Go Low Naturally

Even with all the controversy about cholesterol-lowering statin drugs, sales of them still will be in the billions of dollars this year. There are indeed some people with extremely high cholesterol that can be helped by statins, but many users can be better served with any number of natural alternatives. To learn more about these, I spoke with Jay S. Cohen, MD, author of What You Must Know About Statin Drugs and Their Natural Alternatives http://dailyhealthnews.ed10.net/h/L23B/HOJQ/PJ/K68A1  (Square One).

The Precision-Prescribing Method

In Dr. Cohen's view, most people are far too quick to turn to pharmaceuticals to cure our every ill. He warns that all drugs have side effects, and the side effects of statins -- the top-selling drug group in the US -- often are underestimated. They range from muscle discomfort to gastrointestinal problems to fuzzy thinking and concentration. Many people who begin taking statins are bothered by these side effects, which leads them to stop taking them... and this can lead to greater risk for heart attack or stroke (and perhaps heart failure).

Dr. Cohen's solution lies in what he calls the precision-prescribing method. This means that before taking any drug, first consider nutrition, then natural interventions and only then pharmaceuticals. When considering natural interventions, Dr. Cohen's favorite cholesterol-reducing options include...

Garlic

Some experts swear by garlic for cholesterol control, while others believe that its claims are vastly overrated.

What it does: Garlic has a modest impact on lowering total cholesterol, LDL (the so-called "bad") cholesterol and harmful blood lipids called triglycerides.

Dr. Cohen says: Garlic is a nice adjunct to a cholesterol-lowering program. It is tasty, inexpensive and safe -- so why not toss a fresh clove or two into your next dish? However, keep in mind that its benefits are not as dramatic as those of more aggressive cholesterol-lowering agents.

Guggulipid

This ancient Ayurvedic remedy from the guggul tree has been used for centuries in India.

What it does: Guggulipid reduces cholesterol and inflammation, acts as an antioxidant and reduces platelet aggregation to make blood thinner. High doses also may reduce C-reactive protein (CRP), a marker of inflammation that increasingly appears to be as significant a risk factor as cholesterol.

Dr. Cohen says: Recent studies suggest that guggulipid may not be as reliable as was previously believed. Dr. Cohen recommends its use only under close medical supervision. Talk to your doctor about the best brand to use. A standard dose is 250 mg or 500 mg twice daily with meals, although doses of up to 500 mg three times a day also are used. Side effects include nausea, gas and bloating.

Niacin

Physicians split ranks when it comes to recommending niacin supplementation, with mainstream doctors for the most part prescribing FDA-approved Niaspan, and natural practitioners prefering niacin derivatives that are associated with fewer side effects.

What it does: Niacin, the first supplement therapy shown to improve cholesterol levels, reduces total cholesterol and LDL, and raises the level of "good" HDL cholesterol.

Dr. Cohen says: Niaspan is associated with side effects such as flushing, nausea, vomiting and agitation. A possible side effect of Niaspan is hepatitis, so you should get regular blood tests to check liver enzyme levels while taking this drug. He prefers a niacin derivative known as inositol hexaniacinate. A typical dosage is 600 mg twice daily. Note: A B-50 supplement needs to be taken twice a day in conjunction with the Niaspan in order to avoid an induced deficiency in other B vitamins.

Omega-3 Fatty Acids

These healthy fats are a happy instance in which mainstream and natural physicians agree: Omega-3 fatty acids are good for your heart.

What they do: Omega-3 fatty acids in fish and fish oil supplements increase your good HDL cholesterol, lower levels of harmful triglycerides, help control inflammation and blood clotting and contribute to overall blood vessel health.

Dr. Cohen says: Take your fish oil capsules. An average dose consists of 2 g to 3 g daily. Another option: Eat wild salmon (or other wild ocean fish such as sardines) once or twice a week. Dr. Cohen advises avoiding farmed fish, which tend to be high in mercury and other toxins. Caution: Do not take fish oils with blood thinners or if you have a bleeding disorder without checking with your physician.

Plant Sterols

The American Heart Association and the National Cholesterol Education Program Expert Panel recommend plant sterols as adjunct therapy to reduce potentially harmful LDL cholesterol.

What they do: When you eat plant sterols, they impair the absorption of cholesterol from the intestines.

