Cholesterol CureMichael Vertolli, RH February 1, 2006
Simple Diet, Lifestyle, and Herbal Measures
During the recent election campaign the various party proposals on health care clearly indicated that none of the parties have the remotest idea how to save and improve the delivery of health care in Canada. Whether it be to hire more doctors, open more beds in hospitals, improve waiting times for medical procedures, or cover the cost of medications, throwing more money into a sinking ship will only postpone its inevitable demise. The problem with our health care system is that it is not a health care system at all: it is a sick care system! It utilizes expensive and invasive drugs and medical procedures to superficially mask the symptoms of deeper underlying health imbalances that result from years of chronic abuse of our bodies. As long as the majority of Canadians continue to eat an unhealthy diet and live an unhealthy lifestyle we will inevitably suffer the consequences of our choices. Under these circumstances, it will be impossible to create an effective and efficient health care system without using up the bulk of the provincial and federal budgets and that means significant cuts to other services and a return to the days of huge deficits and growing debt. The real solution to our current health care dilemma is to focus on education and prevention and get Canadians off of the drugs and out of the hospitals. This will require a major long-term restructuring of our health-care system. This approach, unfortunately, tends to be beyond the capabilities of our shortsighted elected politicians who for the most part cannot see beyond next election.
I am saddened when I see so many people who are over-drugged and whose quality of life is compromised by conditions that are easy to treat with natural means, and even easier to prevent. Our health care system has a poor track record in addressing the growing occurrence of common diseases such as high blood pressure, rheumatoid arthritis, fibromyalgia, irritable bowel syndrome, allergies, menstrual and menopausal symptoms, childhood ear infections, and adult-onset diabetes. Drug therapies commonly used in treatment of these conditions can at best reduce symptoms while the underlying causes of these symptoms continue to worsen.
One common symptom that falls into this category is elevated blood cholesterol. It is true that this symptom may be associated with a higher risk of cardiovascular disease in some people. However, high cholesterol levels are easily prevented and treated through diet and lifestyle, and the use of herbs when necessary.
These days a diagnosis of high cholesterol will invariably result in the prescription of a statin drug. Although these drugs are effective at lowering blood cholesterol levels, this comes at a cost. They work by interfering with a liver enzyme necessary for the manufacture of cholesterol. However, this enzyme is also necessary for manufacturing coenzyme Q10. Low levels of this important coenzyme are associated with increased risk of developing many chronic conditions including heart disease. Anyone who is taking statin drugs should therefore supplement 50-100 mg of coenzyme Q10 per day.
Statin drugs are also associated with the gastrointestinal symptoms common with the use of many pharmaceuticals. In addition, statin drugs compromise liver and kidney function and can cause muscle pain and degeneration. Their influence on liver function is particularly of concern since the liver is the main organ that regulates blood fat and cholesterol levels. Supporting liver function is therefore a primary component of natural treatment of abnormal levels of blood fats and cholesterol. Statin drugs not only compromise the capacity of the liver to perform this essential function, they also interfere with herbal treatment of these conditions. Discontinuing use of statin drugs is therefore a first step in the natural approach. Please note, however, that no one should consider taking themselves off these medications without consulting their doctor or a qualified herbalist or other health care professional who has experience with these kinds of protocols.
The first thing that must be considered in addressing blood cholesterol levels is that not all cholesterol is bad cholesterol. Cholesterol and fats do not dissolve well in a liquid medium. Therefore, in order to transport these molecules throughout our body, it is necessary for the liver to manufacture lipoproteins that help them to dissolve in water. There are several kinds of lipoproteins circulating in our blood. High density lipoproteins (HDL) carry cholesterol back to the liver to be recycled or eliminated from the body in bile that is excreted in our feces. They also scavenge free cholesterol floating around or deposited on the walls of blood vessels. Low density lipoproteins (LDL) transport cholesterol to body tissues. When the cholesterol being transported by LDL is chemically altered by oxidative toxins in the blood, it becomes sticky and more likely to precipitate out of solution and onto the walls of blood vessels. A more important indicator of our risk of cardiovascular disease than total cholesterol level is the ratio between the levels of HDL and LDL.
