In some people, cholesterol levels in blood become too high. This is called high cholesterol or hyperlipidemia. High levels of LDL cholesterol (so-called “bad” cholesterol) are considered a major risk factor for heart disease and stroke.
LDL cholesterol is thought to irritate the lining of blood vessels, stimulating arteriosclerosis, commonly known as hardening of the arteries.
Although lowering LDL cholesterol and raising levels of HDL cholesterol (“good” cholesterol) has traditionally been the focus, factors related to free radical damage are drawing increased attention:
- Lipoprotein A is a relative of LDL cholesterol.
- It has thought to be formed when there is free radical damage. Lipoprotein A may adhere to damaged blood vessels, eventually forming atherosclerotic plaques.
- Oxidized cholesterol is found in large amounts in fried and processed foods. Studies have found that oxidized cholesterol may increase the amount of atherosclerotic deposits on blood vessel walls.
Who Needs to Lower Cholesterol?
High cholesterol is usually treated based on total cholesterol, LDL cholesterol, and HDL cholesterol levels, plus the presence of additional risk factors for heart disease:
- Previous heart attack
- Diabetes
- Smoking
- High blood pressure
- Low HDL cholesterol
- Family history of early heart disease
- Age over 45 in men and greater than 55 in women
- 10 year risk of heart attack greater than 20%
Herbs and Supplements for High Cholesterol
Precautions:
A few tips on using natural products to lower cholesterol:
- Talk with your doctor before starting any natural method to lower cholesterol.
- Make your doctor knows what supplements you are taking. Fill out the supplement diary to bring to your next appointment.
- Do not discontinue any medication to lower cholesterol. Speak with your doctor if you have questions about your medication.
Vitamin B3 (Niacin)
Vitamin B3, also called niacin, 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 10% to 20%, lowers triglycerides by 20% to 50%, and raises “good” HDL cholesterol by 15% to 35%. Niacin also appears to significantly lower levels for another risk factor for arteriosclerosis, 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.
Side effect of high-dose niacin:
Skin flushing or hot a flash, 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 common drugs to lower cholesterol (called “statins”), there are concerns that combining the two could result in a serious condition called rhabdomyolysis. They should not be combined unless under the close supervision of a physician.
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.
Research:
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 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.
Soluble Fiber
Soluble fiber appears to reduce LDL cholesterol by reducing cholesterol absorption in the intestines. Soluble fiber binds with cholesterol so that it is excreted.
Soluble fiber can be found as a dietary supplement, such as psyllium powder, or in foods such as:
- Oats, barley, rye
- Legumes (peas, beans)
- Some fruits such as apples, prunes, and berries
- Some vegetables, such as carrots, brussel sprouts, broccoli, yams
Dosages:
Five to 10 grams a day of soluble fiber has been found to decrease LDL cholesterol by approximately 5%.
The FDA allows soluble fiber products to indicate on the label that they are “heart-healthy”.
Plant Sterols and Stanols
Plant stanols and sterols (such as beta-sitosterol and sitostanol) are naturally occurring substances found in certain plants. Stanols are also found as dietary supplements or are added to margarine, orange juice, and dressings.
Research:
Research suggests that plant stanols and sterols may help to lower cholesterol. They are similar in structure to cholesterol and may help block the absorption of cholesterol absorption from the intestines.
Studies have found that stanols significantly reduced total cholesterol and LDL cholesterol, but had no significant effect on HDL cholesterol or triglycerides.
Stanols and sterols appear to enhance the effects of other methods to lower cholesterol. In studies, people taking the statin drugs to lower cholesterol had an additional improvement in their cholesterol levels with stanols/sterols.
Other Supplements that helps to lower cholesterol:
- Policosanol
- Red Yeast Rice
- Coenzyme Q10
- Garlic
- Pantothine
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