Statin Drugs and Natural Solutions for Healthy Cholesterol

Friday, March 5, 2010 by Stephen Sinatra

Some of the most commonly prescribed drugs for maintaining good cholesterol levels are statins like Zocor (simvastatin), Lipitor (avorastatin), Mevacor (lovastatin), Pravachol (pravastatin), and Lescol (fluvastatin).

These drugs can be dangerous if taken with high levels of long-acting niacin (vitamin B3). Side effects also include dizziness, headache, extreme fatigue, swelling of the ankles, muscle weakness, and liver toxicity.

In both men and women, statins may weaken the heart muscle because they lower CoQ10 levels. In women especially, statin drugs may deplete levels of CoQ10, contributing to a weakened immune system.

Still, if you have moderate to severe heart disease involving multiple vessels, I recommend statin drugs to help you obtain and maintain healthy cholesterol levels. In addition, I recommend the following natural solutions:

  • Make sure you take a minimum of 150 mg of standard CoQ10 per day, or 50–60 mg of the hydrosoluble form, to offset the drug’s depleting effect.
  • Niacin is one of my favorite cholesterol-lowering agents if you are not on a statin drug, because of its ability to increase HDL cholesterol (the “good” cholesterol) and lower LDL cholesterol levels (the “bad” cholesterol). Low doses in the range of 100–300 mg three times daily are often effective without resulting in side effects of flushing, heartburn or gout attacks. A prescription form called Niaspan (750–1,500 mg) appears to be well-
    tolerated by most people with minimal side effects.
  • Tocotrienols are antioxidants in the vitamin E family. Research suggests that they act much like statin drugs, minus the adverse side effects, by interfering with the liver’s ability to produce cholesterol. As little as 50 mg per day can have a positive effect.
  • My Pan-Asian Modified Mediterranean-type diet (PAMM) is great for this and for overall cardiovascular nutrition. It’s rich in fiber, healthy fats (omega-3s from fish and fish oil), garlic and onions (two potent cholesterol-busters), and fresh fruits and vegetables. Fiber helps soak up cholesterol and cleanse the colon, preventing rapid absorption of cholesterol.
  • Flaxseed is high in alpha linolenic acid and fiber, vital for healthy heart function.
  • Soy helps prevent the oxidization of LDL and subsequent buildup of artery-clogging plaque. Soy also can help with reducing cholesterol levels, help ease menopausal symptoms, and may help protect against cancers of the breast and prostate.
  • L-arginine—2–4 grams three times a day. TwinLab and Great Earth make good supplements that are widely available in health food stores.

Heart Risk Factors for Women Versus Men

Sunday, February 7, 2010 by Stephen Sinatra
Let’s take a look at how women’s risk factors for heart disease are different from men’s.


Diabetes.
Diabetic women have a higher risk for heart disease than diabetic men. This is because the incidence of diabetes and its complications (including heart disease) is much higher in women. If you are a diabetic woman, your risk for heart disease is five to seven times normal, compared with a risk of only two to three times normal for a diabetic man. For you, proper heart sense means you should increase your physical activity and watch your diet to maintain a healthy body weight.


Overweight.
Women have a higher heart disease risk from being overweight than men do. Recent studies indicate that being only 20 pounds overweight doubles your risk of heart disease. If you are overweight, I don’t want you to go on a diet. Instead, get physically active—it’s your most powerful weapon against fat—and begin eating more fresh fruits and vegetables, pasta, fish and lean poultry.  Eating this way is what I call “healthy heart nutrition” and it just makes sense. (See other blog entries for additional advice on cardiovascular nutrition.)


Cholesterol.
Women have a higher risk for heart disease than men if they don’t have good cholesterol levels. More specifically, if they have have low levels of HDL (“good” cholesterol) they increase their heart risk factors.


You probably already know that there are two types of cholesterol. LDL is the “bad” cholesterol, which oxidizes in your blood and forms the plaque that clogs arteries. HDL carries LDL out of your blood vessels before it can do its damage. Volumes of data have shown that a high LDL is a powerful risk factor for heart disease in men. But for women, the story is different. Recent research indicates that a low HDL, not a high LDL, is the more significant risk factor for a woman to develop heart disease. (This means that some women may need to increase HDL cholesterol levels.)


