Mayo Clinic recommendations: cholesterol-lowering supplements

The Mayo Clinic has a post, updated in 2012, on the topic of “Cholesterol-lowering supplements: Lower your numbers without prescription medication.” As always, we advise you to check with your healthcare provider before starting to use any of these for cholesterol management.

Most of these suggestions have been in the New York Buyers’ Club repertory for quite a while, but we are happy to repeat them here:

Fish oil (omega-3 fatty acids): can lower triglycerides

Green tea: some research on its cholesterol-lowering capacity; epidemiologic evidence suggests that green tea may lower stroke and cardiovascular disease risk. There are several choices for green tea supplements: see Green Tea; Green Tea Decaffeinated; and Green Tea Organic.

Plant sterols: see Cardio Edge for a supplement featuring plant sterols in a formula designed to support healthy cholesterol levels

Garlic extracts: contact NYBC for information on allicin, a garlic extract that has been studied for cardiovascular health

The Mayo Clinic guide also mentions grains, including oat bran and flaxseed, which can lower cholesterol.

Last, the guide discusses red yeast rice, a supplement that can lower LDL cholesterol. Note the caution that some forms of red yeast rice may contain a naturally occurring form of the prescription medication lovastatin. Lovastatin in the supplement may present some dangers to the user, because there is no way to know the quantity or quality of this prescription medication equivalent. For that reason, it is especially important to consult with your healthcare provider and monitor your usage of this supplement.

See the Mayo Clinic guide at

Mayo Clinic: Cholesterol-lowering supplements: Lower your numbers without prescription medication

Pomegranate Juice

Pomegranate juice has become a very popular new drink among the health-conscious in the last few years. Indeed there is an interesting body of research about this fruit, including indications that it may help lower “bad [LDL] cholesterol,” or that it may slow progression of prostate cancer. One caution, however: pomegranate juice may interact with certain drugs, in particular blood pressure-lowering drugs. For that reason, it’s advisable for anyone taking prescription drugs to consult with their health care provider before adding pomegranate juice to their daily routine.

NYBC stocks a pomegranate juice concentrate, which can be mixed with other beverages. Using a concentrate such as this can be significantly less costly than buying the well-known juice brands from your local grocery or health food store.

Here’s the basic NYBC entry:

Pomegranate Juice CONCENTRATE (Jarrow) Each bottle, 12 oz (355 ml) of 100% pomegranate juice concentrate. This is one of the most powerful sources of antioxidants, superior even to blueberries and strawberries. Derived from a California variety, this juice is concentrated to a level of 4 times that of ordinary pomegranate juice…it is thick! The antioxidants found in the juice include ellagic and gallic acid, anthocyanins and tannins, and punicalagin. Punicalagin is perhaps the most powerful. Various studies suggest that this may help to improve the level of glutathione in cells (see the entries on NAC and glutathione), particularly macrophages. It may have benefit for maintaining platelet levels, lowering LDL and sustaining vascular tone.

You can read more in the full entry:

Pomegranate Juice Concentrate (Jarrow)

Jon Kaiser presentation: a nutritional supplement combination therapy to lower cholesterol

We had the opportunity to hear Dr. Jon Kaiser speak in New York last night, in one of his regular information sessions for people wanting to know about holistic/integrative approaches to treating HIV. (It was a double bill, since he had invited his colleague Dr. Ricky Hsu to open the evening with a review of HIV pharmaceuticals, including those just approved.)

While Dr. Kaiser ranged over several topics, including his long-standing interest in micronutrient support for people with HIV and the benefits it can provide, we took the most notes on his approach to reducing cholesterol with nutritional supplements. The need for cholesterol reduction strategies is widespread among people with HIV, since cardiovascular disease is a major concern, especially among those who have been on treatment for a number of years. Yes, as Dr. Kaiser stressed, there are obvious things to start with in order to reduce cardiovascular disease risk: you’ve got to quit smoking, and if you have high blood pressure, you have to work out the (relatively simple) treatment to control it.

But many people with HIV are prescribed statin drugs like Lipitor to reduce cholesterol, and unfortunately the statins come with a handful of potential side effects. So, Dr. Kaiser has recently been offering some of his patients the alternative of a nutritional supplement combination therapy. It consists of low-dose Niacin (to minimize flushing), fish oil (helpful in lowering triglycerides), plant sterols (available now in spreads, by the way), and pantethine. Although he’s only followed a few cases to date, he’s quite encouraged by results, and believes that many people with HIV could achieve good results (comparable to those offered by statins) with this kind of combination therapy.

Of course all of these components have been widely studied for cholesterol control before (you’ll find more information on them on the NYBC website at http://www.newyorkbuyerslcub.org). But it’s another very valuable contribution from Jon Kaiser the integrative health specialist to refine a combination of supplements to serve the particular purpose of reducing cholesterol and cardiovascular risk for people with HIV. We’ll watch for further updates from him on the clinical experience with this combination therapy.

Beta glucans for immune support, cholesterol regulation

Here’s an excerpt from the NYBC info sheet on Beta Glucans, an extract of yeast cell walls which has been used in immune-compromised patients.

Function: Cholesterol regulation, immune support. May also modestly improve blood pressure.

