Cholesterol- Getting Down to the Basics

By Don Ford, M.D.

Blood cholesterol levels have been proven to be a major, modifiable risk factor for the development of heart disease. A risk factor is a condition that increases your chance of getting a disease. The fact that high cholesterol is a modifiable risk factor is important.

Unlike your gender or your age, the cholesterol level in your blood is something you have the ability to change. High cholesterol levels can be treated with lifestyle modifications, supplements and/or prescription medication. Treatment to change blood cholesterol levels have been shown to lower your risk of getting heart disease or having a heart attack or stroke.

Cholesterol builds up in the walls of your arteries. Over time, this buildup causes "hardening of the arteries" so that arteries become narrowed and blood flow to the heart is slowed down or blocked. You can imagine what that looks like if you think about the pipes under your kitchen sink. As they get clogged with food, grease and hair over time, the drainage of water slows and eventually stops completely.

Since blood travels through these arteries, or pipes, to carry oxygen to your muscles, organs and tissues including your heart, a blockage could reduce enough blood and oxygen to your heart that you may suffer chest pain, called angina. If the blood supply to a portion of the heart is completely cut off by a blockage, the result is a heart attack. If this blockage occurs in your brain, the result is a stroke.

High blood cholesterol itself does not cause symptoms; so there are a lot of people that are completely unaware that their cholesterol level is too high. It is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or stroke. Even if you have already had a heart attack or stroke, lower cholesterol will reduce your chance of having second one. Cholesterol lowering is important for everyone--younger, middle age, and older adults; women and men; and people with or without heart disease.

There are different kinds of cholesterol in your blood that can measured through a simple blood test preformed at your doctor’s office. This blood test must be preformed fasting, which means you can not eat or drink anything but water or black coffee for 8-12 hours before your blood test for them to be accurate.

What is LDL?
LDL (bad) cholesterol is the main source of buildup and blockage in the arteries. The majority of LDL is created by your body in your liver. A smaller percentage of it is absorbed through your diet. An easy way for patients to remember LDL is the “bad cholesterol” is to think the L in LDL stands for Lousy cholesterol, or the one you want to Lower.

With this form of cholesterol, studies have shown the lower the better. Babies are born with an LDL of 30-40, so it is hard to lower the LDL too much. Since physicians and various guidelines have different goals for different patients, ask your doctor what your personal goal is for LDL.

What is HDL?
HDL (good) cholesterol helps keep bad cholesterol from building up in the arteries. An easy way for patients to remember this is the good cholesterol is the H in HDL stands for Healthy cholesterol or the one you want to be Higher.

Studies show that with this form of cholesterol, the higher the better. If your HDL is below 40, it becomes an additional risk factor for heart disease. If your HDL is above 60, it actually allows you to subtract one of your other risk factors.

What Is Triglicerides?
Triglycerides are another form of fat in your blood which is often high in patients with diabetes, but can be high in anyone. Some patients may only have high triglycerides while all other cholesterol values remain normal. If you have both high triglycerides and high cholesterol, the condition is called “mixed dyslipidemia”.

What Does Total Cholesterol To HDL Ratio Mean?
Another number that clinical studies have shown to be important in determining your risk of heart disease is the ratio of Total Cholesterol to HDL Cholesterol. In general, it should be less than 4.0. Ask your doctor what your value is, and what your specific goal should be. Again this is a number where the lower it is, the better.

The level of your LDL or “bad cholesterol ” along with the number of other risk factors that you may have for developing heart disease will help your doctor decide not only your individual cholesterol goals, but if necessary what your individual treatment will include.

Other risk factors for heart disease include age, gender (males), cigarette smoking, high blood pressure, diabetes, HDL levels below 40, and a family history of early heart disease. Even though physical activity (sedentary lifestyle) and obesity are not included on this list, these are conditions that need to be corrected as well.

There are several treatment options for patients depending on individual test results and goals. All treatments should include a diet designed to lower cholesterol intake and an exercise plan. Many treatment plans will include dietary supplements and/or prescription medication(s). There are a variety of prescription medications that can target your specific treatment needs, including but not limited to lowering the amount of LDL created by the liver, lowering the amount of LDL that is absorbed from your intestines, increasing levels of HDL or lowering levels of triglycerides.

Your doctor may put you on one, or a variety of medications to meet your individual treatment goals.

Blood cholesterol levels have been proven to be a major, modifiable risk factor for the development of heart disease. A risk factor is a condition that increases your chance of getting a disease. A modifiable risk factor is something you have the ability to change. High cholesterol levels can be treated with lifestyle modifications, supplement and/or prescription medication. Treatment to change blood cholesterol levels have been shown to lower your risk of getting heart disease or having a heart attack or stroke.

There are many different types of cholesterol lowering medications that your doctor may prescribe, however these prescriptions can cause certain nutritional deficiencies that may increase your risk for side effects or diminish the risk reduction you would otherwise get from the cholesterol lowering medications.

