| Q: |
What exactly is
cholesterol? |
| A: |
Cholesterol is a soft, waxy, fat-like
substance found in every cell of the body.
We need cholesterol to help digest fats,
strengthen cell membranes, insulate nerves,
and make hormones.
|
| |
Cholesterol is made primarily in the liver,
but it is also produced by cells lining
the small intestine and by individual cells
in the body. While our body makes all of
the cholesterol we actually need (about
1,000 milligrams a day), we also get additional
cholesterol from foods we eat. The highest
sources of cholesterol are egg yolks and
organ meats such as liver and kidney. No
plant derived food contains cholesterol,
not even peanut butter or avocado, even
though these foods are high in fat. However,
all foods from animal sources such as meats,
poultry, fish, eggs, and dairy products
contain cholesterol. |
| Q: |
How does cholesterol cause
heart disease? |
| A: |
Cholesterol is a soft, waxy, fat-like
substance found in every cell of the body.
We need cholesterol to help digest fats,
strengthen cell membranes, insulate nerves,
and make hormones. |
| |
Although cholesterol serves many important
functions in the body, too much cholesterol
in the bloodstream can be dangerous. When
blood cholesterol reaches high levels, it
builds up on artery walls, increasing the
risk of blood clots, heart attack, and stroke. |
| |
The heart is a muscle, and like all muscles,
needs a constant supply of oxygen and nutrients.
The bloodstream transports these nutrients
to the heart through the coronary arteries.
If the coronary arteries become narrowed
or clogged by cholesterol and fat deposits
(atherosclerosis) and cannot supply enough
blood to the heart, the result is coronary
heart disease (CHD). If not enough oxygen-carrying
blood reaches the heart muscle, a sharp,
sudden chest pain (angina) may occur. If
the blood supply to a portion of the heart
is completely cut off by total blockage
of a coronary artery, the result is a heart
attack. This is most often caused from a
blood clot forming on top of an already
narrowed artery. |
| Q: |
What exactly is
cholesterol? |
| A: |
Cholesterol is a soft, waxy, fat-like
substance found in every cell of the body.
We need cholesterol to help digest fats,
strengthen cell membranes, insulate nerves,
and make hormones. |
| Q: |
What are LDL and HDL cholesterol? |
| A: |
Cholesterol is a soft, waxy, fat-like
substance found in every cell of the body.
We need cholesterol to help digest fats,
strengthen cell membranes, insulate nerves,
and make hormones. |
| |
Cholesterol and other fats can’t dissolve in the blood and, therefore, can’t travel on their own. They have to be transported to and from the cells by special carriers called lipoproteins. The two major lipoproteins are low density lipoproteins (LDL) and high density lipoproteins (HDL). LDL is most often referred to as the “bad” cholesterol whereas HDL is known as the “good” cholesterol. |
| |
LDLs carry cholesterol throughout the body
to the cells. LDLs cause atherosclerosis
by clogging up our arteries with the continual
buildup of fat. HDL, on the other hand,
prevents this fat buildup within arterial
walls, by carrying it away from the arteries,
to the liver where it is eventually processed
and eliminated. |
| |
Both LDL and HDL have been recognized by
the American Heart Association as strong
and independent risk factors that can impact
heart health. While high levels of LDL are
associated with increased risks of cardiovascular
disease (potentially leading to heart attack
or stroke), high HDL can positively impact
heart health, drastically reducing your
risk of heart disease. In fact, studies
have shown that raising your good cholesterol
reduces cardiovascular disease risks more
than lowering bad cholesterol alone. As
a result, the AHA along with the National
Cholesterol Education Program (NCEP) have
established the following guidelines to
keep your heart healthy: |
| |
• HDL levels above
40 (above 60 is optimal)
• LDL levels between 100 and 159 (preferably
less than 130)
• Total cholesterol
(HDL and LDL) under 200 |
| Q: |
What are triglycerides? |
| A: |
Triglycerides are fats used as fuel by the
body and as an energy source for metabolism.
