Last month saw the German pharmaceutical giant Bayer withdraw its cholesterol-lowering drug Lipobay (cerivastatin) from the World market. The drug has been linked with a number of deaths caused by a condition characterised by muscle break-down known as ‘rhabdomyolysis’. In addition, there have been more than a thousand reports of muscle weakness associated with the drug’s use. Doctors will now be looking to swap their patients from Lipobay to other drugs which have similar action in the body such as Lipitor (atorvastatin) or Zocor (simvastatin). However, there is some evidence that other drugs which work in the same way as Lipobay – known as ‘statins’ ” may also cause rhabdomyolysis in a small but significant number of people. As a result, a consumer watchdog organisation in the United States is calling for all statin drugs to carry labels warning clearly of this potential side-effect. In the light of these revelations about the most commonly-used cholesterol lowering medications, some individuals may be tempted to take an alternative approach to lowering their cholesterol level. Here, we take a look at the some of the most effective strategies natural medicine has to offer.
Cholesterol is a waxy, fat-like substance that is transported around the body in the blood stream. Cholesterol can build up on the inside of our arteries and increase our risk of ‘cardiovascular’ diseases such as heart disease and stroke. The cholesterol in the body comes in two main forms; low density lipoprotein (LDL) and high density lipoprotein (HDL). Raised levels of LDL are associated with an increased risk of atherosclerosis and for this reason LDL has been dubbed ‘bad’ cholesterol. HDL, on the other hand, is associated with a reduced risk of atherosclerosis and is therefore often referred to as ‘good’ cholesterol.
Only about a quarter of the cholesterol in the blood stream comes from the diet. The rest is made naturally in the liver. Statin drugs such as Lipobay work by slowing down the rate at which the liver manufactures cholesterol. It has been known for a long time that there is a risk of these drugs causing inflammation in the liver (hepatitis) which is why liver function tests are often recommended for individuals taking statin drugs. The problems of muscle weakness and rhabdomyolysis associated with these drugs has only recently begun to be recognised by many doctors. This revelation may cause doctors to be more reticent about starting a patient on this therapy.
High cholesterol levels often respond to dietary approach. Some foods are known to have a cholesterol-lowering effect such as soya milk and tofu, oat bran, ‘live’ yoghurt, walnuts, garlic and onions. Plenty of these foods should be included in the diet. As well as reducing the level of LDL in the body, it can help to increase the level of HDL. Both oily fish (e.g. salmon, mackerel, herring, trout, tuna) and raw garlic appear to do this, which makes them good choices for anyone with a high cholesterol level. Exercise has been shown to raise HDL levels. This is likely to be one of the reasons why regular exercise reduces the risk of cardiovascular conditions such as heart disease and stroke.
In recent years, there has been growing interest in the role of compounds called ‘sterols’ and ‘stanols’ in reducing cholesterol levels. Sterols and stanols are found naturally in plants, and have a chemical structure very similar to that of cholesterol. Because of this, sterols and stanols can block the absorption of cholesterol from the gut, thereby reducing cholesterol levels in the blood stream. Several studies have proved a cholesterol lowering effect. At a total dose of 2 g per day, sterols and stanols appear to reduce the risk of heart disease by about 25 p.c.
Some food manufacturers have come up with idea of adding sterols and/or stanols to products such as margarine or cream cheese. However, my feeling is that this is essentially giving with one hand and taking with the other: While the sterols and stanols may help to reduce cholesterol levels, the fat that these products contain may increase risk of heart disease and stroke. Sterols and stanols are available, however, in supplement form under the name ‘Lestrin’. This product can be found in health food stores.
Two other natural substances which may help to reduce cholesterol levels are niacin (a form of vitamin B3) and chromium. Large doses of niacin (3 g/day) have been shown to substantially reduce total cholesterol levels and increase HDL levels. As a result, niacin is gaining increasing popularity as a cholesterol treatment even with conventional doctors. However, such large doses of niacin can be toxic to body, particularly the liver, and may induce problems such as flushing, nausea and queasiness. Because of this, large doses of niacin should really only be taken under the supervision of a doctor.
Chromium has been shown in studies to reduce cholesterol levels and increase HDL levels. It is believed that niacin and chromium work particularly well in combination. One report suggests that just 100 mg of niacin combined with 200 mcg of chromium per day may be effective in reducing cholesterol levels for some people. Magnesium is another useful nutrient for treating raised cholesterol. In one study, magnesium at a dose of 430 mg per day was shown to reduce cholesterol levels and increase HDL levels.
The Indian herb guggul (Commiphora mukul) contains compounds called guggulsterones which have the ability to reduce LDL levels. Studies in humans have consistently confirmed that guggul has the ability to reduce cholesterol levels. The normal recommended dose is 25 mg of guggulsterones, three times a day.
Vitamin E may also be of benefit to individuals suffering from high cholesterol. Studies suggest that it when cholesterol, becomes damaged through a process known as ‘oxidation’ that it then has the propensity to settle on the inside of the body’s arteries. Therefore, it is thought that even if the cholesterol level remains unchanged, protecting it from oxidation can help to reduce heart disease risk. Because vitamin E has a cholesterol-protecting effect, it may help to reduce the damaging effects of cholesterol in the body. Studies show that even relatively modest supplementation with vitamin E can reduce heart disease risk by about 40 p.c. The normal recommended dose is 400 ” 800 IU per day.
