Cholesterol, Triglycerides

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Hyperlipidemia  or Cholesterol


What should I know about Hyperlipidemia?

If your health professional says you have hyperlipidemia, this simply means the amount of fat in your blood is higher than it should be. (“Hyper” means high; “lipid” is another word for fat or fat-like substance; “emia” refers to the blood.) Although high cholesterol is the most famous form of hyperlipidemia, blood fats include more than just cholesterol. Triglycerides, phospholipids, and other fatty substances circulate continuously through the bloodstream on their way to and from organs and tissues.

High blood cholesterol gets the most attention because of the link between cholesterol and heart disease. Cholesterol has received a great deal of press, and medical experts agree that high blood cholesterol is a risk factor for heart disease. But cholesterol is not an enemy. The body needs cholesterol and manufactures its own supply. Essential for life, cholesterol plays many important roles. Cholesterol, along with other fats, is a key component of cells membranes. The body uses cholesterol as the building material for hormones such as estrogen and testosterone. Bile salts, which break the fat we eat into small particles that can be digested, are composed largely of cholesterol. Cholesterol is our friend, something the body requires, in the right places and amounts.

Abnormally high levels of cholesterol in the blood can lead to coronary heart disease and other serious conditions, due to build-up of cholesterol-filled plaque in the arteries. But cholesterol by itself is not the problem. Research has shown that abnormalities in the way cholesterol is transported in the blood are the culprits in setting the stage for arteries to become damaged and clogged with plaque. (This is the condition known as “atherosclerosis.”) 

Blood is a watery fluid. Since oil and water do not mix, fats do not travel in the blood in their free form. Instead, they are bundled together with other substances for transport through the blood vessels and delivery to destinations where they are needed in the body. Cholesterol and other fats are shipped in the form of fat-protein packages called “lipoproteins.” Four groups of lipoproteins use the bloodstream as an aqueduct: LDL, VLDL, HDL, and chylomicrons. The protein portion of a lipoprotein forms a sort of shell around the fat and also directs the lipoprotein to its appointed delivery site in tissues and organs. 

Before recommending a treatment plan for high cholesterol and blood lipids, the health professional must first look for the cause. Tests can be performed to rule out other conditions that may elevate blood fat levels such as diabetes and thyroid disorders. Certain medications can raise blood lipids, so their use should be evaluated in people with hyperlipidemia. 

Signs and Symptoms 

With some forms of hyperlipidemia, there are definite signs and symptoms that alert the health professional to the problem. Other symptoms, more difficult to detect forms lack clear diagnostic signals, thus many people are not tested for blood lipid abnormalities until other complications appear.

The link between hyperlipemia and heart disease is strong. Experts agree that high blood cholesterol is a major cause of atherosclerosis. This condition, which clogs the arteries with plaque, begins when cholesterol attached to the arterial wall creates a “fatty streak.” As the process continues, the artery can become completely plugged. When this occurs in a coronary artery, which feeds the heart, the stage for a heart attack is set.

Starting at age 20, adults should have both total cholesterol and HDL checked every five years. If hyperlipidemia is discovered, a complete work-up should be done to assess the situation. The health professional will take a complete physical look at family history and add up the risk factors for heart disease. Triglyceride levels will also be checked.

Conventional Treatment

The National Cholesterol Education Program (NCEP) recommends adults with hyperlipidemia have their total cholesterol measured and risk factors assessed.

 Cutting down the dietary intake of saturated fat and cholesterol and exercising regularly are the first steps in getting blood lipid levels under control. The Step 1 diet recommended by NCEP restricts total calories from fat to less than 30 percent of total daily calories. Saturated fat should not be more than 7 percent of daily calories, and daily cholesterol intake should not exceed 300mg/day.

A number of drugs are used to bring cholesterol levels down. The most common ones include: atorvastatin, cerivastatin, fluvastatin, pravastatin, simvastatin, and lovastatin. Collectively known as “statins,” these drugs block an enzyme that increases cholesterol production in the liver. (They also deplete CoQ10, an important vitamin-like nutrient.)

