It's Only Natural
Chapter XVIII
Hyperlipidemia:
You and Your Blood Vessels
The word Hyperlipidemia may be new to many of my readers. Almost everyone, however, has heard of cholesterol and its relationship to heart disease, hardening of the arteries, and a variety of other chronic diseases.
Investigation has shown that not only cholesterol, but also another group of fatty substances-the triglycerides-play an important part in these ailments. Hyperlipidemia may be an elevation of cholesterol, triglycerides or both, and it manifests itself in one of five types of primary lipid metabolic disorders, caused either by an overproduction or deficient removal of cholesterol and/or triglycerides. (These types are no longer used as much as they were twenty years ago when this was first written, but the basic principles are still the same.)
We now realize that what we thought was originally one condition is actually one of five different primary conditions. As if this were not enough, it is also possible that the elevation of the blood fats (Hyperlipidemia) may also be a secondary manifestation of some other disease, the clinical findings of which may be subtle or even absent. This could occur with such diseases as diabetes, hypothyroidism, nephrosis, ciliary obstruction, glycogen storage disease, dysproteinemia and acute pancreatitis, and it may even be associated with other metabolic dysfunctions such as impaired glucose tolerance, hyperinsulinemia and hyperuricemia.
Thus, the condition that was previously treated by simply putting a patient on a low-cholesterol diet has now proved to be very complicated, but it is one that can be diagnosed and properly treated by modern scientific methods. Hyperlipidemia has been called the most endemic disease in America today, and it is undoubtedly the number one cause of death in this country.
Unlike most of the other treatments discussed in this book, this information on hyperlipidemia is in no way unique to our Healing Centers, but it is included here for two reasons. First, we consider such information vitally important to a large percentage of our patients. Second, simple clarified information on hyperlipidemia hasn't yet been made generally available to the public.
To determine if a patient is Hyperlipidemia, we make it routine to run cholesterol and triglyceride tests and electrophoretic phenotyping on all patients in whom we suspect some form of fatty metabolic disorder. We also run these tests on all patients over forty who present themselves for a general physical examination, because it is impossible to determine by symptoms alone which patients are hyperlipidemic. Time and again, I have run such tests on husband and wife because he wouldn't have it unless she did, only to find that the presumably healthy wife had hyperlipidemia, whereas the great concern for her husband was unfounded.
Owing to the growing interest in this condition among physicians generally, the costs of such tests have come down considerably in the last year and can now be given to almost every patient at moderate expense.
If the patient has elevated blood cholesterol or triglyceride levels, but isn't one of the five primary phenotypes of hyperlipidemia, the physician must search for possible primary diseases that may be causing secondary hyperlipidemia. When any one of these primary diseases is found, its proper treatment should correct the blood lipid levels.
It is interesting to note in this connection that impairment of the glucose tolerance level is often present in phenotypes 3, 4, and 5, and some authorities suggest that a standard oral glucose tolerance test should be done in every subject with hyperlipidemia, regardless of the type suspected. Often hyperinsulinemia (overproduction of insulin) may be present with decreased glucose tolerance. When hyperinsulinemia is present, the physician must be careful to avoid drugs that adversely affect glucose metabolism. Prime examples of these drugs are thiazide diuretics.
Many authorities recommend that thiazide diuretics be avoided in the patient with elevated blood lipids. Unfortunately, many patients with elevated blood lipids also have high blood pressure and one of the most common groups of prescribed drugs for high blood pressure is the thiazide diuretics. Many authorities have noted that blood uric acid levels are often elevated in patients with elevated triglyceride levels and so a uric acid test should be run on each patient with hyperlipidemia. Interestingly, thiazide diuretics also tend to increase the uric acid level and therefore in another instance may again increase the problems of hyperlipidemia.
Although a relation between gallstones and hyperlipidemia hasn't been established, many authorities suggest there is a high frequency of these two conditions occurring concomitantly, therefore making it advisable to check patients who have elevated blood lipid levels for gallstones.
The treatments of most of the primary hyperlipidemias are centered around dietary restrictions. Some drugs are available, but most are toxic and are prescribed even by the most conservative physicians only after dietary restrictions have obviously failed.
