Life Extension Magazine May 2005
As We See It
Doctors Overlook Novel Methods to Prevent Heart Attack
By William Faloon
How Effective Is Vitamin E?
If you were to ask a nutritionist which supplement most effectively lowers C-reactive protein, the most likely answer would be vitamin E. Numerous studies show a significant CRP-lowering effect in response to supplemental vitamin E.36,37 A recent study of baboons showed that alpha tocopherol vitamin E reduced CRP by 52%. When coenzyme Q10 was added to the vitamin E supplementation program, CRP was reduced by 70% compared to baseline.38
Cigarette smoking causes a significant increase in CRP. In a recent study of smokers with established heart disease, 400 IU of alpha tocopherol reduced CRP by an impressive 57%.39
Those with kidney disease undergoing dialysis have high CRP levels. In a study of patients with end-stage kidney disease, 400 IU of alpha tocopherol did not lower CRP levels. This study, however, revealed that in response to alpha tocopherol supplementation, gamma tocopherol levels in the body declined by 61%.40 This finding is significant because of evidence that gamma tocopherol is the preferred form of vitamin E to reduce inflammatory processes.41
In a related study, administration of a gamma tocopherol supplement to dialysis patients resulted in a 52% reduction in C-reactive protein, helping to confirm the critical importance of the gamma form of vitamin E.40
A large body of published research indicates that vitamin E, in either alpha or gamma form, reduces CRP in both healthy individuals and those with serious disease.42
Fiber and CRP Levels
As noted earlier, what you eat has lot to do with your CRP level. Ingesting soluble fiber before you eat diminishes the post-meal spike of excess glucose and insulin in the blood.
In a recent study conducted under the auspices of the Centers for Disease Control and Prevention, 3,920 participants who participated in the National Health and Nutrition Examination Survey were evaluated to ascertain dietary fiber intake and blood CRP levels.44
The CRP level of study subjects who ingested the most dietary fiber was 41% lower than the level of those who ate the least fiber. The doctors who conducted this study concluded:
“Our findings indicate that fiber intake is independently associated with serum CRP concentration and support the recommendation of a diet with a high fiber content.”
A higher intake of dietary fiber may decrease the risk of developing cardiovascular disease. Studies have documented that consuming more fiber safely lowers CRP. Yet cardiologists are overlooking the multiple beneficial effects of fiber in not only lowering CRP, but also reducing excess blood glucose and insulin. All of these factors—CRP, glucose, and insulin—contribute to the atherosclerosis process.
What Level of C-Reactive Protein Is Optimal?
The standard reference range for C-reactive protein (CRP) is 0-3.00 milligrams per liter (mg/L) of blood. The standard reference ranges indicate that CRP under 1.00 mg/L is ideal, between 1.00 and 3.00 mg/L is average, and over 3.00 mg/L is cause for concern.45
As has been the case for many years, we at Life Extension vehemently disagree with today’s standard reference ranges. It is our contention—based on published scientific research—that CRP should be under 0.55 mg/L in men and under 1.50 mg/L in women.
If you were a man relying on your doctor to interpret your blood test results, he would view a CRP level of 2.00 mg/L as being “average.” That would put you at “average” risk of having a heart attack, which happens to be a leading cause of death. Why anyone would accept an “average” risk of having a heart attack is beyond our comprehension.
Life Extension has been consistently ahead of conventional medicine in determining optimal blood marker levels. Since our inception, we have stated that ideal levels of glucose and LDL are under 100 mg/dL of blood. Only recently were reference ranges for glucose lowered from 109-124 to less than 100 mg/dL. Several years ago, doctors announced that LDL should ideally be less than 100 mg/dL instead of the previously accepted range of up to 130 mg/dL.
Mainstream Medicine’s Mediocre Objectives
The two studies published in the New England Journal of Medicine received a lot of publicity because they showed that statin drugs cut heart attack risk by lowering CRP.
The percentage of CRP reduction, however, was not that significant. In one study that evaluated the effects of moderate- to high-dose statin drug therapy, CRP was reduced on average from 2.9 to 2.3 mg/L—a 21% reduction. The other New England Journal of Medicine study observed heart attack risk reduction when CRP fell below 2.00 mg/L and 1.00 mg/L.1,2
We at Life Extension are not impressed by these modest reductions in CRP, yet they are considered a breakthrough by conventional medicine’s mediocre standards.
When you consider that people with a high dietary intake of fiber have 41% lower CRP levels, that supplementation with alpha or gamma tocopherol was shown to lower CRP by around 50%, and that merely eating functional foods such as almonds and soy protein reduces CRP by 28%, the effect of very high-dose statin drugs in reducing average CRP levels by 21% is not remarkable.
