Seven Other Key Supplements

Everyone on the Plan will take a daily multivitamin and a fish-oil supplement (or flaxseed oil for vegans), But some may benefit from additional supplements. Next we outline the strongest candidates and who should consider . them. Remember to check with your doctor before deciding to take any supplement.

Guggul

Guggul, short for guggulsterone (also known as gugulipid), is an extract derived from the resin of the mukul myrrh tree, which grows in India. It has more than 3,000 years of history behind it in treating a variety of medical conditions. Now add high cholesterol to the list. In India and France gugulipid is so effective in treating high cholesterol it’s considered a prescription drug. But in the United States it’s still sold over the counter, often combined with other cholesterol-lowering compounds, such as garlic, macin, and red yeast rice extract. It seems to work by enabling the liver to take in more LDL, thus lowering the amount circulating in the blood. It may also stimulate the thyroid gland, which is involved in cholesterol metabolism (recall from this Chapter that hypothyroidism is a leading cause of high cholesterol)

What the research shows: In studies conducted in India, 205 people with high cholesterol took 500 milligrams of gugulipid a day, After 12 weeks 70 to 80 pereent of the patients saw their cholesterol drop an average of 24 percent and their triglycerides drop an average of 22.6 percent. It took about three to four weeks before cholesterol began dropping, the researchers reported. Additionally, in 60 percent of those whe responded to the gugulipid therapy, HDL levels increased

Who should take it: Anyone with high cholesterol who is looking for an alternative to a prescription drug, particularly if your cholesterol is still ina “gray” zone in whieh medication isn’t specifically recommended

Recommended dose: An effective dose is 75 milligrams of guggulsterones, theactive ingredient in gugulipid, taken in divided doses (25 milligrams three times a day). Read the label carefully to make sure you’re getting the right dosage and a

Warnings/contraindications: Gugulipid may interfere with some medications, such as Inderal (propranolol) and Cardizem (diltiazem). Don’t take it if you have liver disease or inflammatory bowel disease

Red Yeast Rice Extract

Red yeast, grown on fermented rice, has been used in China for more than 1,000 years to improve heart function (and give Peking Duck its red color). It works by blocking an enzyme necessary in the formation of cholesterol and by speeding the removal of LDL from the blood. Think of it as nature’s statin drug. It is so similar to statins, in fact, that the FDA pulled one brand of red yeast rice extract, Cholestin, from store shelves in the summer of 2002, saying it con- tained natural lovastatin, the same compound synthetically produced and sold as the prescription drug Mevacor, Cholestin’s manufacturer quickly reformulated the product using policosanols ther forms of red yeast rice extract, continue to be available over the Internet and through specialty health food stores, individual physicians, and alternative health care providers. Although they haven’t been as closely studied as Cholestin, these alternatives still have some cholesterol-lowering effects and may cost as little as one-fifth the price of prescription statins7), and it’s still sold under the same brand name.

What the research shows: Researchers at the University of California, Los Angeles, studied the benefits of red yeast rice extract on 83 healthy adults with high LDL levels. For 12 weeks the participants received either the extract or a placebo and followed a low-fat, low-cholesterol diet. In the supplement group total cholesterol dropped an average of 46 points after eight weeks. There was no significant decrease in the placebo group. In a larger study conducted at 12 medical centers throughout the United States, 187 men and women with high cholesterol levels took Cholestin for eight weeks. Their total cholesterol dropped an average of 16 percent, from 242 milligrams per deciliter (mg/dl) to 204 mg/dl. Four weeks after they stopped taking the supplement, their counts rose again to prestudy levels.

Who should take it: Anyone with cholesterol levels high enough to require drug treatment, but who doesn’t want bo take a prescription drug, should consider it.

Recommended dose: Follow the manufacturer’s directions.

Warnings/contraindications: Because red yeast rice extract is a natural form of statin, it may have the same side effects as statins, including heartburn, dizziness, muscle weakness, and a very slight chance of liver damage. Don’t mix it with other statin-type cholesterol-lowering medications, although it can be safely combined with niacin supplements. Consider supplementing with coenzyme Q1L0 if you do decide to take red yeast rice extract. Since the extract is a statin, albeit a naturally occurring one, it cam have the same lowering effects on coenzyme Q10 as any of the pharmaceutical s!alitis

Chromium

Chromium is an essential trace mineral first discovered in 1955. Although our bodies contain only a few milligrams, even this tiny amount is cnitical for regulating insulin and blood sugar levels, as well as activating enzymes essential for energy production. We get chromium through food, primarily yeast, grains, nuts, prunes, potatoes, and seafood. But we don’t get enough overall; many Americans are deficient in chromium. One reason is that diets high in refined sugar leach chromium right out of us. Recent studies find that supplementing with chromium may not only lower cholesterol but also help stabilize blood sugar levels and improve insulin sensitivity. Thus, it may be particularly beneficial to people with metabolic syndrome or diabetes,

What the research shows: In one small study of 28 people, those taking 200 micrograms of chromium daily for 42 days had significant decreases in both total cholesterol and LDL, decreases that didn’t occur when they took a placebo. At least eight other studies have found that chromium supplementation improved cholesterol. And numerous studies found supplementing with at least 400 micrograms of chromium improved fasting glucose levels, a sign of improved insulin sensitivity. Be aware that chromium may take several weeks or even months to yield results,

Who should take it: People with metabolic syndrome or diabetes, as well as anyone susceptible to chromium deficiency (including athletes, the elderly, and people who follow diets high in refined sugar),

Recommended dose: 200 to 400 micrograms a day in divided doses for people with insulin resistance; 400 to 1,000 micrograms a day in divided doses for people with diabetes. Use chromium picolinate as your source, For everyone else the amount ina multivitamin should be sufficient.