The specific dietary recommendations for each of the five different primary types of hyperlipidemia differ from each of the others. Therefore, any form of dietary suggestion can only be given after a patient has been thoroughly examined and the proper electrophoretic tests given. Any attempt to treat hyperlipidemia without full and complete diagnostic measures is useless.
With the recent knowledge of fat metabolism and its effects on the body, it is now theoretically possible to stem the rising incidence of cardiovascular deaths. Our main objective now is one of testing as many of our patients as possible so we can detect the specific type of lipid disorder and take corrective measures early in disease to prevent disastrous future events.
The above was written twenty years ago and while many new ideas about this condition have come and gone most of what we wrote then is still germane today.
The following is a paper prepared on this subject by Dr. William Kracht, D.O. one of our most dedicated physicians.
Diet, Lifestyle, and Nutritional Supplements
For Your Heart and Blood VesselsThe cause of atherosclerosis, or plaque formation on the blood vessel walls, is not limited to just one factor. Genetics indeed play a role, but this inheritance factor can be modified by our diet, lifestyle and behavior. Heavy metal accumulation in the body's tissues (iron, lead, mercury and cadmium) can promote this plaque formation. Food allergies can damage the lining of the artery wall. Chlorine and fluoride may also play a role in this process. Low levels of anti oxidants in the body combined with elevated "free radical" molecules can change the cholesterol and fats in the body to "more aggressive floggers." Partially hydrogenated fats found in processed foods and oils are not metabolized in the body and thus become stuck in our cell walls and act to block normal cellular metabolism. High sugar, high fat and low fiber in our typical American diets are known to accelerate this plaque formation. Lastly, tobacco use, alcohol consumption combined with a sedentary lifestyle and the stresses of modern life promote the development of heart and blood vessel disease seen today. The following is a brief outline covering diet, lifestyle and nutritional supplements important in preventing and treating heart and vascular disease.
Best Diet for the Heart
The best diet to lower your blood cholesterol and fats and help protect the heart and blood vessels from "clogging" is a high complex carbohydrate, high fiber, low fat diet with the addition of vegetables for trace minerals and certain other beneficial foods and supplements. Cholesterol actually plays a small part in this big picture. The amount of cholesterol in our food accounts for only 10%-20% of the body's total cholesterol. The remaining 80-90% is manufactured by the liver and intestines from fats, proteins and certain forms of carbohydrates (starch) in your diet. Thus, the goal is to decrease the "bad" fats, sugars and proteins that lead to cholesterol synthesis and substitute better foods for your heart and blood vessels. The following are guidelines are given as an addition and emphasis to the Basic Maintenance Diet (see Diet Appendix):
High Complex Carbohydrates
Eat no simple sugars. Avoid foods and beverages that have sugar listed as one of the first three ingredients. These include cakes, candies, ice cream, certain cereals, Jell-O, ketchup, etc.. Remember all excess sugar is converted into fat. Sugar may play a larger role in heart and blood vessel blockage than cholesterol.
Use no white flour or products that contain white flour. Raw unfiltered honey, unsulphured black strap molasses, pure maple syrup and date sugar may be used in small amounts as acceptable sweeteners.
Follow the recommendations on high complex carbohydrates in the Basic Maintenance Diet.
High Fiber
Oats (oatmeal, oat bran) and legumes (dried beans, peas and lentils) are the best whole food fiber foods to lower cholesterol.
Flax fiber and psyllium are good fiber sources. The least expensive method is to buy whole flax seeds (store them in the freezer) and grind 2 tablespoons in a blender for 15-30 seconds and then use the powder to your desire. You also gain the benefit of the good oils (essential fatty acids) from the flax seed in addition to its fiber benefit. If psyllium is used, 1 tsp three times per day (1 tablespoon per day total) of the pure powder is recommended.
Oat bran, 3-4 tablespoons per day may be supplemented to the diet to give 15-20 grams of nutritional dietary fiber. It can be stirred into juice, water or added to cereal or baked into baked goods.
Low Saturated Fat
Pay particular attention to the section of "Fats" in the Basic Maintenance Diet. Avoid fried food as the devil avoids holy water.
Olive oil is the best oil for lowering cholesterol. If you like sardines of tuna, try to obtain these packed in olive oil. Make your own salad dressing with olive oil. Buy extra virgin.