Other medications for lowering cholesterol include gemfibrozil, which promotes enzymes that break down cholesterol, and bile acid sequestrants (BASR) such as colestipol and cholestyramine, which aid the liver in removing cholesterol from the blood. Estrogen replacement therapy is generally recommended for postmenopausal women for lowering LDL cholesterol. Generally, LDL cholesterol is reduced by approximately 15-25 percent and HDL increases by 15-25 percent with a 0.625mg dose of synthetic estrogen.

Cholesterol Lowering Medications

 HMG-CoA Reductase Inhibitors (Statins)

  • Atorvastatin  (Lipitor®)
  • Fluvastatin  (Lescol®; Lescol® XL)
  • Lovastatin  (Mevacor®)
  • Pravastatin  (Pravachol®)
  • Simvastatin  (Zocor®)

Nutrient Depletions

Cholesterol lowering medications deplete coenzyme Q10 levels. A deficiency of the antioxidant coenzyme Q10 may be associated with long-term conditions including heart disease and high blood pressure.

Symptoms of coenzyme Q10  deficiency include gingivitis, fatigue, cardiac abnormalities, heart disease, high blood pressure.and weakened immune function.

Supporting Research 

  • Bargossi AM, Grossi G, Fiorella PL, et al. Exogenous CoQ10 supplementation prevents ubiquinone reduction induced by HMG-CoA reductase inhibitors. Mol Aspects Med. 1994;15(Suppl):S187-S193.
  • Belichard P, Pruneau D, Zhiri A. Effect of a long-term treatment with lovastatin or fenofibrate on hepatic and cardiac ubiquinone levels in cardiomyopathic hamster. Biochim Biophys Acta. 1993;1169(1):98-102.
  • Bliznakov EG, Wilkins DJ. Biochemical and clinical consequences of inhibiting coenzyme Q10 biosynthesis by lipid-lowering HMG-CoA reductase inhibitors (statins): A critical review. Adv Ther. 1998;15(4):218-228.
  • Chan A, Reichmann H, Kogel A, et al. Metabolic changes in patients with mitochondrial myopathies and effects of coenzyme Q10 therapy. J Neurol. 1998;245(10):681-685.
  • De Pinieux G, et al. Lipid-lowering drugs and mitochondrial function: effects of HMG-CoA reductase inhibitors on serum ubiquinone and blood lactate/pyruvate ratio. Br J Clin Pharmacol. 1996;42(3):333-337.
  • Folkers K, Langsjoen P, Willis R, et al. Lovastatin decreases coenzyme Q levels in humans. Proc Natl Acad Sci USA. 1990;87(22):8931-8934.
  • Folkers K, Morita M, McRee J Jr. The activities of coenzyme Q10 and vitamin B6 for immune responses. Biochem Biophys Res Commun. 1993; 28(19391):88-92.
  • Ghirlanda G, Oradei A, Manto A, et al. Evidence of plasma CoQ10-lowering effect of HMG-CoA reductase inhibitors: a double-blind, placebo-controlled study. J Clin Pharmacol. 1993;33(3):226-229.
  • Hanaki Y, Sugiyama S, Ozawa T, Ohno M. Coenzyme Q10 and coronary artery disease. Clin Invest. 1993;71(8 Suppl):S112-S115.
  • Kaikkonen J, Nyyssonen K, Tuomainen TP, et al. Determinants of plasma coenzyme Q10 in humans. FEBS Lett. 1999;443(2):163-166.
  • Kamikawa T, Kobayashi A, Yamashita T, et al. Effects of coenzyme Q10 on exercise tolerance in chronic stable angina pectoris. Am J Cardiol. 1985;56(4):247-251.
  • Laaksonen R, Ojala JP, Tikkanen MJ, Himberg JJ. Serum ubiquinone concentrations after short- and long-term treatment with HMG-CoA reductase inhibitors. Eur J Clin Pharmacol. 1994;46(4):313-317.
  • Mortensen SA, Leth A, Agner E, Rohde M. Dose-related decrease of serum coenzyme Q10 during treatment with HMG-CoA reductase inhibitors. Mol Aspects Med. 1997;18(Suppl):S137-S144.
  • Munkholm H, Hansen HH, Rasmussen K. Coenzyme Q10 treatment in serious heart failure. Biofactors. 1999;9(2-4):285-289.
  • Nakamura R, Littarru GP, Folkers R, et al. Study of CoQ10-enzymes in gingiva from patients with periodontal disease and evidence for a deficiency of coenzyme Q10. Proc Natl Acad SciUSA. 1974;71(4):1456-1460.
  • Singh RB, Niaz MA, Rastogi SS, et al. Effect of hydrosoluble coenzyme Q10 on blood pressure and insulin resistance in hypertensive patients with coronary heart disease. J Hum Hypertens. 1999;13(3):203-208.
  • Singh RB, Wander GS, Rastogi A, et al. Randomized, double-blind placebo-controlled trial of coenzyme Q10 in patients with acute myocardial infarction. Cardiovasc Drugs Ther. 1998;12(4):347-353.
  • Watts GF, Castelluccio C, Rice-Evans C, et al. Plasma coenzyme Q (ubiquinone) concentrations in patients with simvastatin. J Clin Pathol. 1993;46(11):1055-1057.

