Statins Part 2- IM
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Statins Part 2- IM

In part one I wrote that combination therapy with antihyperlipidemic drugs increase the risk for adverse reactions from any one of them individually. Acupuncture, Chinese herbal medicine, and food as medicine can be use to minimize the need for combination therapy. When initiating Chinese herbal therapy, it is helpful to know what herbs will be beneficial for the combination of dyslipidemia one has (elevated total cholesterol, LDL, VLDL, TG; low HDL etc):

WHAT IS DYSLIPIDEMIA?
Dyslipidemia is a general term that means abnormal levels of lipids and/ or lipoproteins in the blood. Many people are concerned with lowering their bad cholesterol, which is hyper-LIPOPROTEINemia (elevated LDL/low density lipoproteins). And elevating their good cholesterol, which is HDL/high-density lipoptrotein. This is because too much LDL and/or too little HDL (LDL>HDL ratio) is the main predictor of cardiovascular and peripheral vascular diseases. 

  • LDL (a.k.a. bad cholesterol) transports lipids from the liver to tissues. 
  • HDL (a.k.a. good cholesterol) transports lipids from tissues back to the liver. HDL prevents the accumulation of fatty plaque on blood vessel walls (atherosclerosis) and in cells (e.g. fatty liver disease).

Cholesterol & triglycerides (TG) are lipids, meaning they do not dissolve in water. The liporproteins  bind with cholesterol and triglycerides (TG) to carry them through the aqueous environment of blood & cells, and transport them to various places in the body.

  • TG = excess calories, sugar and alcohol are converted to TG, then stored in adipose tissue cells as FAT. 
  • Cholesterol = produced by the liver and obtained from animal foods. 
  • Cholesterol + TG bind = elevations are also due to diets rich in cholesterol and saturated fats, inactivity, obesity, smoking, and alcohol consumption. 

Certain drugs such as some high blood pressure medication and psychotropics can also cause any combination of dyslipidemia.  Primary Familial Hyper-cholesterolemia is caused by over production or inadequate clearance of lipoproteins (LDL, HDL). It is a genetic disorder with some variants causing LDL to escalate to 600mg/dl or higher at a very early age (30s). Secondary dyslipidemias are caused by underlying diseases such as hypothyroid, diabetes, renal insufficiency, hepatitis, hypertension etc. Hypolipidemias can be induced or can be genetic.

NOT SUCH A BAD GUY?
Western medicine likes TG level to be below 150 mg /dL. But there is no clarity on what too low is - 50, 35, and 10 mg/dL are some set points. A Naturopath might scoff at a TG level of 50. This is because TGs, 1) store unused calories (as adipose tissue/ fat) for energy, 2) benefit brain growth, development & function, 3) benefit the flow of fat and glucose to and from the liver.  

Cholesterol is the chemical backbone of steroid hormones (DHEA, progesterone, estrogens, testosterone, vitamin D etc). It is a component of bile, which is needed for the complete digestion and assimilation of fats, and fat soluble vitamins (A, E, D). It is essential for cell membrane structure, integrity, and flexibility. 

The liver produces cholesterol, so a deficiency is unlikely. But certain nutrients and medications can challenge cholesterol levels as well, with overuse or improper dosage. Low TG levels is cause by low fat or vegetarian diets, malnutrition. Or excessive amounts of vitamin C, fish oils, and lecithin. Or and improper use of nicotinic acid/niacin and fibrate drugs (e.g. Lopid and Tricor).

DYSLIPIDEMIA IN CHINESE MEDICINE
Dyslipidemia, atherosclerosis and obesity are roughly translated to "the accumulation of Dampness and Phlegm" in Chinese Medicine. Dyslipidemia is a function of what is not in ones diet (e.g. fruits, vegetables, fatty acids etc.). As well as suboptimal digestion, absorption, assimilation, and utilization of food stuffs.  Lastly, the "when, what & how" one eats is the feng shui of health....

...What
High fructose syrup (HFCS) is a most notable cause of damp & phlegm accumulation in our modern day and age. Unlike cane sugar, HFCS is not assimilated very well by the Liver and is quickly converted to damp and phlegm [fat]. Plain cane sugar is much less problematic.

...When
Irregular eating patterns confuses the digestive system via many complex mechanisms. According to the Horary clock [the Chinese circadian rhythm of qi flow], Stomach time (7 a.m. to 9 a.m) and Spleen time (9 a.m. to 11) are optimal for priming the digestive system.  Not warming/nurturing the digestive tract at these times sets one up for poor digestion. This timing is also supported by Western observations on the body's ability to generate glucose surges after meals vs. glucose storage for later use as energy.

...How
Starting the day with a warm cup of water or ginger tea primes the Stomach qi (digestive enzymes). A whole grain congee primes the Spleen qi (assimilation for energy). The hardiest meal of the day should be lunch. And late night eating should be avoided. In Chinese Nutritional therapy, as well as holistic nutrition, there are many ways to choose then prepare food stuff in order to optimize/ maximize/ preserve nutrient value. It is most important to eat in a unhurried manner, and chew ones food thoroughly.

HERBS FOR DYSLIPIDEMIA
Xu, Shi & Che (2012) found that Chinese herbs that Activate Blood Circulation (ABC) could treat atherosclerotic plague [AS] in multiple ways: lowering blood lipids, inhibiting platelet adhesion & aggregation, and improving blood viscosity. The final effect of ABC herbs on stabilizing AS was slightly less than that of Simvastatin, but showed superior effects on increasing HDL. The ABC herbs studied were Radix Salviae Miltiorrhizae (dan shen), Radix Paeoniae Rubra (chi shao) , Rhizoma Chuan xiong, Radix Notoginseng (san qi), Semen Persicae (tao ren), Wine steamed Rhizoma Rhei (da huang). 

