Anti-Cholesterol HERBS

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There are over 50 million Americans with high cholesterol. High cholesterol is a risk factor for heart disease, stroke, and Alzheimer's disease. Cholesterol is a fatty substance, which is necessary for hormone production and to insulate nerve fibers. When there is too much cholesterol it builds up on the arterial wall, causing narrowing of the arteries and impeded blood flow. "Bad" LDL cholesterol represents cholesterol moving through the body. Elevated levels of LDL increase the risk of heart disease. "Good" HDL cholesterol protects against heart disease as it measures cholesterol being cleared from the body. Triglycerides are also associated with a risk of heart disease and diabetes. It is ideal to keep triglyceride levels below 150 mg/dL, total cholesterol below 200, LDL below 130, and HDL above 40.

Although drugs can be used to lower cholesterol, side effects are common and include digestive complaints, dizziness, headaches, rashes, and muscle and liver damage. Exercise and diet recommendations are extremely important in treating high cholesterol. At the Get Well clinic in Oakland, we also recommend our clients with high cholesterol to have a daily stress reduction and exercise program. This is believed to be protective against heart disease and has many other health benefits such as lowering high blood pressure and diabetes risk.

Dietary recommendations:
Eat plenty of fruits and vegetables. Fruits and vegetables contain fiber and antioxidants. Soluble fiber has been shown to reduce LDL and total cholesterol if you take 5-10 grams daily. Good sources of soluble fiber include beans, lentils, oats, barley, apples, citrus fruits, pears, Brussels sprouts, carrots and flaxseed. If you are not allergic to soy products, they also reduce cholesterol levels. It is also important to avoid trans fats, which are found in many margarine and processed foods such as vegetable shortening, hydrogenated fats, or partially hydrogenated fats. Similarly, refined carbohydrates such as cookies, cakes, crackers, chips, and sodas should be avoided as they can increase triglycerides and may lower HDL cholesterol. Dairy products are not advised as they contain saturated fat. All meat and poultry should be lean.

Must you avoid all fat?
Olive oil has been found to lower LDL cholesterol. In addition extra virgin olive oil is rich in antioxidants that protect LDL cholesterol from oxidation, which is an early step in plaque formation. Fish oil and flax oil also appear to protect the heart and may support normal cholesterol levels. Fish containing omega 3 fatty acids such as salmon, tuna, mackerel, and sardines can be eaten as much as desired. The dosage of flax is 1-3 tablespoons per day in the form of freshly ground seeds or oil which can be used as a salad dressing or cooked vegetable garnish. Finally nuts in moderation may also protect against heart disease, high triglycerides and cholesterol levels. A handful of almonds, walnuts, or cashews are recommended.

Gugulipid
Gugulipid is derived from a species of myrrh called Commiphora mukul. This plant is traditionally used to treat obesity and fat obstruction. This has led scientists to study gum guggul and its extracts in order to lower cholesterol and triglycerides and to aid in weight loss. In scientific studies, gugulipid has been shown to lower bad LDL cholesterol and triglycerides, and raise beneficial HDL cholesterol. As reported in the May 30, 2002 issue of Science, a research team at Baylor School of Medicine found that the plant sterol guggulsterone may block a receptor in the liver cells involved with cholesterol metabolism. This receptor is known as FXR (farnesoid X receptor). FXR plays a crucial role in cholesterol metabolism by mediating the rate of bile acid produced by the liver (cholesterol is eliminated from the body through bile release). For example, in a twelve-week study with a controlled diet, gugulipid significantly reduced total cholesterol and triglycerides levels in 78.9 percent of patients.

In human experiments, cholesterol levels typically drop 14-27 percent in four to twelve weeks, while triglycerides drop 22-30 percent. Typical dosage in clinical studies corresponds to 25 milligrams of guggulsterone three times per day. Gugulipid performs similar to cholesterol lowering medication without side effects. It appears that gugulipid helps the liver metabolize cholesterol and stimulates thyroid function. This extract may also prevent the development of atherosclerosis and inhibit platelet aggregation thus preventing stroke or embolism. It also has anti-inflammatory properties in laboratory experiments. Gugulipid is found along with policosanol in Polilipid; it is processed to be rich in guggulsterones. General dosage is 1-2 tablets per day before meals, although better results may be obtained using 3-4 tablets per day.

Policosanol
Policosanol is a plant product derived from rice bran or sugar cane that has been demonstrated in multiple clinical studies to safely reduce LDL ("bad") cholesterol while significantly raising HDL ("good") cholesterol. In addition, it can be used to improve pain free walking distance for people with intermittent claudication (hardening of the arteries). Policosanol is comprised of the long chain fatty acids octacosanol, hexacosanol, tricontanol, tetracosanol, and dotricontanol.

At the University of Bonn, Germany, a review of the scientific studies was reviewed. At doses of 10-20 mg/day, policosanol lowered total cholesterol by 17-21%, LDL cholesterol was reduced 21-19%, and HDL cholesterol was raised 8-15%. In a six-month study, 10 mg of policosanol per day reduced total cholesterol by 16%, LDL cholesterol by 24%, and increased HDL cholesterol by 29%. In another study participants received either 20 mg/day or 40 mg/day of policosanol, or a placebo, for six months. LDL cholesterol dropped and HDL cholesterol increased in both groups that received policosanol. There was no change in the placebo group. Researchers found that there was little difference between the two dosage levels.

