Description Cholesterol is a naturally occurring fat, or lipid, that is necessary for overall body function. Approximately 1,000mg of cholesterol is produced daily by the liver and additional cholesterol is obtained from animal foods. Cholesterol helps build cell membranes, synthesizes various sex hormones, promotes bile synthesis for digestion, and is essential for transporting fat-soluble vitamins such as A, D, E, and K through the body. This steroid molecule does not dissolve in blood and is transported throughout the body by several proteins. Once cholesterol is manufactured, it is difficult for your body to remove and must be excreted through stool. Problems occur when cholesterol accumulates on blood vessel walls, which can eventually interfere with blood flow and potentially cause a heart attack or stroke.
LDL vs. HDL There are two types of cholesterol: low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Lipoproteins are special cells produced by the liver that transport cholesterol to and from cells. LDL distributes the cholesterol to cells, which use what they need, and leftover cholesterol stays in the bloodstream to be picked up by HDL for return to the liver, which facilitates its elimination. LDL is considered the "bad" or "least desirable" type of cholesterol. This form of cholesterol is essential for transporting fat-soluble vitamins such as A, D, E, and K, but an excess can cause cholesterol to build up or form plaque on arterial walls supplying the heart and brain with oxygen and nutrients. HDL is considered the "good" type of cholesterol and is responsible for potentially reducing the risk of heart disease. However, only so much HDL is present in the body and it cannot handle a cholesterol excess. As a result, LDL cholesterol particles continue to float through the bloodstream and may build up or form plaque on arterial walls, as mentioned above. Plaques form around a fibre deposit, or fibrin and this process can continue, eventually forming a blockage. This process is called atherosclerosis, or the formation of a fatty deposit. A blood clot occurs when this cap breaks off and floats through the body, creating a dangerous situation of blocking blood flow in the arteries of your legs, brain, ears (leading to hearing loss), coronary arteries (leading to heart disease), kidneys, and genitals.
Levels & Ratios Cholesterol is measured in milligrams per deciliter (mg/dL) or millimoles per litre (mmol/L) of blood. A "normal"/desirable blood lipid profile is as follows: - Total Cholesterol: <200mg/dL (5.2mmol/L)
- LDL Cholesterol: <130mg/dL (3.4mmol/L)
- HDL Cholesterol: >35mg/dL (0.9mmol/L)
- Triglycerides: <200mg/dL (2.3mmol/L)
Total cholesterol counts can also be too low. If your total lies below 180 mg/dL you may be at greater risk of gallbladder disease, acute infections, anemia, and autoimmune diseases. It is important to watch the ratio of HDL to LDL. In general, the more HDL you have, the better. For example, 60 mg/dl HDL to 130 mg/dl LDL is better than 35 mg/dl HDL to 155 mg/dl LDL.
Symptoms and Signs:As mentioned above, a cholesterol test will determine your HDL:LDL ratio and you may act on this information accordingly. A high LDL level should be treated and your naturopath or other health practitioner can help determine the most viable approach for your needs.
Causes: A diet high in saturated fats (from fried foods, hydrogenated oil products, et cetera) and low in dietary fibre can result in high cholesterol levels. Some individuals seem to have naturally high levels of cholesterol and must watch their levels carefully. This may be due to genetic factors, where the liver has a defect or absence of LDL/HDL receptors. If HDL does not bind to a receptor, it will merely float around the body and can become lodged on an arterial wall. Cholesterol is a pre-cursor to stress hormones (adrenals) and cortisol. Increased stress from various physical / chemical / emotional / personal stressors can thus lead to higher cholesterol levels in the body. Certain drugs and medications can increase cholesterol levels. High blood pressure medications, such as beta blockers, may elevate LDL levels, while oral contraceptives and steroids can pose potential problems as well. Coffee increases the burden on the liver, can elevate cholesterol levels, and can double your risk if you are susceptible to high cholesterol. Diabetes also increases the risk of high cholesterol, as LDL and HDL are dependent on insulin to function. The lowered metabolic rate of hypothyroidism also slows cholesterol excretion, increasing concentrations in the body. A sedentary lifestyle can also contribute to high LDL cholesterol levels.
What to Expect: High cholesterol, plaque formation, and blood clots can all increase the likelihood of coronary heart disease, heart attack, stroke, high blood pressure, breast cancer, and prostate cancer.
