Extra Ammo for High Cholesterol


Some supplements work. Some work against you. Know the difference.

Are you one of the 143 million people in the US with borderline-high (200 to 239) or high (240 and up) cholesterol levels? Maybe you're taking a statin (a safe, very effective prescription drug) to lower cholesterol, but you need more help. Or maybe statins just aren't right for you, and you'd prefer a nonprescription supplement Stop! Before you buy just any supplement claiming to cut cholesterol, find out what works and what's safe.

Phytosterols and Phytostanols

These compounds, refined from soybeans or pine trees, really work: Studies show that they cut bad LDL cholesterol by an average of 10 to 15%. In fact, if you have borderline-high cholesterol that you can't reduce with a heart-healthy diet and exercise, the government's National Cholesterol Education Program now recommends adding 2 g of sterols or stanols a day to your diet.

What's new is that you no longer need to purchase special margarines and salad dressings such as Benecol and Take Control to get these compounds. You can now get sterols and stanols in pills, such as Cholesterol Success by Twinlab (120 tablets, $18 to $30) and Cholestatin by KAL (60 tablets, $12). (See "Get the Most out of Sterols and Stanols' on p. 70.)

Already taking a statin? "Adding phytosterols to statins will result in additional cholesterol lowering," according to Alice Lichtenstein, DSc, professor of nutrition science at Tufts University and vice-chairperson of the American Heart Association,s nutrition committee. Just don't quit your statin. 'Phytosterols are not as potent. If your doctor says you should be on a statin, there's a reason for it," adds Dr. Lichtenstein. Neither sterols nor stanols have any known interactions with prescription drugs.


Guggulsterone comes from the guggul tree in India, where it's been used to treat ailments for 3,000 years. Indian studies have reported that guggulsterone lowers cholesterol, and a new US study confirmed that effect, at least in animals. But the researcher, David Mangelsdorf, PhD, professor of pharmacology at the University of Texas Southwestern Medical Center, has good news and bad news.

"Guggulsterone definitely helps the body rid itself of cholesterol, but it has a downside as well: It interacts with a number of drugs." Of particular concern is that guggulsterone can prevent cholesterl--lowering statin drugs from working. The bottom line: According to Dr. Mangelsdorf, more research is needed. Definitely don't try guggulsterone (also known as guggulipid) before consulting your doctor, particularly if you take any other prescription drugs.


Policosanol, made from sugarcane or beeswax, is getting buzz because of clinical trials performed in Cuba that reported that it lowered LDL cholesterol dramatically. But there's concern that all of the policosanol studies have been performed by the same researchers. "It's always better if we have several independent groups studying a product; it makes the results more convincing,' says Dr. Lichtenstein. Other concerns: We don't know whether policosanol interferes with prescription drugs. Also, it may thin the blood, so it's best not to mix it with other anticoagulants such as Coumadin or aspirin. Bottom line: Consult your doctor before trying policosanol.

PHOTO (COLOR): First in margarine, now in pills: a proven cholesterol cutter.


By Allison Sarubin, Fragakis, RD

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