What’s striking is the reduction in heart attack risk and the slowing of coronary atherosclerosis in patients receiving the statin drugs. We believe that some of these benefits are attributable to the effects of statin drugs in improving the health of the arterial wall (endothelial function), a mechanism that was not discussed in the press reports. These same effects, however, have also been demonstrated in response to supplementation with folic acid,46-51 fish oil,52-54 vitamin C,55-59 and lipoic acid.60-64
Some Common-Sense Approaches
For those with coronary atherosclerosis who do not respond to natural approaches, statin drug therapy may be considered. For a statin drug like Lipitor®, ask your doctor about taking 10 mg every other day. Higher doses should be considered only when all else fails.
The subjects in the New England Journal of Medicine studies were given daily doses of 80 mg of Lipitor® (a very high dose) or 40 mg of Pravachol® (a moderate dose). The best results occurred when blood tests revealed LDL levels under 70 mg/dL and CRP under 1.00 mg/L. To achieve these results, the subjects used a daily dose of up to 80 mg of Lipitor®. In some cases, the more moderate dose of 40 mg of Pravachol® achieved the same optimal blood results. The researchers emphasized that the favorable clinical results were based solely on the blood test numbers—that is, it did not matter which drug (Lipitor® or Pravachol®) was used. Those with the lowest LDL and CRP had the fewest heart attacks and slower progression of coronary atherosclerosis.
The problem with using 80 mg of Lipitor® daily is side effects. Some of the toxicities associated with high-dose intake of statin drugs are well known, while the long-term effects are unknown.
If a cardiac patient wishes to achieve LDL levels below 70 mg/dL, it might be safer to use a lower dose of Lipitor® combined with a diet-modification program. This program would include: eating cholesterol-lowering functional foods such as almonds and soy protein; consuming soluble fiber before each meal; avoiding trans fatty acids, saturated fats, and high-glycemic carbohydrates; and supplementing with alpha and gamma tocopherol and acetyl-L-carnitine, along with fish oil, folic acid, vitamin C, and lipoic acid. These nutrients are known to help suppress triglycerides, maintain healthier endothelial function, and suppress CRP. Using natural supplements like Sytrinol™ could further reduce the statin drug dose needed to lower LDL levels.65
The Statin Drug Controversy
There has been a longstanding dispute between mainstream and alternative medicine regarding the safety and efficacy of statin drugs. We at Life Extension have taken a balanced approach in our reporting, emphasizing both the pros and cons of statin drug therapy.
In the November 2004 issue of Life Extension, an article entitled “Cholesterol & Statin Drugs: Separating Hype from Reality,” authored by William Davis, MD, presented the facts about the benefits of statins, along with data showing that these drugs are often over-prescribed.66
One of the problems we have identified when evaluating our members’ blood test results is that cholesterol levels are often reduced too much in response to statin drug therapy. It is our position that the ideal cholesterol blood level is 180-200 mg/dL and that levels below 160 mg/dL are particularly dangerous. Cholesterol is required for the natural synthesis of hormones,67,68 for blood vessel wall maintenance,69 and for maintaining proper cell membrane structure and function.70 Driving cholesterol to abnormally low levels can wreak havoc throughout the body.
The dose of statin drugs prescribed by most doctors often results in cholesterol readings far below 160 mg/dL. The obvious solution to this problem is to take a lower dose of the statin drug. We have found that cutting the dose of a statin drug in half and even by three-quarters maintains LDL under 100 mg/dL and total cholesterol under 200 mg/dL.
How dangerous is too-low cholesterol? A huge study followed 350,977 middle-aged men for an average of 12 years. Those whose total cholesterol levels were under 160 mg/dL doubled their risk of brain hemorrhage and significantly increased their risk of death from cancers of the liver and pancreas, digestive diseases (particularly hepatic cirrhosis), suicide, and alcohol dependence syndrome. In addition, men with total cholesterol under 160 mg/dL had increased risks of cancers of the lung, lymphatic, and blood (leukemia) systems, and chronic obstructive pulmonary disease.71
A study of 11,563 men showed that over a five-year period, men whose cholesterol levels were below 160 mg/dL had a 2.27-fold increase in mortality from non-cardiac deaths and the same rate of death for heart attack compared to men with higher cholesterol levels.72
Numerous studies indicate that those with cholesterol levels below 160 mg/dL suffer severe health consequences, with mental depression and suicide being particularly troublesome. Since cholesterol is the precursor to “feel good” hormones like testosterone and estrogen, some scientists believe that reducing cholesterol to too low a level can have a significantly negative impact on one’s mental health.73-79
Doctors are prescribing higher-dose statin drugs for the purpose of preventing heart attacks without considering that these same drugs may be lowering their patients’ cholesterol levels too much. We at Life Extension have long advocated safer approaches for maintaining vascular health that may accomplish better results without side effects. While drug company public relations firms and the media heavily tout the statin drugs, Life Extension members learn the facts that underlie the headlines.