There are many dietary and lifestyle factors that influence the levels of both HDL and LDL in our blood. Managing these is important in both prevention and treatment of abnormal levels of blood fats and cholesterol and their potential to contribute to development of cardiovascular disease. If we want to improve our blood fat and cholesterol profile, it is important that we incorporate the following recommendations in our diet and lifestyle:
• Increase aerobic exercise. Exercise increases the level of HDL and decreases LDL in our blood. As a bare minimum we should get an hour of mild to moderately strenuous exercise such as walking or biking every day and a good aerobic workout for at least 20 minutes three to four times per week.
• Try to achieve a body weight in the normal range for your height. People who are overweight have lower levels of HDL and higher levels of LDL. Remember that crash diets are not the answer. A “diet” is a diet. The only diet and lifestyle that will allow us to keep the weight off once we reduce it is one that we can live with for the rest of our lives. Beware of any diets or products that promise rapid weight loss. The only healthy way to lose weight is to permanently reduce calorie intake and increase activity level.
• Increase consumption of fruits and vegetables. The fibre in these foods increases elimination of cholesterol from our body. Soluble fibre is the most effective. Best sources are fruits, whole flax seeds and whole oats. Fruits and vegetables also contain antioxidant constituents that help to prevent oxidation of fats and cholesterol in our blood and other forms of damage to our blood vessels. The Allium vegetables (onions, garlic, leeks, shallots) are helpful at improving blood cholesterol and fat profiles, as are spices, particularly ginger and turmeric.
• Decrease consumption of and exposure to all forms of toxicity including smoking, pollution, agricultural chemicals, food additives, industrial chemicals, etc. As the toxicity level of our blood rises, so does the alteration of blood fats and cholesterol and many forms of damage to our blood vessels that initiate processes ultimately leading to cardiovascular disease.
• Decrease consumption of high glycemic index carbohydrates. These carbs are easily absorbed and produce a rapid spike in blood glucose levels. They include sugar and other natural sweeteners, all flour products except those made from stone-ground whole grains (whole grain pastas are not as bad if eaten al dente: i.e. slightly under-cooked), potatoes, puffed grains (even whole grain), some fruit and vegetable juices, etc. These foods decrease HDL and increase blood fats (triglycerides). Do not consider this an endorsement of popular low carb diets. These diets are not healthy. They ultimately lead to liver, kidney and nervous system dysfunction, increased toxicity, loss of bone density, and other health problems. Complex carbohydrates, such as those found in many fruits and vegetables, whole grains and beans, are the best source of fuel for our body and they also have an overall beneficial influence on blood fats and cholesterol.
• Reduce consumption of saturated fats. These harmful fats increase the level of LDL in our blood. Saturated fats are primarily found in red meats, dairy products, and palm kernel oil.
• Reduce consumption of trans-fats. These fats increase the level of LDL in our blood. Trans-fats are found in partially hydrogenated vegetable oils, vegetable shortenings and deep fried foods.
• Reduce consumption of rancid oils which increase the level of LDL in our blood. Rancid oils are difficult to avoid. All commercial polyunsaturated vegetable oils are rancid to some degree, as are shelled or roasted nuts and seeds, nut butters and any oily foods that have been exposed to oxygen, light and heat.
• Increase consumption of mono-unsaturated vegetable oils. These oils decrease the level of LDL and increase the level of HDL in our blood. Best sources are olives, extra virgin olive oil and avocados. They are also found in most nuts. To insure the quality of the oil in nuts, it is important that they are freshly hulled and eaten raw. Almonds and Brazil nuts are the only ones that stay relatively stable for a period of time after being hulled because they contain significant amounts of natural antioxidants.
• Increase consumption of polyunsaturated vegetable oils. These oils decrease the level of LDL and increase HDL in our blood. Of importance here are the omega-3 and omega-6 polyunsaturated oils of which the most important are linolenic acid and linoleic acid, respectively. They are both essential fatty acids because our body cannot manufacture them.
