Dear HM,

There is a great deal we can discuss regarding cholesterol. I will try to break the topic down into several categories.

Cholesterol Testing

The most important thing an adult can do to gauge their potential for heart problems is to get their cholesterol checked. If you have not had your cholesterol checked, you may be setting yourself up for health problems in the future. This can be done at a doctor's office, a pharmacy or any public location offering the test. Many tests can determine your risk right on the spot and others may take a couple of days, if performed by the physician's lab service.

When you have your cholesterol checked, you will need to get results based on four figures: your total cholesterol, your levels of LDL (low-density lipoproteins) and HDL (high-density lipoproteins), and your triglyceride count. These four figures will help your physician understand your risk factors for circulatory and cardiovascular disease. They may require you to get yet another test that measures your VHDL and VLDL (V stands for "very") to further determine your risks.

The ratio of "good" fats (HDL) to "bad fats" (LDL) is most important. A person with high levels of HDL is less at risk for problems. High triglyceride levels can indicate future problems as well. That is why it is important to gauge all the levels.

About Cholesterol and Cholesterol Medications

Simply put, cholesterol is a fat. Cholesterol is a necessary fat substance for the body and found in every cell. It performs many positive functions. We use cholesterol for many purposes, including the creation and transportation of hormones. All of our sex, or steroid, hormones are comprised of the fatty substance. We also use several vitamins in the creation of cholesterol, including the adrenal support nutrient known as pantethine. Most of this action takes place in the liver and adrenal glands.

Cholesterol is comprised of several fractions, including high-density lipoproteins (HDL) and low-density lipoproteins (LDL). It is generally recognized that high total cholesterol counts are unhealthful. High levels of HDL cholesterol are healthful for the body, while elevated LDL cholesterol levels can increase the risk of cardiovascular disease.

The most common medical approach to cholesterol reduction is through the use of statin medications. These medications have been shown to be successful, but are expensive and may be accompanied by side effects, most notably muscle weakness and fatigue. These side effects may be related to a nutritional deficiency of CoEnzyme Q10. As a part of the action of the medication, there is a blocking of this important nutrient.

CoQ10 plays an important role in creating cellular energy and is also quite protective of the heart muscle. For those taking statin medications, supplemental use of CoQ10 is highly recommended by our pharmacists, to help regain energy and to protect the heart. For those taking statin medications, click here for added nutritional support.

Nutritional Approaches to Healthy Cholesterol

Most of the nutrients associated with cardiovascular health are important for protecting the arteries and maintaining good lipid (fat) control. Additionally, the use of lecithin, essential fatty acids and choline bitartrate is quite important in maintaining cholesterol balance. Lecithin provides choline to help maintain good cholesterol (HDL) and additionally, utilizes fats for the production of cell membranes. Lecithin is known as the perfect phospholipid.

Phospholipids are the essential fat for our cellular make-up and protect the energy-producing mitochondria of the cell. An incredible supplement tableting base, known as NT Factor, contains a technologically advanced form of phospholipids, as well as food factors to help absorb nutrients, protect the gastrointestinal tract and add nourishing essential fatty acids with each tablet. The NT Factor is found in a number of products found at the Wellness Store. Please contact me for more information

Deficiency of essential fatty acids is linked to many health problems. Although many people have excess amounts of harmful fats, many individuals fail to receive sufficient ranges of the essential fatty acids required by various body systems. Essential Fatty Acids provides essential Omega 3 and 6 oils plus important GLA and Omega 9 oils.

Essential fatty acids are important for the regulation of cholesterol and choline bitartrate enhances metabolism of cholesterol. Only recently has research offered an understanding of the role of dietary fats in health. The body uses fats for a variety of reasons, including as a preferred source of energy. Fats provide structural protection around organs and are main components of cell membranes. Fats are the building blocks of hormones and may be converted to prostaglandins, which regulate processes such as inflammation.

