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Best supplements for cholesterol: A pharmacist’s top two supplements for high cholesterol – Express

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Cholesterol is a fatty substance made in the liver. It is vital for the normal functioning of the body, but having too much of it in the blood can lead to heart disease. People who have high cholesterol are advised to make changes to their diet in order to lower the level of cholesterol in the blood. If patients struggle to make appropriate dietary changes or the dietary changes they make don’t help, they may be prescribed cholesterol-lowering medication. The most common medication for high cholesterol is statins. Statins block the enzymes in the liver that help to make cholesterol, leading to a reduction in cholesterol levels.

However, statins can have undesirable side effects like headaches, muscle pain and stomach problems.

Statins will only be prescribed to patients who continue to be at high risk of heart disease, according to the NHS, so making efforts to lower cholesterol via dietary changes is essential.

Express.co.uk spoke to LloydsPharmacy pharmacist Pareena Patel, who recommends two particular dietary supplements for lowering cholesterol.

Plant stanols and sterols

Stanols and sterols are plant chemicals that have a similar structure to cholesterol. They are absorbed from the intestines into the blood stream and block some cholesterol from being absorbed, in turn lowering the cholesterol in your blood.

Plant stanols and sterols can be found in foods including vegetable oils, nuts and seeds, but not in high enough quantities to lower cholesterol levels.

Because it is not possible to get enough plant stanols and sterols from an everyday diet, specialist ranges of dairy foods such as margarines and yoghurt drinks have been fortified with them to help lower cholesterol levels.

“Most diets provide a small amount, however people who have high cholesterol levels may benefit from increasing their intake by eating foods that have added fortified plant stanols,” said Patel.

“A certain amount of plant stanols and sterols must be consumed each day for the desired effect to be achieved – specifically between 1.5 and 3.0g.

“Be sure to follow the manufacturer’s instructions on the amounts you should consume each day.”

Beta-glucan

Beta-glucan is a type of fibre that forms a gel which binds to cholesterol in the intestines. This helps limit the amount of cholesterol that is absorbed from the gut into the blood.

“Beta-glucans help to lower cholesterol levels by slowing food transit in the intestine, so the body takes longer to digest food. This means that cholesterol isn’t absorbed as quickly,” said Patel.

Beta-glucan can be found in foods such as oats and barley, but it can also be taken as a supplement.

“Lifestyle and dietary changes should always be the first step in the management of high blood cholesterol,” said Benecol nutritionist Sarah Franciosi.

“Making some simple dietary changes such as replacing saturated fat with unsaturated fat, eating more fibre, and introducing products with added plant stanols can all help to bring cholesterol levels back to within a normal healthy target range.”

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Global Dietary Supplements Market Overview 2019-2026 : Amway, Bayer, Glanbia, Herbalife International of America, Abbott – Industry News Network

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Best supplements for tiredness – the 1p a day capsules to boost energy and prevent fatigue – Express

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Feeling tired all of the time could be caused by not getting enough sleep, or by spending too much time at work. Tiredness that goes on for long periods of time isn’t normal, and may be caused by an underlying medical condition. But, taking some supplements may help you to feel more energetic, and less lethargic. You could lower your chances of feeling tired, and improve your day-to-day energy by taking vitamin B12 supplements, it’s been claimed.

Feeling fatigued more than usual could be a sign of a vitamin B12 deficiency, warned Harvard Medical School.

Vitamin B12 is needed to make red blood cells, DNA and nerves. But it can’t be made naturally in the body, and is needed from your diet.

You could top up on vitamin B12 by eating more clams, liver, beef, Greek yogurt, or even eggs.

“Vitamin B12 deficiency can be slow to develop, causing symptoms to appear gradually and intensify over time,” said the medical school.

“Given the array of symptoms a vitamin B12 deficiency can cause, the condition can be overlooked or confused with something else.

“Vitamin B12 deficiency symptoms may include weakness, fatigue, strange sensations, numbness, or tingling in the hands, legs, or feet.

“A standard multivitamin delivers 6 micrograms, more than enough to cover the average body’s daily need.

“If you are over age 50, the Institute of Medicine recommends that you get extra B12 from a supplement, since you may not be able to absorb enough of the vitamin through foods.”

You could also be at risk of a vitamin B12 deficiency if you develop a swollen, or inflamed tongue, or difficulty walking.

Most people should be able to get enough vitamin B12 from their daily diet, said the NHS.

