THE RIGHT PRESCRIPTION
For some people (like diabetics or younger people with high cholesterol), natural remedies may not be enough and conventional therapies must be added. The most successful and widely prescribed medications are statins, which work in the liver to reduce the production of cholesterol and also help your body reabsorb some of the cholesterol that has accumulated in your blood vessels. Two other medications work in the digestive tract: Cholesterol absorption inhibitors block absorption of dietary cholesterol, and bile-acid sequestrants bind cholesterol-rich bile acids in the intestine and prevent them from being reabsorbed into the bloodstream. No drug is without side effects. The main complaints are gastrointestinal discomfort, diarrhea, and constipation, which for most people subside naturally within a couple of weeks—but other patients require a dosage adjustment. Statins have come under fire because of two rare but potentially severe side effects: liver damage and muscle breakdown that can lead to kidney failure. If your physician prescribes statins, you should be tested and evaluated periodically to make sure you show no signs of either. By her late 20s, Jackie Lieberman saw her total cholesterol top 300 mg/dL. “I tried everything to stay off medication,” she says. “I started eating more fruits, vegetables, and grains, less cheese and ice cream, and fewer high-fat foods. I started taking vigorous yoga classes, and I lost 35 pounds.” After two years of this regimen, her cholesterol had dropped to only 267 mg/dL, so her doctor put her on Crestor (rosuvastatin) and told her that because she has a family history of high cholesterol, she’ll probably always take medication. She continues to exercise, watch her diet, and take omega-3 and soluble fiber supplements. At her last checkup this past January, her total cholesterol was down to 226 mg/dL—not perfect, but a big drop from where she’d started. Lucky for Lieberman, her heart-protective HDLs are very high (86 mg/dL on her most recent test) and her triglycerides have always been below the desirable limit.