Lowering cholesterol naturally

I specialize in the care of menopausal women and it is at menopause that many women catch up to men in their risk of cardiovascular disease. There are many ways to lower cholesterol if yours is high, yet many women are reluctant to take prescription statins. Beyond a healthy diet and regular aerobic exercise, here is an article from Dr. Rick Fogoros with some additional comments from Dr. Andy Weil, which I inserted, on how to safely lower your cholesterol. I favor pysllium, oatmeal and plant sterols as an initial approach. I prefer FDA-approved supplements such as the Cholesterol Shield available on my website at www.doctorgottfried.com. You should do this under the guidance of a knowledgeable physician, and only use these supplments if you need them. Non-prescription Cholesterol Lowering From Richard N. Fogoros, M.D., High LDL cholesterol levels (“bad cholesterol”) and low HDL cholesterol levels (“good cholesterol”) are now recognized as being major risk factors for cardiovascular disease. Fortunately, powerful prescription drugs are now available that allow doctors to control abnormal cholesterol levels in most patients. Some of these drugs – especially the statins – have been shown to significantly improve the prognosis of patients with coronary artery disease. Anyone with known coronary artery disease, or anyone with very high cholesterol levels, should be under a physician’s care to assure optimal control of their blood lipids. But does everyone with an elevated cholesterol level need to resort to powerful prescription drugs? Not necessarily. There are ways to achieve moderate lowering of cholesterol levels short of using such drugs. We will review several effective non-prescription means of lowering cholesterol. Some of these methods are very useful and safe, and simply ought to be part of any healthy lifestyle. Others require dietary changes that some might consider at least a little unusual, but appear to be safe and effective. Countless purveyors of various magic potions for lowering cholesterol advertise on the radio, in magazines and newspapers, and on the Internet. These potions fall into two general categories – those that are completely worthless, and those that incorporate some of the non-prescription methods for reducing cholesterol that we are about to discuss. Often there is nothing wrong with purchasing items in the latter category, except for two things: a) if you buy the ingredients yourself, you will be paying far less than if you buy the magic potion; and b) if you buy the ingredients yourself, you will have much more control over the quantity and quality. And finally, since most of this stuff is available in your corner grocery, it’s often just as easy to do it yourself. When is it all right to consider non-prescription cholesterol lowering? It is entirely reasonable for otherwise healthy people with moderate or borderline elevations in cholesterol to try non-prescription methods before resorting to prescription drugs. Patients already taking prescription cholesterol-lowering drugs, and whose cholesterol levels remain a bit too high, might be able to gain better control by adding one or more non-prescription methods. But we must emphasize – once again – that if you already have coronary artery disease, or if your cholesterol levels are very high, you need to be under a doctor’s care to assure adequate treatment. In these cases, “do-it-yourself” could prove to be dangerous if not lethal. Non-prescription methods for treating cholesterol Here is the list of non-prescription methods that have been demonstrated in scientific studies to be of use in improving abnormal cholesterol levels. I have divided the list into two parts: methods that are effective and safe, and methods that are effective but entail at least some risk. Click on the individual cholesterol-lowering methods for more details. Effective and Safe • Lifestyle changes: diet, exercise, weight loss • Plant sterols (sterol esters) Plant sterols are extracts of certain plants that, when ingested, inhibit the absorption of cholesterol in the small intestine. Thus, dietary cholesterol never gets into the system. Two plant sterols are now available in a spreadable form, as a substitute for margarine. An extract of the soy plant – sitosterol – is available in a product called Take Control (Lipton). And an extract of pine needles – sitostanol – is available in a similar product called Benechol (McNeil). Neither product tastes exactly like margarine and are unsuitable for cooking, but most people find them to be reasonably good to eat. Spreading 1 – 2 tablespoons of the spread on bread each day, as a substitute for margarine (and, of course, in combination with a low fat diet,) can reduce LDL cholesterol levels by up to 10%. • Soy products Soy products have been touted as having so many outlandishly beneficial effects that one feels like a huckster even mentioning them. But the fact is, several well-conducted studies have shown that soy products can reduce cholesterol levels significantly. “Soy products” refers to the soy isoflavones – estrogen-like substances found in various plants – and soy protein. To produce a reduction in cholesterol levels, both the isoflavones and soy protein