NutraMD Cholesterol Essential Nutrients® supplement was designed to work with your cholesterol lowering medications by replacing lost nutrients reducing the risk of dangerous side effects, and promote better health.

Medications for treatment of High Cholesterol:

The three main classes include statins, fibrates, and bile acid sequestrants.Statins include the following medications: Lipitor (atorvastatin) Zocor (simvastatin)Pravachol (pravastatin).
Mevacor (lovastatin) Crestor (rosuvastatin) Advicor (lovastatin + niacin). Caduet (atorvastatin + amlodipine).

The main function of statins is to reduce an individual¡s risk for cardiovascular disease (i.e., heart attack, stroke, peripheral vascular disease, atherosclerosis, arteriosclerosis, and plaque development in arteries) by reducing the total and LDL cholesterol levels as well as by reducing certain plaque promoting factors and increasing artery dilating factors.

Your doctor may prescribe a statin if you have high cholesterol or have had heart attack or stroke in the past. If you have been diagnosed with high blood pressure or diabetes but do not have high cholesterol, your doctor may still prescribe a statin to reduce your risk for cardiovascular disease. Statins help lower cholesterol by blocking it's direct synthesis throughout the body but primarily in the liver, however the action of the medication also blocks the synthesis of Coenzyme Q10 (CoQ10) and has a potential negative effect on the synthesis of vitamin D.

* CoQ10 deficiency has been linked to the following diseases and symptoms:
Congestive heart failure, high blood pressure, rhabdomyolysis (muscle break down), muscle and joint pain, and fatigue.

Therefore to achieve maximum benefit from the statin medication and minimize potential side effects of nutrient deficiencies, you should compliment your prescription medication by taking NutraMD Cholesterol Essential Nutrients® supplement. By doing this you will balance the risk/benefit ratio further in your favor.

Fibrates include the following medications: Tricor, Antara, and Lofibra (fenofibrates) Lopid (gemfibrozil).

The main functions of fibrates are to lower triglycerides and raise HDL (good cholesterol). These medicines also have a mild lowering effect on LDL (bad cholesterol) and total cholesterol. Your doctor may prescribe fibrates in combination with a statin or bile acid sequestrants. The down side of fibrates is there ability to increase muscle pain and myalgia (including rhabdomyolysis).

11-15 These medications also have the ability to raise homocysteine levels.
1 1-15 Homocysteine is a chemical (amino acid metabolite) which when elevated is a risk factor for heart disease, atherosclerosis, stroke, cancer, Alzheimer's disease, and osteoporosis. The only substances known to lower homocysteine levels are the B-vitamins (folate, riboflavin, cobalamin, and pyridoxine).

Therefore to reduce the potential risks while taking fibrates, you should also be taking NutraMD Cholesterol Essential Nutrients® supplement.

Bile Acid Sequestrants include the following medications:
Questran or Questran Light (cholestyramine)
Welchol (colesevelam HCl).

The main functions of bile acid sequestrants are to lower cholesterol by binding to it in the intestine and preventing its absorption thus allowing its excretion in the feces. Your doctor may prescribe this type of medicine in combination with fibrates and statins.

Unfortunately, bile acid sequestrants will also bind to vitamins A, D, E, and K as well as essential fats in the intestine preventing their absorption into the blood stream thus leading to their deficiencies. A few of the problems which arise from deficiencies of vitamins A, D, E, K, and essential fatty acids include the following: Heart disease, high cholesterol, stroke, high triglycerides, cancer, thyroid disease, autoimmune disease, bone disease, arthritis, joint pain, muscle pain, cataracts, skin lesions, allergies, and many other.

Therefore, to reduce potential side effects of nutrient deficiencies you should take NutraMD Cholesterol Essential Nutrients® supplement as long as you are on bile acid sequestrants.

In summary, cholesterol-lowering medications prescribed by your doctor are necessary to treat your condition; however, you should also be aware that the long term potential nutritional side effects can be just as big a risk factor for your condition as well as other conditions. Put the odds in your favor and maintain your health with NutraMD Cholesterol Essential Nutrients® supplement.http://www.essential-nutrients.net/
C. Donald Ford, MD, Diplomate of the American Board Internal Medicine.

Dr. Ford has practiced general internal medicine for the past 22 years. He is a native Texan and trained at Baylor University, the University of Texas Medical School at Houston, and Scott and White in Temple. He is a Clinical Assistant professor at Baylor College of Medicine. In addition to general Internal Medicine, his practice includes travel medicine, vascular disease prevention, and Integrative Medicine with nutrients. He has been interested in the body’s ability to heal itself since medical school, and has used nutrients throughout his career to help patients use less prescription medication, or avoid it altogether.

While he sees the tremendous value prescription medications can provide, he is also aware of the value and place for nutrients.

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