Niaspan (extended release Niacin) is used more for lowering triglycerides and raising HDL and hasnt been shown to do much for the LDL (the "bad") cholesterol. It also causes flushing and is difficult to take because of that.
Dr O.

My doctor put me on something called Niaspan. Basically it's a time released niacin tablet that raises HDL and improves your HDL/LDL ratio. It seems to work well but it causes an uncomfortable prickly sensation.
I don't know if anyone would want to try over the counter niacin tablets to attempt the same results, I suppose it's possible though.

Thanks for the infor! :D

Add one more recommendation to your list - Make sure that you don't have sleep apnea. Hyperlipidemia is a known consequence of sleep apnea.

Response to comments made in number 7:

http://www.youtube.com/watch?v=_St...
http://www.youtube.com/watch?v=Ukh...

100 people were studied with Lipitor and a 100 people with a placebo and within 3 years there was 2 people in the lipitor group had a heart attack and 3 in the placebo group. This is where they get that the mortality rate is better with the Lipitor group. Exactly what I argued earlier that about the same number of people die with high cholesterol than with low cholesterol.

http://www.douglassreport.com/repo...

Here was an interesting article I found posted at DS website that sort of comments on some of the things that I said.

Shakysara: If you are swimming 20-30 minutes 3 times a week and getting your heart rate up than good for you!
Cody 39: No I dont believe in any of the EDTA stuff...there is no data for it. I am an evidence based medicine person..I have to be since I train medical students and residents...I need the science and the proof.
Dr O.

Q: Does any kind of exercise help? Due to my disability I can only swim without pain. Used to run and use skinny skis, but ate meat at every meal.

Dear Dr. O: I just dropped my total cholesterol 100 points with a statin (Crestor) and diet changes. My triglycerides remained a bit high so my practitioner recommended 1000 mg of omega 3 FA. I found a product with 1200 mg (horse pill)and decided to go with that. Unfortunately, my mother's cholesterol was very high, but she lived to be 97. I think what helped her was the fact that she walked everywhere and had a strange diet. Some days she would only eat bread--no butter. She died of a liver laceration from a fall.

p.s. sorry Dr Orrange and not Orange. I didn't mean to turn you into a fruit.

Thanks Dr Orange,

I guess I did a lot of rambling in the last post that didn't make much sense to anyone else reading it and probably made people think that I am against lowering the cholesterol. I will explain exactly my position in much more ramblings (sorry) and why I believe what I do.

I do not doubt that lowering cholesterol can help reduce the risk of heart disease. Many doctors are now starting to argue that cholesterol itself is not necessarily the killer but other things with it such as inflammation and high homocysteine levels. I do not believe that focusing on cholesterol alone will solve the problem. People should be made aware that C-reactive protein is a better indicator of possible heart problems than cholesterol. Atherosclerosis is caused by inflammation. It is this inflammation that can cause the cholesterol plaque to rupture and even in small amounts. I believe this is what happened to Tim Russert. This is why low dose aspirin helps reduce the risk of heart disease because it not only helps prevent clotting but it also helps with inflammation. Yes, Lipitor can help with inflammation too.

Homocysteine is another big risk factor for heart disease as it is an amino acid that is associated with low levels of B6, B12 and Folic acid as I mentioned in my last post. One should be made aware that supplementing with B6, B12 and folic acid does help keep homocysteine levels in check unless a person is suffering from renal disease. I especially need to be taking such supplements due to the fact that I am a big meat eater, but I also try to get those vitamins from fruits, green leafy vegetables and so on. Little info is known on how homocysteine increases the risks of heart disease but there is evidence that this too can lead to inflammation and the hardening of the arteries.

I didn't do a good job in making this clear in my previous post as it sounded as though I did not agree with cholesterol and heart disease. I am all for getting the cholesterol down and that is why I recommended Pantethine or a low carb diet. I was merely arguing that lowering cholesterol alone might not improve your chances of not dying from a heart attack as inflammation can cause someone even with low levels of cholesterol to die. This is why I argued in my previous post that there seems to be an equal number of people dying from heart disease whether their cholesterol was high or low. My boss eats like garbage but was told by his doctor that his LDL cholesterol was nice and low and now my boss is believing that he is not at risk for a heart attack. Lipitor will not prevent a heart attack nor having low cholesterol. We need to focus on the other things associated with cholesterol that can kill you. Gasoline by itself is not dangerous but like a match and watch out. Cholesterol itself might not be a dangerous thing but other factors with that can make it very dangerous and even deadly.

