A thorough evaluation of your heart attack risk requires much more than cholesterol level checks. Early detection of heart disease risk is critical if you want to prevent a heart attack.
Three main types of lipoproteins exist:
All three types of lipoproteins come in different sizes. HDL carries the so-called "good" cholesterol. We now know that HDL can be grouped into large and small sizes. Large HDL removes cholesterol from the arteries while small HDL does not participate in this activity. As such it could be important to know if you have large HDL, acting to protect your heart, or small HDL, not adding any protection. When measuring HDL cholesterol there is no way to know the size of HDL.
LDL carries the so-called "bad" cholesterol. Unlike HDL with one good size and one bad size, all LDL is bad. LDL comes in three sizes and the smallest size is thought to be the most dangerous type. Small LDLs penetrate the artery wall easier than large LDLs and they are also more easily trapped in the artery wall where their cholesterol can be released to cause plaque build-up.
VLDLs mainly carry particles called triglycerides. The VLDLs are the group most influenced by when you last ate. Large VLDL particles are the most dangerous. A combination of high numbers of both large VLDL particles and small HDL particles may place an individual at substantial increased risk for heart disease.
Elevated cholesterol levels have been seen in patients with atherosclerosis, diabetes, hypothyroidism and pregnancy.
Although an elevated total cholesterol (hypercholesterolemia) is associated with an increased heart attack risk, newer tests are more predictive. A simple and inexpensive blood test for high sensitivity C-reactive protein (hs-CRP) has proved to be more accurate than cholesterol screening in predicting a person's risk for a heart attack according to researchers at the Brigham and Women's Hospital in Boston. [NEJM, 3/23/2000]
Here are some statistics about total cholesterol:
There are several causes of erectile dysfunction, and a high cholesterol level is one. Cholesterol builds up inside of all of one's arteries. In the heart it can cause a heart attack. In the brain it can cause a stroke. And clogs in the penile artery can cause ED.
Increased risk of gout is strongly associated with obesity, hypertension, high cholesterol and diabetes.
Elevated total cholesterol greater than 270mg may be associated with mercury toxicity.
High cholesterol is one of the consequences of untreated hypothyroidism.
See the link between Low HDL/LDL Cholesterol Ratio and Manganese Need.
A study of 9,600 Americans found that those who ate plenty of legumes had lower total cholesterol. Legumes are rich in soluble fiber, which has been shown to help lower total cholesterol and LDL (''bad'') cholesterol levels, the study authors note. [Archives of Internal Medicine 2001;161: pp.2573-8].
The statin drugs used to treat elevated blood cholesterol levels by blocking cholesterol synthesis also block CoQ10 synthesis. Supplemental CoQ10 should be considered in anyone on statin drugs.
It is thought that the connection between high cholesterol and Alzheimer's disease exists in a protein called beta-amyloid, a sticky substance that builds up in the brains of Alzheimer's patients leading to nerve cell damage and loss of cognitive function. Accumulation of the protein is believed to be related to higher cholesterol levels.
Taurine lowers serum cholesterol levels by combining with cholesterol to form bile.
Cysteine is sometimes used to improve cholesterol ratios.
Several studies have shown a mild lowering effect on total cholesterol and LDL cholesterol. Garlic oil does not produce this cholesterol-lowering benefit like raw, cooked or powdered garlic does. Large doses are required (6,000 to 8,000mg per day) to produce this effect, which causes gastrointestinal discomfort for some people. Furthermore, this benefit does not become evident until after 3 months of continuous use.
Choleretics typically lower cholesterol levels because they increase the excretion of cholesterol and decrease the synthesis of cholesterol in the liver. Consistent with its choleretic effect, cynara extract from artichoke leaf has been shown to lower blood cholesterol (13%) and triglyceride levels (5%) in both human and animal studies.
One month of treatment reduced total and LDL-cholesterol levels, but had no effect on HDL-cholesterol levels, in a study of 40 patients with diagnosed chronic venous insufficiency. [Phytother Res 2002;16(2): pp.1-5]
August, 2017: A dietary review of 49 observational and controlled studies found that plant-based vegetarian diets – especially vegan diets – are associated with lower levels of total cholesterol, including lower levels of HDL and LDL cholesterol, compared to omnivorous diets.
Numerous earlier studies also found that cholesterol levels are much lower in vegetarians [1-4]. Vegetarian diets reduce serum cholesterol levels to a much greater degree than is achieved with the National Cholesterol Education Program Step Two diet [5-8]. In one study published in The Lancet [7] total cholesterol in those following a vegetarian diet for 12 months decreased by 24.3%.
The ratio of HDL- to total-cholesterol has been shown to be significantly lower in vegans as compared to lacto-ovo-vegetarians. The recommended minimum ratio of HDL total cholesterol is below 5, optimal being below 3.5 according to the American Heart Association.
It should be noted that there is not necessarily a strict relationship between cholesterol intake and blood cholesterol level. A properly functioning liver regulates the blood cholesterol level by storing, producing, releasing and excreting cholesterol as appropriate – primarily as bile. Even vegans, whose dietary intake of cholesterol is by definition essentially zero, have cholesterol in their blood (usually at very healthy levels) because their bodies manufacture it.