Triglyceride levels fluctuate easily, changing
after every meal. Increased levels are almost
always a sign of too much carbohydrate and
sugar intake. Triglycerides in high amounts
make the blood more sluggish and less capable
of transporting oxygen, particularly through
the smallest blood vessels. High triglycerides
is yet another independent risk factors for
cardiovascular disease, leading to a heart
attack or stroke. |
| |
There are several medications physicians
can prescribe for people with elevated triglyceride
levels. Some of the most effective are the
statins, but keep in mind there are some
potentially dangerous side effects associated
with their use. |
| |
Natural medicine has thankfully found other
options. Both the HDL-boosting combination
and the LDL-lowering pantethine and plant
sterols blend mentioned earlier can safely
and effectively lower triglycerides. |
| Q: |
What is this “HDL-boosting” formulation you’ve developed and how does it work? |
| A: |
In my many years of practice as a cardiologist,
I’ve met a multitude of patients with
undesirable cholesterol levels. And while
numerous prescription medications have been
developed to lower bad cholesterol, there
are few medications that target good cholesterol.
Patients with naturally low good cholesterol
(HDL< 40), who are not able to significantly
alter their HDL levels through diet and exercise,
have had little medical support to help reduce
their already increased heart disease risk. |
| |
I, therefore, referred to medical literature
where I found that multiple nutrients that
have been clinically shown to favorably
alter good cholesterol levels. My formulation
combines heart healthy vitamins and minerals,
including vitamins C, E, B6, B12, niacin,
folic acid, magnesium and selenium, with
protein-building amino acids, powerful antioxidants,
such as coenzyme Q10 (CoQ10), alpha lipoic
acid (ALA), N-acetyl cysteine (NAC), and
policosanol, and extracts of hawthorn, garlic,
grape seed, soy isoflavones, all of which
have been shown to beneficially affect heart
health. |
| |
The effects of this HDL-boosting combination
were evaluated in an open label pilot study
conducted at Scripps Memorial Hospital in
2002. The trial involved 50 patients, with
varying cardiovascular health histories,
who were evaluated prior to the study, then
again at three and six months. |
| |
After three months of supplementation,
good cholesterol levels increased in all
groups and the overall lipid profile (i.e.,
HDL, HDL-2, triglycerides, homocysteine)
had improved. The changes were more pronounced
at the six-month time point, where good
cholesterols rose by more than 11% and levels
of HDL-2 (the best cholesterol) rose up
to 24.4%. Additionally, the supplement helped
reduced triglycerides levels by approximately
30%. These changes were even more impressive
in “at risk” groups (i.e., those
with HDL levels of less than 40) where total
HDL increased by 23% after six months, HDL-2
rose by 50%, and triglycerides decreased
by nearly 40%. Decreases in homocysteine,
an amino acid found in the blood that has
been inversely linked to cardiovascular
health, were observed as well. And since
we know that an increase in HDL –
as little as one percent – can reduce
heart disease risk by two to three percent,
these findings have significant implications
for the prevention and treatment of cardiovascular
disease. |
| Q: |
What exactly is HDL-2? |
| A: |
It has been well-documented that high levels
of HDL cholesterol are inversely related to
coronary artery disease risk. What is less
well-known is that there are subtypes of HDL,
most notably HDL-2 and HDL-3, each of which
offers unique protection. |
| |
HDL-3, the smaller form, is produced by
the liver and intestines. This subtype is
responsible for scavenging or “scooping
up” free cholesterol from the blood
vessel walls. The cholesterol carried by
HDL-3 is then chemically modified, forming
a new larger-sized and more buoyant subtype,
known as HDL-2, or “mature HDL,”
which transports the cholesterol to the
liver for processing and elimination. The
HDL molecules are then recirculated in the
blood stream to continue scavenging more
cholesterol. |
| |
Research suggests that HDL-2, because it
moves the cholesterol away from peripheral
sites (like the arterial wall), provides
more heart-protection than the HDL-3 form.2
It is also theorized that the larger-size
holds a greater number of receptor sites,
allowing HDL-2 to carry a larger amount
of cholesterol to the liver. |
| Q: |
Does the “HDL-boosting” combination affect LDL levels? |
| A: |
Although supplementation did not result in a significant reduction in LDL, antioxidants such as the ones found in this formulation can help stabilize LDL and prevent build-up in the arterial wall. This stabilization of LDL can not always be easily measured. |