One of the concerns about our consumption of polyunsaturated fats is that the majority of food sources of these important nutrients tend to be high in the omega-6 fatty acids and low in the omega-3. Many Canadians do not get adequate amounts of omega-3 fatty acids in their diet. To make matters worse, there is evidence that the higher the ratio of omega-6 to omega-3 fatty acids in our diet, the less efficiently our body is able to utilize the omega-3. Therefore it is not only important to increase our consumption of polyunsaturated fatty acids, but also to decrease the ratio of omega-6 to omega-3 fatty acids.
It is not hard to get adequate amounts of omega-6, therefore we should focus on increasing consumption of omega-3 fatty acids. By far the best source of omega-3 is flax oil. I believe that taking 2-3 teaspoons of flax oil per day is an important addition to almost any diet. It can be used in salads (I mix it 50/50 with extra virgin olive oil) and it is very good when mixed with grains such as in hot cereals, on pasta and other cooked grains such as brown rice, millet, quinoa, etc. Polyunsaturated oils go rancid very rapidly. Never cook flax oil. Always add it to your food just before you eat it. Similarly, if using it in a salad dressing, never make more than you can use immediately. Only use flax oil that is pressed and stored in a way that protects it from exposure to oxygen, light and heat. Read the labels carefully.
Other good sources of omega-3 are raw, freshly hulled walnuts and fatty cold water fish such as sardines and wild-caught salmon. Farmed salmon is not a good source. Personally, I do not recommend fish as a great source of omega-3 for several reasons. Firstly, to ensure the quality of the oil, the fish must be freshly caught or flash-frozen. Secondly, all fish are becoming increasingly more contaminated with environmental pollutants. The larger the fish and the closer to shore that they live, the greater the problem. Finally, all commercial fish stocks are rapidly being depleted. It has been estimated that they will all collapse beyond recovery within 10 years if current levels of harvesting continue. Fish, therefore, are no longer an ecological or ethical food option.
Fish farming is not a good alternative. Farmed fish tend to have higher levels of toxic contamination than wild fish and lower levels of omega-3. Until sources of farmed fish that are organically raised in clean water on a diet that is high in omega-3 (fish don’t produce omega-3, they must get it from eating algae) become available, I cannot recommend fish as an omega-3 or protein source.
Because polyunsaturated vegetable oils are readily oxidized, increasing consumption of them also increases the risk of oxidative tissue damage. Therefore it is also recommended to supplement 50-100 mcg of selenium and 200-400 IU of vitamin E per day. These nutrients help protect fats and oils from oxidation in our body. I only recommend natural vitamin E, preferably in the form of mixed tocopherols (sometimes called “natural ratio” vitamin E). In addition, selenium, vitamin E and vitamin C supplementation have all demonstrated the ability to help improve the profile of cholesterol and fats in our blood and to protect our blood vessels from oxidative damage. Vitamin C is most effective when used in the form of a mineral ascorbate combined with flavonoid and anthocyanin extracts.
Contrary to popular opinion, consumption of cholesterol itself is not particularly of concern. Unfortunately, misuse of this information by the media has led many people to believe that they can eat all of the high cholesterol foods that they want. This is incorrect because the foods that contain cholesterol also tend to be the foods that are highest in saturated fats.
Overall, vegan diets, as long as they are healthy, well-balanced diets, tend to be associated with the best blood cholesterol and fat profile. I am not recommending that everyone become vegan or even vegetarian as this is a personal choice, but it is preferable that anyone with high LDL or triglycerides or other risk factors associated with cardiovascular disease modify their diet so that it is closer to vegetarian.
HERBS THAT CAN HELP
There are also many herbs beneficial for normalizing blood fat and cholesterol levels and reducing the risk of cardiovascular disease. The natural health products industry has been promoting the use of concentrated extracts of specific herbs known to lower blood cholesterol (hypocholesterolemic) and fats (hypolipidemic). This approach is reductionistic. It is modelled on the medical treatment of symptoms with statin drugs and does not address underlying causes.
By far the most important underlying causes are dietary and lifestyle factors elaborated above. These must be addressed. However, if our condition has already progressed to the point where blood cholesterol and fat levels have been disturbed, you can bet that the functioning of a number of organs has already been compromised – even if it is not to the point where it can be detected by modern diagnostic methods.
