artichoke-leaf-extract

Artichoke leaf extract capsules

Did you know that better heart health and lower cardiovascular risk can be had with two natural products that you can buy right over the counter? Well it’s true! Artichoke extract and pantethine are what we are talking about, and it can help you cut your risk of heart disease without dangerous side effects.

Interested? Well then read on…

Millions of people use the popular statin drugs to lower cholesterol but heart disease still continues to be the number one killer of Americans. Statins lower LDL cholesterol and inflammation while raising hdl but they have serious side effects that can dramatically lower the quality of life and put you at risk for serious health complications. One area where statins fall short is raising HDL levels. They don’t elevate HDL enough to significantly improve your HDL LDL ratio.

Statins can also raise your risk for rhabdomyolysis: (muscle breakdown), kidney damage, and even diabetes. This is due to it’s interference in the biochemical pathways which bio-synthesize both cholesterol and coenzyme Q10, which your body needs to help create energy from the foods you eat in order to power the cells of the heart.

Thus statins not only commonly cause muscle pain and weakness, but can also ironically increase the risk for cardiomyopathy which is muscle damage to the heart!

While there are certain people for whom the risk of statins is justified by their effectiveness, the vast majority of people would likely be better off with natural alternatives, and there are two good ones we have access to, pantethine and artichoke extract. These two supplements or “nutraceuticals” as they are sometimes called, can lower LDL AND raise HDL safely and naturally without the risks of serious side effects.

Enter Artichoke Extract…

An extract from artichoke leaves can raise your levels of HDL, while pantethine which is an analog of vitamin b-5 can lower LDL without causing deficiency of coenzyme q10 (as statins do). The use of these two compounds together has been shown to reduce by up to 11% the risk of heart disease. Pretty powerful stuff for two natural substances!

Artichokes which are actually considered to be in the “thistle’ family contain powerful substances called flavonoids that can lower LDL levels and increase HDL. The flavonoids act as antioxidants, preventing the oxidation of LDL particles in your arteries. In addition artichoke extract can increase your levels of bile acids, which help remove cholesterol from the body.

The clinical results with artichoke extract were based upon an intake of 1,800 mg/day of dry artichoke leaf extract for 6 weeks. This resulted in an 18.5% reduction in total cholesterol, with an improvement in the HDL/LDL ratio. It was also shown to cause an average of over 36% increase in endothelial function (the layer of cells that line the arteries) which also helps to prevent heart disease.

Next Up – Pantethine…

Pantethine lowers LDL levels without reducing coenzyme q10. It does this by inceasing the breakdown rate of serum cholesterol and reducing the rate of cholesterol synthesis. Pantethineis an energy molecule that helps increase fat burning in the body.

It also improves the ratio of HDL to total cholesterol which has a protective effect on your artery walls, reducing plaque formation and lesions in the aorta and coronary arteries.

A four month study was undertaken where the dosage of pantethine was 600mg/day for the first eight weeks and then a higher dose of 900 mg/day for the second eight weeks. This resulted in a modest decrease of LDL with a slight increase in coenzyme q10, unlike statin drugs.

When you consider that every reduction of 1% in LDL levels equals a 1% reduction in heart disease risk, pantethine significantly reduces the risk of heart attack by 11%. This is a very significant result and more reason to include pantethine in your supplement regimen.

In Summary…

All of us are at risk for heart disease as we age, and the primary issue in that risk is elevations in inflammatory LDL particles and low HDL levels. Many of the
patients put on statin drugs stop taking them because of the severity of the side effects, leaving them vulnerable to risk of heart disease once more. However the
combination of pantethine and artichoke extract can help lower LDL and raise protective HDL without the side effects that characterize statin use.

People who are at low risk may be able to achieve effective protection just by using these natural compounds rather than statins drugs. For people who have
extremely high LDL and/or very low HDL, a combination of low dose statins AND natural compounds like pantethine and artichoke extract may be the ideal
combination to avoid side effects AND effectively decrease the risk of heart disease.

As always, any therapy whether drug based OR natural that is intended to protect against heart disease should be managed by your doctor, possibly with the help of
a nutritionist or other wellness professional who is well versed in natural healing therapies, nutrients, and nutraceuticals.

