Taking On The ‘Silent Killer’

Cholesterol is often called the ‘silent killer’, showing no outward sign, but accumulating along the arteries, and increasing the risk of heart disease and stroke.

Yet, the body needs good cholesterol to function effectively. High-density lipoprotein (HDL), another name for ‘good’ cholesterol, is the proverbial clean-up crew that helps to transfer low-density lipoprotein (LDL), or ‘bad’ cholesterol, to the liver for elimination. Cholesterol also plays an important role in the production of hormones, bile and Vitamin D, and acts as a structural component in cell membranes.

Traditional Chinese Medicine (TCM) views cholesterol as a natural part of the flow of nutrients and energy that travels within blood vessels around the body. In fact, there isn’t actually a term for ‘high blood cholesterol’ in TCM, says Eu Yan Sang physician He Yuying. Instead, TCM practitioners talk in terms of imbalances caused by factors like poor diet, a sedentary lifestyle, advancing age, and genetics, she explains.  

These imbalances impact the liver, spleen and kidney systems, causing deficiencies in these systems, and symptoms like excessive phlegm, the stagnation of moisture and blood, and a deficiency of yin in the liver, all of which can cause chest pains and complications in the heart and blood vessels, she says.

Portrait of a silent killer

It is vital that cholesterol levels be regularly monitored – high cholesterol, known medically as hypercholesterolaemia, produces no external symptoms.

Hypercholesterolaemia occurs when total cholesterol (TC) levels exceed 240mg/dL, or when LDL cholesterol (LDL-C) exceeds 130mg/dL. A person with other risk factors for heart disease — such as smoking, hypertension or diabetes — should aim for a lower TC level.

Cholesterol plaques build up in the arteries, a condition called atherosclerosis. This could partially or totally obstruct blood flow to organs such as the brain, heart or kidneys, as well as to the extremities.
A 2014 Euractiv report quoting the World Health Organization and the Cardiovascular Resource Group names cholesterol as a major cause of death globally, responsible for 2.6 million deaths per year. Europe chalked up the largest number of cholesterol-related deaths, with 133 million sufferers in Germany, France, Italy, Spain and the UK alone. In the US, too, heart disease and stroke are among the leading causes of death in both men and women.

For many doctors and their patients, the answer to managing cholesterol is statins, which inhibit an enzyme that promotes the production of cholesterol in the liver.  

TCM offers a complementary approach to managing cholesterol, bearing in mind multiple factors, from age to lifestyle, before issuing a treatment regime that often involves both herbal medication and acupuncture, as well as diet and lifestyle changes.

A holistic approach

For 60-year-old Anna*, high cholesterol and high blood glucose levels both showed up during a general health assessment. She also experienced bloating and watery stools, and decided to try TCM.

Physician He, who was treating her, prescribed herbal medication aimed at improving qi circulation and boosting kidney yin. Anna also reduced her intake of cold, fatty and spicy foods and began exercising more. Over the course of four months, her total cholesterol level came down from 264mg/dL to 234mg/dL, and her other symptoms also improved.

TCM herbs that help with cholesterol levels include pu-erh tea (普洱茶), oyster mushrooms (平菇) and Red Yeast Rice (红曲), all of which contain natural statins. Other herbs commonly prescribed include Hawthorn Fruit (山楂), which lowers blood lipids and helps treat certain cardiovascular diseases; Cassia Seeds (决明子), which promote bowel movements, reduce weight gain from nutritive obesity, reduce triglycerides (blood fats) and suppress the formation of atherosclerotic plaque; Coix Seeds (薏苡仁), which improve digestion and treat hypolipidemia; and Finger Citron Fruit (佛手柑), which treats poor digestion, improves appetite and lowers blood cholesterol.  Specific herbs or herb-combinations are prescribed based on each individual’s symptoms.

Anna continued with her herbal medication to try and bring the levels down further, into the normal range. Her level of hemoglobin A1c, which indicates average plasma glucose concentration, continued to improve, based on readings taken 10 months after her initial blood test.

Besides herbal remedies, acupuncture can also help maintain a balance in cholesterol levels. A 2014 study on menopausal rats at Peking University in Beijing, China, found that acupuncture and moxibustion lower plasma LDL and increase plasma HDL, and have a positive effect on blood lipids.

Any kind of medication for cholesterol, however, needs to be supported with lifestyle changes, says Physician He.

“You need to get enough exercise and sleep, and eat well, with a diet that includes fruit, vegetables, whole grains, and good quality fats. You should also avoid alcohol, smoking, and consuming meat and dairy products high in saturated fats. That will make a big difference,” she says.

High cholesterol: Are you at risk?

•    Diet: This is the biggest factor, since a diet rich in saturated fats naturally leads to increased cholesterol levels.
•    Age: Blood cholesterol levels tend to rise with age. Men over 35 and those over 20 with risk factors for heart disease (family history, obesity, smoking) should test their cholesterol levels more frequently. Generally, those between 20 and 79 should get their cholesterol levels checked every four to six years.
•    Gender: Men over 35 and post-menopausal women have the highest risk of developing unhealthy cholesterol levels.
•    Family History: High cholesterol levels tend to run in families, as genetics partly determine how much cholesterol your body makes.
•    Weight: Being overweight increases your risk of high cholesterol levels as well as of other ailments, including heart disease.
•    Lifestyle: Heavy drinkers and smokers, and those with a sedentary lifestyle, are at higher risk