Edward Leyton, MD, CCFP
Dr Leyton:I am 35 years old, a female and have dangerously high cholesterol. I have just finished nursing my baby and am taking endless supplements to reduce the cholesterol.
Dr Leyton:I am 35 years old, a female and have dangerously high cholesterol. I have just finished nursing my baby and am taking endless supplements to reduce the cholesterol. I'm not sure what is necessary and how much I should be taking of each.
Cholesterol is an essential nutrient used by the body to make steroid hormones and bile acids. However, only small amounts are required for this purpose. Any excess cholesterol is stored by the body and transported attached to a variety of proteins. Cholesterol that is attached to the so-called low-density lipoproteins (LDL) is the kind that can cause problems. Cholesterol carried on high-density lipoproteins (HDL) will protect your heart. The ratio of your total cholesterol (Tc) to your high density cholesterol should be less than five-to-one. A ratio of seven-to-one will raise your risk of heart disease to twice the average. A ratio of 11-to-one will raise your risk of heart disease to three times the average.
A common misconception is that the cholesterol in your diet will always lead to elevated cholesterol in your blood. This is only true for some people who have a genetic predisposition to high cholesterol and whose intake of cholesterol is more than 300 mg/day. The level of cholesterol in the blood is primarily synthesized by the body using any type of food or alcohol.
Any program to change your cholesterol should consist of ways to raise your HDL and lower your LDL. Some suggestions are:
Diet: Make sure you have a diet high in fibre, with plenty of cold water fish such as salmon and a variety of vegetables and fruits. Avoid processed foods which tend to contain large amounts of hydrogenated fat and a particularly dangerous form of fat known as trans-fat. Oat bran is a good cereal to use. Green tea and foods like onions, garlic, chili peppers and shiitake mushrooms all have some cholesterol lowering effects.
Exercise: Optimal aerobic exercise consists of raising your pulse rate into a training zone for 20 minutes three times a week minimum. You can do this safely by walking at a brisk pace for 45 minutes three to four times a week.
Stress Reduction: With a young family it is often difficult to take time to yourself, but this is an important part of your total fitness program. Take a few moments in the day to periodically sit and breathe quietly. Share household duties with your partner so that you can get some time to yourself.
Supplements: Most people can lower their cholesterol without having to resort to supplements. However, if your cholesterol is not significantly lowered by the above regimen you may introduce the following supplements:
Niacin: Vitamin B3 is a powerful cholesterol lowering vitamin, but there have been some side-effects with it. The recommended dose for lowering cholesterol with niacin is 1,000 mg to 3,000 mg daily. One of the harmless but unpleasant side-effects of niacin is a significant flushing and itching that can occur about 30 minutes after taking it. I advise people to begin with a low dose of niacin and gradually build up to the 500 mg three times a day which is the median dose needed to lower your cholesterol. Start with a dose of 50 mg three times a day. Another rare but significant side-effect of niacin is its potential to cause abnormal liver function tests. Although this is usually reversable, you should have your liver function tests monitored both before taking niacin and at weekly intervals while you build the dose up.
Lowering your cholesterol is not an emergency. Take time to find out what changes you need to make to optimize your total/HDL ratio.
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