Hyperlipidemia is a rather generic name for elevated cholesterol and/or triglycerides. Cholesterol and triglycerides are the two main "fats" that are measured in the blood. Cholesterol is transported in the blood stream by three main components: very low density lipoproteins (VLDL), low density lipoproteins (LDL), and high density lipoproteins (HDL). VLDL and LDL are mainly responsible for transporting cholesterol and triglycerides from the liver to other cells of the body (muscle, adipose tissue, etc), and HDL is responsible for moving cholesterol and triglycerides from these cells back to the liver and thus out of the body. Basically VLDL and LDL move fat into the body and HDL moves it out. This is why VLDL and LDL are considered the "bad cholesterol" and HDL is considered to be the "good cholesterol" - a very simple consideration. An excess of VLDL and/or LDL is associated with an increased risk of atherosclerosis and thus heart attack (myocardial infarction or MI) and stroke, whereas a greater level of HDL is associated with a lower risk.
Current recommendations are (fasting measurements):
Total cholesterol less than 200
LDL less than 160 if you do not have coronary heart disease (CHD) and
fewer than two risk factors
LDL less than 130 if you do not have CHD and have 2 or more risk
factors
LDL less than 100 if you have CHD or Diabetes
HDL greater than 40
Triglyceride less than 150
The ratio of total cholesterol to HDL and the ratio of LDL to HDL are considered when determining cardiac risk factors. The higher the ratio of total cholesterol to HDL, the ratio of LDL to HDL, or the ratio of triglycerides to HDL, the greater the risk.
The most common reason for elevated cholesterol and triglyceride levels is diet and lifestyle, though genetics can play a role as well. Cholesterol levels also tend to increase with age and diabetes, due in part to the one of the mechanisms responsible for genetic causes of elevated cholesterol/triglycerides - damage to the LDL receptor. Dietary and lifestyle modifications are essential to treat any form of high cholesterol (hyperlipidemia), though will have a more profound effect on non-genetic related causes.
Lifestyle modifications include increased exercise and weight loss. Exercise will increase the levels of HDL and decrease the levels of LDL, resulting in less cholesterol stored in cells and more excreted. The benefits of weight loss should be obvious, as the weight that is lost will mostly be FAT.
If you are diagnosed with hyperlipidemia, not matter how high the levels, the first steps will be to increase your exercise and change your diet as outlined below. If you smoke, stop. If you drink alcohol, limit your intake to no more than two drinks per night, and limit your intake of beer and liquor as much as possible. It is reasonable to try non conventional therapies before resorting to drugs such as the statins, since these (though remarkably effective) drugs can be dangerous to the liver.
A diet high in saturated fats, high in refined carbohydrates, and/or low in fiber will lead to elevated cholesterol levels. Thus it would seem reasonable to limit saturated fats and refined carbohydrates and increase your intake of fiber (vegetables and fruits).
Brief recommendations:
Consume more dietary fiber (vegetables and fruits, or psyllium)
Limit refined carbohydrates.
Eat foods as natural and unprocessed as possible.
Eat non-starchy vegetables.
Eat less natural carbohydrate-dense foods.
Do not drink soft drinks, fruit juices or alcohol.
Use olive oil only, not regular vegetable oils.
Eat more omega 3 FA whenever possible.
Avoid trans-fatty acids.
For more information, see the expanded section on dietary recommendations.
Niacin (vitamin B3) is well established as a treatment for high
cholesterol. At therapeutic doses niacin can decrease total and LDL
cholesterol by up to 25%, triglycerides by up to 50%, and increase
HDL by up to 25%. At the doses necessary for lowering of cholesterol,
the side effect of skin flushing and the possibility of liver damage
are important considerations. Inositol hexaniacinate was developed in
Europe to decrease the incidence of skin flushing. It is the
recommended way to take niacin to lower cholesterol. The extended
release forms of niacin are not recommended, as they have a higher
incidence of liver toxicity.
Dose (of inositol hexaniacinate): 500 to 1000mg three times
daily, taken with food.
Safety concerns: Side effects: skin flushing, stomach
irritation, itching, headache, potentially liver toxic (inflammation)
- all resolve with discontinuing nicain. Must be used under the
supervision of your physician, as periodic liver enzyme checks are essential.
Studies have established garlic as an effective treatment for
lowering cholesterol, decreasing total cholesterol by 9 to 12%. Most
researchers feel that the prime active ingredient is alliin, a rather
volital substance that quickly degrades to allicin once the clove is
cut or crushed. Though raw garlic is the most reliable form of
alliin, due to its strong odor and the amount necessary for
therapeutic doses, it is not the most desirable form. Preparations
that are standardized to a guaranteed alliin content are preferred.
Dose: 900 mg daily, extract standardized to contain 1.3%
alliin (12 mg alliin). Expect at least 1 to 4 months for desired effect.
Safety concerns: Generally safe at recommended doses, but care
should be observed if also taking any type of blood thinning
medications including ginko biloba and vitamin
E.
Preliminary studies have confirmed the effectiveness of gugulipid or guggul,
an extract from the Indian mukul myrrh tree. A reduction of about
11% for total cholesterol (decreasing LDL levels and raising HDL
levels), and 17% for triglycerides have been demonstrated.
Dose: 25 mg of guggulsterone three times daily.
Safety concerns: Generally safe at recommended doses.
Fiber
It is well known that increased dietary fiber leads to lower
cholesterol levels. Though fiber obtained through a diet high in
vegetables and fruits is superior, oat bran and psyllium are
acceptable supplemental alternatives.
Dose:
Recent evidence indicates that soy protein can reduce total
cholesterol by about 9%, LDL cholesterol by 13%, and triglycerides by
10%. It is thought that isoflavones
are the active ingredient.
Dose: 25 g daily. (1/2 pound of tofu or 2 1/2 cups of soy milk).
Safety concerns: May not be safe in women with history of
estrogen receptor positive breast cancer (isoflavones
are phytoestrogens, having weak estrogen-like activity).
Elevated cholesterol increases your risk of heart attack and stroke. It is becoming increasingly common in our society, part of a collection of illnesses called Syndrome X, that is largely the result of a diet high in highly processed carbohydrates and low in fiber, as well as an alarming lack of routine exercise. Total cholesterol over 200 is considered to be too high. Current recommendations for HDL, LDL, and triglyceride levels are dependent upon certain risk factors. Initial treatment is based on lifestyle modification that includes a change in diet and an increase in the level of exercise. In most cases, following the dietary guidelines outlined here, and a serious commitment to regular exercise can bring cholesterol levels within the recommended range. There are several natural treatments than can be used as an adjunct to diet alone, or even with cholesterol lowering medication.
Consume more dietary fiber (vegetables and fruits, or psyllium)
Limit refined carbohydrates.
Eat foods as natural and unprocessed as possible.
Eat non-starchy vegetables.
Eat less natural carbohydrate-dense foods.
Do not drink soft drinks, fruit juices or alcohol.
Use olive oil only, not regular vegetable oils.
Eat more omega 3 FA whenever possible.
Avoid trans-fatty acids.
Niacin: (inositol hexaniacinate):
500 to 1000mg three times daily, taken with food.
Garlic: 900 mg daily, extract
standardized to contain 1.3% alliin (12 mg alliin). Expect at lest 1
to 4 months for desired effect.
Gugulipid: 25 mg of guggulsterone
three times daily.
Fiber: Psyllium: 10 g with each meal; Oat bran: 5 to 10 g with
each meal.
Soy Protein: 25 g daily. (1/2
pound of tofu or 2 1/2 cups of soy milk).