~Atherosclerosis (Coronary Artery Disease), Part 6 - Summary

SUMMARY
  • To inhibit oxidation of LDL
  • To lower cholesterol levels
  • To inhibit formation of atherogenic homocysteine
  • To inhibit formation of arterial blood clots
  • Additional Suggested Supplements
Nutritional supplements are multifaceted therapeutic agents. Nutrients often participate in a variety of biochemical functions, affording them diverse mechanisms impacting multiple health conditions. In this summary, only the function specific to the heading will be illustrated. The reader is strongly advised to consult the foregoing text for a full description of the therapeutic potential of each of the nutrients. A compendium of each of the highlighted nutrients also appears in the protocol Cardiovascular Disease: Comprehensive Analysis.

Nutritional supplements listed in the summary contribute to the prevention of atherosclerosis and arterial blockage by:
  • Lowering and inhibiting the oxidation of cholesterol and LDL
  • Improving HDL levels
  • Lowering serum triglycerides, fibrinogen, blood glucose, homocysteine, and iron levels
  • Inhibiting abnormal blood clot formation
  • Reducing inflammatory markers such as C-reactive protein
To inhibit oxidation of LDL:
  1. Coenzyme Q10 works synergistically with vitamin E to prevent LDL oxidation. Use 30 to 400 mg daily. Life Extension's CoQ10 emulsified formulation significantly increases the amount of CoQ10 absorbed into the bloodstream compared to previous versions.

  2. Garlic protects against the oxidation of LDL and arterial wall damage. Use 1200 to 2400 mg twice daily with meals.

  3. Life Extension Herbal Mix: This formula contains pharmacological levels of premium-grade herbal extracts that provide protection against oxidized LDL. Among the ingredients contained in the herbal mix are green tea (which contains large amounts of catechin flavonoids to protect against the oxidation of LDL); ginkgo biloba (thought to protect LDL against oxidative stress caused by superoxide, peroxyl- and hydroxyl-radicals); grape seed-skin extract (short-term ingestion of purple grape juice reduces the susceptibility of LDL to oxidation in coronary artery disease. The prevention of LDL oxidation is a mechanism by which flavonoids in purple grape products may prevent adverse cardiovascular events, independent of alcohol use); bilberry extract (because bilberry protects cholesterol from oxidizing in test tubes, it is theorized that it protects against arteriosclerosis). The suggested dose of Life Extension Herbal Mix is 1 tablespoon mixed with water or juice, taken early in the day.

  4. Life Extension Mix contains a potent spectrum of antioxidants that have been shown to inhibit the oxidation of cholesterol. The mix's trace elements zinc and selenium are essential elements required for the activity of antioxidant enzymes, thus providing physiological antioxidant protection. Use 3 tablets, 3 times per day, preferably with meals.

  5. Policosanol's many biochemical properties include protecting LDL against oxidation. Some individuals need only 5 to 10 mg of policosanol while others require 20 mg a day.
To lower cholesterol levels:
  1. Artichoke extract: A suggested dosage is one capsule three times per day, containing 300 mg of artichoke standardized to contain 13-18% caffeoylquinic acid.

  2. Chromium: The trace mineral chromium is noted for modulating blood glucose levels and reduces cholesterol. For most individuals, 500 -1000 mcg of chromium daily is recommended.

  3. Ginger reduces cholesterol levels by impairing cholesterol absorption and encouraging the conversion of cholesterol to bile acids (the synthesis of bile acids is the predominant route for excretion of cholesterol). Use 300 to 600 mg, 1-3 times per day.

  4. CLA reduces cholesterol and triglyceride levels. Hypercholesterolemic animals responded well to CLA supplementation, with regression of established atherosclerosis. Use 3000 mg early in the day. Avoid taking CLA with fiber supplements or high fiber meals.

  5. Grapefruit pectin: Various studies demonstrate the effectiveness of grapefruit pectin as a hypocholesterolemic. If using the powder, begin with less than 1 scoop per day, gradually increasing to 2-3 scoops. If using tablets, use one 1000-mg tablet per day with meals.

  6. Curcumin: The hypocholesterolemic effects of curcumin were demonstrated in laboratory animals. Animals fed curcumin (along with a cholesterol diet) had about one half of the blood cholesterol as animals fed equal amounts of cholesterol but without curcumin. Use 900 mg, 1-2 times daily.

  7. Niacin: In large doses (1-3 grams per day) niacin can lower cholesterol levels. Much lesser amounts may be needed if used with chromium. Read the side effects associated with niacin usage in this protocol.

  8. Policosanol: As a hypocholesterolemic, policosanol was shown to be comparable to traditional statins like Mevacor®, Zocor®, and Pravachol®. Some individuals need 5-10 mg to maintain healthy levels of cholesterol; others 20 mg per day.