The good news is that HDL is sensitive to factors such as smoking, obesity and lack of exercise. If your HDL is low (less than 35 mg/dL) you can raise it by quitting smoking and dropping excess weight through a combination of smart eating, healthy heart nutrition, and physical activity such as walking and dancing. If you are postmenopausal, you might also consider estrogen replacement therapy (ERT), which raises HDL, lowers LDL, and has other beneficial effects on your heart. Have your HDL level checked six weeks after you start an HDL-raising program. Chances are you will see a change for the better.


High Triglycerides.
When you get your cholesterol checked, I also want you to have your doctor check to see if you have healthy triglycerides levels. Triglycerides are another type of blood fat. A high triglyceride level is more dangerous for women than for men, so if your triglycerides are elevated (above 200 mg/dL), I want you to put some effort into lowering them, especially if you are a diabetic. This is because if you are a diabetic woman who also has high triglycerides, your risk of developing heart disease increases to 200 times normal. Please stop and think about this. You can lower your triglycerides using the powerful combination of exercise and weight control.

Viva Las Vegas: The Annual Anti-aging Conference

Tuesday, January 5, 2010 by Jan Sinatra
On the Road with Dr. Sinatra - December 2009

Every December, Dr. Sinatra and I always head to the American Academy for Anti-Aging Medicine's annual conference in Las Vegas. (There is great video of Dr. Sinatra presenting at the 14th annual Anti-Aging Medicine conference in 2008... check it out!)

This engaging conference is abundant with many stimulating and educational sessions on the latest topics and technologies in the world of alternative medicine. While I personally have some resistance to the term “anti”-aging, the caliber of speakers and vendors there is downright exceptional!

I can remember over a decade ago, Drs. Ron Klatz and Stephen Goldman had the vision to create this collegial academy so that there was a format for formal training in areas of alternative medicine for doctors and other healthcare professionals who are motivated to practice integrative medicine. Their first conference was held at the cozy and charming Alexis Park Hotel on Harmon Boulevard in Las Vegas. Now, the American Academy for Anti-Aging Medicine has several annual conferences in the US and the UK, and attendance in Vegas is so great that, for years, they been held in the larger hotels like the Venetian and Mandalay Bay.

Dr. Sinatra has been board certified in anti-aging medicine for years. He also contributes questions to their certification exam, has given some of the oral exams, and has lectured on various cardiology topics at the American Academy for Anti-Aging Medicine for over a decade. This year, he taught a six-hour fellowship program on the subject of the metabolic cardiology treatment approaches that he has been using successfully for years. The talk included approaches for lowering blood pressure naturally, as well as how to increase HDL cholesterol levels, lower LDL cholesterol levels, and improve blood circulation without drugs.

Dr. Sinatra spoke at the last two annual Orlando-based American Academy for Anti-Aging Medicine conferences held in April. There he met Houston-based attorney Richard Jaffee. After hearing him lecture on energy medicine and the emotional aspects of disease, Mr. Jaffee introduced Dr. Sinatra to his friend Suzanne Somers. The end result: Suzanne interviewed Dr. Sinatra for her book Knockout, which was released in October 2009. Like Rick Jaffee, Dr. Sinatra was honored to help with her mission to inform the public about alternative cancer care options that are available.

Who knows what may happen in 2010? For now, a plan to continue to teach other physicians at the Boca Raton American Academy for Anti-Aging Medicine training module in March.

Walking Can Prevent Heart Attack and Stroke

Thursday, November 5, 2009 by Stephen Sinatra

I can’t say enough about the health benefits of exercise. It strengthens the heart and circulatory system, builds stamina, and improves mood. It’s also an effective means for lowering blood pressure levels, increasing HDL cholesterol, and improving poor blood circulation.

I’m often asked what the best form of exercise is. I say it’s the one you will consistently do! Walking, dancing, cycling, lifting weights—it doesn’t matter. The goal of exercise is simply to get out and get moving.