apparently must be ingested. A diet containing 25 grams of soy protein and 50 to 60 milligrams of soy isoflavones per day can reduce LDL cholesterol levels by about 10%. • Fibers: oats, psyllium Several studies have now documented that dietary fibers can cause a significant reduction in cholesterol levels. While any fibers tend to be beneficial, the best form of fiber for cholesterol reduction appears to be foods containing soluble fibers – that is, fibers that dissolve in water. The soluble fibers contained in oats, for instance, have been shown to have a substantial impact on cholesterol levels when added to a low-fat diet. Other foods high in soluble fibers are lentils, pinto beans, citrus, black beans and barley. For those people (and you know who you are) that prefer taking medical products instead of eating healthy food, psyllium (the fiber found in Metamucil,) has also been demonstrated to cause a significant reduction in cholesterol levels (but tragically, only in conjunction with a low-fat diet). Effective, but with Risk • Red rice yeast From DrWeil.com: Of all the natural supplements available to help lower cholesterol, red rice yeast extracts are by far the most effective. Red rice yeast (Monascus purpureus) has a long history of use in China as a natural food coloring and healthful ingredient. It is a source of naturally occurring statins, and because it delivers a mix of those compounds rather than a single molecule, it is much less likely to cause the side effects that sometimes occur with the pharmaceutical versions. As you may know, in 2001 the FDA banned the sale of the most popular brand of red yeast rice extract, Cholestin, because one of its components (lovastatin) was already a patented drug when Cholestin came on the market (the product now sold as "Cholestin" in the United States does not contain any red rice yeast). You can still obtain Cholestin that contains red rice yeast extract in some European countries, and other brands of red rice yeast extract are still sold in the U.S. Because supplements are unregulated and the demand for quality ingredients is growing, some products will not actually contain any red rice yeast extract and will be ineffective. If you don't get satisfactory results, you can always switch to a better quality brand or even to a prescribed statin. The most common side effects of prescribed statin drugs are headache, digestive upset, liver dysfunction, and muscle pain. These last two problems can be serious, but statins are well tolerated by most people, and serious side effects are rare. Red rice yeast supplements can cause the same side effects in sensitive people, but in my experience the incidence is significantly less than with the purified prescription compounds. I recommend that anyone who takes statins or red rice yeast extract supplements for cholesterol control should also take 90 - 120 mg of coenzyme Q10 every day, since these drugs inhibit the body's natural synthesis of CoQ10, which is needed for formation of ATP, our bodies' energy currency. (That may account for the muscle pain that some people experience.) No matter what supplement or drug you use for cholesterol control, be sure to get at least 30 minutes a day of aerobic exercise and reduce the amount of saturated fat and trans-fats in your diet. Other beneficial lifestyle changes include drinking green tea, eating one clove of garlic per day (diced or crushed in food), and consuming more soluble fiber (such as oat bran), foods rich in omega-3 fatty acids (good sources include salmon, sardines and walnuts) and plenty of leafy greens and fresh fruits. Andrew Weil, M.D. • Alcohol (Dr. Gottfried adds here: limit alcohol to red wine - no more than 4 oz 2-5 days/week) • Policosanol One of the more popular non-prescription cholesterol-lowering agents in recent years has been policosanol. Policosanol is a mixture of fatty alcohols derived from waxes of sugar cane (the main source of marketed policosanol,) yams, and beeswax. It originated in Cuba, and most of the clinical studies that have claimed a benefit with this substance were conducted in Cuba. Because of its increasing popularity, some companies that sell multi-vitamin pills have famously added policosanol to their formulations. Now, however, a study appearing in the May 17, 2006 issue of the Journal of the American Medical Association finds no evidence of a lipid-lowering benefit with policosanol. In a placebo-controlled randomized trial using genuine Cuban policosanol, German investigators tested the substance in a group of 143 patients. After 12 weeks of therapy, they found no evidence that policosanol - in doses up to 80 mg/day - reduced LDL cholesterol or any other lipid measures, as compared to placebo. DrRich comments: This study from Germany appears to be legitimate. It was conducted by a pharmaceutical company hoping to gain approval to market policosanol in Europe, and which had every reason to hope for a positive outcome. It was conducted in multiple medical centers with careful randomization, multiple measures of lipid levels, and the use of a central lab to assure consistent and accurate lipid measurements. I find this study more persuasive than those coming out of Cuba, and I plan not to spend any money buying policosanol.