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The answer, like many of my courageous medical comments, is a firm “It depends…”
Most of my patients aren’t thrilled when I reach for a prescription pad, especially when it’s for a drug they might have to take for the rest of their lives. Consider also the dollar signs that appear in the eyes of pharmaceutical industry executives if you are, say, 40 years old and your doctor writes you a Lipitor prescription to lower your bad cholesterol. If you live to be 80, over your life span you’ll be spending about $50,000 on this drug.
Statins like Lipitor are the main medication family used for lowering cholesterol. These drugs interfere with your body’s ability to manufacture cholesterol. Undeniably, statins lower cholesterol, and as far as meds go, most people tolerate them without too much trouble.
However, you also can make dramatic reductions in your cholesterol levels using lifestyle changes and supplements. I would definitely go this route first.
Here are your first steps:
1. Lower the saturated fat in your diet by cutting back on meat and fat-containing dairy products (butter, cheese, 2% and whole milk, cream, ice cream). If you need help, visit a nutritionist. In the Chicago area you can make an appointment with Marla Feingold, the clinical nutritionist at WholeHealth Chicago.
2. Start exercising.
3. Reduce stress.
4. Get your weight down (steps 1 through 3 are the way to accomplish this).
Here are the supplements that help lower cholesterol:
• Red yeast rice is molecularly very similar to the statin drugs–so much so, in fact, that the pharmaceutical industry tried unsuccessfully to get it pulled from health food store shelves. Sold as red yeast rice extract in the product Choleast, the usual dose is one or two capsules twice daily.
• Niacin, one of the B vitamins, lowers both LDL (bad) cholesterol and triglycerides. You’ll need a larger dose than the one found in most B complex capsules. As a prescription (so your insurance company will pay for it), niacin is sold as Niaspan. You can also find it over-the-counter in your health food store as inositol hexaniacinate. Because capsule sizes vary, just follow the instructions on the package. Niacin may cause a flushing sensation, but this often clears up as your body gets used to the vitamin.
• Pantethine, another B vitamin, slows cholesterol production in your liver and lowers LDL and triglycerides. Although it has a similar name, pantethine is not the same as the pantothenic acid found in your B vitamin. The dose of pantethine needed to lower cholesterol is 300 mg taken three times daily.
• Sterols are molecularly similar to cholesterol and block its absorption through the intestines. There are several brands, available in your health food store or from our apothecary, derived from either sugar cane or beeswax.
Pantethine, and sterols are sold in convenient capsule packets in a product called Triplichol, which also includes capsules of fish oil. You take one packet twice a day.
If you’re going to try dietary changes and supplements–Choleast or Triplichol, or both–give them at least two full months to work and then get your cholesterol rechecked.
Supplements simply do not work for everyone and if you want to avoid the heart problems associated with high cholesterol, you just may have to bite the bullet and use a prescription drug.