| |
The clinical trial measured both LDL and lipoprotein a (Lp(a)) levels. Lp(a) is a subfraction of LDL cholesterol. If HDL-2 is the best HDL, then Lp(a) could be considered the worst LDL cholesterol. This subfraction is an indicator of inflammation, and studies suggest that high levels of Lp(a) can speed up blood clot formation leading to blockage in the coronary arteries. |
| |
The study found that although the reduction in Lp(a) did not reach statistical significance, there was a general trend towards Lp(a) reduction. It is my belief that an extension of the study may lead to significant results. |
| Q: |
Is the combination safe? |
| A: |
Yes. The formula combines essential vitamins and minerals, at levels recommended by the American Heart Association (AHA), with amino acids, antioxidants, and botanicals, all of which have been used safely for years. The six-month pilot study, which involved 50 patients with varying cardiovascular histories, found no serious adverse effects following supplementation and demonstrated the combination is safe to use with statin drugs. |
| |
In fact, both this HDL-boosting combination and the pantethine and plant sterol combination, clinically shown to reduce total and LDL cholesterol levels, have very safe profiles. |
| Q: |
What is pantethine and how does it lower cholesterol? |
| A: |
Pantethine, a form of pantothenic acid (also known as vitamin B5) is found in small amounts in foods such as liver, salmon, and yeast. Pantethine lowers cholesterol by blocking its production. |
| |
Cholesterol synthesis, or the production of cholesterol in the human body, is an incredibly complex process. It involves many biochemical reactions and enzyme activity requiring several steps. |
| |
Studies have shown that pantethine safely and effectively inhibits several of these enzymes and coenzymes. It blocks the activity of one coenzyme involved in cholesterol synthesis, HMG-CoA, by about 50%. This results in significantly lower cholesterol production. But, that’s not all. To compensate for the lowered cholesterol production, the liver pulls LDL out of the bloodstream. The end result? Studies have shown that on average, pantethine can lower total cholesterol levels by 16%, LDL cholesterol levels by 14%, serum triglycerides by 38%, and can raise HDL cholesterol by 10%. |
| Q: |
What are plant sterols and how do they lower cholesterol levels? |
| A: |
Plant sterols are the fats of plants. They are found in nuts, vegetable oils, corn, and rice. Plant sterols are structurally similar to cholesterol and are able to act as a stand-in for cholesterol and block its absorption. |
| |
The liver receives about 800 mg of cholesterol every day from intestinal absorption. Cholesterol is absorbed from the intestines through receptor sites—special channels that are shaped exactly like cholesterol molecules. The cholesterol enters these channels and is then absorbed into the bloodstream. Because plant sterols look like cholesterol, they fit perfectly into these channels. The cholesterol, being blocked from absorption, remains in our intestines where it is eventually excreted. |
| |
If we eat enough plant sterols, the amount of cholesterol transported from the intestinal tract to the liver is greatly reduced. And, just like pantethine’s effect on the liver, this cholesterol reduction causes the liver to pull LDL cholesterol out of the blood, reducing both total and LDL cholesterol levels. |
| Q: |
Should only people with actual heart disease or those with high cholesterol levels be concerned about cholesterol? |
| A: |
No, recent studies have shown that reducing bad and raising good cholesterol in people without heart disease greatly reduces their risk for ever developing CHD, including heart attacks and atherosclerosis. This is true for those with high total cholesterol levels and for those with average cholesterol levels. |
| |
Because of the potential side effects, physicians today generally do not prescribe statin drugs to people without actual heart disease or high cholesterol levels. Rather, they recommend dietary and lifestyle changes be implemented first. However, as we’ve discussed these changes are in some instances not enough to favorably alter undesirable cholesterol profiles. Fortunately, the HDL-boosting combination and the LDL-lowering pantethine and plant sterols blend can naturally and very effectively help those people with heart disease, uncontrolled cholesterol levels, high triglyceride levels (or all three!) as well as those of us just wanting added “health insurance” for our hearts. |
