Article on Treatment of Cholesterol

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Date: February 15, 2006 Re: Clinical Trial Examines Combination of Statin and Psyllium Therapy in Treatment of Cholesterol Moreyra A, A, Koraym A. Effect of combining psyllium fiber with simvastatin in lowering cholesterol. Arch Intern Med. 2005;165:1163-1166. People with elevated low-density lipoprotein cholesterol (LDL-C) have an increased risk for coronary heart disease. Statins are a class of drugs that are useful for reducing LDL-C and decreasing LDL-C associated morbidity and mortality. Studies show that the soluble fiber in psyllium husk also decreases LDL-C. There are no controlled studies that examine a combination therapy of statin and psyllium. The authors hypothesize that the combination will be more effective and test the hypothesis in this randomized, double-blind,

placebo-controlled, 3-arm parallel study.Patients (n = 68; 40 males; 28 females; age: 18-80 years) with hyperlipidemia requiring treatment participated in this study conducted at the Wood Medical School, New Brunswick, New Jersey. The first phase of the study consisted of 4-week diet stabilization and baseline assessment. Next, patients received either 8-weeks of (1) simvastatin 20 mg plus placebo (Tang beverage [Kraft Foods North America Inc, Rye Brook, NY]), (2) low-dose simvastatin 10 mg plus placebo, or (3) low-dose simvastatin 10 mg plus psyllium soluble fiber (18 g smooth-texture orange-flavored Metamucil [Procter & Gamble Co., Cincinnati, Ohio] containing 5.1 g psyllium husk and 3.6 g of soluble fiber). Lipid and lipoprotein levels were evaluated. Demographic and baseline characteristics were similar among the treatment groups. At the end of treatment, compared to baseline, total cholesterol decreased 61 mg/dL in the 20 mg simvastatin group

and 66 mg/dL in the combination group. Compared to the patients taking 20 mg simvastatin only, more patients taking the combination treatment reached the LDL-C goal; however, the difference was not significant. Apolipoprotein B (important for lipid transport and metabolism) levels were reduced more with the combination treatment than with simvastatin alone (P < 0.05). Simvastatin and psyllium had no statistical or clinical effect on triglyceride levels. The combination treatment was well tolerated.The data shows that adding psyllium soluble fiber to a small dose of statin is as effective in lowering cholesterol as a double dose of statin. Statins are safe and well tolerated but higher doses cause more adverse events than lower doses. The authors conclude that psyllium supplementation is a safe and well-tolerated alternative to escalating the dose of statin to enhance the LDL-C lowering effects. It is important to note that this study was conducted with a soluble fiber

rather than an insoluble fiber. The typical American diet is often deficient in dietary and soluble fiber. Low-carbohydrate diets, like the Atkins diet, reduce fiber intake even further. Additional soluble fiber would benefit most Americans.— S. Oliff, PhDHerbs for Health Suzi What is a weed? A plant whose virtues have not yet been discovered. health/ http://suziesgoats.wholefoodfarmacy.com/

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