Warnings/contraindications: If you have diabetes, check with your doctor; taking chromium may alter your requirements for insulin or other diabetes medication.

Coenzyme Q10

Humans naturally produce the vitamin-like compound known as coenzyme Q10, or CoQ10. In fact, e it’s found in every cell in your body. And you get more of this powerful antioxidant through food, primarily = red meat, nuts, dark green vegetables, and vegetable oils. It provides energy for every cell, particularly the heart. Without it your heart wouldn’t have the wherewithal to beat. No surprise, then, that the heart contains higher concentrations of CoQ10 132 than any other tissue, or that people with heart disease have up to 25 percent less CoQ10 than their heart-healthy counterparts. Doctors in other countries commonlyprescribe this supplement for heart disease patients.

Working together with vitamin E, CoQ10 piggybacks on LDL particles as they travel throughout the body, helping to protect them from oxidation. You may remember from Chapter | that LDL becomes much more dangerous to your arteries once it has been oxidized, the biological equivalent of rusting.

Levels of CoQ10 naturally decline as we age, But studies also find that cholesterollowering statin drugs like Lipitor (atorvastatin) and beta-blockers like Inderal (propranolol) deplete CoQ10 by interfering with the body’s ability to make the compound. This may be one reason for the muscle weakness sometimes associated with statins.

What the research shows: While CoQ10 doesn’t appear to have any effects on cholesterol levels per se, it. may help prevent LDL oxidation. At Jeast that’s what one rabbit study suggests. Two groups of rabbits were fed a diet rich in trans fatty acids to raise their cholesterol and triglyceride levels. Then one group received CoQ10 in its rabbit chow. The result? That group had significantly less arterial plaque than the control group. Moreover, the plaque that was present was more stable—that is, less likely to burst and cause a heart attack.

Who should take it: Anyone with a high LDL level and anyone taking a statin drug might consider supplementing with CoQ10 if they can afford it—this supplement isn’t cheap. CoQ10 may also be helpful for people with high blood pressure or congestive heart failure.

Recommended dose: 100 milligrams in divided doses (50 milligrams twice a day). Take it with food to enhance absorption.

Warnings and interactions: Some literature suggests CoQ10 may interact with blood-thinners such as Coumadin.

Psyllium

This source of soluble fiber—the outer coating of the psyllium seed—has been marketed as a laxative for more than 60 years under the brand name Metamucil. But now we know it also has armazing cholesterol-lowering properties, Just 10 grams a day can lower your total cholesterol 5 percent and your LDL 9 percent. Ideally, on the Live Jt Down Plan you’ll be getting all the soluble fiber you need through fruits, vegetables, and beans. But if you don’t fee! you can consistently eat food rich in soluble fiber, try a psyllium supplement.

What the research shows: In an analysis of eight different studies, University of Kentucky researchers found that taking about 10) grams a day of psyllium for eight weeks reduced LDL 7 percent.

Who should take it: Anyone who isn’t getting at least 25 grarns of dietary fiber a day.

Recommended dose: 10 grams a day of an over-the-counter psylliium supplement, such as Metamucil, Citrucel, or Fiberall.

Warnings/contraindications: Take with plenty of water to reduce bloating and gas and prevent constipation.

Arginine

Arginine, or L-arginine, is eventually converted = to nitric oxide in your body. Nitric oxide, you ae — – may recall from Chapter 2, is produced = , mainly in the blood vessel walls. It keeps the = endothelium, or artery lining, smooth and slick, helping to prevent the buildup of plaque. Dietary sources of arginine include oats, eggs, and soybeans.

What the research shows: When John P. Cooke, M.D., Ph.D., associate professor of cardiovascular medicine at Stanford University, gave 43 volunteers large doses of l-arginine (6 to 21 grams a day), blood flow and artery flexibility improved significantly after one week. Cooke also found supplementing with arginine can reduce the stickiness of blood platelets, white blood cells, and even the artery walls in people with high cholesterol. Less stickiness means less likelihood of plaque and clots.

Who should take it: Anyone with impaired endothelium function would likely benefit from taking extra arginine. But since there’s currently no easy way for you to tell if your endothelium function is impaired, consider taking arginine if you have existing heart disease or multiple risk factors for heart disease, and your diet is less than ideal. (If you eat plenty of oats, eggs, or soy, you probably don’t need it.)

Recommended dose: 2 to 3 grams daily in divided doses.

Warnings/contraindications: Side effects may include stomach upset, diarrhea, headache, or shingles. Don’t use it with Viagra since it may cause a dangerous drop in blood pressure. It’s also not recommended for people with cancer or a history of cancer, serious infections, or inflammation.

Hawthorn

Hawthorn is a spiky bush or tree found in Europe, northwestern Africa, and western Asia. It’s considered an extremely valuable medicinal herb, used since the Middle Ages as a remedy for many conditions. Its medicinal properties may be due in part to its high concentration of antioxidants called flavonoids.

What the research shows: Studies suggest that this herb can help reduce angina attacks by improving blood and oxygen supply to the heart by dilating blood vessels. It also guards against LDL oxidation.

Who should take it: We aren’t ready to put everyone on the  Plan on hawthorn supplements because the evidence of its benefits isn’t yet definitive, But if you already have heart disease, or you have high blood pressure or high cholesterol, and you want to do everything you can to lower your risk, it’s probably a good idea.

Recommended dose: 100 to 300 milligrams standardized extract daily,

Warnings/contraindications: Don’t take this if you’re taking a vasodilator. Hawthorn may lower blood pressure and prevent blood clotting. If you are taking any prescription or over-the-counter medications that also have these effects, make sure you talk to your doctor before starting hawthorn.