Essential fatty acids are derived from both plant and animal sources and contain substances known as lignans. Lignans are great antioxidants. The substances have antiviral and antibacterial properties as well. Lignans also help the cardiovascular system. Studies with lignans show significant reduction in LDL cholesterol (the "bad" ones), significant elevation of HDL cholesterol (the "good" ones) and a general reduction of plaque build-up in the arteries. Essential Fatty acids are a great supplement for anyone to consider. If problems with the heart or cholesterol are a potential issue, there is perhaps a more urgent need. Click here for this foundation product.

Fiber is also shown to reduce total cholesterol and triglycerides, so the consumption of quantities of dietary fiber should be considered an important part of your heart and cholesterol metabolism health. There are two kinds of fiber: soluble and non-soluble fiber. Fiber is necessary for many of the body's key functions. We need fiber for proper digestion and elimination of wastes, including excessive fats that can contribute to high cholesterol. Go down the cereal section in the supermarket and you will find hundreds of products that make the claim to reduce cholesterol. They make this claim because high fiber diets will reduce the fats.

Fiber promotes the body's ability to detoxify itself. It helps to regulate the fats and cholesterol we use. Fiber is also crucial in keeping our digestive system moving, which will keep cancerous activity from forming in the digestive system, including the colon.

Fiber, of course, is best obtained from eating fresh fruits and vegetables. Nuts, grains and certain proteins also contain fiber. A health level of fiber is between twenty and thirty grams daily. Four to six servings of fruits and veggies can produce this.

Many people choose to supplement fiber in their diet, and I believe they are smart for doing so. There are both soluble and insoluble fiber supplements available and both offer specific benefits to the body.

Nutritional Supplements and Cholesterol Metabolism

For those people that cannot afford statin medications, promising nutritional products and attention to diet may fill the bill in supporting healthy cholesterol levels. In particular, a nutritional product known as policosanol is showing great promise as an effective regulator of healthy cholesterol metabolism. First and foremost, policosanol has shown the ability to reduce total cholesterol levels.

Several studies support the benefits of policosanol. One clinical trial determined that, after eight weeks, patients showed a marked reduction in total cholesterol and LDL cholesterol levels. (1) A similar study showed that patients taking 10 milligrams of policosanol daily for two years has an 18% reduction in total cholesterol and a 25% reduction in LDL cholesterol. Notably, after 12 months, the HDL cholesterol was elevated by 21%. (2) Several larger clinical trials were conducted to verify these results and they were even more exciting.

437 patients were enrolled in a double-blind, randomized study and after 12 weeks, patients receiving the policosanol showed a reduction of 21% in LDL cholesterol, a 17% reduction in total cholesterol and a 28% increase in HDL cholesterol. (3)

In studies comparing the natural product to statin medications, policosanol not only held its own, but showed impressive results! By comparison, those taking the natural products showed higher elevations in HDL cholesterol, and a greater reduction in total and LDL cholesterol. Further, some of those taking the medication showed adverse side effects not noted in the policosanol group. This study was followed by several others, which demonstrated similar results. (4,5)

Policosanol has also been widely studied and shown to be beneficial for those with heart, menopausal and blood sugar concerns: all concerns of which cholesterol plays a role. Policosanol is gaining a great reputation in the medical field in part because the studies show no adverse effects or toxicity. (6,7)

Herbs and Cholesterol Metabolism

A couple of herbs or derivatives of plants are showing great results in the control and functioning of normal cholesterol levels. Garlic provides a very functional food source for the proper maintenance of cholesterol. Many consider garlic the first line of defense for protecting the circulatory system and reducing LDL levels of cholesterol. Raw garlic cloves have been shown to be the most effective manner of introducing the herb into its functioning capacity. Garlic tablets and capsules provide an excellent method of delivering these nutrients into the system as well.