Herbal treatment of these symptoms therefore requires a holistic approach that uses hypocholesterolemic and hypolipidemic herbs that also normalize functioning of all organs involved. We must support liver and pancreas function to normalize cholesterol, fat and carbohydrate metabolism, and we must also use herbs that heal and protect our blood vessels.
Herbal treatment is a two-stage process. In first stage we support liver function by using herbs that are cholagogue (increase the flow of bile), antihepatotoxic (protect the liver from toxicity) and bitter. Some of the better herbs for this purpose include dandelion root (Taraxacum officinale), burdock root or seed (Arctium spp.), common plantain herb (Plantago major), elecampane root (Inula helenium), milk thistle seed (Silybum marianum), chicory root (Cichorium intybus), yellow gentian root (Gentiana lutea) and centaury herb (Centaurium erythraea). All of these herbs also benefit pancreas function due to their bitterness and constituents that improve metabolism of carbohydrates by both the pancreas and liver. It is important that these herbs are taken in a form that allows us to taste their bitterness as some of their activity occurs by reflex from the bitter taste receptors in our mouth. If we use tinctures, they should be mixed with 1-2 ounces of water and held in our mouth for 30-60 seconds. In the case of teas this is not necessary because we are consuming a much larger volume. A good formulation should contain two of these herbs, at least one of which is a relatively strong bitter.
The bitter/cholagogue herbs will work best if they are supported by aromatic, pungent (spicy) herbs. These herbs also improve liver and pancreas function in addition to benefiting blood vessels and improving circulation. Good examples are garlic bulb (Allium sativum), turmeric rhizome (Curcuma longa), ginger rhizome (Zingiber officinale), cinnamon bark (Cinnamomum verum), rosemary herb (Rosmarinus officinalis) and cayenne fruit (Capsicum anuum). We usually use one or two of these herbs. Collectively they should make up a small proportion or the formulation will be too hot. For addressing blood cholesterol and fat issues I have found that a combination of two parts turmeric to one part either ginger or garlic to be very effective. All three of these herbs have cholagogue and antihepatotoxic properties as well. I tend to use ginger more than garlic because most people don’t want to deal with garlic breath.
Finally, we must also include herbs that have antioxidant constituents that protect our blood vessels and blood components (including cholesterol and triglycerides) and help to heal our blood vessels as well. Although all herbs are antioxidant to some degree, some of the better herbs for this purpose are maidenhair tree leaves (Ginkgo biloba), hawthorn berries, leaves and flowers (Crataegus spp.), St. John’s Wort herb (Hypericum perforatum), field horsetail herb (Equisetum arvense), purple loosestrife herb (Lythrum salicaria) and thyme herb (Thymus vulgaris). We should include two of these herbs collectively at a similar proportion to the cholagogue herbs.
A formulation like this should be used until levels of blood cholesterol and fats have completely normalized for a couple of months and then we begin the second stage of treatment. This involves the continued use of one or two of the pungent herbs mentioned above (e.g. turmeric with ginger), but this time we combine them with two or three adaptogenic herbs such as lacquered polypore fruiting body (Ganoderma lucidum), North American ginseng root (Panax quinquefolius), Siberian ginseng root (Eleutherococcus senticosus) and Chinese milkvetch root (Astragalus membranaceus). This formulation should be taken for two to three months. It will not only continue to normalize function, but will also optimize it.
The treatment of disturbances of blood fats and cholesterol is usually fairly straightforward if the appropriate lifestyle and dietary factors are addressed. However, it can sometimes be complicated by genetic or other unforeseeable issues. Anyone taking medications or who attempts to treat themselves and obtains poor results should consult with a qualified herbalist or other natural health care practitioner.
The moral of this story is that there are safe, effective, alternative options to many common mainstream medical treatments. If these options were more accessible to Canadians, we could significantly improve the effectiveness of health care in this country while reducing the cost. I hope that at some time in the near future politicians will finally get the message and start proposing real solutions instead of the same old, same old.
Michael Vertolli is a Registered Herbalist practising in Vaughan (just north of Toronto). He is the Director of Living Earth School of Herbalism, which offers in-class and online general interest courses, certificate, and diploma programs. For more information: 905-303-8723. Visit his website: www.livingearthschool.ca Blog: michaelvertolli.blogspot.ca