Beta glucans enhance the power of the immune system by activating a certain type of white blood cell known as macrophages. These cells patrol the body and fend off foreign invaders such as bacteria and fungi by engulfing them.

Beta glucans are also well known to be effective in lowering blood lipid levels and are the key factor for why oat bran is so beneficial in this regard. Like other soluble fiber components, beta glucans work by binding cholesterol, facilitating its elimination from the body. Because beta glucans lower the bad LDL and increase the good HDL blood cholesterol levels, they are useful in preventing coronary heart disease.

See also the NYBC entry on

New England Journal of Medicine Editorial: Vytorin and Zetia may not work, and should only be prescribed as a last resort

Here’s the latest news on Vytorin and Zetia, two drugs that are widely prescribed as cholesterol-lowering agents.

We repeat some of the suggestions we made when the failings of these two drugs were first revealed: consider such alternatives as statins plus niacin*; or a supplement based on plant sterols and other components, Cardio Edge from Douglas Labs.

* See NYBC entries for Niacin 100mg (recommended as initial dose to minimize “flushing”) and Niacin Timed-Release / Niatab 500mg, the full-strength dose.
 —- 
Journal Issues Warning on Two Cholesterol Drugs
New YorK Times
By ALEX BERENSON
Published: March 30, 2008

CHICAGO — Two widely prescribed cholesterol-lowering drugs, Vytorin and Zetia, may not work and should be used only as a last resort, The New England Journal of Medicine said in an editorial published on Sunday.

The journal’s conclusion came as doctors at a major cardiology conference in Chicago saw for the first time the full results of a two-year clinical trial that showed that the drugs failed to slow, and might have even sped up, the growth of fatty plaques in the arteries. Growth of those plaques is closely correlated with heart attacks and strokes.

We accessed the full story at http://www.nytimes.com on 3/30/2008.

Cardio-Edge (Douglas Labs): a plant sterol, Sytrinol and pomegranate-based supplement to maintain cardiovascular health and support healthy cholesterol levels

The NYBC co-op has recently added this item in the category of cholesterol management. For a while now we have been interested in the potential of plant sterols for maintaining healthy cholesterol levels, and we noted that our well-regarded supplier Douglas had formulated a supplement that incorporates both plant sterols and two other plant-based components that show a potential benefit in cholesterol management.


Cardio-Edge (Douglas Labs). Cardio-Edge is designed to help maintain cardiovascular health and support healthy cholesterol levels. Its significant components are:

Plant sterols (phytosterols) from soy – 200 mg
Sytrinol – 75 mg
Standardized pomegranate extract (fruit; standardized to 40% ellagic acid) – 25 mg

Plant Sterols
Blood cholesterol is derived from the diet and synthesized in the liver. Sterols work by reducing the absorption of both forms of cholesterol–sterols compete with cholesterol for absorption. Sterols and sterol esters can now be found in many foods including orange juice, rice drink, and margarine.

Sytrinol
This is a proprietary extract of polymethoxylated flavones and tocotrienols from citrus and palm fruits. Sytrinol is intended to have the following effects, some of which you can monitor with routine bloodwork to assess its effect for you. These include:

1) Decrease apoprotein B, needed for LDL synthesis
2) Decrease action of an enzyme in the liver that makes triglycerides
3) Inhibit HMG-CoA reductase in the liver

Sytrinol includes a patented combination of citrus PMFs and alpha, delta and gamma tocotrienols derived from palm fruit. Palm tocotrienols have been shown to inhibit HMG CoA reductase, the enzyme responsible for regulating cholesterol synthesis in the liver. Clinical studies in both animals and humans support Sytrinol’s role in reducing total and LDL-cholesterol as well as triglycerides.

In human clinical studies involving hypercholesterolemic subjects, no side effects were observed with four weeks of supplementing with a daily dose of 300 mg of Sytrinol.

Pomegranate
Recent science has been focusing on the cardioprotective aspects of pomegranate. This brightly colored fruit contains numerous cornpounds known for their antioxidant capabilities, including anthocyanidins, catechins, tannins, and gallic and ellagic acids. Research has shown that supplementation with pomegranate juice can decrease macrophage lipid accumulation and cellular cholesterol accumulation in mice. Recently, research in humans has confirmed a beneficial effect of consuming pomegranate juice on parameters such as LDL oxidation, blood pressure, and blood vessel health.

Please let us know if you have questions or comments about this new item on the NYBC list–emails are welcomed at contact@newyorkbuyersclub.org.

Pantethine for cholesterol control

Pantethine, a biologically active form of pantothenic acid or Vitamin B5, has been used for several decades in Japan and Europe to treat fatty liver and as an adjunct treatment in managing cholesterol. In the US, pantethine is available as a dietary supplement. Research points to its ability to lower LDL (the so-called “bad” cholesterol) and triglycerides, while raising HDL (the so-called “good” cholesterol). A good review of pantethine may be found on the website of the Oregon State University/Linus Pauling Institute:

http://lpi.oregonstate.edu/infocenter/vitamins/pa/

For people with HIV who are using nutritional supplements to help improve their lipid profile, there’s a good info sheet from the Canadian AIDS Treatment Information Exchange, featuring a description of pantethine:

http://www.catie.ca/pdf/Supple-e/Nutrients_e.pdf

See also the NYBC entry on Pantethine for a description of its role in lipid metabolism.