Forty years ago, medical researchers from India uncovered an ancient text from the Ayurvedic medical writings that described a treatment for high cholesterol using a number of plants including a resin from a myrhh tree, known as guggul. They began to test the resin and found that it not only lowered cholesterol, but also protected against the development of hardening of the arteries. Researchers across the world have since excitedly reported results that confirm the early Sanskrit texts. Several countries established guggul as a recognized treatment for cholesterol problems.

Alternatives to High Prices in Cholesterol-Lowering Medications

At the Wellness Store, we are as alarmed as you are about prescription pricing of cholesterol medications. We recognize that the high price of name-brand medications is an issue with most patients and that some of our patients, particularly those on fixed income, cannot afford their medications. We want to work with you and your physicians to provide dietary suggestions, lifestyle recommendations and products that may help to provide and support healthy cholesterol levels.

If there is an opportunity to control and improve cholesterol levels through nutritional and natural methods, we may not have to depend on medication to safeguard our body against the potentially damaging effects of high cholesterol.

Certainly, by taking a stance that nutrition, exercise and proper lifestyle choices are important, we can enjoy the benefits of a "wellness" approach to life and be willing customers in the wellness industry, as opposed to unwilling customers in the sickness industry. If you are overweight, you can really help your heart and your cholesterol levels by losing some weight. Studies now are also suggesting that the amount of sugar and processed foods you eat may play a role in your heart and cholesterol risk factors. I can provide you with an excellent diet plan if you are interested. Contact me at the Wellness Store for an appointment.

Finally, HM, it is really important to learn more information about the comprehensive methods of maintaining healthy cholesterol levels and protecting your heart. It is the nutritional and lifestyle issues we confront that really help us to prolong our life and not be a "slave" to the medications that are available. They only help control the problems, but cannot make us healthier. Let's not let high prescription prices dictate our health and happiness. Instead, let's find a more "natural" solution!

Questions about Health?
Ask "Mike"
For Consultation with Jerry "Michael" Casso R.Ph.
Phone: (504) 888-3077

1. Pons P, Rodriguez M, Robaina C, Illnait J, Mas R, Fernandez L, et al. Effects of successive dose increases of policosanol on the lipid profile of patients with type II hypercholesterolaemia and tolerability to treatment. Int J Clin Pharmacol Res 1994;14(1):27-33.
2. Canetti M, Moreira M, Mas R, Illnait J, Fernandez L, Fernandez J, et al. A two-year study on the efficacy and tolerability of policosanol in patients with type II hyperlipoproteinaemia. Int J Clin Pharmacol Res 1995;15(4):159-65.
3. Mas R, Castano G, Illnait J, Fernandez L, Fernandez J, Aleman C, et al. Effects of policosanol in patients with type II hypercholesterolemia and additional coronary risk factors. Clin Pharmacol Ther 1999;65(4):439-47.
4. Castano G, Mas R, Arruzazabala ML, Noa M, Illnait J, Fernandez JC, et al. Effects of policosanol and pravastatin on lipid profile, platelet aggregation and endothelemia in older hypercholesterolemic patients. Int J Clin Pharmacol Res 1999;19(4):105-16.
5. Prat H, Roman O, Pino E. [Comparative effects of policosanol and two HMG-CoA reductase inhibitors on type II hypercholesterolemia]. Rev Med Chil 1999;127(3):286-94.
6. Canetti M, Moreira M, Mas R, Illnait J, Fernandez L, Fernandez J, et al. A two-year study on the efficacy and tolerability of policosanol in patients with type II hyperlipoproteinaemia. Int J Clin Pharmacol Res 1995;15(4):159-65.
7. Crespo N, Illnait J, Mas R, Fernandez L, Fernandez J, Castano G. Comparative study of the efficacy and tolerability of policosanol and lovastatin in patients with hypercholesterolemia and noninsulin dependent diabetes mellitus. Int J Clin Pharmacol Res 1999;19(4):117-27.
8. Mirkin A, Mas R, Martinto M, Boccanera R, Robertis A, Poudes R, et al. Efficacy and tolerability of policosanol in hypercholesterolemic postmenopausal women. Int J Clin Pharmacol Res 2001;21(1):31-41.