That said, I have to admit I’m a big fan of walking. It’s simple, doesn’t require special equipment or a gym membership, and it can help reduce your risk of heart attack and stroke. In a study reported in the Journal of the American Medical Association (JAMA), 4,065 nurses ages 40 to 65, without cardiovascular disease or cancer, completed detailed physical activity questionnaires. The surveys revealed that walking was associated with reduced risk of stroke.

Walking is easy to incorporate in your day. Walk up and down stairs instead of taking elevators. Steadily increase the distance while walking your dog. Instead of parking in the closest space to the store or office entrance, park at the far end of the parking lot. Consider walking short distances for errands instead of driving.

If you’ve been inactive for a while, start slow. Walk 10 minutes every other day for one week. Each week, increase your time by increments of 5 or 10 minutes. Within a month, you’ll be taking 30-minute strolls. Do this every other day, and you’ll have a good workout routine. Five days a week is optimal.

As for speed, you don’t have to maintain a brisk pace. Actual walking speed isn’t as important as we’ve been led to believe. In fact, researchers in the JAMA study I mentioned found that speed didn’t matter; it was the length of time women walked that was significant.

Simple, right? If you agree, lace up those sneakers and get out there. It’s one of the simplest—and most effective—steps you can take (literally) to prevent heart attack, stroke, and other cardiovascular problems.

 

Improper Grilling Can Mimic Cardiovascular Problems

Wednesday, August 12, 2009 by Kimberly Day

Now that the summer is in full force, you are likely hooking up the barbeque and gathering with friends to enjoy dinner in the great outdoors. As enjoyable as these get-togethers can be, research has shown that grilling meat at high temperatures can create a number of harmful compounds.

 

High heat from an open flame creates COPs, highly carcinogenic compounds that are similar to the oxidized cholesterol found in your bloodstream. Along with the COPs, high heat creates other groups of harmful compounds, including heterocyclic amines (HCAs), compounds that have been found to increase your risk of several of the most common kinds of cancer, including breast, prostate, colon, and stomach cancers.

 

Tasty Ways to Protect Your BBQ

 

Fortunately, a marinade consisting of 10 percent plain soy sauce and one percent sugar has been found to cut the production of COPs by more than 60 percent. Plus, additional research also shows that adding tart cherries, red grapes, or plums (all good sources of pigmented antioxidants) to hamburger meat can cut HCA formation by 94 percent.

 

While it’s easy enough to mix some soy sauce or a handful of crushed cherries or grapes into a pound of lean hamburger or ground turkey, I prefer to use a marinade for my favorite fish. Not only do you get delicious protection from the potentially harmful side effects of grilling, but you get the heart-health benefits of omega-3s, including increased HDL cholesterol and LDL cholesterol levels, improved blood circulation, and reduced risk for heart attack and stroke.

So eat up and enjoy how delicious healthy heart nutrition can taste!

 

A Taste of the Orient

 

This taste delight combines the protection of soy sauce with the essential fatty acid and fiber benefits of nuts. I find this marinade works best with a mild fish such as halibut.

 

1/2 cup organic almond butter

1/3 cup soy sauce

2 tablespoons lime juice

1 tablespoon raw honey

1/2 teaspoon powdered ginger

1/8 teaspoon cayenne pepper

  1. Warm almond butter in small saucepan over medium low heat.
  2. When slightly softened, add soy sauce and remaining ingredients and blend well.
  3. Remove from heat and pour into large, shallow bowl.
  4. Add your fish and marinate in refrigerator for one to three hours.
  5. Can also be used as a sauce.
     

 

Two Birds, One Stone: Niacin Increases HDL and Lowers Lp(a)

Tuesday, July 28, 2009 by Stephen Sinatra

You’ve heard me say time and again that reducing cholesterol is not the magic bullet that will prevent heart attack and stroke. I stand by this statement wholeheartedly—but I don’t want you to interpret it to mean that cholesterol is unimportant.

Optimum cardiovascular health requires maintaining a healthy cholesterol ratio—that is, keeping your LDL cholesterol levels (the so-called “bad” cholesterol) in proper balance with your HDL levels (the “good” type of cholesterol). It also calls for minimizing the amount of Lp(a) in your blood, and not letting your triglyceride levels get out of hand.