  9. Proanthocyanidins: Lower blood cholesterol levels and shrink cholesterol deposits in arteries of animals. Use 100-300 mg of grape seed extract per day.

  10. Sytrinol™, a formula derived from citrus and palm fruit extracts to form a powerful antioxidant with numerous heart health benefits while possessing anti-inflammatory properties. Sytrinol™ contains polymethoxylated flavones, shown in studies to help maintain healthy levels of apoprotein B (a structural protein needed for endogenous synthesis of LDL cholesterol) and decrease diacylglycerol acetyl transferase (a liver enzyme needed for endogenous synthesis of triglycerides).
To inhibit formation of atherogenic homocysteine:
  1. Folic acid is typically the most effective agent that significantly lowers blood levels of homocysteine. Use a complex that also contains at least 300 micrograms of vitamin B12. (Folic acid and vitamin B12 are cofactors required by the same series of enzyme that reduce homocysteine levels and are defective in 11% of all Caucasians.) Use 800 mcg of folic acid with every meal.

  2. Essential fatty acids: Fish oil lowers provides multiple protective benefits against atherosclerotic disease by supplying EPA and DHA. Super EPA/DHA with Sesame Lignans is from a new source of pharmaceutical grade fish oil with a unique 35%/25% ratio of EPA/DHA. The premium fish oil in Super EPA/DHA with Sesame Lignans has been tested for pollutants including dioxins, furans, PCBs and heavy metals. For optimal absorption, avoid taking essential fatty acids with fiber supplements.

  3. Trimethylglycine: TMG is an effective homocysteine-lowering substance in the dose of 500-1500 mg a day. If homocysteine levels are too high, and do not respond to folic acid, B6, and B12 administration, up to 9000 mg of TMG may be needed along with higher amounts of other remethylation and methylated factors.

  4. Vitamin B6: For many individuals, the Life Extension Mix contains sufficient amounts of vitamin B6 to keep homocysteine levels under control. Vitamin B6 reduces homocysteine using mechanisms that use folic acid and by other mechanisms that do not (the transsulfuration pathway). This pathway converts homocysteine to the powerful antioxidants cysteine and glutathione, but a deficiency of the B6-dependent enzyme, cystathionine-ß-synthase, can inhibit this process. Larger doses of vitamin B6 can often overcome this inhibition. Chronic mega-dose vitamin B6 supplementation (300–500 mg daily) can result in neurological symptoms that typically fade when the dosage is reduced or discontinued. Careful monitoring to determine the lowest vitamin B6 dose capable of controlling homocysteine levels is essential. Some individuals lack the enzyme (pyridoxine phosphokinase) necessary to convert vitamin B6 to its active cofactor form. In this case, use the biologically active pyridoxal-5-phosphate to control elevations in homocysteine.

  5. Creatine offers a new method of reducing homocysteine levels. The daily intake of 2,000 to 4,000 mg daily of creatine should diminish production of homocysteine. Less production means less accumulation. Remethylating agents will have less homocysteine to convert back into methionine or catabolize into cysteine, cystathionine, and glutathione.

  6. Choline derivatives: Phosphatidylcholine (420 mg), a-glycerolphosphorylcholine (use 600 mg of Alpha GPC), and choline (TwinLabs or Solgar, 350 mg) are dietary sources of methylated compounds normally made by the body and which require the conversion of SAMe into homocysteine. Biosynthesis of choline derivatives probably accounts for the second most important use of SAMe and leads to significant accumulation of homocysteine.
To inhibit formation of arterial blood clots:
  1. Low-dose aspirin: one tablet daily of Healthprin (81 mg) with the heaviest meal of the day inhibits platelet aggregation and reduces systemic inflammation.

  2. Garlic decreases fibrinogen and inhibits platelet aggregation, and thins the blood; the recommended dosage is 1200 to 2400 mg twice daily with meals.

  3. Ginkgo biloba improves circulation and reduces platelet aggregation, as well as fibrinogen levels. Ginkgo counters the viscosity produced by excess production of platelet-activating factor (PAF), which thickens the blood. Some clinicians routinely prescribe ginkgo for patients 50 years or older. Use 120 mg daily.

  4. Green tea, like aspirin, inhibits thromboxane A2 (inhibition of thromboxane A2 lessens the risks of blood clot formation and the dangers imposed by arterial constriction). Heart attacks and strokes are less likely to occur if fibrinogen levels or PAF are not excessive. Green tea lowers fibrinogen levels and is a PAF inhibitor. Drink several cups of green tea per day or use 725-1450 mg daily of a powdered green tea extract. Capsule forms should provide 93% active polyphenols.

  5. Niacin reduces fibrinogen levels, lessening the risk of clot formation; one to three grams of niacin a day may be needed to reduce certain cardiovascular risk factors. Much lower doses of niacin may be effective if taken with chromium. Read the caveats regarding niacin usage in this protocol.