I do recommend a low carb diet simply because it not only lowers bad cholesterol but triglycerides as well. Triglycerides being a type of fat (lipid) that is used for energy and often stored elsewhere on the body as fat. Those that consume a lot of calories might have high triglyceride levels in their blood. High triglycerides can lead to insulin resistance (metabolic syndrome) that can increase ones risk for diabetes and heart disease. A low carb diet has shown amazing results on a persons triglyceride levels. It is always good to see your doctor first before starting a low carb diet or any diet out there to make sure you do not have other factors (under-active thyroid, kidney disease or some medicine that you are on) that can cause high triglycerides if that is what you are suffering from. One recommendation that doctors give is to eat less calories but the better answer is a diet that is low in starchy foods especially those starchy foods that are low in fiber. Foods low in fiber and high in carbs get absorbed into the bloodstream as sugar much faster. Pasta is one of those foods. If one loves pasta then try eating it al dente (chewy) to prevent it from easily turning into glucose. Brown whole wheat pasta (yuck) is probably the best route. So there are ways to lower your triglycerides without doing a low carb diet but be smart about it. Corn, carrots, white bleached rice, pasta, potatoes, bananas are foods that can contribute to this problem so know what foods to limit the portions on. Always look at the fiber content and subtract it from the total carbs to get an idea of how much you might be affecting your blood sugar levels. Buy a Hostess cup cake and you will see over 60 grams of carbs and less than one gram of fiber (ouch). It is those high carbs that leads to obesity and other problems.

To sum up all of my rambling is to say that a person shouldn't be worried about their cholesterol alone. I now have to ask my doctor when he checks my cholesterol to check the other risk factors that go along with it or you will not find those things out in a simple blood test. Inflammation, homocysteine is something that we all should be concerned about. I would be more concerned if I had low cholesterol with high triglycerides, inflammation and high homocysteine levels rather than high cholesterol with low triglycerides, low levels of homocysteine and inflammation. Drugs doesn't have to be the answer that depletes you of a vital CoQ10 that is highly concentrated in ones heart. Be careful of studies done against it as often they are flawed. Drug companies do want their profits and anyone can do a study on Vioxx that they (drug companies) knew was killing people but continued selling the crap. You can read about the doctors who received money and special vacations for promoting that drug and later were dropped simply because they started telling others of possible risks they noticed with the drug. Statin drugs do lower CoQ10 levels and one should supplement with CoQ10 when taking a statin drug if you go that route. You will need to buy a good CoQ10 since most sold in stores are garbage and very little is absorbed by the body when taken. Take CoQ10 with a fish oil supplement or a tablespoon of olive oil to help it absorb better. The benefits have been proven even though some recent flawed studies are trying to dismiss this product. Most doctors simply go by what they hear and never by what they see to be true and will dismiss what they see on something else. Well known Dr Al Sears has plenty to share about this problem of many doctors out there that dismiss the amazing benefits of CoQ10. CoQ10 should be taken especially if you are taking a statin drug (100mg or more).

So, a person should not only focus on lowering cholesterol only but other factors as well that can make up a deadly combination. Make sure if you have a blood test that you have your doctor check these other factors as well. Do things that will help reduce your risk of all of these factors. Quit smoking, eat right, lose weight, exercise, supplement with certain vitamins and so on. Taking care of your teeth is also very important as gingivitis as evidence seems to show a link between gum disease and heart disease.

I do have a question for you Dr Orange. Do you believe the garbage about taking EDTA for calcium build up, metals in the body and so on? I hear so much hype over it and cannot make a educated decision. I hear one group (doctors) swear by it and other groups say that it is useless and others that say it is dangerous. I do know that doctors will administer it through an I.V. but there are now oral products and suppositories out there now. Will EDTA oral chelation do anything at all? I have heard that it might deplete minerals in your body as a reason not to take it. There is so much garbage on the market that I can't keep up with it all. I was hoping you have some insight into this. Thanks

Hey Cody
Thanks for all of your input. Remember that both lipitor and zocor do have plenty of data (published placebo controlled randomized trials) that do show mortality benefit from lowering LDL cholesterol....this is especially true for those with 2 or more cardiac risk factors and those with existing heart disease.
Dr O.

