The Good, The Bad and The Ugly
By Tara Finley, OMD, ND |
What is Cholesterol?
Cholesterol is a vital and necessary component of every cellular membrane, including those in the brain, nerves, muscles, skin, liver, intestines, and heart. It is also converted into steroid hormones (e.g. estrogen, testosterone and cortisol), is the precursor to bile acids that aid in the digestion of food, especially fats, and is used in making vitamin D.
How does cholesterol cause damage in the body?
High cholesterol, also called hypercholesterolemia, dyslipidemia, hyperlipidemia, and lipid disorder, is a risk factor for heart disease and stroke. Although, several recent studies suggest that cholesterol is not the true culprit, oxidation is. If oxidation causes damage to the lining of the arteries, then cholesterol (along with other substances) can cause the formation of plaques. If a plaque ruptures and dislodges, or if a clot is formed by platelets collecting on the plaque, a stroke may be the result. If plaque builds up enough to completely block the artery, the lack of blood flow will cause tissue death beyond that point.
What types of labs can my health care provider order to assess my cardiovascular risk?
LDL (“bad” cholesterol)
HDL (“good” cholesterol)
Triglycerides – fatty acids circulating in the blood
C – reactive protein – marker of inflammation in the lining of the blood vessels
Apolipoprotein A1 – marker for assessing the cholesterol clearing capacity of the blood
Apolipoprotein B – marker for assessing the cholesterol depositing capacity of the blood
Lipoprotein (a) – largely governed by genetics and is highly correlated with increased heart disease and blood clot formation risk
What raises cholesterol?
The majority of cholesterol is made in the body; the minority is taken in through diet. Other factors that can affect non-diet contributions to high cholesterol include obesity, lack of physical activity, age, gender, heredity, smoking, high blood pressure, diabetes, and hypothyroidism. Genetics definitely can play a role, as with the overproduction of lipoprotein (a).
Although a high saturated fat diet can raise cholesterol, it is more the imbalance of “bad fats” to “good fats” that is the problem. A balanced diet includes saturated fats, but is much more heavily weighted with the omega-3 fats found in nuts, fish, wild game and grass fed beef. There is also no room in a healthy diet for hydrogenated oils or trans-fatty acids. These fats along with refined sugars can greatly raise LDL and Triglyceride levels to an unhealthy level.
What natural products are scientifically shown to lower cholesterol?
Red Yeast Rice (traditionally used in China) is effective at lowering Total Cholesterol and Triglycerides. Its mechanism of action is the same as a statin pharmaceutical medication, a class of hypolipidemic drugs that lower cholesterol by inhibiting the enzyme HMG-CoA reductase. Therefore the same cautions need to be taken with its use. As with statins, CoQ10 should always be supplemented with Red Yeast Rice as they both decrease the body’s endogenous production of this vital coenzyme.
Niacin (not niacinamide), also known as vitamin B3, is capable of raising HDL and lowering LDL. Inositol hexanicinate is the safest form to use.
Policosanol, a natural mix of primary alcohols isolated from purified sugar cane wax, has performed better than numerous statin medications with fewer side effects at lowering cholesterol.
Omega-3 Fatty Acids (EPA and DHA), from fish oil, have been shown to favorably and therapeutically affect triglycerides and LDL levels.
Plant Sterols such as beta-sitosterol are also effective at lowering total cholesterol and LDL. These are found in fruits, vegetables, soybeans, peanuts, olive oil, and flax oil.
To receive the most comprehensive, safe and effective treatment plan, the above nutritional supplements should only be prescribed by a licensed health care practitioner who is capable of ordering and interpreting the necessary lab work and follow up lab work to monitor for success and potential side effects. If a patient is taking Red Yeast Rice or Niacin, liver enzymes should be periodically measured. Patients diagnosed with liver disease or diabetes or when on certain medications need to be monitored carefully even when taking natural products. A patient should never discontinue current medications without first discussing it with their doctor or with the assistance of a health care practitioner.
What other factors should be taken into consideration when creating a plan to lower cholesterol and optimize total health?
A 1998 study reported in the New England Journal of Medicine found that, due to the standard American diet and lifestyle, most atherosclerosis begins in childhood and increases with age. Therefore, by the time most Americans are 40 years old, they have definite signs of cardiovascular disease.
The risk of developing cardiovascular disease is inversely proportional to the dietary intake of fruits and vegetables. Eight or more servings a day correlates with a 30% less chance of having a heart attack or stroke. Since cardiovascular disease is an inflammatory disease and diet and lifestyle changes can reverse the damage created by this inflammation, it is never too late to make these changes. Therefore, a lifestyle that includes a diet high in fruits and vegetables, plentiful omega-3 fats, exercise, maintenance of optimal weight, minimal stress and the absence of smoking and trans-fats would be the best approach. Natural substances should be introduced when needed and pharmaceutical medications as a last resort.
1. Spectracell Laboratories Clinician Handouts, 2006.
2. Nutrisearch Comparative Guide to Nutritional Supplementation, Lyle MacWilliam Msc, FP, 2007.
3. NaturalStandard.com – The Authority on Integrative Medicine