Medical References:

Atherosclerosis. 1984 Jan;50(1):73-83.
Controlled evaluation of pantethine, a natural hypolipidemic compound, in patients with different forms of hyperlipoproteinemia.
Gaddi A, Descovich GC, Noseda G, Fragiacomo C, Colombo L, Craveri A, Montanari G, Sirtori CR.

Plant Foods Hum Nutr. 2015 Aug 27. [Epub ahead of print]
Pharmacological Studies of Artichoke Leaf Extract and Their Health Benefits.
Salem MB1, Affes H, Ksouda K, Dhouibi R, Sahnoun Z, Hammami S, Zeghal KM.
Int J Food Sci Nutr. 2013 Feb;64(1):7-15. doi: 10.3109/09637486.2012.700920. Epub 2012 Jun 29.
Beneficial effects of artichoke leaf extract supplementation on increasing HDL-cholesterol in subjects with primary mild hypercholesterolaemia: a double-blind, randomized, placebo-controlled trial.
Rondanelli M1, Giacosa A, Opizzi A, Faliva MA, Sala P, Perna S, Riva A, Morazzoni P, Bombardelli E.

cholesterol-particlesHow did we arrive at the conclusion that LDL cholesterol is the villain in heart disease?

Well…once again we see the mistakes made by researchers that lead us to think of LDL as the culprit.

A little history…

It had to do with a machine used in the laboratory, called an analytical centrifuge that created evidence that ultimately mislead researchers and clouded the issue of cholesterol sub-particles.

Invented in 1949 and used until 2004, this device was used to spin blood plasma samples at 40,000 rpm to separate out the cholesterol fractions such as HDL and LDL.

However this spinning process cannot separate the particles with the precision required to identify all of the sub-fractions of cholesterol that are present in the blood. It may have been state of the art when it was first used, but still fell far short in the accuracy required to actually identify all the sub-fractions of cholesterol.

This started the characterization of cholesterol particles as either good or bad cholesterol, depending on the particle density. This was a gross oversimplification that stuck in the minds of the public.

For many years this simplified version of a person’s risk of heart disease based on their ratio of good and bad cholesterol stood as the cutting edge of cholesterol testing and heart disease prevention.

This was accompanied by the now debunked view that saturated fats caused heart disease because of their association with cholesterol. People avoided saturated fats out of a fear that was not founded in good science.

They also consumed statins, the most prescribed class of drugs on Earth due to the same fear of cholesterol and it’s supposed relationship to heart attacks.

Americans have consumed some 14 billion dollars in cholesterol lowering drugs, which some health experts have advocated be given to people of all ages including children allegedly to prevent heart disease.

John Abramson argues in his book Overdosed America that lowering LDL cholesterol has inadvertently become the main focus of preventative medical care in the United States.

Cutting edge thinking about LDL cholesterol

Yet a more recent breakthrough utilizing a new technology called ion mobility analysis has shaken the traditional concept of cholesterol’s role in heart disease to the core, and called the entire LDL cholesterol theory into question.

Ronald M. Krauss, of the Children’s Hospital Oakland Research Institute, is using ion mobility analysis to count cholesterol particles such as LDL and HDL down to the smallest sub particle types using principles of physics.

Even though it’s extremely expensive and not widely available, this technology has helped to rewrite the rules on how we think about cholesterol and heart disease.

Rather than continuing to believe that LDL cholesterol is the bad cholesterol here, we now know that there are four types of LDL particles that factor into the risk of heart disease.

Some LDL particles are benign and others more dangerous. Thus it makes no sense to continue to base diet and drug recommendations on an outdated theory when the science regarding cholesterol particle types is far more precise now.

We could be using drugs that target the wrong particles, and making dietary recommendations that are doing more harm than good at this point, all while dramatically escalating health care costs and actually making treatment less effective!

Low Density Lipoproteins

LDL comes in four sizes:

  • Large (big fluffy particles)
  • Medium
  • Small
  • Very Small

As the LDL particle size decreases the particles become more dense, (and more dangerous). This is because the large fluffy particles can’t lodge in your artery walls as plaque, while smaller dense LDLs CAN!

High fat diets tend to increase the large fluffy LDL particles, while low-fat high carbohydrate diets increase the smaller more dense particles.

From this you can see why the standard medical advice about how we should eat to avoid heart disease is seriously flawed! It was all based on an oversimplified and outmoded concept of the nature of cholesterol particles.

