadin)
Garlic extract
May reduce total cholesterol, LDL cholesterol and triglycerides
May cause bad breath, body odor, heartburn, gas, nausea, vomiting or diarrhea
May interact with blood-thinning medications, such as warfarin (Coumadin)
Green tea extract
May lower LDL cholesterol
May cause nausea, vomiting, gas or diarrhea
May interact with blood-thinning medications, such as warfarin (Coumadin)
Oat bran (found in oatmeal and whole oats)
May reduce total cholesterol and LDL cholesterol
May cause gas or bloating
Sitostanol (found in oral supplements and some margarines, such as Benecol)
May reduce total cholesterol and LDL cholesterol
May cause diarrhea
Another popular cholesterol-lowering supplement is red yeast rice. There is some evidence that red yeast rice can help lower your LDL cholesterol. However, the Food and Drug Administration has warned that red yeast rice products could contain a naturally occurring form of the prescription medication known as lovastatin. Lovastatin in the red yeast rice products in question is potentially dangerous because there's no way for you to know what level or quality of lovastatin might be in red yeast rice.
Sometimes healthy lifestyle choices, including supplements and other cholesterol-lowering products, aren't enough. If your doctor prescribes medication to reduce your cholesterol, take it as directed while you continue to focus on a healthy lifestyle. As always, be sure to tell your doctor if you decide to take an herbal supplement. The herbal supplement you take may interact with other medications you take.
· Other herbal products: The results of several studies suggest fenugreek seeds and leaves, artichoke leaf extract, yarrow, and holy basil all may help lower cholesterol. These and other commonly used herbs and spices -- including ginger, turmeric, and rosemary -- are being investigated for their potential beneficial effects relating to coronary disease prevention.
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