Although regular exercise and a cholesterol lowering diet will go a long way toward helping you achieve these goals, I also recommend that you try some targeted nutritional supplements for an extra boost. One of them is niacin (vitamin B3). It’s a fantastic nutrient that can help you increase HDL cholesterol, as well as lower both triglycerides and the dangerous subtype of cholesterol known as Lp(a).

These are huge benefits. For me, keeping HDL levels high and Lp(a) down are more significant than lowering LDL or even total cholesterol. Elevated Lp(a) is a serious, widespread, and underemphasized problem, and niacin is probably one of the best nutrients to lower it. And the higher your good cholesterol levels, the more protection you have in your blood vessels.

The only downside to niacin is the flushing sensation it generates. This hot, tingly, pins-and-needles feeling is disconcerting to a lot of people, but it usually lasts no more than 30–60 minutes, and it is most pronounced during the first week or so that you take the supplement (it can also occur when you increase your dosage). You can find no-flush forms of niacin, but they’re not as effective. I would stick with the regular kind.

I recommend taking 1–2 g a day in divided doses with meals. Start with 250 mg and slowly work your way up to minimize the flushing effect. Let me know how it works for you!

 

10 Must-Know Facts About Cholesterol

Monday, June 1, 2009 by Stephen Sinatra

One of the most important parts of maintaining healthy cholesterol is understanding how your body uses and manages this essential lipid. Why? Because having a cholesterol level that is too low is just as dangerous as having a cholesterol level that is too high. Most people don't realize it, but blindly following the cholesterol guidelines put forth by pharmaceutical companies (whose primary interest is to sell you their drugs, not to make you healthy) could put your long-term health in jeopardy.

To help you get some perspective on what constitutes a good cholesterol level, I've identified 10 vital facts about cholesterol in the body. Keep them in mind the next time your doctor raises the issue of reducing cholesterol, and make sure that any decision to do so is truly in your best interest (and if you must improve your numbers, opt for natural therapies such as a cholesterol lowering diet, as well as lifestyle changes and nutritional supplements that can help increase HDL cholesterol and reduce LDL cholesterol levels).

1) Cholesterol is a raw material made by your liver, brain, and almost every cell in your body. Enzymes convert it into vitamin D, steroid hormones (including the sex hormones estrogen, progesterone, and testosterone, and stress hormones), and bile salts needed for digesting and absorbing fats. Cholesterol is a major part of the membranes surrounding cells and the structures within them.

2) The body makes cholesterol as needed. When you eat more in your diet, the body makes less. If you eat less, the body makes more. On average, 85 percent of blood cholesterol is made in the body, and the rest comes from food.

3) You can have different levels of cholesterol at different times of the day.

4) Cholesterol tends to go up in the winter and down in the summer.

5) Cholesterol soars after any surgery, and it increases when you have an infection, mental stress, or have suffered a heart attack. The reason for this is that cholesterol is a healing agent needed to help create new cells, and it’s produced whenever healing is required. Your cholesterol level will also rise and fall depending on exposure to environmental agents and toxins.
 
6) When a doctor finds a high level of cholesterol, instead of reaching for the prescription pad, he or she should look for the reason the cholesterol is high and treat the cause. If the cause is successfully addressed, cholesterol often comes down.
 
7) It’s interesting to note that the herbs, antioxidants, and nutraceuticals that reduce cholesterol do so by neutralizing damaging agents in the blood stream. Thus, the liver doesn’t have to produce as much cholesterol. Moreover, the supplements support other biochemical processes necessary to heal wounds.
 
8) The endothelium is the razor-thin lining of blood vessels. The damaging agents we are exposed to—toxic chemicals, pathogens, free radicals, and inflammatory substances—wind up in our blood stream and damage this thin layer of cells. When this happens, the liver sends LDL to the site to make repairs. As the healing process concludes, the spent LDL particles are carried back to the liver by HDL and removed from the body.
 