Circulation and Varicose Veins

Dear Mike,

I am so sick of looking at the spider veins in my legs. I have had a couple removed, but others are now showing. How do they appear? Can you help me prevent more from appearing?

DO, Beaumont

Dear DO,

Sometimes, we can look to nutrition for answers to our appearance, not just our health. I tell my patients that good nutrition approaches to life can actually make us more attractive, and in this case, it is definitely true!

Varicose veins, or spider veins, may be more than unsightly manifestation of aging. In fact, aging has little to do with the appearance of our veins. More often than not, varicose or spider veins are the result of some underlying problem. Women are more inclined than men to develop varicose veins and they can occur during pregnancy or other complications of our body.

Varicose veins are veins close to the skin that are swollen, twisted, or stretched. Veins in the legs and pelvic region are most commonly affected. There are a number of ways to get them, and there are a number of ways to prevent them. Unlike our arteries, which have muscles, veins work to send blood to the heart through gravity. There are vein valves that prevent blood from backing up, and when there is a problem with the valve, the blood does not move through the vein.

Blood not moving causes a swelling of the vein and that dilation that occurs is a varicose action. If the valve not working affects several veins and capillaries, spider veins are the result. Varicose veins are normally blue in appearance, are swollen, and may cause pain and aching in the leg or at the site of the vein.

Patients report heaviness in the legs and leg cramps, and in some cases, ulcers or sores may develop around the varicose area. A diagnosis of varicose veins may include an ultrasound exam to determine if there is a clotting problem in the blood flow.

Today's traditional treatment plan for varicose veins is supportive stockings. If there is accompanying swelling along the veins, these stockings are especially important. Regular walking, avoiding prolonged standing, elevating your feet as often as possible may all help your veins from getting worse.

Sclerotherapy and surgical treatments are also available. Sclerotherapy entails a solution of an irritable substance injected into the veins, causing the vein to close and the blood to route to other veins.

While this may make the leg look better, there is potential for problems to reoccur after the procedure is performed. I hope you will agree that it probably makes sense to try to prevent the formation of the veins.

Here are some tips:

* From a nutritional standpoint, the diet must have more dietary fiber. The straining and constipation that results from a lack of fiber can create enough pressure to cause varicosity. Add fibrous foods to the diet and also consider a fiber supplement.
* There are herbs that have historically been used to help venous flow. These include gingko biloba, horse chestnut, and butcher's broom.
* Click here for a formula that contains these elements. There are also herbs that aid in breaking down fibrin, which can cause varicose veins. Onions, garlic, ginger, and cayenne are good herbs to consider in this.
* Add antioxidants to your diet. These nutrients aid in circulation. A potent antioxidant,
* CoQ10, has been shown to aid against the formation of spider veins. Plant-based antioxidants may also be quite supportive. Grape seed extract, bilberry, and a French herb known as pycnogenol are examples of this type of product.
Essential fatty acids, such as fish oils, will also aid in circulatory process. The minerals magnesium and zinc are also important in the process.

From a healthy standpoint, consider exercise for good muscle flow, circulation, and maintaining a good weight. Obesity is considered a prime suspect in varicose vein formation.

Constipation and digestive problems may also cause this problem. A higher fiber diet will help, but is not always easy to obtain without other digestive products, such as enzymes and beneficial flora. If you are constipated, contact me for more information or check out some related products that will aid against this. Also, you may wish to learn more about the intestinal function in general, by clicking here.

DO, varicose veins are not something you need to take lying down. You can change some nutritional habits, improve your digestion, and add valuable nutrients in your diet, either through your food or supplements. Contact the Wellness Store for more information about nutritional and natural approaches to good health.

Mike Casso, R.Ph.

Questions about Health?
Ask "Mike"
For Consultation with Jerry "Michael" Casso R.Ph.
Phone: (504) 888-3077