Remedies Some prescription drugs can lower cholesterol. However, side effects include heart failure, blurred vision, muscle aches, fatigue, impotence, and increased cancer risk. Fortunately, a large variety of alternative remedies exist to deal with this situation.
Foods Fruits and vegetables contain beta sistosterol (among other sterols). As with plant sterols in general, beta sistosterol may help lower cholesterol levels by blocking the reabsorption of cholesterol from the intestine. Finland margarine, for example, contains beta sistosterol as an attempt to lower the Finn's typically high cholesterol levels. Add more fruits and vegetables to your diet and purchase organic whenever possible. As an emulsifier, lecithin helps lower LDL levels by dispersing the fat in water where it is then removed from the body. Lecithin also protects against atherosclerosis and cardiovascular disease by reducing fatty buildup on artery walls and vital organs. If using granules, take 1 tablespoon 3 times daily and keep refrigerated in a tightly sealed bag when not in use. If using capsules, take 1200mg 3 times daily before meals. A major study in the New England Journal of Medicine based on 38 earlier studies found that diets high in soy protein reduce cholesterol levels. In addition, the more soy one eats, the lower one's cholesterol is likely to be. A diet containing 25g of soy protein daily can reduce cholesterol levels by 9mg/dl, 50g by 17mg/dl, and 75g by 26mg/dl. Isoflavones in soy may also help lower cholesterol levels. Eat soy products such as tofu, tempeh, and soy butter to obtain a realistic goal of 25 to 50g soy protein daily.
Food Supplements Essential fatty acids help balance cholesterol levels and provide your body with necessary fats to ensure proper brain and nervous system function. Flaxseed/linseed oil, borage oil, pumpkin seed oil, hemp seed oil, evening primrose oil, fish, eggs, and walnuts are all sources of EFA's. The oils may be the most ideal. Take one tablespoon daily on yogurt, rice and/or bean dishes, salads, and vegetables. If using flaxseed oil capsules, take 2 to 3 capsules daily, in the morning. If using evening primrose oil capsules take 1 500mg capsule daily, in the morning. Do not cook with these oils. Heat denatures these oils and they lose their nutritional value. Be sure to keep oils refrigerated as they will go rancid if not kept cool. Dietary fibre is also key to reducing cholesterol levels, as soluble fibre binds to cholesterol, facilitating its excretion. Psyllium, oat bran, and pectin are all ideal sources of soluble fibre. If using psyllium, add 7.5g of seed or 5g of husks to water or juice. Take 1 to 2 times daily. It is important to maintain adequate fluid intake when using psyllium seed to prevent constipation. Ensure you drink plenty of fluids. Psyllium seed husk may cause bloating. In addition to dietary sources, oat bran is available in capsule or tablet form and may contain additional beta glucans or "B-glucans". Take oat bran with plenty of water to avoid constipation. NOTE: Large amounts of oat products may reduce your body's ability to absorb calcium. Pectin is found in apples, bananas, beets, cabbage, carrots, citrus fruits, dried peas, and okra. Beta glucan, found in oat bran and barley, is also thought to be able to reduce cholesterol levels. An American Journal of Clinical Nutrition report stated that beta glucan increased the excretion of cholesterol and other fats. If supplementing, take 3 to 8mg daily. Guar gum is another fibre source and can be added to baked recipes.
Herbs Fenugreek seed powder both lowers LDL levels and raises HDL levels. Take 1,200 mg daily. The tea form of Fenugreek cannot be guaranteed to have cholesterol-lowering properties, as adequate studies have not been conducted. Flaxseed is high in soluble fibre (mucilage) and can thus lower cholesterol levels. To obtain the mucilage, soak the seeds in water for several hours, then take as is, or heat. Eat the seeds when finished. Among its many benefits, garlic can lower LDL and raise HDL while lowering blood pressure, fighting off bacteria, and strengthening the immune system. It also decreases levels of HMG-Coa, an enzyme that produces cholesterol. Allicin is considered the active ingredient in garlic. You can increase the content of allicin in garlic by crushing the buds and leaving them out for five minutes or more. The oxygen in the air facilitates the conversion of alliin to allicin. Take at least two cloves daily. If supplementing, take 400 to 500mg up to three times daily. If using a tincture, take 2 to 4mL three times daily. Guggulipid lowers triglyceride levels, raises HDL levels, and decreases cholesterol synthesis by the liver. Take 250 to 500mg 3 times daily.