Typical cholesterol tests can’t differentiate between large and small LDL particles. There are also genetic, environmental, and lifestyle factors that affect LDL particle size.

Enter “Ion Mobility Analysis”

Using ion mobility analysis, Dr. Krauss and his colleagues determined that there are some 11 different particles. This was done using a sample of 4,600 healthy men and women volunteers.

Eight percent of the test subjects went on to develop heart disease, and using statistical algorithms the researchers developed a series of three very accurate predictors for who would go on to develop heart disease.

Here are the correlations that Dr. Kraus’s team found:

    1. High levels of small and medium LDL particles with low HDL (called atherogenic lipoprotein phenotype) Also known as pattern B
    2. Low HDL levels
    3. High total LDL cholesterol

So as it turns out LDL cholesterol and the risk of heart disease is a complex relationship that standard cholesterol tests are almost useless to predict.

The PLAC Test

There is one test however that can give you a better idea of what your risk is. You can read about it in my article called “The PLAC Test.” This is the latest test that really utilizes our new knowledge of LDL to make more accurate predictions about what your real risk for heart disease is.

Using this test you can make better choices about lifestyle and diet, because they are based upon a more complete understanding of the science of cholesterol particles.

niacin taken to lower cholesterolNiacin for cholesterol has for years been the choice of natural supplements that lower cholesterol.  Niacin (vitamin b-3) can improve cholesterol profiles when used in high doses such as 1,000 to 3,000 milligrams per day.

The use of niacin to lower cholesterol has a lot of sound scientific research behind it. It is considered to be the most effective way to lower cholesterol naturally that is currently available.

This is far above the MRD (minimum daily requirement for vitamin b-3, so when it’s being used to lower cholesterol levels, we call that a “therapeutic dose.” These dosages will cause a reaction call a “niacin flush,” which if you are not used to it may be a little disturbing.

This flushing can be controlled by gradual increases in the dosage so that the body has time to adjust and does not react as strongly.

When using niacin for cholesterol, your skin will turn red and you will feel itchy. This is due to what’s called vasodilation. Niacin (also referred to as nicotinic acid) will lower cholesterol levels, reduce triglycerides, and improve the cholesterol hdl ratio, by boosting hdl levels.

Recent studies have shown that a lower dose (1.5 grams/day) of niacin is effective in lowering ldl levels and also boosting hdl levels. This dosage is better tolerated by the majority of people and is thought to be relatively safe for the liver.

Non-flush – niacin for cholesterol

There is a form of niacin that will not trigger as much flushing as regular niacin. The information on this form is contradictory, but some research indicates that it can be effective at both lowering ldl and raising hdl. It’s called extended release niacin.

People DO still get some flushing from this form, but much less. The issue of people not taking the regular form of niacin to lower cholesterol is because of the unpleasant flush, is not a problem with extended release niacin. Because it is so much milder, it may be more effective simply because people will not avoid taking it. This is called “patient compliance” in medical terms.

Together with using extended release niacin, other strategies to lessen the flush reaction are taking it with meals or snacks, and avoiding alcohol when taking it.

Niacin to lower cholesterol – dosage and side effects

Taking niacin for cholesterol, inhibits the breakdown of hdl in the body, which obviously results in higher hdl levels and a better cholesterol hdl ratio. Higher hdl levels alone lower the risk of heart disease, but niacin helps in another way, by lowering ldl levels as well.

Niacin taken at (1-3 grams/day) prevent the breakdown of fats which the liver uses to make lipoproteins. This lowers levels of both ldl and triglycerides, a very beneficial result. Lower triglyceride levels result in lower levels of ldl cholesterol which also lowers risk of heart attacks.

Side effects beyond the flushing reaction are rare but can include alterations in blood pressure, gastrointestinal distress, and liver damage. Although vitamins that lower cholesterol are safer than drugs, you really should seek expert medical advice when using niacin for cholesterol, both from the standpoint of safety and effectiveness.

You also need medical advice to avoid potential bad reactions from taking niacin for cholesterol with any drugs that you are on. Again the advice of a doctor is needed, because they are familiar with side effects and adverse reactions from combining drugs and nutrients.