Policosanol has also been compared with drugs. For example, in a trial involving 113 patients, 59 patients received 10 mg per day of policosanol with a low cholesterol diet, and 54 patients were given besafibrate at 400 mg per day while on a low cholesterol diet for eight weeks. In policosanol-treated subjects, LDL cholesterol fell by 18%, triglycerides by 15%, while in the drug group LDL fell 11%, and triglycerides by 6%. To test the effects with coronary heart disease (CHD) and high cholesterol, a 23 patient, double blind study was conducted. Electrocardiogram (EGG) and serum blood samples were followed for 14 months. The policosanol group showed a reduction of total and LDL cholesterol, and 5 out of 12 patients exhibited a tendency to improve their CHD. Further studies have indicated equal effectiveness to the chemical drugs lovistatin, simvastatin or provastatin. It is hypothesized that policosanol inhibits cholesterol synthesis in the liver. Not all studies show a triglycerides lowering effect.

Astra Garlic Herbal Formula
Among Health Concerns' successful products is a formula called Astra Garlic. It is used primarily to treat and prevent hyperlipidemia, atherosclerosis, and degenerative disorders of the cardiovascular system. In China much research has been conducted on the circulatory system.

The main ingredient in this formula is garlic, which has been found to have vasodilatation effects on peripheral blood vessels as well as anti-atherosclerosis and anti-hypertension effects. In a study in which 800 mg per day of garlic in pill form was administered, 261 patients showed a 12% reduction in cholesterol, compared with a 3% reduction in a control group taking a placebo. It should be mentioned that the garlic has been concentrated and prepared so that it does not cause breath odor.

Astragalus (huang qi) is known to tonify qi and stabilize the exterior. Animal experiments have shown a decoction of astragalus injected intravenously to have a strong blood pressure lowering effect through vasodilatation, and an increase in cardiac output.

Research on ho-shou-wu (Polygoni Multiflori) has found this herb to possess properties that lower blood cholesterol levels. In vitro studies of filtered decoctions of ho-shou-wu have shown sedimentation to occur when cholesterol was added to the decoction. Experimental animals fed high cholesterol diets, and then given preparations of ho-shou-wu, showed decreased levels of fibrous plaque formations as opposed to control group animals. In a clinical trial composed of 86 patients whose overall serum cholesterol level was 295, a ho-shou-wu preparation was administered for two months resulting in an average drop of 38.2 mg. There were no side effects.

Ganoderma (ling zhi) is known to have immune enhancing effects. Research has found it also to posses certain effects on the circulatory system, primarily in treating angina and other accompanying symptoms of coronary heart disease. Its anti-cholesterol activity is still being investigated.

Crataegus (shan zha) is known in Chinese medicine to remove food stagnation. It has also been shown to have an anti-cholesterol property. In a clinical trial of 20 patients whose average cholesterol level was 252.2 mg, crataegus was administered daily for six weeks. All patients showed a decline in cholesterol levels with the average decrease for the entire group being 46.2 mg. Other research has found crataegus leaves and flowers to possess anti-hypertension properties.

Angelica (dang gui) is a strong tonifier of blood. It also reduces blood pressure effectively. In animal studies angelica preparations, including decoction and tincture, reduced blood pressure. Other animal studies have found that angelica may protect blood vessel walls against plaque adhesion.

Salvia (dan shen) activates blood and removes blood stasis. In a clinical trial, 34 patients were treated for thromboangitis obliterans using powdered salvia soaked in wine for 15 days. Fifteen patients experienced complete relief from their symptoms, 9 showed marked improvement, 3 some improvement, and 7 patients experienced no changes in symptoms. Most patients remarked that after taking the salvia wine, their pain was alleviated and they had sensations of heat spreading or even rushing into their extremities. Most individuals did not experience side effects, although a few suffered itching of the skin. In another clinical trial of 323 patients who had coronary heart disease, salvia tablets (20 mg of herb each) were administered orally for 10 months. About 80% of these patients experienced complete relief from their angina.

The final herb in Astra Garlic is white atractylodes (bai zhu). In Chinese medicine it is known to tonify the spleen/stomach and dry dampness. Research has shown white atractylodes to possess anticoagulation properties. Healthy volunteers who took one tablespoon of a 1:20 solution of atractylodes decoction, three times daily for four days, showed an increase in prothrombin time. This returned to normal 10 days after administration was stopped.

Conclusion
While Astra Garlic and Polilipid (gugulipid and policosanol) are effective at reducing cholesterol levels, it is important that they be combined with a stress reduction and exercise program, and a diet rich in fresh fruits and vegetables. The dosage of Polilipid is 1-2 tablets a day before meals, however for a stronger effect 2 tablets twice per day before meals is recommended. For Astra Garlic, the average dose is 3 tablets three times per day before or between meals. For relatively healthy individuals with high cholesterol, Polilipid may be the best choice. For individuals suffering from degeneration of the cardiovascular system, Astra Garlic or a combination of Astra Garlic and Polilipid may prove to work best. Clinical experience has revealed that these preparations if used correctly are compatible with pharmaceutical drugs. However any reduction in medication should be supervised by the patient's physician.

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By Andrew Gaeddert, Herbalist

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