No hydrogenated vegetable oils. This includes margarine. Again, a little butter may be better than margarine but try to use olive oil any time you want to use butter or margarine.
Keep fatty meats to a minimum, instead substitute cold water fish that have the "good" fish fats: haddock, salmon, sardines, mackerel, herring, flounder. Fish with lowest levels of mercury include pollack, salmon, bass, sole, cod, haddock, flounder and shellfish
Cholesterol
The most important aspect of cholesterol in foods to understand is the fact that cholesterol is changed when exposed to high temperatures (it becomes oxidized) making it even more likely to cause "clogging" of the blood vessels, thus adding fuel to the fire. When it comes to honestly viewing cholesterol, it is the oxidized form that really causes problems. The best way to understand oxidation is to look at rust. Rust result from metal that has become oxidized. The same process happens to our body's tissues when internal oxidation occurs. Again, avoiding fried foods is one of the best ways to prevent this internal oxidation.
Eggs in moderation are all right occasionally providing you are following the rest of this diet. You may poach, soft boiled, or lightly scramble (low heat) but don't hard-boil or fry (again, this causes oxidation). Egg beaters are not recommended as they have partially hydrogenated fatty oils and a higher content of oxidized cholesterol!
Beverages
Avoid tap water than contains chlorine and fluoride. Chlorine may cause blood vessel wall damage and fluoride is toxic to nervous tissue. Use bottled spring water preferably in glass.
Avoid coffee, black tea and cola. If you choose decaffeinated coffee, be sure to obtain water processed and not chemical processed decaffeinated brands (Sanka and Brim). Herbal teas (especially ginger) are preferable as are coffee substitutes such as Postum and Pero.
Avoid alcohol. It is high in sugar and increases the risk of heart disease. The only exception may be small amounts (1 glass or less per day) of red wine. However, wine contains sulfites and pesticide residues and this should be taken into consideration. Try naturally sparkling spring water with lemon or lime as your social drink
Miscellaneous Foods to Help Lower Your Risk of Heart Disease
Use ginger, garlic and onions liberally. These foods can help lower cholesterol levels and decrease the stickiness of platelets thus decreasing the possibility of blood clots. Garlic can also raise HDL levels. Garlic and onion have the additional benefit of helping the liver's detoxification ability.
Grapefruit has been shown to be very effective in lowering blood cholesterol levels, probably from its fiber content. Soybeans (topic) and other vegetable protein in place of meats and dairy products. Soy has very low fat and has been found to lower cholesterol levels. Alfalfa sprouts-Have been shown to regress blood vessel plaques in monkeys. Make liberal use of sprouts. Cultured milk products-yogurt, kefir, buttermilk, Pineapple, chickpeas (humus), eggplant are all able to help lower blood cholesterol levels.Use ginger and cayenne pepper as spices instead of salt.
Lifestyle and Behavior Modifications
Discontinue all uses of Tobacco products. Tobacco products are probably the number one cause of heart disease and blood vessel clogging. Statistical evidence reveals a mean increase of about 70% in the death rate and a 3-5 fold increase in the risk of heart artery disease in smokers compared to non smokers. No program can be assured of success while continuing the use of tobacco products. If you are undergoing chelation, tobacco products are capable to completely defeating the action of EDTA due to the release of killer free radicals. Tobacco is admittedly one the most addictive substances commonly used. If discontinuing tobacco products is difficult for you, please let us know so that we may help establish a cessation program for you.
Exercise
Exercise is protective against heart disease. Exercise is also one of the few tools we have for raising the good HDL cholesterol in the blood. A carefully graded, progressive, aerobic exercise program is a necessity. The best program to start is simply walking. Start slowly if you have not been exercising and slowly increase the amount of time to 30 to 60 minutes 3-5 days per week. If possible, try to reach a pace of 15 minutes per mile. Although not really aerobic exercise, Tai Chi can also be added for muscle stretching and motion. If you are over 50 or have known heart or vascular disease, do not start an exercise program before talking to your Center doctor.
