Cholesterol alternatives, by Dr.

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Alternative Ways to Support Healthy Cholesterol Levels

by Dr. Many of us may take or know someone who takes a statin drug (Lipitor, Zocor, Crestor, Mevacor, etc.) for high cholesterol. But did you know there are other effective options for supporting healthy cholesterol levels? There is substantial evidence on the effectiveness of red yeast rice, niacin, garlic and omega-3 fatty acids for this use.Updated treatment guidelines to the Third Report of the National Cholesterol Education Program (NCEP) were published in 2004. New evidence suggested a benefit from an LDL-C (bad cholesterol) goal <70mg/dL for high-risk patients and <100mg/dL for moderately high-risk patients. This has resulted in more aggressive treatment for high cholesterol, which has opened the door for alternative treatments to support these goals.Red yeast rice (Monascus purpureus) has been used in China as a preservative, spice, food coloring and medicinal remedy. It is the product of fermenting red yeast over rice. The key ingredient, Monacolin K, inhibits the enzyme responsible for cholesterol synthesis. This is similar to the mechanism of action of the prescription medication Mevacor (lovastatin).A study conducted by the UCLA School of Medicine and published in the American Journal of Clinical Nutrition in 1999 showed red yeast rice significantly lowers total cholesterol, LDL-C, and total triglycerides.Red yeast rice can cause similar side effects to statins such as heartburn, gas, dizziness or muscle pain but usually with a lower incidence. Do not take if you have liver problems. As with statins, it is suggested to take a CoQ10 supplement to restore this depletion.

The FDA recently issued a warning regarding certain red yeast rice products sold over the Internet. These products were found to contain lovastatin.Niacin (nicotinic acid, vitamin B3) is a water-soluble vitamin found in foods such as yeast, meat, fish, milk, eggs, green vegetables and cereal grains. It is a widely accepted treatment for high cholesterol. Multiple studies show niacin is very effective at increasing HDL-C (good cholesterol) and somewhat effective at lowering LDL-C. It is included as part of the treatment guidelines published by the NCEP.Niacin is available in immediate release, extended-release, and sustained release formulations but not all are considered equivalent. A common reaction with niacin is flushing and/or itching. Gradually increasing the dose and taking with food helps minimize this. Time-release preparations may cause less flushing but are more expensive and have more risk of liver toxicity. "No-flush niacin" is available as inositol hexanicotinate.Garlic (Allium sativa) can be used for more than adding flavor to our favorite dish. According to the National Institutes of Health, multiple studies have shown a small decrease in total blood cholesterol and LDL-C. Its effect on HDL-C is still not clear.

An easy way to supplement with garlic is eating two to three raw cloves per day. Organic garlic oil capsules are the next best option. Odor-free supplements are available but the processing diminishes potency. Large doses may cause gas or indigestion. Use with caution if you have an increased bleeding risk or take blood thinners, such as aspirin or Coumadin (warfarin).Omega-3 fatty acids are anti-inflammatory fatty acids found in cold-water fish (wild salmon, cod liver) and certain nuts/plants (flaxseed). Fish oils contain EPA and DHA. Flaxseed contains ALA, which is converted in the body to EPA and DHA. According to The Omega-3 Miracle, many studies show taking fish oils lowers triglyceride levels. The National Institutes of Health acknowledge this, in addition to a small increase in HDL-C. But both sources warn fish oils could increase LDL-C. Taking a garlic supplement may help balance this effect.Since it may be difficult to get the necessary dose of omega-3 fatty acids through diet alone, it is important to find a high-quality fish oil or flaxseed oil supplement. Taking vitamin E may protect the body from damage due to oxidation of the oils. Use with caution if you have an increased bleeding risk or take blood thinners.Lifestyle modifications are essential to optimize healthy cholesterol levels. These include:

At least 30 minutes of aerobic exercise most days of the week.

Decrease your intake of saturated fat and trans-fat (cutting back on processed and refined foods).

Increase your intake of soluble fiber, leafy greens, and fresh fruits. A good rule of thumb is to "eat the rainbow" everyday.September is National Cholesterol Education Month, so now is the perfect time to start making small changes to support healthy cholesterol levels for life. Talk with a pharmacist at Uptown Drug to learn how these alternative treatments can work for you.Dr. is a part-time pharmacist at Uptown Drug & Gift Shop (444 S. Flower St., Suite 100, (213) 612-4300. She is currently working on certifications in integrative nutrition and as a master herbalist. She welcomes any question at drgonzel@....Body Shoppage 28, 11/12/2007© Los Angeles Downtown News. Reprinting items retrieved from the archives are for personal use only. They may not be reproduced or retransmitted without permission of the Los Angeles Downtown News. If you would like to re-distribute anything from the Los Angeles Downtown News Archives, please call our permissions department at (213) 481-1448.

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