Vital Functions of Cholesterol 


Cholesterol is the main sterol found in animal fat such as egg yolks, meats, milk products and other animal fats. It is not available in most vegetable foods.  

  • it provides rigidity to cell membranes (compensates for changes keeping fluidity within limits required for normal function)
  • is a precursor to sex (testosterone, estrogen) and adrenal hormones (cortisol and aldosterone)
  • is a precursor to vitamin D and bile salts (main components of bile necessary for the emulsification of fats in the small intestine)
  • it protects our skin against dehydration, cracking and helps heal skin tissue and prevent infections.
  • it may act as an antioxidant when antioxidant levels are low
  • can be lowered safely by treating the root cause with specific vitamins, minerals and herbs

Sources: approximately 85% is produced by the body according to its needs. Approximately 15% comes from dietary sources.

Cholesterol can be metabolized as an energy source, can only be excreted if there is enough fiber in the diet and can be changed into bile acids if the cofactors are present. Without fiber up to 94% of cholesterol and bile acids are reabsorbed and recycled leading to elevated serum cholesterol levels.

Old dogma: High HDL level should protect from cardiovascular disease, and high LDL indicates cholesterol overload, slow removal and deposits in arteries.  

New research: cholesterol consumption has remained above constant over the last 100 years, while cardiovascular disease has skyrocketed… The real culprits are: 

  • Refined sugar, total fat, chemical additives and trans fatty acids
  • vitamin, mineral and antioxidant deficiencies leading to oxidize cholesterol
  • essential fatty acid deficiencies
  • disruption in normal biochemistry of life (modern lifestyle) 

A strong risk factor for CVD is not LDL, but Lp(a) which carries a 10 times higher risk factor for cardiovascular disease than LDL alone.

Natural Treatment

There are a great many vitamins, minerals, herbal supplements and other natural remedies that have been shown to effectively lower cholesterol safely and effectively. Which therapies are chosen will be based on the root cause of the elevations in cholesterol and not just the symptom. Your practitioner will carefully evaluate your situation and put together an effective protocol at safely lowering your cholesterol with natural remedies rather than dangerous medications that merely treat the symptom.

Diet & Lifestyle

Diet: The first and most important step for reducing cholesterol is to change the diet. Most low fat, low protein diets that are designed to improve cardiovascular risk are also a high-carbohydrate (no matter what the source) diet. This type of diet has proven to actually increase LDL cholesterol and triglycerides. Many foods labeled “cholesterol free” actually contain hydrogenated oils or trans-fatty acids, which have been associated with an increased risk of cardiovascular disease. Partially hydrogenated oils may increase LDL, triglycerides, and lipoprotein levels, while decreasing HDL levels.

