Here’s another question I asked Dr. Cynthia Shelby-Lane and her answer.

Lisa Nelson RD: Should individuals with low HDL levels receive treatment even if all other levels are normal?

Dr. Shelby-Lane: According to ScienceDaily (May 29, 2005) — High circulating levels of the “good cholesterol” HDL are associated with decreased risk of cardiovascular disease. HDL helps the liver excrete extra cholesterol by binding to a receptor in the liver called scavenger receptor-BI (SR-BI). However, the signaling events between HDL and SR-BI that afforded heart healthy benefits were not known.

In a study appearing online on March 24, 2005, in advance of the April 1, 2005 print edition of the Journal of Clinical Investigation, Philip Shaul and colleagues from the University of Texas Southwestern Medical Center examine the following pathway:

The authors show that HDL activates an enzyme called eNOS and sets off a cellular signal that depends on cholesterol efflux and two intact domains of SR-BI — the transmembrane domain and its cytoplasmic tail. These regions of SR-BI may serve as “cholesterol sensors” which set into motion cellular events to activate eNOS. This may be the mechanism responsible for the ability of HDL to reduce cardiovascular disease risk.

Lisa Nelson RD: Again, let’s clarify. If an individual has low HDL levels they should seek treatment even if all other cholesterol levels are normal. Correct? Correct?

Dr. Shelby-Lane: Again, a low HDL is an isolated risk factor and should be included in the overall health picture, and can be modified with diet, nutrition, and some newer drugs.

February is American Heart Month. In recognition of American Heart Month you can access Heart Health Made Easy at a 25% savings. Learn more about this take action guide to lower cholesterol and blood pressure at http://www.hearthealthmadeeasy.com.

All the best,
Lisa Nelson RD
How to Lower Cholesterol in 8 Simple Steps

Here’s another question I asked Dr. Cynthia Shelby-Lane and her answer.

Lisa Nelson RD: Is it safe for individuals taking medication for heart disease, such as Lipitor, to eat grapefruit or drink grapefruit juice?

Dr. Shelby-Lane: I am including information that may help answer your question about grapefruit and a variety of nutritionals that affect statin drugs for the lowering of cholesterol.

Zocor (Simvastatin), for example, is a Statin drug, used to lower high cholesterol levels, and also known as HMG-CoA reductase inhibitor. Zocor may affect the absorption or utilization of vitamins E and coenzyme Q10. Tests showed the average concentration of coenzyme Q10 in blood plasma decreased by approximately 50% after statins were used for 30 days. Supplementation is considered beneficial.

Grapefruit and grapefruit juice may increase the effects of HMG-CoA reductase inhibitors and should not be consumed at the same time. It is suggested that these medications be taken with water. Grapefruit contains substances that may inhibit the body’s ability to break down statin drugs increasing the toxicity of the drug. Muscle pain, tenderness, or muscle weakness may be a result. If you begin to notice these symptoms, contact your doctor.

Niacin is the form of vitamin B3 used to lower cholesterol. Large amounts of niacin taken with a statin drug may cause serious muscle disorders (myopathy). Reasonable levels of niacin combined with statin drugs have been shown to enhance the cholesterol lowering effect. For proper dosage, consult your physician before taking niacin.

Pomegranate juice has been shown to inhibit the same enzyme inhibited by grapefruit juice. This may cause reactions similar to grapefruit juice when it is used with statin drug treatments.

A study of 37 people with high cholesterol treated with diet and statin drugs found vitamin A increased in the blood over two years of therapy. People taking statin drugs and vitamin A supplements should have blood levels of vitamin A monitored.

Magnesium and aluminum containing antacids were reported to interfere with statin drug absorption. To avoid this interaction, take statin drugs two hours before or after any aluminum/magnesium containing antacids. Some magnesium supplements such as magnesium hydroxide are also antacids.

It should be noted that doctors often recommend supplementing with 100 mg of coenzyme Q10 per day for maintaining healthy levels. However, those on statin drugs may have a greater need for a higher dose. It further should be noted that the symptoms associated with the combination of grapefruit juice and statin drugs (muscle weakness and discomfort) are commonly reported as symptoms associated with CoQ10 depletions. Supplementation with coenzyme Q10 is strongly recommended.

The herbs Artichoke plant, Garlic and Plantain may decrease blood cholesterol levels, and therefore enhance the effects of Zocor. Consult with your pharmacist or physician before taking them.

All the best,
Lisa Nelson RD
Be Heart Healthy and Lose Weight