Reasons for Lowering High Cholesterol Levels
If you have had your cholesterol level tested and your results have shown that the levels of cholesterol in your blood are higher than the recommended amount, then you will almost certainly be advised to take action to reduce it.
The reason that doctors check cholesterol levels is because high cholesterol is associated with increased risk of cardiovascular disease and bringing cholesterol levels down is widely believed to reduce the symptoms of heart disease where it already exists and to help prevent it arising in people considered to be at risk.
High Cholesterol Treatments Options
There are a number of approaches that can be used to lower your cholesterol level. Doctors advise that your first course of action should be to make appropriate modifications to your diet and lifestyle.
If this does not sufficiently lower your cholesterol levels then there are other options, such as drugs and supplements, that can be considered.
Diet & Lifestyle Changes for Lowering High Cholesterol
The first step in natural cholesterol reduction is increasing exercise.
While this may not be what many people want to hear, increasing exercise levels truly does play a major part in reducing cholesterol levels and offers many, many other health benefits.
Increasing exercise helps to reduce cholesterol levels by using more energy so that the body starts to convert fat into useable energy which, in turn, causes the liver to increase its production of HDL (“good” cholesterol) which helps to mop up LDL (or “bad” cholesterol). For more information about cholesterol and an explanation of LDL and HDL cholesterol, see the article: Cholesterol Explained
Another way exercise can help you lower your cholesterol levels is by helping you to lose weight if you are overweight. Being overweight tends to increase the amount of LDL in your blood, so losing any excess weight will help to lower cholesterol levels, as well as putting less of a strain on your heart. It can also help to reduce blood pressure, another risk factor for heart disease.
Most public health organizations recommend, that we try to do a minimum of 30 minutes a day of moderate to vigorous exercise (such as walking, jogging, cycling, gardening, etc).
But a 2002 study1 found that more intense exercise is better than moderate exercise for lowering cholesterol. In the study of a group of overweight, sedentary people who did not change their diet, it was found that those who got moderate exercise (the equivalent of 12 miles of walking or jogging per week) lowered their LDL level to an extent, but the people who took more vigorous exercise (the equivalent of 20 miles of jogging a week) lowered it even more.
Eating a healthier diet is another change you can make to help lower your cholesterol levels naturally.
While it is generally recommended that we reduce our consumption of high cholesterol foods (including things such as eggs, liver, kidneys, prawns, etc), these foods are not the major source of the cholesterol in our bodies. In fact our body synthesises most of its cholesterol from the foods that we eat, even though they may not contain any cholesterol themselves.
The foods that seem to lead to increased cholesterol levels are saturated and trans fat (hydrogenated fats) which are often found in processed foods and bakery products and refined carbohydrates and sugars. Not surprisingly, foods prepared/cooked from fresh natural ingredients are much better for your cholesterol levels than most convenience foods.
Wherever possible you should try to eat wholegrain carbohydrates, a wide variety of fruits and vegetables, lean proteins and oily fish, pulses, nut and seeds and cold pressed vegetable oils.
Eating foods containing high levels of beta-sitosterol, found in most plants, especially soybeans, can reduce cholesterol by 10 per cent.
Drug Treatments for Lowering High Cholesterol
Statins are the most well known of the drug treatments for lowering cholesterol. Statin drugs, such as Lipitor, work by inhibiting the production of an enzyme which plays an important role in the production of cholesterol in the liver.
Statin drugs can lower cholesterol levels significantly, but the evidence for them reducing/preventing heart problems is much less clear cut and they may have serious side effects. For more information about statins, see the articles: Statins for Lowering High Cholesterol , Lipitor Basics, Side Effects of Statins.
Although statins are the most commonly prescribed drug for lowering high cholesterol levels, there are other pharmaceutical treatments.
Bile Acid Sequestrants, such as Questran or Welchol, work somewhat differently to statins. These drugs bind with bile acids in the small intestine, preventing them from being absorbed by the body and increasing the amounts excreted in the stools. This reduction in the amount of bile in the body causes the liver to convert cholesterol into bile acids to replace the bile excreted. In this way the amount of cholesterol in the blood is lowered.
However bile acid has an important role to play in the digestion of fats and taking bile acid sequestrants may lead to nutritional deficiencies. Bile Acid Sequestrants are also less effective at reducing cholesterol than statins.
Bile Acid Sequestrants may cause serious side effects.
Nicotinic Acid a form of a B vitamin (B3) called niacin, can also be used to lower cholesterol levels.
The amount used in the treatment of high cholesterol is many times the usual recommended daily amount of 35mg. When used to treat cholesterol, doses of nicotinic acid of between 1,000-2,000mg, taken two or three times a day, may typically be prescribed, although a starting dose may be around 250mg three times daily.
High doses of nicotinic acid work by blocking the breakdown of fats in the adipose tissue (body fat) which causes a decrease of the fatty acids in the bloodstream which in turn decreases the production of cholesterol in the liver.
The high doses of Nicotinic Acid needed to lower cholesterol often cause symptoms such as facial flushing that patients can find hard to tolerate.
Ezetimibe (Ezetrol and Zetia) is a kind of drug referred to as a cholesterol absorption inhibitor, which works by decreasing the amount of cholesterol absorbed in the intestine, resulting in a reduction of the cholesterol in the blood.
Although Ezetimibe has been shown to reduce cholesterol levels, recent studies have suggested that it did not help to reduce major coronary events and even increased artery wall thickness. It has been recommended that the drug is only used when other treatment options have failed to have a satisfactory response.
A study into Ezetimibe was halted due to an increase in the number of cancers being diagnosed and increased cancer deaths in the study group, which was significantly above the rate found in the control group.
Supplements for Lowering High Cholesterol
Take omega-3 fatty-acid supplements, preferably with vitamin B6. Some studies say that omega-3 lowers LDL, while others suggest that it may raise it slightly. However most studies do seem to agree that people who eat lots of oily fish tend to have healthier hearts than those who don’t, which is surely the most important thing.
Red yeast rice may be another route to consider as it contains the same compound as found in lovastatin. However the FDA has argued that it should be regulated as a drug, although currently (partly depending on how it is labelled) it can be sold as a supplement. However, bear in mind that since it can contain the same active ingredient as some prescription statin medications, there may be similar side effects, but without the regulatory controls that are applied to the prescription medications.
You may wish to consider taking the nutritional supplement, Policosanol (or polycosanol, which is the generic term for a natural extract of plant waxes). It is said to lower LDL cholesterol (“bad” cholesterol) and increase HDL cholesterol (“good” cholesterol). However, studies into the effectiveness of policosanol have shown conflicting results.
There is also a product called Bio Lipotrol which is meant to naturally lower cholesterol. It is a combination of supplements (Red Yeast Rice, Inositol, Policosanol and Guggal Gum extract) that are supposed to lower cholesterol.
Inositol (or more properly Inositol hexaniacinate) is a form of Niacin often described as “no flush” or “flush free”. Unfortunately there is now evidence that this is not effective (unlike ordinary niacin/nicotinic acid) at reducing cholesterol.
The effectiveness of Policisanol and Guggal at lowering cholesterol levels has also been questioned by some studies.
- Duke University Medical Center [↩]