In addition, these foods are generally rich in refined sugars, which can raise insulin levels. Food selection is a key issue. Nutrition surveys indicate that only 9 percent of the American population eats five fruits and vegetables a day. People also do not include legumes or enough whole grains in their diet. These foods are essential for providing dietary fiber, which not only is known to reduce cholesterol levels, but also the water soluble fiber found in legumes helps to regulate blood sugar. 

Fiber and Fiber Sources: The American Heart Association (AHA) recommends increased intake of dietary fiber in the form of whole grains, vegetables, fruits, legumes, and nuts because they have been shown to do the following: 

  • Reduce total and LDL cholesterol more effectively than a diet low in saturated fat and cholesterol alone
  • Help control weight and intake of calories by promoting a sense of fullness
  • Improve cholesterol and triglyceride levels as well as blood sugar in people with diabetes
  • Soluble fibers such as those in psyllium husk, guar gum, and oat bran have a cholesterol-lowering effect when added to a low-fat, cholesterol-lowering diet. Studies have shown psyllium, in particular, to be quite effective in lowering total as well as LDL cholesterol levels. Oat bran (3 g per day) has also been shown to lower total cholesterol. 

The second important dietary strategy for reducing heart disease is to cut down on the intake of essential fatty acids and, in particular, the omega-3 fatty acids. Low levels of omega-3 (alpha-linolenic acid), along with an excess of omega-6 (linoleic) fatty acids from refined polyunsaturated vegetable oils can contribute to increased triglycerides, raise blood pressure, and increase platelet stickiness. 

Foods that may help to lower elevated cholesterol levels include soy products, oat bran, yogurt, carrots, walnuts, onions, garlic and especially artichokes . High fiber foods such as whole grains, vegetables, fruits, and legumes can also help to lower cholesterol levels. Although egg yolks contain high levels of cholesterol, studies report that eating eggs regularly does not elevate blood cholesterol levels in most people. Although switching to a vegetarian (low-cholesterol) diet may help some individuals lower elevated cholesterol levels, many health professionals now believe that dietary cholesterol is not a major contributor to cholesterol levels. 

In the late 1940′s and early 1950′s, food processors began dramatically increasing their use of inexpensive, polyunsaturated vegetable oils in the production of a wide variety of processed foods. During this time, food processors created a new industrial process called partial hydrogenation. This process involved bubbling hydrogen gas into the vegetable oils under extremely high temperatures and pressures with metal catalysts. This process changes the consistency of the vegetable oils from a liquid to the semi-solid hydrogenated fats and oils present in processed foods. The process of partial hydrogenation gave food processors another benefit. It increased the shelf life of processed food products by making the fats and oils in processed foods less likely to become rancid. 

There are health-related problems associated with partially hydrogenated fats and oils. The high temperatures and pressures that are required during the process of partial hydrogenation causes many of the fats to change their shape, resulting in formation of the trans fatty acids mentioned above. One of the problems associated with trans fats is they block 6-delta desaturase, an enzyme that is required for the metabolism of cholesterol. By blocking this enzyme, trans fats inhibit the body’s ability to excrete cholesterol. Foods containing partially hydrogenated oils actually act to raise LDL-cholesterol levels and increase the risk of cardiovascular disease.

Exercise: Regular exercise is another way to positively change cholesterol levels. Regular endurance exercise training has been associated with decreased levels of total cholesterol and increased HDL-cholesterol. Various forms of aerobic exercise that can help improve HDL levels include regular walking, aerobics, dancing, jogging, swimming, and cycling.

Over­all, it’s more impor­tant to focus on the root cause and what are the under­ly­ing mech­a­nisms that are caus­ing sickness and lack of vitality rather than just treat­ing it symp­to­mati­cally.  Each per­son is encour­aged to seek out a qual­i­fied nutri­tion­ist or other qualified healthcare practitioner in order to assess exactly which nutri­ents, herbs, home­o­pathics and nat­ural reme­dies; in which com­bi­na­tion; in what pro­por­tion are right for the par­tic­u­lar indi­vid­ual and are intended at treat­ing the root cause rather than just a symptom