Cholesterol: An introduction.
Cholesterol is a waxy, fat-like substance found in every cell in your body that is required to maintain good health. When it is in the right amount, your body uses it to produce hormones and vitamin D while assisting digestion. However, too much cholesterol can pose a problem. At unhealthy levels, cholesterol can lead to high blood cholesterol (BLOOD CHOLESTEROL, 2022).
Cholesterol comes from two key sources: your liver, which manufactures all the cholesterol you need, and dietary animal sources, such as meat, poultry, eggs and dairy products. These nutritional sources are typically higher in dietary fats: saturated and trans fats, which comprise the rest of the cholesterol in the body. These dietary fats can cause your liver to produce more cholesterol than needed. An overconsumption of animal products high in saturated fats from unhealthy eating patterns, combined with the genes you inherit from your parents, can lead some people to elevated harmful cholesterol levels (Lordan et al., 2018).
Types of Cholesterol Levels
There are two main types of cholesterol in your blood that the lipoproteins carry and also subgroups of LDL cholesterol levels:
Low-density lipoprotein (LDL), sometimes called “bad” cholesterol.
High-density lipoprotein (HDL), sometimes called “good” cholesterol.
Low-density Lipoprotein (LDL) levels.
Too much LDL cholesterol in your blood increases significant health risks, namely coronary artery diseases and other heart diseases. At the same time, high LDL levels can cause the buildup of a sticky substance called plaque in your arteries. Over an extended period, this plaque build-up can narrow the arteries or entirely block them, leading to three different risk scenarios (What Is a Cholesterol Test?, n.d.):
1. If the blood flow to the heart is blocked, it can cause a heart attack.
2. If the blood flow to the brain is blocked, it can cause a stroke.
3. If the blood flow to the arms or legs is blocked, it can cause peripheral artery disease.
Very low-density Lipoprotein (VLDL) levels.
Very low-density lipoprotein (VLDL) is another "bad" cholesterol type. This form of VLDL levels isn't usually part of a regular cholesterol test because it's hard to measure. Approximately half of VLDL levels are triglycerides, so your VLDL level is estimated as a percentage of your triglyceride level (Huang & Lee, 2022).
High-density Lipoprotein (HDL) levels.
HDL (high-density lipoprotein) cholesterol is occasionally called "good" cholesterol. It absorbs cholesterol in the bloodstream and carries it back to the liver, which disposes of it from the body. Higher HDL cholesterol levels can reduce your risk for heart disease and strokes (Toth, 2003).
Staying Proactive by using the 3 C’s can help reduce your Risk Factors
Regarding cholesterol, remember the 3 Cs: check, change, and control (BLOOD CHOLESTEROL, 2022). That is:
· Check your cholesterol levels. Knowing your numbers and staying proactive will allow your physician to assess your risk.
· Changing your diet and lifestyle by taking a preventative stance can help improve your levels.
· Controlling your cholesterol, with help from your physician, dietitian or healthcare provider if needed, can prevent coronary heart disease and any future heart attack or stroke risk.
Conventional Drug-based Therapies – Some Pros and Cons
Conventional medicine approaches to high cholesterol levels are combated with statin drugs. Statin drugs are a lipid-lowering class that are the best-studied medications for lowering LDL cholesterol (LDL-C) levels. They are the most effective drugs for the prevention of heart attack, strokes, and coronary heart disease, which can lead to death. Statin types of drugs are considered the first line for treating lipid disorders, with studies showing they can lower LDL-C levels by as much as 60% (Feingold, 2021).
The Pros of Statin Drugs
The apparent advantage of statin drugs is their potent lipid-lowering effect that can reduce cardiovascular risk and decrease mortality (Pinal-Fernandez et al., 2018).
The Con’s for Statin Drugs
With all prescription drugs, there are always some disadvantages to consider. The drawback of using statin drugs is that they may have some adverse side effects associated with them; some effects include increased risk of diabetes, musculoskeletal issues, and hemorrhagic stroke. Although studies have shown that the frequency of adverse effects of the use of statin drugs is low in a selected population group, the benefits of statins considerably outweigh the potential risks (Pinal-Fernandez et al., 2018).