  6. Fish oil decreases fibrinogen levels, addressing a major pathological process leading to thrombotic occlusion. Omega-3 polyunsaturated fatty acids (eicosapentaenoic acid and docosahexaenoic acid, EPA & DHA) may affect platelet aggregation and lower thromboxane A2 within platelets (thromboxane A2 is considered pro-aggregating). Four Super  EPA/DHA w/Sesame Lignans soft gels per day are recommended for healthy individuals. For optimal absorption, avoid taking essential fatty acids with fiber supplements. Because EPA/DHA can interfere with blood clotting, those who suffer from any type of hemorrhagic disease related to excessive bleeding should consult their physician first. Those taking anticoagulant drugs, like Coumadin, should inform their doctor that they are taking EPA/DHA supplements. The physician may want to more closely monitor and adjust the dosage of anticoagulant medication based on laboratory measures of coagulation.

  7. Tocotrienols with Sesame Lignans offer cardiovascular-protective functions by inhibiting platelet aggregation. Tocotrienols have shown superior action in maintaining arterial health. This wonder nutrient is so effective because of its structure of double bonds in the isoprenoid side chain, making it a great scavenger of free radicals.*Sesame lignans have been added to help block or inhibit the enzyme that breaks down tocotrienols allowing tissue levels of tocotrienols to build up in the body. This translates into much greater antioxidant protection, decreasing destructive free radicals.

  8. Major and trace minerals: Magnesium inhibits platelet aggregation. Selenium also helps to thin the blood. When the blood is thin, there is less chance that blood clots will form and trigger a heart attack by lodging in an already-narrowed artery. Use 200 mcg of selenium per day and 400 mg of magnesium in divided dosages per day.

  9. Vitamin E decreases blood viscosity and platelet aggregation. Use 1-2 Gamma E Tocopherol with Sesame Lignans per day. Take with food for optimal absorption. Individuals taking anticoagulants like warfarin (Coumadin®) or heparin should advise their physician if they are taking any kind of blood viscosity reducing agent like vitamin E.

  10. Vitamin C: Along with numerous antioxidant functions that support cardiac health, vitamin C reduces fibrinogen levels (abnormally high fibrinogen levels may increase blood clots). Use 6 grams per day unless this dosage causes gastrointestinal distress; if so, reduce to a level that is not distressing.

  11. Policosanol works well with aspirin to inhibit formation of clots. Each agent influences different activities of platelets. Thromboxane is a blood vessel constricting hormone that is repressed after two weeks of policosanol therapy. Some individuals need only 5-10 mg per day of policosanol; others require 20 mg daily. Do not use natural agents to inhibit platelet aggregation and traditional anticoagulant medicines until consulting with your physician.
  12. Curcumin's ability to control platelet aggregation is due to thromboxane inhibition (a promoter of aggregation) and increased prostacyclin activity (an inhibitor of aggregation). Use 900 mg, 1-2 times daily.

  13. Ginger: The platelet-aggregating factor, thromboxane A2, is inhibited by ginger. Ginger inhibits PAF. Adequate amounts of PAF are essential to coagulation, whereas, excesses are associated with blood clot formation, stroke, and heart disease. Prostacyclin, an inhibitor of platelet aggregation, is activated by ginger, further reducing the likelihood of clotting. Use 300-600 mg of ginger, 1-3 times daily.

  14. Because bromelain inhibits clot formation and digests plaque in arteries, it is useful in atherosclerosis. Use 1/8 to 1/4 teaspoons of Bromolain Powder (2.9 grams/tsp) containing per teaspoon: 2500 mg of bromolain, which equals 3500 milk clotting units (MCU) or 2000 gelatin digestive units (GDU). The use of 1/8 to 1/4 teaspoons is 312-625 mg taken between meals.
CAUTION: Combining multiple nutrients that have similar therapeutic actions, such as anticoagulant actions, may be inadvisable for some individuals. If you are taking anticoagulant drugs, you should never administer natural agents that also influence coagulation factors without physician supervision.

Additional Suggested Supplements:
  1. Herbal Cardiovascular Formula contains potent extracts of ginger and curcumin that help lower cholesterol levels. Use 1 capsule in the morning and the evening. If cholesterol levels are not significantly lower after 30 days, double or triple the dose. These extracts produce anti-inflammatory effects that slow the progression of aortic stenosis and inhibit abnormal platelet aggregation.

  2. Fiber blocks iron absorption, is a hypolipidemic and antidiabetic agent, and an aid to weight loss. Use 10-30 grams of soluble fibers, including pectins, guar, and psyllium.
FOR MORE INFORMATION: The American Heart Association, Dallas, Texas, (214) 373-6300.


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