There is one product that is overlooked and worked wonders for me and a co-worker. Mega doses of Pantethine dramatically reduced my cholesterol levels. The product that I used was JARROW FORMULAS that contain 450mg of Pantethine. I took it 3 times a day. The results were so amazing with a guy I used to work with that it amazed his doctor. He told the doctor that he didn't change anything he was doing or eating and it worked great. Here is one brief article about Pantethine:

"Pantethine is not itself a vitamin; it is a special derivative of vitamin B5, also called pantothenic acid. Several studies found that pantethine, taken three times daily in therapeutic doses of 300 mg (a daily dose of 900 mg) can:

- lower cholesterol(http://www.mitamins.com/disease/High-Cholesterol.html)
- lower triglycerides (a blood lipid)
- raise HDL (“good” cholesterol)
- lower LDL (“bad” cholesterol).

Studies found the same effect in dialysis-dependent diabetics without side effects, which is extremely important because kidneys in these patients are particularly sensitive to stronger high cholesterol medication."

I've seen doctors question it but as for me and others that 'actually' tried it will never question it. I found the stuff to be fabulous. This was the stuff Dr Atkins swore by and I decided to give it a shot after my co-worker had amazing results with it. I used this stuff several times in my life when I strayed from a good diet to get back on track quickly.

The question I would like answered is why no proof that lowering cholesterol improves your chances of not dying from a heart attack. I am now hearing doctors say that the same number of people with high cholesterol still die just as much from heart attacks as those with low cholesterol readings. The real problem seems to be inflammation and homocysteine levels. Homocysteine can be controlled with vitamin B6 B12 and folic acid if my memory serves me correctly. I just sometimes question statin drugs that make the drug companies richer and haven't been proven to reduce the risk of heart disease and am now told that it depletes the body of CoQ10 as some doctors believe would increase your risk of heart disease. The commercials with Dr Jarvik (inventor of the artificial human heart) and Lipitor are deceiving since Dr Jarvik is not a licensed to practice medicine and was deceiving in their commercials by having you think that Dr Jarvik was canoing when it wasn't even him nor does he even canoe. Congress drilled Pfizer for this with questions. As much as some hate this doctor, he lives right by me and do enjoy him very much : http://www.mercola.com/article/sta...

I'm glad that you mention Red Yeast Rice because the FDA fought that one trying to make it a drug and lost. They claimed that it contained statins and could cause liver problems even though they had not one bit of evidence to prove that from a natural product since the Chinese have used it for years with no problems at all. My mom used it and had good results. I think the drug companies were more worried about their pocket books.

A quick solution to lowering cholesterol is to cut back on the bad carbs. The nurse was convinced when drawing my blood that my cholesterol would be sky high because of all the fat and eggs that I was eating but the opposite was true. My cholesterol and triglycerides took a nose dive when I cut out the breads, rice, candy and so on and my good cholesterol went up. My blood pressure was down too and I had more energy than ever on that diet. I have seen many do a low carb diet and experienced a huge drop in their cholesterol. I don't entirely agree with doctor Atkins but the diet did outperform other high carb/low fat diets to the test, but I do not believe that one should be on it lifelong like one guy I know. I recommend to do the diet for a month and then gradually increase the carbs slowly as to not shock the hell out of the body. I started increasing my carbs by introducing oatmeal in the morning. I still avoid certain foods. I do not need bleached rice. I limit bananas that are high in sugar and low in fiber. I tend to eat raspberries, blueberries and strawberries that add up in cost by the end of the month though. I limit my portions of pasta now too. All these things are slowly reintroduced back in my diet over a period of weeks but I never allow my carbs to go over 60 to 80 grams in the day. Protein Power by Dr Eades is a good book to start with and I am sure that any person with high cholesterol will benefit from it.

