Cholesterol

Q. I have heard that some people taking glucosamine and chondroitin experience increased cholesterol. I believe I am one of them. I have been taking this combination for arthritis pain. This year when I went in for my yearly blood test, my cholesterol had gone up from 160 to 324. I could hardly believe it. I have cut back on the pain formula and am now trying to bring my cholesterol down. Could glucosamine and chondroitin be responsible? A. We have heard from many readers that their cholesterol rises when they take glucosamine and chondroitin, but there are no scientific studies to substantiate this potential side effect.

Each week a nutritionist from the University of Maryland Medical Center provides a guest post to The Baltimore Sun's health blog Picture of Health (baltimoresun.com/pictureofhealth), which is reprinted here. This week, Elaine Pelc weighs in on eggs. Are eggs really incredible? Yes! Eggs are affordable, a great source of lean protein, full of vitamins and minerals and low in calories, weighing in at about 70 calories each. Over the years eggs have received a bad rap for their cholesterol content.

Q. I have been taking Lipitor for the last two years to lower my cholesterol. Last year I had an outbreak of cold sores on my lip. My dermatologist said my immune system was compromised and prescribed Valtrex daily for one year. Could this problem be related to Lipitor? A. Research suggesting that cholesterol-lowering drugs like Lipitor, Mevacor or Pravachol can suppress the immune system is brand-new. Swiss researchers have shown that these compounds prevent activation of some immune system cells.

Among the latest no-nos for healthy eating, the federal government said Monday that Americans should consume less salt in an effort to lower their risk of high blood pressure and a host of other chronic diseases. People should limit their intake to about one teaspoon of sodium daily, according to dietary guidelines released from the U.S. Department of Agriculture and the U.S. Department of Health and Human Services. That figure should be even lower for people 51 and older, African-Americans, or anyone with high blood pressure, diabetes or kidney disease — a group that is about half the U.S. population.

Q. Your column about the dangers of low cholesterol caught my attention. For years I avoided all fat in my diet, but then I was unable to conceive. After including fat in my diet briefly, I became pregnant, but lost the baby when I returned to my no-fat regimen.After the miscarriage, my gynecologist told me my cholesterol (94) was not sufficient for making the sex hormones I need to sustain a pregnancy. I changed my diet, raised my cholesterol to 114 and had a healthy, normal, successful pregnancy.

Q. I was always in good health until I hit menopause. Over the next few years, I gained weight, my blood pressure rose and so did my cholesterol. The blood pressure is under control on atenolol, but the cholesterol didn't drop with diet and exercise. My doctor wanted to prescribe a statin cholesterol drug, but I dreaded the side effects. By accident, I discovered that the psyllium hull powder I started taking for irritable bowel problems had really brought my cholesterol down. In two months the total cholesterol dropped from 220 to 180, and my LDL went from 160 to 102. I was thrilled.

CHICAGO -- Not since aspirin has a class of drugs come along that does so much more than originally intended that it could end up being used as a preventive against many major diseases. Statins, which lower cholesterol, have been proved in clinical trials to reduce heart attacks and strokes by 30 percent to 50 percent. They are the most widely prescribed drugs in the United States; one in 10 adults takes them. But their full value in improving the nation's health rests with research attempting to establish the ability of statins to prevent cancer, Alzheimer's disease, diabetes, osteoporosis, high blood pressure, multiple sclerosis and macular degeneration.

Q. I am trying to get my cholesterol down and reduce my risk of heart attack. My cholesterol is 266, HDL 72 and LDL 177. I know the ratio is good but would like the numbers to be lower. I've heard that wine is beneficial, but I don't tolerate it well. Would grape juice do any good?A. Your lipid ratio is excellent (3.7). To calculate this ratio, divide total cholesterol by HDL. Any number lower than 4.5 is considered good.Grape juice probably won't lower your LDL (bad) cholesterol, which is a little high.

A small clinical trial has shown for the first time that it is possible to use drugs to remove plaque from clogged arteries, a finding that could lead to radically new ways to treat heart disease, the No. 1 killer in the United States. Infusions of a genetically engineered mutant form of high-density lipoprotein, the so-called good cholesterol, over a five-week period were shown to reduce plaque volume in patients suffering from chest pain. "This is an extraordinary and unprecedented finding," said Dr. Steven E. Nissen of the Cleveland Clinic Foundation, who led the study reported in today's issue of The Journal of the American Medical Association.

Although doctors were disappointed this week when Pfizer Inc. stopped clinical trials of a drug designed to boost levels of "good cholesterol," experts say there are other methods of increasing levels of protective, high-density lipoproteins (HDL) in the blood. The bad news: most of them require willpower. "The cornerstones are diet and exercise," said Dr. Roger Blumenthal, head of the preventive cardiology program at the Johns Hopkins School of Medicine. "The only real medication that has an impact on HDL is niacin."