9) The brain is particularly rich in cholesterol and accounts for about one-quarter of all the cholesterol we have. About 20 percent of the fatty myelin sheath that coats every nerve cell and fiber is made of cholesterol, and neuron function depends on it. It’s not surprising that a connection has been found between naturally occurring cholesterol and mental function, and that lower cholesterol levels are linked to poorer cognitive performance.
 
10) Some research suggests that doctors should be extremely cautious about prescribing statin drugs to the elderly, particularly those who are frail. I agree. I have seen frail individuals become even weaker and more prone to infections after taking these medications. Many of these patients later told me that their strength, energy, appetite, and vitality returned when they discontinued the statins. These folks clearly need their cholesterol—as do the very young.

Lp(a): The Most Dangerous Form of Cholesterol

Thursday, March 5, 2009 by Stephen Sinatra
A few weeks ago, I posted some thoughts on why I don't believe that reducing cholesterol is the magic bullet that will prevent or cure heart disease. For starters, cardiovascular problems just aren't that simple, and on top of that, most cholesterol is completely harmless.

There is, however, one form of cholesterol that always requires aggressive treatment. It's called lipoprotein(a), or Lp(a), and it's one of the most dangerous heart risk factors.

Lp(a) is a subtype of LDL cholesterol that is highly inflammatory and thrombotic, which means it causes the blood to thicken and clot. Everyone has some Lp(a) in their blood stream--but when it increases abnormally, Lp(a) can raise your risk of having a heart attack up to 25 times.

Finding out if you have high Lp(a) is relatively simple. Just ask your doctor for one of the new-generation blood lipid tests that measure your cholesterol subtypes. There are two of them on the market, one called the Lipoprotein Particle Profile, or LPP, and another called the Vertical Auto Profile, or VAP. I prefer the LPP because I think the measurements are more precise, but both will tell you how much Lp(a) is circulating in your blood. As a general rule, you want your score to be less than 10 mg/dL.

Unfortunately, treating high Lp(a) is a little bit more complicated. One challenge is that there are no drugs with the ability to reduce it. Another is its genetic nature. High Lp(a) is often hereditary and is not the result of a poor diet or lack of exercise--which means you can't cure the problem through lifestyle changes, either.

That leaves just one genuinely good option, and that's to use natural therapies that offset the toxic effects of Lp(a) in the blood. Since Lp(a) causes inflammation and thickening of the blood, you want to look for products that have the opposite effect. I like fish oil (1-2 g daily) and nattokinase (50-100 mg daily). Fish oil is a natural blood thinner and has been shown to reduce inflammation, while nattokinase helps break down fibrin in the blood--one of the components that lead to clots. I also like high doses of vitamin C (1-2 g daily) for its antioxidant effects, as well as niacin (500 mg), which helps lower blood pressure.

Another option that I like is delta tocotrienol. Tocotrienol compounds occur naturally in plants and protect the carotenoids in plants from degradation. New research shows that delta tocotrienol is an effective means for reducing cholesterol overall, and it may be effective specifically on Lp(a). I recommend 100 mg daily.

Though it's somehwat less effective than targeted nutritional supplementation, you can also attack Lp(a) through a heart-healthy, cholesterol lowering diet. The PAMM eating plan (Pan Asian Modified Mediterranean) is a good place to start. It emphasizes healthy fats such as olive oil, along with whole grains, beans, legumes, nuts, fresh fruits and vegetables, and very small servings of meat (preferrably fresh, wild fish--not farm raised). This will help keep your ratio of HDL cholesterol to LDL cholesterol in proper balance, and the fresh fruits and legumes--such as chickpeas and lentils--indirectly help to reduce Lp(a) by lowering insulin levels.

Finally, there are certain people for whom an Lp(a) test is an absolute must. The first group includes anyone with a family history of heart disease. Lp(a)'s tendency to run in families means that these folks, above everyone else, need to find out if their levels are in the normal range. The test is alo essential if you're a postmenopausal woman or you have diabetes, because we know that Lp(a) increases in both of those groups. Women, it is hypothesized, experience elevated levels due to falling estrogen levels. This may be why the incidence of heart disease quadruples among menopausal women.
 
Of course, I urge the rest of you to have your Lp(a) level tested, too. The best way to prevent cardiovascular problems is to know your risk factors--and act accordingly.