Cholesterol Treatment

Statins are the main prescribed treatment

Statins have variable results on cholesterol and there is a common pattern for those that respond and have less side effects are the ones with a holistic cardioprotective protocol including diet, lifestyle, gut flora and genetics.

Statin side effects are listed and referenced in a larger blog titled “Statin Review”.

Fuzzy logic

Microbiome predicts statin responders

Even though statin medications have been sold to millions of people for many years, we still do not have a good understanding as to why the individual results vary so much. With recent technological advancements in mapping of the gut flora Rima Kaddurah-Daouk and team in 2011 found a link with gut bugs. It is now possible to predict those who are likely to respond to statins by testing gut flora.

Coincidentally (or is there no such thing) it is the same gut flora profile that protects against cardiovascular disease and cholesterol.

Natural statins

Natural statins from red yeast rice have similar side effects when dosed to provide equivalent statin levels as the drugs. But when used as nature intended or in traditional doses and protocols they have other components that work synergistically with the HMG-CoA reductase inhibition from the statins. Such as antioxidant, anti-inflammatory, modulate gut flora, improve insulin sensitivity and blood pressure.

Balancing act – functional ingredients combined with bad effects.

Glucose increases bile production and cholesterol clearance BUT Insulin blocks it. This is one mechanism that insulin resistance and refined sugars can increase cholesterol and why natural sugars found in amongst natural protein, fats, fibres and cofactors can help lower cholesterol. If you have excessive insulin secreted in response to your absorbable carbohydrate (ultimately all ends up as blood glucose) consumption you get cholesterol issues. As seen in insulin resistance syndromes and metabolic syndrome.

When you see research demonstrating statins increase risk of diabetes and insulin resistance you start to worry about the whole story.

Cocoa has shown amazing benefits for cholesterol and cardiovascular disease via its polyphenol antioxidant actions. Statistical analysis suggested chocolate would be good as a source of cocoa and shows protective effects, theory into polyphenols and antioxidants confirmed the hypothesis. However, when chocolate is studied in isolation and with chocolate containg a percentage of cocoa but the rest being sugars and transfats the research showed chocolate that we eat to be naughty is as bad as we expected being full of sugar and trans fats. There is only so much the poor polyphenols can do. We need a holistic approach.

Pomegranate peel and seed and pulp have shown great anti-cholesterol and cardioprotective effects. Don’t rush out buy all the tastiest pomegranate juice and products as the actives come from the bitter astringent parts.

Targets for cholesterol control

– Anti-inflammatory and antioxidants.
o NRF2 activators – turmeric, shisandra, withania, brassicas, resveratrol.
o Essential fatty acids – pomegranate seed oil, safflower oil, fish oil, krill oil, olive oil.
– Gut microbiome.
– PPAR modulation.
– Insulin control.
– Macro split – 40 carb: 30 protein: 30 fat providing there are functional ingredients making up the calories. Good oils, high polyphenol, fibre and nutrient dense carbs, clean and functional protein.
– Fibre – inhibit absorption of cholesterol and aid elimination. Production of cardioprotective short chain fatty acids SCFA.
– Sterols – compete for absorption.

Use the cholesterol

– Hormone production – gonadal and adrenal hormones. Trend to see cholesterol rise as hormone production slows or is inhibited.
– Make bile and eliminate cholesterol naturally.
o Cholagogues and choleretics
 Berberine.
 Globe artichoke (not jerusalem artichoke).
 Schisandra.
 Yellow dock.
 Dandelion root (not leaf).
 Black bean.
o Lipotropes.
 Choline, inositol, b12, folate, methionine (but don’t supplement), glycine, taurine, cysteine.
o Healthy gut flora, probiotics.
– Ketone production – intermittent fasting (ketogenic not exogenous ketones they will do the opposite).
– Olive leaf extract.
o Adhesion molecules, endothelial function, antioxidant.
o Comparable to statins for dropping cholesterol.
o Stacks well with statins.
– Policosanols look very interesting to block cholesterol absorption but new research is looking promising for synergistic actions.
– Pomegranate peel and seed oil can decrease LDL oxidation and plaque formation.
– Garlic – manage microbiome and TMAO production from choline and carnitine, antioxidant, endothelial.
– Grape seed and skin – antioxidant.
– Mulberry leaf tea.
– Blueberries, goji berries.
– Capsicum.
– Yerba mate – antioxidant, insulin and triglyceride and fat burning actions.
– Panax, shilajit reduce cholesterol and increase hormones.
– Wrightia tinctoria.
– Sumac, turmeric, garlic, onion, ginger, black cumin seed.

Statin side effects suggestions:
– BCAA – use 5 grams during exercise
– CoQ10 – 200mg daily. use ubiquinol in preference to ubiquinone.
– Shilajit – 1000mg daily (4 x alpha mars)

 

Rima Kaddurah-Daouk et al.Enteric Microbiome Metabolites Correlate with Response to Simvastatin Treatment. PLoS One. 2011; 6(10): e25482. Published online 2011 Oct 13. doi: 10.1371/journal.pone.0025482
PMCID: PMC3192752
Seema Patel. Functional food red yeast rice (RYR) for metabolic syndrome amelioration: a review on pros and cons. World J Microbiol Biotechnol (2016) 32:87 DOI 10.1007/s11274-016-2035-2
Yakala GK, Wielinga PY, Suarez M, Bunschoten A, van Golde JM, Arola L, Keijer J, Kleemann R, Kooistra T, Heeringa P. Effects of chocolate supplementation on metabolic and cardiovascular parameters in ApoE3L mice fed a high-cholesterol atherogenic diet. Mol Nutr Food Res. 2013 Nov;57(11):2039-48. doi: 10.1002/mnfr.201200858. Epub 2013 Aug 15.
Cholesterol lowering with bile salt hydrolase-active probiotic bacteria, mechanism of action, clinical evidence, and future direction for heart health applications.
Jones ML, Tomaro-Duchesneau C, Martoni CJ, Prakash S.
Expert Opin Biol Ther. 2013 May;13(5):631-42. doi: 10.1517/14712598.2013.758706. Epub 2013 Jan 28. Review.