A team of 30 volunteers from Johns Hopkins plans to partner with Baltimore City schools to offer city teens screening for early signs of heart disease. The free exams will look for key risk factors including obesity, high blood pressure, elevated cholesterol levels, diabetes and family history of disease. With the findings, officials hope to curb increasingly common bad eating and exercising habits before they become engrained. Hopkins officials already had been screening Maryland athletes for heart abnormalities and decided to expand the program to some 2,000 13-year-olds expected to attend a high school fair at Baltimore Polytechnic Institute Nov. 13 from 9 a.m.-2 p.m. "One of the surprise findings from our other heart screenings was that basic risk factors for cardiovascular disease are too common among Maryland high-school students, and these students and their parents are simply unaware that they face a serious health problem," said Dr. Theodore Abraham, a cardiologist at the Johns Hopkins Hospital who is spearheading the screening efforts.

I have been on so many cholesterol-lowering drugs I have nearly lost count. Crestor, Lipitor, Zetia and Zocor all give me terrible pains in my shoulders, back and arms. I also have had dreadful muscle cramps in my calves, especially at night. I don't know how much longer I can stand taking Crestor, but my doctor just says that without it I'm a heart attack waiting to happen. Is there any natural way to lower cholesterol? I want to stay healthy, but the pain interferes with my ability to exercise and has affected my quality of life.

Now that my son is in day care, I am constantly getting his colds and coughs. What can you recommend for easing the symptoms? I am not big on drugstore remedies. Readers of this column are enthusiastic about ginger. Here are just a few anecdotes: "I must testify what a wonderful hot drink one can make from grating about 1 inch of fresh ginger, putting it in a little wrap of cheesecloth or in one of those mesh spoons used for tea leaves and letting it steep in a mug of hot water. It is fantastic for combating colds ... a refreshing and spicy tonic."

I have normal LDL cholesterol but low HDL, as low as 26. With diet and exercise, I can get my HDL to the mid-30s, which is not great. Lipitor lowered my LDL below 80, but sadly my HDL didn't budge. After being on Lipitor for a couple of months, I woke up one morning and had no idea what day of the week it was or that the company picnic was the day before. At work, I could not make simple postings of dollar amounts from hard copy to electronic spreadsheet (I would forget the amounts). At a meeting, I could not remember names, and later at home, I kept asking my wife the same question, as I could not remember her answer.

Last week's recommendation by the American Academy of Pediatrics to give cholesterol-lowering drugs to some children as young as 8 is troubling. Millions of Americans take statins - the world's most-prescribed medications - to reduce the risk of heart disease by lowering their levels of "bad" cholesterol. These drugs have certainly prolonged the lives of thousands of middle-aged men with heart disease. But there is insufficient evidence that statins benefit other groups, notably younger children.

Keith Miller leads what doctors call a healthy, active lifestyle. The suburban Baltimore teenager has always loved sports and plays soccer competitively. He avoids eating pizza and junk food. But despite all that, Miller had cholesterol levels nearly five times his average peer and underwent a double bypass surgery to repair his heart two years ago when he was 15. Though open-heart surgery remains unusual in young patients, medical experts fear that cholesterol levels are rising at an alarming rate.

For hearts and blood vessels, HDLs are knights in shining armor. Better known as "good" cholesterol, these high-density lipoproteins clear the plaque stuck to artery walls by low-density lipoproteins (LDLs), the "bad" cholesterol. Since the 1970s, doctors have known that the battle between these biomolecular adversaries can determine life or death. But while researchers have come up with powerful medicines to lower LDL, they have had little luck with drugs to increase HDL. Now, after more than a decade of work, scientists are unraveling HDL's secrets and developing a variety of HDL-boosting drugs and therapies.

Each week a nutritionist from the University of Maryland Medical Center provides a guest post to The Baltimore Sun's health blog Picture of Health (baltimoresun.com/pictureofhealth), which is reprinted here. This week, Elaine Pelc weighs in on eggs. Are eggs really incredible? Yes! Eggs are affordable, a great source of lean protein, full of vitamins and minerals and low in calories, weighing in at about 70 calories each. Over the years eggs have received a bad rap for their cholesterol content.

He's an office worker who runs at least 30 miles a week and has already logged marathons in 38 states. She's an artist who spends much of her day on her feet preparing for shows -- with breaks to walk the dog. They're slim and healthy 50- somethings. But, to their utter annoyance, they both have high cholesterol. Kelly Kietzke and Diane Getty of South Baltimore know they can't overcome their genes. They could re-evaluate their diets. But what to strip? What to add? Their meals already seemed pretty healthful.

Two of the world's best-selling drugs to lower cholesterol might have no benefit, researchers reported yesterday, a development that significantly could alter how patients are treated for heart disease. Based on the news, a top medical journal encouraged doctors to stop prescribing them routinely. Vytorin and a related drug, Zetia, did not reduce fatty plaque in arteries any more than a generic, researchers presenting at a cardiology conference in Chicago said. Plaque is a buildup of cholesterol in the arteries and is believed to play a key role in heart attacks and strokes.