High Cholesterol

Hypercholesterolemia or high cholesterol occurs when you have abnormally high levels of fats (cholesterol or lipoproteins) in the blood. Lifestyle changes can help reduce cholesterol levels.

Signs and Symptoms

High cholesterol has few if any symptoms. The key to controlling your cholesterol is to change your lifestyle by exercising regularly eating a low-fat diet and losing weight if you need to. When you have your routine physical get your cholesterol checked.

What Causes It?

Risk factors for high cholesterol include the following.

• A diet high in saturated fat
• Cirrhosis
• Poorly controlled diabetes
• Underactive thyroid gland
• Overactive pituitary gland
• Kidney failure
• Porphyria a disorder caused by deficiencies of certain enzymes
• Heredity
• Alcohol abuse
• Certain drugs

What to Expect at Your Provider's Office

Your health care provider can order a blood test to check for your total cholesterol level at any time. The ideal level is about 120 to 200 milligrams of cholesterol per deciliter of blood (mg/dl) or less. It is important however to remember that it is not just the total cholesterol count that matters but the ratio of high-density lipoproteins (HDL or "good" cholesterol) to low-density lipoproteins (LDL or "bad" cholesterol).

Treatment Options

Treatment Plan

There are many things you can do to help yourself treat high cholesterol. Eat a diet low in cholesterol and saturated fat to reduce your LDL level. Maintain a healthy weight and exercise regularly. A small amount of alcohol each day increases HDL and lowers LDL levels. However more than two drinks a day have the opposite effect. Finally do not smoke. If all of these measures fail your health care provide may prescribe drugs to lower your cholesterol.

Drug Therapies

Prescription

• Bile acid sequestrants—for example cholestyramine/cholestipol; increases bile acid excretion which lowers LDL; side effects include bloating and constipation
• Nicotinic acid—lowers LDL; various side effects
• HMG CoA reductase inhibitors (statins)—for example Pravastatin or Lovastatin; help lower cholesterol levels; various side effects
• Fibric acid derivatives—for example gemfibrozil; help lower cholesterol levels; various side effects

Over the Counter

N/A

Complementary and Alternative Therapies

The digestion metabolism and utilization of fats as well as minimizing the effects of hypercholesterolemia are areas in which alternative therapies can be very effective.

Nutrition

• Vegetable proteins have been shown to lower cholesterol levels while animal and milk proteins have been shown to raise them. Thus a vegetarian or semi-vegetarian diet has been shown to be effective.
• Eat more foods high in omega-3 oils (cold-water fish nuts and seeds) which can help decrease cholesterol levels. Include foods that help reduce cholesterol such as those high in water-soluble fiber (legumes grains and pectin-containing fruits such as apples grapes bananas prunes lemons plums grapefruit oranges). Reduce consumption of sugar and simple carbohydrates. Eat more foods that support the liver such as beets carrots yams artichokes dark bitter greens and lemons.
• Omega-3 fatty acids (1 000 to 1 500 mg 2 to 3 times per day) lower total cholesterol levels. Found in fish oil capsules and flax seed.
• Selenium (200 mcg per day) for normal processing of fats
• L-taurine (200 mg per day) helps the body excrete extra cholesterol.
• Vitamin C (1 000 mg three times per day) and E (400 to 800 IU per day) are needed for cholesterol metabolism.
• B complex especially B₁₂ (1 000 mcg per day) folic acid (400 to 800 mcg per day) betaine (1 000 mg per day) and B₆ (50 to 100 mg per day) reduce high levels of homocysteine.
• Coenzyme Q10 (50 to 100 mg per day) for your circulatory system
• Chromium (200 mcg one to three times per day) is helpful for people who have high cholesterol as a complication of diabetes.
• Magnesium (200 mg two to three times per day) helps your body function efficiently and lowers blood pressure.
• Panthenine (500 mg three times per day) reduces cholesterol.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Unless otherwise indicated teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and simmer 10 to 20 minutes for roots barks and berries. Drink 2 to 4 cups per day.

• Garlic (Allium sativum) is most effective when included in the diet in the raw form or taken in capsules.
• Herbs that support the liver may be taken singly or in combination. Herbs to consider include milk thistle (Silybum marianum) dandelion root (Taraxacum) burdock root (Arctium lappa) blue flag (Iris versicolor) greater celandine (Chelidonium majus) and blue vervain (Verbena hastata). Tinctures (15 to 20 drops per dose) or infusions (1 heaping tsp. per dose) are best taken 10 to 20 minutes before meals. Greater celandine should be taken with caution (no more than 2 ml daily) as it can lead to intestinal pain.
• Hawthorn berries (Crataegus oxyanthoides) lower high blood pressure and help lower cholesterol levels. Take 200 mg 2 to 3 times per day of dried extract or 30 drops three times per day of tincture.
• Ginger (Zingiber officinalis) can lower cholesterol levels.
• Alfalfa (Medicago sativa) has been shown to lower cholesterol levels.

Homeopathy

Homeopathy may be useful as a supportive therapy.

Acupuncture

Acupuncture can assist with improving liver and gallbladder function.

Following Up

Your provider will check your cholesterol levels regularly.

Special Considerations

It is important that you make a healthy low-fat diet and regular exercise part of your everyday life to control your cholesterol over the long term.

Supporting Research

Auer W Eiber A Hertkorn E et al. Hypertension and hyperlipidaemia: garlic helps in mild cases. Br J Clin Pract. 1990;44:3–9.

Barrie SA Wright JV Pizzorno JE. Effects of garlic on platelet aggregation serum lipids and blood pressure in humans. J Orthomelec. 1987;2:15–21.

Bordia A. Effect of garlic on blood lipids in patients with coronary heart disease. Am J Clin Nutr. 1981;34:2100–2103.

Bordia A Bansal HC Arora SK et al. Effect of the essential oils of garlic and onion on alimentary hyperlipemia. Atherosclerosis. 1975;21:15–19.

Jain AK Vargas R et al. Can garlic reduce levels of serum lipids? A controlled clinical study. Am J Med. 1993;94:632–635.

Johns Hopkins Health Information. Accessed at http://www.intelihealth.com on January 25 1999.

Murray MT Pizzorno JE. The Encyclopedia of Natural Medicine. 2nd ed. Rocklin Calif: Prima Publishing; 1998.

Silagy C Neil A. Garlic as a lipid lowering agent-a meta-analysis. JR Coll Physicians Lond. 1994;28:39–45.

Steiner M Khan AH Holbert D Lin RI. A double-blind crossover study in moderately hypercholesterolemic men that compared the effect of aged garlic extract and placebo administration on blood lipids. Am J Clin Nutr. 1996;64:866–870.

Vorberg G Scneider B. Therapy with garlic: Results of a placebo-controlled double-blind study. Br J Clin Pract. 1990;7–11.

Warshafsky S Kramer RS Sivak SL. Effect of garlic on total serum cholesterol: a meta-analysis. Ann Intern Med. 1993;119:599–605.

Werbach M. Nutritional Influences on Illness. New Canaan Conn: Keats Publishing; 1988.

Yamamoto M. Serum HDL-cholesterol increasing and fatty liver improving actions of Panax ginseng in high cholesterol diet-fed rats with clinical affect on hyperlipidemia in man. Am J Chin Med. 1983;1:96–101.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.