A study of 9,600 Americans found that those who ate plenty of legumes had lower total cholesterol. Legumes are rich in soluble fiber, which has been shown to help lower total cholesterol and LDL (''bad'') cholesterol levels, the study authors note. [Archives of Internal Medicine 2001;161: pp.2573-8].
It is important to realize that diet is the key to lowering cholesterol levels. Restriction of processed grains, sugars and dairy, and replacing all fluids with water are key. Many doctors are finding large and relatively quick drops (as much as 100 points in several weeks) in people who follow these recommendations.
Minor cholesterol (LDL) reductions can be achieved by adding whole grains (especially oats) to the diet. This may seem confusing! Although moderate grain consumption (due to its fiber content) can lower cholesterol somewhat in some individuals, radical grain restriction may substantially lower cholesterol levels in others. If large reductions are needed or other cholesterol-lowering methods are ineffective, grain and sugar restriction may be the answer.
Soluble fiber from fruit pectin has lowered cholesterol levels in most trials. Doctors often recommend that people with elevated cholesterol eat more foods high in soluble fiber.
Controlling cholesterol levels may be a case of not only what is eaten but how often. Men and women who eat six or more times a day have cholesterol levels that are about 5% lower than those of less frequent eaters. The researchers found lower levels of cholesterol in the frequent eaters regardless of their body mass, physical activity or whether they smoked. From other studies we know that a 5% lowering of cholesterol may be associated with a 10% reduction in coronary heart disease risk. [British Medical Journal, Dec 1, 2001]
So-called "good fats" that come from raw nuts and seeds are an important part of protecting the cardiovascular system. Pecans, for example, will lower total cholesterol, triglycerides, apolipoprotein B and lipoprotein(a). [A Monounsaturated Fatty Acid Rich Pecan Enriched Diet Favorably Alters the Serum Lipid Profile of HealthyMen and Women, Jnu 2001;131: pp.2275-2279]
Whole almonds or almond oil (replacing half of the habitual fat intake) reduced plasma triglyceride, total and LDL-cholesterol concentrations, and increased HDL-cholesterol levels in a trial of 22 men and women with normal lipid levels. [J Nutr 2002;132(4): pp.703-707]
The fiber supplements of choice for hypercholesterolemia are psyllium, pectin or guar gum. The amount of pectin in approximately two servings of fruit rich in pectin such as pears, apples, grapefruit, and oranges is 15gm. Psyllium or guar gum are obtained by supplement. The RDA for total fiber is 20-30gm. The fiber from whole grains – especially oats – does have a cholesterol-lowering effect, especially in someone on a previously low fiber diet.
Three months of supplementation with ground flax seed at 40gm per day reduced serum total cholesterol in a study of postmenopausal women. [J Clin Endocrinol Metab 2002;87(4): pp.1527-32]
Soybean isoflavone fraction, which contains primarily genistein, daidzein and glycetein, has been shown to have a hypocholesterolemic effect.
A soy protein isolate reduced total and LDL-cholesterol concentrations in a study of 60 patients with high cholesterol levels. [Eur J Clin Nutr 2002;56(4): pp. 352-35]
Monounsaturated fatty acids – as contained in olive oil – reduce total and LDL cholesterol concentrations without reducing the levels of HDL cholesterol, thus leading to favorable changes in the serum lipid profile and possibly to changes in the physicochemical properties of lipoproteins. In this way olive oil, with its high monounsaturated fatty acid content, may contribute to the prevention and management of hypercholesterolemia, a dominant risk factor for the development of atherosclerosis, and to the prevention of CHD.
In a study of 100 patients at the Warsaw Institute of Hematology, GHB was shown to lower cholesterol levels.
Melatonin helps to decrease total cholesterol and "bad" LDL cholesterol levels.
A selenium deficiency is associated with hypercholesterolemia.
In experiments, potassium-supplemented individuals not only had their high blood pressure reduced but reduced their cholesterol measurements as well, confirming that a deficiency of potassium is associated with hypercholesterolemia.
Zinc deficiency is associated with hypercholesterolemia.
Chromium recently has been shown to lower blood cholesterol while mildly raising HDL (high-density lipoprotein), the good portion of cholesterol. This lowers the risk ratio for coronary artery disease.
Chromium picolinate supplementation at 1,000mcg per day over a 13-week period combined with exercise decreased total cholesterol, LDL cholesterol and insulin levels in a recent small study of both males and females. [J Nutr Biochem, 1998;9: pp.471-475]
Henry Schroeder, MD, who has done numerous studies with chromium, has shown that 2mg of inorganic chromium given daily reduced cholesterol levels by about 15%.
A deficiency of inositol is associated with hypercholesterolemia (increased blood-fat levels).
Probably the best form of vitamin B3 to use for the purpose of cholesterol reduction is inositol hexaniacinate (flush-free niacin). It is often given at 500mg tid for two weeks, then increased to 1,000mg tid. If using regular niacin, start out with 100mg tid working up to 1,000mg tid with meals.
Niacinamide is not effective for lowering cholesterol. Niacin may also be helpful by transforming small unprotective HDL particles into larger ones which do offer a protective effect to the cardiovascular system.
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