Stress Management Techniques
Stress Management Techniques are an integral part of a heart and blood vessel program. Dr. Dean Ornish found it to be of utmost importance to his success in treating heart disease but also the most difficult for his patients to follow. Autogenic training is the word we like to use to describe stress management techniques. The stress response in the body has been shown to raise cholesterol levels, raise blood pressure, and cause spasm of the blood vessels in the heart. This is quite evident as more heart attacks occur Monday mornings than any other day of the week. At our Healing Centers, we have available autogenic training tapes and other self biofeedback exercises than can be done in the comfort and privacy of your own home. These tapes and stress management techniques are inexpensive and essential in preventing the progression of many types of medical conditions, and moreover, are essential in helping to reverse them.
Supplements
The following briefly discusses some of the more common nutritional and herbal substances that may be beneficial in heart and vascular diseases. Your Center doctor will outline a program to meet you individual needs.
Vitamin C-Helps to prevent the accumulation of cholesterol plaques on the blood vessel walls. It also helps repair tiny "cracks" in the blood vessel walls that act as a nidus for blood clot formation. It also functions as one of the body's chief antioxidant Recommended doses range from 1000-6000 mg. Per day.
Vitamin E-Another antioxidant-prevents platelet stickiness and may increase good HDL levels. Recommended doses range from 200-1200 IU/day.
Antioxidant Formula-A balanced antioxidant formula that combines both vitamins, minerals and plant substances that act as potent antioxidants and free radical scavengers is recommended.
Magnesium-is probably the most important mineral in heart and blood vessel disease. It is nature's "calcium channel blocker" and helps relax tense vessels and muscles and promotes proper function of the heart and blood vessel cells. Recommended doses range from 300 1000 mg/day. The glycinate, malate and citrate forms appear to be the best absorbed and utilized.
Calcium, Zinc, Copper, Chromium and Selenium-are all other trace minerals essential to help lower blood fat levels and promote normal functioning of the heart and blood vessel cells. A balanced high potency trace mineral supplement in recommended.
Vitamin B6 and Folic Acid-are important if the homocysteine levels in the blood or urine are elevated. Elevated homocysteine levels have been demonstrated as a risk factor for vascular disease.
Niacin-in the form of "inositol hexaniacinate" is a very effective cholesterol lowering nutrient. It also elevates good HDL and also lowers triglycerides. Dosages range from 300- 1,800 mg/day.
Carnitine (or Acetyl L-Carnitine)-is a type of molecule that is synthesized from the amino acid lysine and functions to helps the heart muscles to utilize oxygen from the blood. Doses up to one gram a day may be used.
Lecithin granules (from soybean)-Helps lower cholesterol and free fats (triglycerides) and may increase HDL levels. Doses of 1-2 tablespoons per day are recommended.
Pantethine-is especially helpful for elevated cholesterol levels and angina symptoms. Doses range from 300-1200 mg/day.
Essential Fatty Acids-At this time we recommend flax seed oil for your essential fatty acid supplementation. Doses range from 1-2 tablespoons per day. Keep the bottle in the refrigerator and use it within one months time from opening. One may also use fish oil pills but there is a recent concern over their mercury content. Doses for the fish oil pills (Max EPA ) are 1-2 pills three times per day with meals or one may use Cod liver oil, 1 tablespoon per day; it is cheaper than fish oil pills. You may want to alternate the flaxseed oil and cod liver oils every other day. Be sure to buy small bottles, add 800 IU of Vitamin E oil (it acts as a preservative) and keep them in the refrigerator.
Gugulipid-is the extract from the mukul myrrh tree native to India and demonstrates significant cholesterol and triglyceride lowering effects and without side effects.
Ginkgo Biloba-is a extract from the ginkgo tree leaves and has been shown to promote blood flow, especially in the brain. It is also a very potent antioxidant.
Coenzyme Q-10-is a substance demonstrated to promote normal heart function and may be helpful in heart failure and angina
Cratageus and Hawthorn are other plant remedies that demonstrate favorable effects upon the heart and blood vessels.
Thus we have for you some of the most up-to-date information to help you prevent a build up in the blood vessels of plaque, America's most serious killer. Let me implore you however to not attempt to treat yourself for this problem. The information is constantly changing and it is the responsibility of our Center physician to keep abreast of all that is new. Let him (or her) guide you in this field especially, since the path to cleaner blood vessels is fraught with many unseen dangers.
Summary
Of all the chapters in this book, this could be one of the most important to your own life. I want to emphasize one simple message: If you are in middle life, and have not had a complete lipid profile you may be in danger. Let your Center physician know that you what this test.