Lower your statin drug dose… your cholesterol… and your risks

Lowering cholesterol levels is a popular past-time in mainstream medicine, and it usually has two very negative effects. One is that, with the recommended levels of ‘bad’ LDL and total cholesterol being set lower and lower, the number of patients taking statin drugs continues to grow exponentially…

The second is that mainstream medicine does not acknowledge many of the other critical factors in whole body health, like systemic inflammation, the relationship between allergy and immune dysfunction, the critical importance of heavy metal detoxification, or the importance of maintaining good hormonal balance.

But, by golly, they’ll make sure your cholesterol counts are in the basement! As a result, up to 80 per cent of statin users are taking these drugs completely unnecessarily, and most likely at dosages far too high.

I see women with a total cholesterol level of 220 with no cardiac symptoms placed on 80mg of Lipitor for no good reason whatsoever, medical
or otherwise.

I’ve seen 93 year olds placed on dangerous doses of statins, again with no medical evidence that this does anything more than mess with metabolism that has lasted successfully
for 93 years.

Although I maintain that the current recommendations of total cholesterol and LDL cholesterol levels are much too low and can lead to the dangerous use of statin drugs, I agree that, in some situations, it’s appropriate to lower a patient’s lipid levels somewhat – if only to calm down a concerned GP!

The age-old war on supplements continues

Many alternative health and natural medicine practitioners like me have turned to using red yeast rice, a natural alternative to statins known to contain ‘statin-like activity.’ But, as discussed by The Point Institute (an independent research group that looks at natural treatments for chronic illness), even red yeast rice can raise some questions of health and efficacy.1

According to the American Food and Drug Administration (FDA), products containing red yeast rice cannot claim to lower cholesterol. Yet that’s exactly what red yeast rice does. It contains a compound called monacolin K, the same compound present in the statin drug lovastatin.

Red yeast rice is obtained through a process of fermentation of the Monascus purpureus, a traditional Chinese medicine mold. The same process, using other molds in the fermentation activity, is used to produce most of the statin drugs.

The end result is that both compounds – monacolin K or similar – have lipid- lowering activity. But if a red yeast rice product has enough lipid-lowering activity, it technically is considered a drug by the FDA and should be taken off the market, as it’s not being used legally.

One form of red yeast rice, marketed under the name Cholestin, was actually banned as being a ‘drug’ when the FDA determined that the level of monacolin K was above ‘natural, food grade levels’. (A judge subsequently overturned the decision and allowed the product to continue being regulated as a dietary supplement.)2

The European Food Safety Authority (EFSA) has set the legal limited dosage of red yeast rise at about 10mg of monacolin K daily. The red yeast rice that I use in my practice is below that minimum.

But some red yeast rice supplements have relatively little of the products of fermentation, which make these ineffective in lowering lipids. And so, this has left existing red yeast rice products in a dilemma.

Lower your lipids with citrus

This dilemma has led me to search for safe and effective alternatives to red yeast rice for my patients. One group of natural substances that have been found to have plenty of health benefits is plant components called polyphenols – in particular one group of polyphenols, called flavonoids.

Flavonoids are components usually found in brightly-coloured plants and have been shown to have a variety of health-promoting activities. Some of these polyphenols have been studied particularly for their cholesterol-lowering effects.

Of the polyphenols studied, I have found one to be particularly promising: the citrus fruit called bergamot. Bergamot (Citrus bergamia) is a fruit about the size of an orange that grows exclusively in the Calabrian area of southern Italy. Scientists actually think it’s a hybrid cross between a lime and an orange. While bergamot is edible, we mostly know it as the flavouring that gives Earl Grey tea its particular taste.

As a class of fruit, all citrus contain high amounts of flavonoids, particularly compounded in their peels. What makes bergamot so promising is that it has very high levels of certain flavonoids that promote lipid-lowering activity.

Among these is the flavonoid called naringin, which is also plentiful in the peels of grapefruit. Naringin’s ability to lower cholesterol has been studied extensively in animals and it has also been shown to help protect against diabetic neuropathy.

Another characteristic of bergamot is it contains a high concentration of the utterly unpronounceable group of flavanoids, ‘neohesperidosides’. These too lower cholesterol through a mechanism very similar to that of statin drugs.

That is, they compete with the enzyme HMG-CoA reductase (trust me, you don’t want to know its full name), the rate-limiting step in the production of cholesterol in the liver.

That’s the same exact target of most cholesterol-lowering strategies, including statin drugs and red yeast rice. And, in addition, neohesperidin has shown activity in lowering the storage of triglycerides (blood fats), another fatty accumulation,associated with atherosclerotic cardiovascular disease.

Turn to this fruit to lower your risks

Obviously, with such promise, bergamot is gaining attention in the research world as a safe and effective treatment of high cholesterol levels.

A clinical study published in the International Journal of Cardiology in 2013 gave 77 patients either a placebo, rosuvastatin (Crestor), bergamot-derived polyphenolic fraction (BPF), or BPF with Crestor.

Both the rosuvastatin and BPF groups showed a lowering of LDL, a lowering of total cholesterol, and some increase in ‘good’ HDL cholesterol. There was also evidence in both groups that HMG-CoA reductase was being blocked.3

Just as important, the study demonstrated a lower level of two critical biomarkers for oxidative cardiovascular damage (oxidized LDL receptor LOX-1 and phosphor-PKB antibodies).

While these results don’t ‘prove’ bergamot to be ‘better’ than statins, their similar performance in a clinical trial setting does suggest that adding BPF to statin treatments might allow you to reduce the dosage levels at which you are taking your statin drug.

And that’s important, since the higher the dose of statins, the more likely liver and kidney damage and muscle pain and weakness are to occur.4

In fact, the effect on blood lipids of the BPF/rosuvastatin combo was ‘significantly enhanced’ over either therapy used on its own.

Likewise, in a recent double-blind, placebo-controlled study, 237 patients were stratified into three different levels of high cholesterol. Within each level, the patients were given either a placebo or BPF in doses of either 500mg or 1,000mg.

After 30 days, both levels of BPF lowered total cholesterol and LDL, and raised HDL cholesterol in the majority of patients. There were also reduced levels of triglycerides and in blood-sugar, and evidence of HMG-CoA reductase- lowering activity.

No such change happened in the placebo group.

Interestingly, there was also some evidence of vasodilation leading to decreased blood pressure in the BPF. The authors concluded that BPF provides potency comparable to low level statins, and is ‘a safe alternative for patients suffering from statins toxicity’.

A travel-free way to get this Mediterranean citrus

To promote their healthy cholesterol levels, I’ve been switching my patients over from red yeast rice to Bergamot BPF, a product I get from Ortho Molecular Products, a manufacturer I trust.
It contains the highest concentration available of the extracts of all the bergamot fruit’s potent phenolic compounds. It’s also gluten-free with no artificial colourings or flavours.

The manufacturer suggests taking two capsules per day. As with any supplements, don’t start taking them without consulting your with your doctor or alternative health specialist first to make sure they’re safe for you to take – especially if you’re already on statins. (And he may recommend a different dosage.)

Wishing you the best of health,

Dr. Jonathan V. Wright
Nutrition & Healing

Full references and citations for this article are available in the downloadable PDF version of the monthly Nutrition and Healing issue in which this article appears.

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