Dr. Cohen says: With plenty of research to back up their benefits, plant sterols are a good, safe way to reduce cholesterol. Small amounts are present in vegetable oils, seeds, nuts and some vegetables and fruits, or you can buy supplements in health-food stores. Studies show that 1.8 g a day reduces LDL by an average of 10%. Dr. Cohen does not recommend margarines enriched with plant sterols if they also contain harmful trans fats. (Check the labels.)

Policosanol

Made from sugar cane in Cuba and commonly produced from citrus peels in this country, many experts believe that policosanol is a safe and natural substance that can be as or even more effective than statin drugs in lowering cholesterol (and without the side effects).

What it does: When you take policosanol, your liver produces less cholesterol overall and absorbs more LDL cholesterol. In addition, blood is thinner (which protects you from heart attack and stroke) and inflammation is reduced.

Dr. Cohen says: The jury is still out on policosanol, with mixed results from the various studies. However, the good news is that it's safe and inexpensive. If you want to give policosanol a try, Dr. Cohen recommends the sugar cane-based variety, which seems to be of higher purity. Check the labels. The usual starting dose is 5 mg or 10 mg a day taken with dinner. (For more on policosanol, see Daily Health News, August 26, 2004 http://dailyhealthnews.ed10.net/h/KVN3/HOJQ/PJ/K68A1 .)

Red Yeast Rice

It is this traditional element of Asian cuisine that imparts a rich red color to Peking duck.

What it does: Red yeast rice contains a natural form of lovastatin, the active ingredient in the statin drug Mevacor. Less expensive and with fewer side effects than statins, this supplement lowers total cholesterol, LDL and triglycerides. It also may reduce elevated CRP.

Dr. Cohen says: Red yeast rice is well researched, and its benefits have been clearly demonstrated. Dr. Cohen cautions that it may produce side effects similar to those of statins, and should be taken only under the supervision of your health-care provider. (For more on red yeast rice, see Daily Health News, November 9, 2004 http://dailyhealthnews.ed10.net/h/3R7S/HOJQ/PJ/K68A1 .)

Soy

According to the FDA, 25 g of soy protein a day, as part of a diet low in saturated fat and cholesterol, may reduce the risk for heart disease.

What it does: Soy reduces total cholesterol by as much as 9%, as well as lowering LDL and triglycerides. It also may have a beneficial impact on the smaller-particle LDL-cholesterol, a newly recognized risk factor for heart disease.

Dr. Cohen says: It's hard to take in 25 g of soy every day -- the equivalent of about six ounces of tofu. Moreover, some controversy surrounds the intake of large doses of soy, which critics warn may have a negative impact on estrogen-sensitive tissues and the thyroid. That said, Dr. Cohen recommends including a moderate amount of soy in your diet as a nice adjunct to more aggressive cholesterol-lowering treatments.

Do Not Self-Treat

Although you can purchase all of the dietary supplements listed above on-line or from quality health-food stores, Dr. Cohen says that it is always best to consult first with your health-care provider. What works for one person may not work for another -- dosages and combinations vary according to each person and his/her condition, and many dietary supplements must be used with caution (if at all) with prescription drugs. In addition, regular blood tests are required to determine whether supplements are successful in bringing risk factors within target range.

As always, keep in mind that drugs -- or, for that matter, supplements -- are not the only solution. For some, the core issue in lowering cholesterol is improving cholesterol export from the liver rather than decreasing absorption from the gut.

Additionally, reducing inflammation has been identified as being even more critical to lowering heart attack risk than reducing cholesterol levels. And, important lifestyle adjustments to benefit your heart include a healthy diet low in saturated fat and rich in veggies, fruits (especially berries), soy and wild ocean fish... regular exercise... maintaining a healthy weight... not smoking... and managing stress. So choose a medical team with formal training and clinical expertise in managing a regimen focused on diet, nutrition and natural interventions as well as an understanding what statin drugs can and can't do.

Carole Jackson, Bottom Line's Daily Health News, August 8, 2005

 

Sources:

Go Low Naturally

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Jay S. Cohen, MD, associate professor (voluntary) of family and preventive medicine at the University of California, San Diego. Dr. Cohen is author of What You Must Know About Statin Drugs and Their Natural Alternatives http://dailyhealthnews.ed10.net/h/L23B/HOJQ/PJ/K68A1  (Square One)

and Over Dose: The Case Against The Drug Companies http://dailyhealthnews.ed10.net/h/ALDP/HOJQ/PJ/K68A1  (Tarcher/Putnam). Visit his Web site at www.medicationsense.com

 

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