A Holistic Approach to Managing Your High LDL-C Levels
I strongly urge you to consult your doctor and healthcare provider before making any lifestyle changes, including diet and/or implementing a natural supplements approach. They can make recommendations and instruct you on how to do it safely without putting yourself in harm while offering support during this transition.
Lifestyle Changes and Diet When Dealing with High Cholesterol
Lifestyle modifications include a healthy diet (DASH) (Sacks et al., 2001). The Dietary Approaches to Stop Hypertension (DASH) was introduced in 1997. The National Institute of Health's National Heart, Lung, and Blood Institute created and promoted the DASH diet for reducing blood pressure. It is a healthy eating plan designed to help treat or prevent high blood pressure. It helps people manage their total sodium intake in their diet while promoting staying active through physical activity. (Eckel et al., 2014). In addition to the DASH diet, studies show that the Dean Ornish–style diet, commonly called the Ornish diet, is considered the gold standard for lowering LDL cholesterol levels. This vegetarian diet consists of fruits, vegetables, soybean products, nonfat milk, and yogurt with no oils or animal products and has been shown very positive results for the users. The set back to this diet is it is very strict, which most users find challenging to adhere to (Rosenthal, 2000). Weight reduction is another meaningful lifestyle change that needs to be considered to help reduce and manage LDL cholesterol levels (Stefanick et al., 1998) (Dudum et al., 2019).
Evidence-Based Supplements to Combat High LDL-C
High cholesterol is noted throughout this article as a major health risk for cardiovascular disorders that requires a significant lifestyle (diet and staying active) and, in some cases, pharmaceutical medication treatment of lipid-lowering drugs. However, there has been a growing interest in understanding how a natural holistic approach can assist in managing high cholesterol levels through dietary supplements (Magno et al., 2018).
Garlic – dried garlic or fresh garlic.
Garlic has been marketed as a cholesterol-lowering agent. However, because it is not a licensed medication, there is insufficient evidence to recommend garlic therapy as an effective lipid-lowering agent. However, there is no evidence to suggest it is harmful. The current available data support the likelihood of garlic therapy being beneficial over a short period (Silagy & Neil, 1994).
Product: Natural Factors GarlicRich Garlic+Reishi.
As used in herbal medicine, GarlicRich® Super Strength Garlic + Reishi from Natural Factors supports the immune system. It helps maintain cardiovascular health courtesy of a 10:1 garlic concentrate and 30:1 organic reishi mushroom extract for adaptogenic support. Each capsule provides the full spectrum of active garlic compounds in a delayed-release format to help reduce garlic breath. Used in herbal medicine to help reduce elevated blood lipid levels (hyperlipidemia) in adults.
Dietary Soluble Fibers
Various soluble fibres are associated with a small but significant total and LDL cholesterol reduction. The effects on individual plasma lipids from digesting soluble fibre from oats, psyllium, or pectin were shown not to be significantly different. Increasing soluble fibre can contribute to dietary therapy in the assistance of lower cholesterol (Brown et al., 1999).
Product: NOW Psyllium Husks Whole
Studies have shown that psyllium may help lower total and LDL “bad” cholesterol levels, which may help reduce the risk of heart disease.
Phytosterols
Phytosterols are naturally occurring compounds found in plants that are very similar in structure to cholesterol, which can help safely lower cholesterol levels. It is found in unrefined plant oil, like vegetable, walnut and olive oil. It is also found in soybeans, flaxseed, almonds, pistachios, and sunflower seeds. It has been shown that ingesting these sterols can decrease cholesterol levels by interfering with cholesterol absorption (Rosenthal, 2000).
Product: New Roots Herbal Plant Sterols
Plant Sterols help maintain healthy cholesterol levels and reduce low-density lipoproteins (LDL) and total cholesterol. New Roots Herbal Plant Sterols are a non-GMO source of sterols which help inhibit the absorption of harmful low-density lipoproteins (LDL cholesterol). Plant sterols form the cell walls of plants and are similar to cholesterol in molecular structure and function. They actively compete with animal cholesterol for absorption sites within the intestine and block their absorption. Plant Sterols can be used safely with other cholesterol-lowering products for additional results.