Below is a list of herbs and the aspects of dyslipidemia they are shown to benefit. Shan zha and tea (camillia leaf) stand out as a versatile herbs to self-treat with. Shan Zha (Chinese hawthorne berry) is traditionally soaked in wine or liquor then imbibed for almost all aspects of dyslipidemia. Oolong tea [neutral], Black tea [warming], or Green tea [cooling] facilitate the digestion of fats after a rich meal. It is important to take a bedtime dose of for elevated total cholesterol. This is because cholesterol is synthesized at night.

LDL 
 shan zha, tea, jie geng, sanqi, cassia,
VLDL 
 shan zha 
TG 
 shan zha, rou gui, aloe vera, lychii, fenugreek
T. Chol 
 shan zha, tea, rou gui, aloe vera, ginger, lychii, reishi, fenugreek, sanqi,  pumpkin, ge gen, Chinese  willow, cassia.
HDL 
  tea, rou gui, ginger, reishi, lychii,
Inc Digest
Dec Absorp
of fats
  tea/ jie geng/ tea

TEAS FOR DYSLIPIDEMIA
There are many Chinese and Western herbals and formulas for the patterns associated with dyslipidemia (see below). Simplicity is important because any intervention must become part of a person's lifestyle choices on a daily basis. Using food-as-medicine is a good way to accomplish this! Seek a healthcare professional's consult before using any herbs for cardiovascular health (especially if you are already taking medication for CVD; take a blood thinner; are/or expect to get pregnant):

  • High cholesterol + obesity + HTN15g shan zha (Chinese hawthorne berry) +  12g he ye (lotus leaf)

  • Hyperlipidemia + obesity + blood stasis:  10g lu cha (green tea) + 10g he shou wu + 10g ze xie (diuretic) +  10 dan shen

  • High cholesterol + blood stasis, frees the network vessels: 30g shan zha + 10g yi mu cao (motherwort, see cautions) + 5g tea 

  • High cholesterol + blood stasis: 9g dan shen + 3g lu cha

  • Atherosclerosis + HTN + blood stasis: 10g dan shen +  10g raw shan zha + 5g mai men dong (cardio-tonic)

  • Atherosclerosis (with chest bi), post stent placement: vinegar-soaked shan zha, hong hua (saffron) & xie bai (like shallots). Tea of san qi powder, shan zha, hong hua. Foods: Chicken or lean pork stew with san qi powder, and he mu er (improves blood viscosity) gao liang (sorghum), red quinoa (S. American sorghum), blanched chives, rice or red wine-soaked chives (Pang).

  • Ku Ding Cha is a traditional Chinese tea researched to lower cholesterol. It is decocted from leaves of the Illex genus: holly plant leaf, solitary leaf. It is also known as  gaolu tea, fuding tea or, chading. In TCM terms, Ku Ding Cha regulates blood flow, dries phlegm, and generates fluids (Luria & Zelicha, 2009)

  • Trinity Tea proprietary product that contains many of the herbs mentioned in this article.

PATTERNS ASSOCIATED WITH DYSLIPIDEMIA
Root Patterns 
  • dampness and/or phlegm accumulation 
  • blood stasis 
      Causes (diet, lifestyle, aging, genetics):
  • turbid-damp-phlegm in the liver & gallbladder
  • Liver qi stagnation transforming to phlegm
  • Spleen qi deficiency
  • Kidney yang deficiency
  • Lung, Stomach & Kidney yin deficiency. 

Branch Patterns (manifestations or sequela of dyslipidemia)
  • Blood stagnation and phlegm accumulation in the chest (angina, heart attack)
  • Liver fire and yang rising (hypertension) generating wind (transient-ischemic attacks, stroke)
  • Phlegm stagnation blocking the orifices (arterial and venous insufficiency)


Integrative  Medicine  Tip: Vitamin K is highly anti-atherosclerotic, inhibiting the deposition of calcium in vessel walls, with subsequent hardening of vessels walls. A combination of vitamin K and D3 is recommended for both cardiovascular disease and osteoporosis (there are combination D3/K supplements). D3 facilitates the absorption of calcium from the GI tract into the blood. K2 facilitates the transport of calcium from the blood into bones. Rich sources of vitamin K1 are green leafy vegetables, brussels sprouts, watercress, avocados, kiwi fruit, and olive oil. Sources of vitamin K2 are meats, eggs & certain cheeses. Vitamin K3 is the prescription form given via IM injection (Professional Medical Education).


Reference 
Pang, J. Dietetics: Cardiovascular & digestive. In HealthCMi.
Weber, D. Mai men dong. Dui Yao: The Art of Formula Construction. Retrieved from
Xu, H., Shi, D., & Che, K. (2012). Atherosclerosis: An integrative east-west medicine
     perspective. Evidence-Based Complementary & Alternative Medicine 2012. Retrieved
Luria, U., & Zelicha, K. (2009). Cholesterol and Chinese medicine. Journal of Chinese Medicine
     89, 30-35.
Professional Medical Education. Nutrition for hepatitis C. In Hepatitis C Professional Training and Certification program.

(double click on videos for full screen view)















An Apple, Beet & Carrot A Day                      Hawthorne-Western










Hawthorne- Chinese                                        San Qi

















Culinary Herbs & Oils for CVD                          Dan Shen (Note"blood stasis". See
                                                                                                                    blood flow  & velocity improve
                                                                                                                    when plaque is  reduced.


















Ku Ding Cha- this tea is very bitter

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