Lifestyle Avoid junk foods high in saturated fats and hydrogenated oils, such as potato chips and snack foods. Read the labels on margarine, commercially-prepared baked goods, and salad dressings, and pass on those items containing hydrogenated or partially hydrogenated oils. "Partially" hydrogenated is not a viable alternative and should be avoided as well. Hydrogenated oils should be strictly avoided when cooking. Instead, cook with safflower oil, which is low in both saturated and monounsaturated oils and high in linoleic acid (omega-6 fatty acids). Be careful when cooking with oils through. When heated to a high enough temperature, all oils become hydrogenated and the beneficial qualities of the fats are lost. Butter, coconut oil, and lard should all be avoided, as these oils are high percentages of saturated fats. High fat meats should also be avoided. Choose leaner cuts or eat chicken or turkey. It is also important to note that only foods from animal sources contain cholesterol. You may wish to consider reducing your meat intake and replacing with a more vegetarian diet. 2-carbon acetates are the starting block for cholesterol. These compounds are found in sugars, proteins, and the saturated fats in red meat, dairy, and eggs. Excess calories from these foods are first stored as glycogen in the liver and then converted to 2-carbon acetates, which lead to cholesterol production. Reducing your consumption of these foods will help eliminate a known source of indirect cholesterol production Avoid alcohol, as it places an excess burden on the liver and can increase cholesterol levels.
Minerals Chromium, particularly in the form chromium picolinate, can produce modest decreases in cholesterol and improves the HDL:LDL ratio. Take 400 to 600mcg daily.
Therapies, Healing Aids, and More According to the New England Journal of Medicine (1998, 339: 12-20), exercise helps reduce low-density lipoprotein (LDL) levels. Exercise also promotes circulation, increases oxygen availability, and boosts mood levels. A healthy diet low in saturated fat and high in fruits, vegetables, and soluble fibre should be considered the most effective, long-term approach to dealing with cholesterol. And by providing your body with the nutrients needed to properly function, this approach can act as a preventative against a variety of other ailments. If you are overweight, consult with your naturopath or other health practitioner to outline a plan to help reduce your weight.
Vitamins Vitamin A and beta carotene can inhibit the body's production of cholesterol. Carrots (for beta carotene) and tomatoes (for lycopene) are ideal sources. In addition, carotenoids reduce the oxidation of LDL. It is best to obtain these substances from a healthy diet rich in fruits and vegetables. If you choose to supplement, look for mixed carotenoids and take 15mg / 25,000 IU daily. Vitamin B3 (Niacin) reduces LDL levels, raises HDL, and lowers serum cholesterol levels. Take 50mg up to 3 times daily. You may wish to start at a lower dosage and work your way up. DO NOT exceed 300mg total daily intake, unless under the supervision of your naturopath or other health practitioner. NOTE: Do not take B3 if you have a liver disorder, gout, or high blood pressure. Also, do not be alarmed if you experience a niacin flush -- a dilation of blood vessels resulting in redness and tingling around joints, certain muscles and other portions of your body, and increased warmth. Depending on dosage, the effect can last from several minutes to an hour. The effect is completely normal, though you may be caught off guard at first -- especially if you do not know it is coming. Vitamin B6 deficiency can increase heart attack risk by five times. Deficiencies also lead to increased homocysteine levels -- a metabolite of methionine that can damage cells lining the arteries. Take 50 to 100mg daily. Do not take 100mg at one time as your body may not be able to fully absorb it. Take divided doses, instead. Vitamin C's antioxidant properties prove beneficial in reducing free radical damage (particularly to blood vessels) caused by plaque breakup. The vitamin lowers LDL and raises HDL and promotes collagen and elastin production. In addition, vitamin C helps balance normal vasodilation -- the relaxation of blood vessels. High cholesterol levels often interfere with this process and this can lead to heart disease. Take 1,000mg to 6,000mg daily, in divided doses. Start at the lower dosage and increase up to bowel tolerance. Vitamin E helps prevent the initial plaque damage on arteries. It also lowers LDL and raises HDL. Vitamin E also works with vitamin C to promote blood vessel relaxation (vasodilation). Take 400 to 800 IU daily.
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See also Diabetes, Hypothyroidism, Stress
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