Speaking of drugs that are promoted directly to the public, cholesterol-lowering medications are among the most widely advertised. These drugs are hugely promoted because they are generating enormous profits for the manufacturers. Numerous studies show that they are effective in reducing cholesterol but this does not tell the whole story.

Such pervasive promotion diverts attention, not to mention resources, from dietary controls and natural substances that are even better than the drugs, but far less expensive. The ads offer drugs to control a problem that usually has its roots in lifestyle, so people may easily get the idea that they can ignore their diets, since the drugs will correct the effects of their poor choices. In addition, because these ads are paid promotion, rather than public education (although the companies often refer to their ads as informational), they minimize the potential drug side effects and costs.

For example, one of these drugs, Baycol (cerivastatin) was removed from the market when it was discovered that the side effect of muscle degeneration was far more frequent than expected. This side effect, called rhabdomyolysis, leads to muscle breakdown products passing through the kidneys and causing kidney failure and death. Other statins can also cause this side effect, as well as hepatitis, jaundice, other liver problems, susch as liver cancer, gastrointestinal upsets, reduced platelet levels, anemia, joint pains, headache, sore throat, runny nose, and skin rashes. It is unfortunate that the public does not have the opportunity for balanced education about these products.

A study published in the Journal of the American Medical Association shows that even though statin drugs lower cholesterol, they also lower serum levels of valuable antioxidants. For example, they cause a 20 percent decline in beta-carotene, a 16 percent drop in vitamin E, and a 22 percent reduction of coenzyme Q10, all of which are important nutrients for the heart.

These researchers were actually studying how a diet rich in vegetables, fruits, nuts, and whole grains can lower cholesterol in addition to any lowering effect from the statins. What they found was that diet still plays an important role in managing cholesterol. In addition to its safety, it has many other benefits unrelated to the heart.

This study showed another damaging effect of the statins: an increase in serum insulin levels. Insulin is essential for maintaining a normal blood sugar, but high levels are associated with a condition called insulin resistance, a risk factor for heart disease and the development of diabetes. The diet reduced serum insulin levels, reversing some of the negative drug effects.

While you may not have heard of it, a substance called octacosanol is more effective than the statin drugs in lowering cholesterol, and it has other benefits also. This is the main component of a complex called policosanol, and the research is impressive. In studies doing direct comparisons with statin drugs, the octacosanol was superior.

Octacosanol is a waxy alcohol derived from sugar cane or wheat germ. In a study of octacosanol and Pravachol (pravastatin), 10 mg daily of either product lowered LDL- cholesterol by 19.3 percent, the drug only 15.6 percent, it lowered total cholesterol by 13.9 percent (the drug only 11.8). The drug did not affect triglycerides or HDL, but octacosanol raised the good HDL by 18 percent, and lowered the triglycerides by 14 percent.

The change in the ratio of total cholesterol to HDL was lowered 25 percent by octacosanol, compared to only 15 percent by pravastatin. Inhibition of platelet aggregation reduces heart disease, and this effect was greater with octacosanol than the drug. Further, octacosanol protects the LDL from oxidative damage, and oxidized LDL is the most damaging form.

From all this information, octacosanol is clearly a superior choice: it is without side effects, and it is far less expensive than the medications.

These benefits have been known for more than ten years, but clearly the vast majority of people know of the drugs, while the natural and inexpensive alternative remains mired in obscurity.

Other dietary supplements also help maintain healthy cholesterol levels and reduce heart disease risk. Niacin, or vitamin B3, lowers cholesterol, and appears to have some of the same antiinflammatory effects as the statins, apparently a part of their benefit profile. Slow release niacin does not cause as much of a flush reaction as the plain niacin, but it has caused some
liver function abnormalities in a few patients. Taking a
non-flush form of niacin, inositol hexaniacinate, provides the same cholesterol effects without the liver changes, but it is more expensive. Effective niacin doses are 1500 to 3000 mg daily. Vitamins E and C reduce total cholesterol and raise HDL levels, but not as much as octacosanol. They also protect the LDL from oxidation, and in clinical studies they reduce heart disease. It is impossible to get therapeutic levels of vitamin E (400 to 800 IU) from the diet. Vitamin C is easier to find in foods, and on a diet rich in raw fruits and vegetables it is possible to get over 2000 mg daily, but it is likely that you will need supplements to get this amount. The bioflavonoid quercetin is anti-inflammatory and inhibits oxidation of LDL.

Chromium supplements in the range of 200 to 400 mcg daily reduce total cholesterol and raise HDL levels, and up to 1000 mcg also help control blood sugar levels. As diabetes is a heart risk factor, this in itself is an important benefit.

In earlier issues, I have discussed the benefits of red yeast rice, pantethine, garlic, and L-carnitine, but octacosanol appears to be one of the best supplements for the heart, particularly when combined with exercise and plus fish with omega-3 oil and the healthiest oil in the world – coconut oil.