Natural supplement or prescription

Odd as it might seem there ARE prescription forms of niacin. I have no information which suggests they work any better than what you can get over the counter, and in fact, they may have more side effects depending on how they were formulated.

If you are advised to take a prescription form of niacin for cholesterol, research the side effects very carefully as they are likely to be greater than what you would get with a natural supplement. You want to lower cholesterol naturally and safely!

Remember also that as effective as niacin is, you have to do all of the other things which protect you from heart disease, like eating a healthy diet, getting the right exercise, and reducing your stress. These strategies work together to keep your heart healthy.

What are optimal cholesterol numbers? Doesn’t this contradict the latest theory that cholesterol does NOT cause heart disease. The truth is that it is a “factor” but not the “cause”!

cholesterol numbersHow do we establish what the optimal levels for LDL and HDL are? These are important questions because the idea that cholesterol specifically causes heart disease is so deeply ingrained in the average person (and most doctors as well).

This is a difficult question to answer definitively because the issue is just so complex. I can tell you what some of the guidelines are, and of course they vary from one source to another. There is a generally accepted “optimal range” for cholesterol numbers.

Here are the guidelines issued by the American Heart Association.

 

Desirable Borderline Risk High Risk
Total Cholesterol 200 or less 200-239 240 and over
HDL 60 or higher 40-59 40 or less (men)
HDL 60 or higher 50-59 50 or less (women)
LDL less than 100 130-159 160-189
Triglycerides less than 150 150-199 200-499

 

 

 

 

 

Keep in mind that these guidelines somewhat reflect the influence of the drug industry and their attempts to increase their market for cholesterol lowering drugs called “statins.”

The recommended cholesterol numbers keep being adjusted downward, in my opinion in order to get doctors to prescribe more statin drugs which of course boots revenues of the drug industry.

In addition, there are other tests which are called “inflammatory markers,” that have a direct bearing on your risk for developing heart disease, and these tests should also be used to more accurately determine what your overall risk of cardiovascular disease is.

Once you know your level of risk based on the latest tests and analysis of particle types, then you can target your lifestyle strategies (exercise, diet, and stress reduction) to protect your heart health. This should always be the end point of ANY testing…a program to address whatever risks the tests have identified.

What really DOES Causes Heart Disease?

Here’s a simplified explanation. Heart disease is caused by inflammation. That is what actually damages the lining of your arteries. As Dr. Stephen Sinatra likes to say “Cholesterol is found at the scene of the crime, but it’s not the perpetrator!”

When arteries are damaged, your body uses LDL to try and repair the damage, kind of like patching holes in a wall. Obviously the LDL did not cause the damage, but gets attached to the artery walls and accumulates eventually clogging the artery. This is called an “occlusion.”

When the LDL particles that stick to your arteries become oxidized and thus inflammatory, the process of arteriosclerosis begins. This is where the small highly inflammatory LDL particles called HP(a) come in.

So again, the cholesterol did not initiate the process of heart disease, but it IS an important factor in the progression of heart disease. With that out of the way, lets move on…

Focus on Particle Size and Type, Not Just Cholesterol Numbers

The real focus should be on the type and particle size NOT just the levels. According to Dr. Stephen Sinatra, an integrative cardiologist who is board certified by the American College of Cardiology, if your LDL particles are large and fluffy then you really don’t need to worry so much about your LDL levels.

However if the LDL’s are small dense highly inflammatory particles, then your risk is greatly elevated. There is a test that measures for these small inflammatory particles (HP(a)), called the Lipoprotein Particle Profile (LPP) test.

The LPP test measures the level of HP(a) which is a small dense LDL particle which is very toxic and inflammatory to the blood, potentially causing your blood to become “hyper-coagulated” which is another word for sticky and more likely to clot.

The takeaway message is that if you have this dangerous inflammatory LDL particle, then obviously the higher your total cholesterol numbers, the more of this dangerous particle you have, and the greater your risk. Simply stated, high levels matter when you have dangerous LDL particles in your blood.

So in closing, optimal cholesterol numbers are totally dependent on particle size and type. If your cholesterol particles are the small dense inflammatory type, then you need to make a greater effort to lower your levels.

If your LDL type is large and non-inflammatory, then your total levels are not something to be overly concerned about. You should take the time to consult with an integrative cardiologist to determine how best to manage your heart health.