Niacin (B3)
Niacin, a B-vitamin (B3), has been shown to help raise high-density lipoprotein (HDL) "good" cholesterol by more than 30% while helping to lower triglycerides by 25%. However, be aware that some individuals taking cholesterol medications have shown little additional benefit while experiencing discomfort (Žák, 2015).
Product: Natural Factors Niacin Inositol Hexanicotinate - Flush Free
Vitamin B3, also known as niacin, is a member of the water-soluble B complex family of vitamins. Niacin supports the cardiovascular system by positively affecting cholesterol levels by reducing LDL and triglycerides while raising levels of HDL – the good cholesterol. Inositol by itself is also used therapeutically to reduce cholesterol.
Takeaway: Anyone considering discontinuing their statin medication to try a more holistic approach should consult with their doctor first. Coming off any prescription drugs can be dangerous. Your doctor will guide you with proper dosing, combining a statin with other cholesterol-lowering agents, or switching you to another prescription medication.
References
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Huang, J.-K., & Lee, H.-C. (2022). Emerging evidence of pathological roles of very-low-density lipoprotein (vldl). International Journal of Molecular Sciences, 23(8), 4300. https://doi.org/10.3390/ijms23084300
Lordan, R., Tsoupras, A., Mitra, B., & Zabetakis, I. (2018). Dairy fats and cardiovascular disease: Do we really need to be concerned? Foods, 7(3), 29. https://doi.org/10.3390/foods7030029
Magno, S., Ceccarini, G., Pelosini, C., Jaccheri, R., Vitti, J., Fierabracci, P., Salvetti, G., Airoldi, G., Minale, M., Saponati, G., & Santini, F. (2018). Ldl-cholesterol lowering effect of a new dietary supplement: An open label, controlled, randomized, cross-over clinical trial in patients with mild-to-moderate hypercholesterolemia. Lipids in Health and Disease, 17(1). https://doi.org/10.1186/s12944-018-0775-8
Pinal-Fernandez, I., Casal-Dominguez, M., & Mammen, A. L. (2018). Statins: Pros and cons. Medicina Clínica, 150(10), 398–402. https://doi.org/10.1016/j.medcli.2017.11.030
Rosenthal, R. L. (2000). Effectiveness of altering serum cholesterol levels without drugs. Baylor University Medical Center Proceedings, 13(4), 351–355. https://doi.org/10.1080/08998280.2000.11927704
Sacks, F. M., Svetkey, L. P., Vollmer, W. M., Appel, L. J., Bray, G. A., Harsha, D., Obarzanek, E., Conlin, P. R., Miller, E. R., Simons-Morton, D. G., Karanja, N., Lin, P.-H., Aickin, M., Most-Windhauser, M. M., Moore, T. J., Proschan, M. A., & Cutler, J. A. (2001). Effects on blood pressure of reduced dietary sodium and the dietary approaches to stop hypertension (dash) diet. New England Journal of Medicine, 344(1), 3–10. https://doi.org/10.1056/nejm200101043440101
Silagy, C., & Neil, A. (1994). Garlic as a lipid-lowering agent-a meta-analysis. Journal of the Royal College of Physicians of London, 28(1), 39–45.
Stefanick, M. L., Mackey, S., Sheehan, M., Ellsworth, N., Haskell, W. L., & Wood, P. D. (1998). Effects of diet and exercise in men and postmenopausal women with low levels of hdl cholesterol and high levels of ldl cholesterol. New England Journal of Medicine, 339(1), 12–20. https://doi.org/10.1056/nejm199807023390103
Toth, P. P. (2003). Reverse cholesterol transport: High-density lipoprotein’s magnificent mile. Current Atherosclerosis Reports, 5(5), 386–393. https://doi.org/10.1007/s11883-003-0010-5
What is a cholesterol test? [Cholesterol Levels]. (n.d.). MedlinePlus Trusted Health information for You. Retrieved December 18, 2023, from https://medlineplus.gov/lab-tests/cholesterol-levels/
Žák, A. (2015). Niacin in the treatment of hyperlipidemias in light of new clinical trials: Has niacin lost its place?Medical Science Monitor,21, 2156–2162.https://doi.org/10.12659/msm.893619
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