One additional benefit of a low carb diet was that it cured me of GERD that I was suffering from for 9 years. Every time I tried coming off of Prevacid the pain would hit right away. I still remember the look on my doctors face when he asked me if I needed a refill on Prevacid and I told him that I no longer need it. Low carb diet has been proven now to relieve even the worst sufferers of GERD. Dr Sherry A Rogers wrote a book called NO MORE HEARTBURN that goes into great detail how to cure yourself of this problem. Go to amazon.com.

Here are some testimonials to the affect of a low carb diet:

"One small study, published by Dr. W.S. Yancy Jr. in the journal Alternative Therapies in Health and Medicine, analyzed five case studies of GERD sufferers who chose to go on a low-carb diet. All five patients experienced resolution of their symptoms within one week. The researchers were not able to provide a definitive explanation for the drastic change."

The National Institute of Diabetes and Digestive and Kidney Diseases said:

"The committee is aware of new research which indicates a controlled carbohydrate diet may dramatically reduce the incidence of gastro esophageal reflux (heartburn)."

From personal experience, a low carb diet worked wonders with weight, blood pressure, cholesterol, triglycerides and GERD. The diet cannot hurt you. I do recommend that if you try it that you do not eat the bacon, salami, beef jerky, ground beef very often that I did initially even though I did have amazing results. I decided to make the approach healthier. I would eat chicken, turkey and would eat it with a bowl of greens. If I did have a hamburger then I would eat it without the bun and would eat an avocado with it for the high level of potassium. Tuna fish mixed with an avocado does taste good instead of mayo. I also used Olive Oil (cold pressed) as a salad topping instead of dressing even though Ranch is permitted on the diet. I kept each meal initially to under 20g of carbs. The first 3 days I felt lousy and then my energy levels soared. I lost 12 pounds in two weeks and 24 pounds in less than two months with no exercising. My blood pressure took such a nose dive that my doctor had to wean me off the BP medicine as my blood pressure went way down and I had a pulse in the 40's. I had a problem in my teen years with a bp reading of 170/100 and was placed on a drug called Corgard. My only warning is to learn to increase the carbs slowly after being on it a month. Start with a single meal (breakfast) that you increase the carbs and then work it into your lunch for a while and then dinner to prevent your body from putting the weight back on you. I did the very restricted diet for the first month, the second month I increased the carbs by 10g and then the third month by another 10g. I still eat a high protein/low carb diet and feel great too.

Intersting suggestions and I will print them off for further 'digestion' In the UK, things are slightly different but not that much! Plant sterols are broadly accepted as useful in lowering cholesterol and, as well as yogurts, drinks and margarines with added plant sterols, you can actually buy them in capsule form. However, if I recall from my GP's advice, you should never consume more than 3g daily.

Also, I have stopped taking my high strength Omega3 capsules for a while because it has been suggested to me that there could be a link between Vitamin D and sarcoidosis (currently not a problem, btw). Does anyone know whether all sources of Omega3 are linked to Vit D? Forgive the ignorance!

generic Toprol XL ($4 medicine at walmart) sorry for my bad spelling.

What I always think is funny, I've had hypertension ever since I was 13 years old (25 years now) but my cholesterol has never been above 140, and all other heart tests show normal. I used to get heartburn all the time until I stopped drinking pop, the lack of carbonated pop in my diet put an end to the heartburn problems in its tracks, and even lowered my BP a little, to the point where they lowered my Toprol XL from 100mg 2x/day to 25mg once a day. Then I started staying away from sugary foods, starches like pasta, rice, etc, and my BP dropped even more, to the point now where I take general Toprol XL 25 mg half in morning half at night, and that keeps it way under 115/70 now, just from a simple diet change.

The only fiber I get now is in fruits and vegetables, and thats been enough for me, whoever said chocolate or pasta had health benefits doesn't know what their talking about lol I get more then enough antioxidants in a glass of welch's grape juice everyday.

my dr told me about omega 3 but not red yeast rice i'll have to try on zocor now 40 and it is barely working runs in family bad tyvm

Thank you for the tips. My doctor has been on me about lowering my triglycerides/cholesterol since 10/07. I am taking niacin and Tricor. My triglycerides have come down from 565 to the low 200's. I still have more work to do. I will definitely be trying these ideas.