But, if you do decide to take vitamin B12 supplements, you should avoid taking more than 2mg a day, as it could be harmful.

Other than a vitamin B12 deficiency, your persistent tiredness could be caused by stress or anxiety.

Anaemia, an underactive thyroid and sleep apnoea could also lead to feeling tired all of the time.

If you’ve been feeling tired for more than four weeks, it’s a good idea to speak to a doctor, said the NHS.

Making sure you get enough sleep could help to prevent you from feeling sleepy the next day.

Most adults need between six and nine hours of sleep every night to perform at their best the next day.

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FDA proposes overhaul of dietary supplement industry – Healio

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The dietary supplement world is a murky place where you spend your money on a product that may or may not have any active ingredient in it, may not contain the promised dosage or concentration of the active ingredient, or it might include adulterants and contaminants.

I have read and written about many examples of this.

For example, some natural products for male enhancement, muscle building and weight loss that have been adulterated with unlabeled prescription drugs, including those banned by the FDA because they have been proven to be unsafe. In addition, the dietary supplement Kava had been considered safe for years before cases of liver toxicity suddenly started popping up, leading to worldwide restrictions and cautionary messages from the FDA. Kava didn’t suddenly become more dangerous; what likely occurred is that its growers started substituting a variety of the plant that grew faster to create greater yields, but the locals knew they should never use for medicinal purposes. 

The list goes on: some kratom products contain a far greater concentration of 7-hydroxymitrogynine than would occur naturally, leading to suspicion that it is enriched with a chemical that has stronger opioid effects and addiction potential; some cannabidiol products had only 12.5% of vaporization liquids, 25% of tinctures, and 45% of oils labelled correctly (plus or minus 10% of the labeled value). In most cases, these products contained far less cannabidiol than promised and some cannabidiol products contain enough THC to put the user in legal jeopardy of marijuana possession. Some dietary supplements have been shown to contain excessive amounts of cancer-causing polycyclic aromatic hydrocarbons and contaminants such as heavy metals and mold.  

How many more debacles must occur where the public trust is shoved aside to make a quick buck before people turn their back on natural remedies? The FDA can take decisive action that can reduce misinformation, fraud, abuse and unintentional poor cultivation and manufacturing practices. This can enhance the safety of dietary supplements sold in the U.S. and actually sustain this marketplace over the long-term.

No dietary supplement should be touted to prevent or cure any disease. Using a mouse study, in vitro cell study, or case report to market a dietary supplement’s disease modifying effects is fraudulent and hurts the public’s trust.

The FDA already had guidance on good manufacturing practices, but following them is not compulsory before placing a dietary supplement product on the U.S. market. Manufacturing plants, including those overseas, need to be personally inspected by the FDA. We know from the generic drug market and now the debacle with angiotensin receptor blocker manufacturers that the FDA’s history of inspecting foreign manufacturers is poor. Furthermore, all products should be tested periodically by an outside lab certifying that the products are free from contamination and adulteration, while possessing the promised dosage of the active ingredient, before it is allowed to be sold and randomly checked periodically thereafter. This would protect consumers and put the onus on the final manufacturer to ensure the quality of the products they are receiving from other cultivators or manufacturers. All of the costs of this outside testing should be borne by the manufacturers plus a surcharge to pay for additional FDA inspectors overseas. The current system where an overwhelmed FDA tries to fit in oversight of dietary supplements has to change.

Commissioner Gottlieb’s most recent proposal is sound and would go a long way in ensuring dietary supplement safety, but the agency will need a marked increase in resources to bring it to reality.

References:

Alltucker K, Hafner J. USA Today. “Why do blood pressure medications keep getting recalled? Here’s what we do know.” Accessed Feb. 12, 2019.

Liva R. Integrative Medicine: A Clinican’s Journal. “Facing the problem of dietary-supplement heavy-metal contamination: How to take esponsible action.” Accessed Feb. 12, 2019.

Tournas VH. Journal of Food Safety. 2009;doi:10.1111.j.1745-4565.2009.00167

White CM. Am J Health Syst Pharm. 2018;doi:10.2146/ajhp161035.

White CM. J Clin Pharmacol. 2018;doi:10.1002/jcph.1263.

White CM. J Clin Pharmacol. 2019;doi:10.1002/jcph.1387.

White CM. The conversation. “Beware of natural supplements for sex gain and weight loss.” Accessed Feb. 12, 2019.


  • C. Michael White, PharmD, FCP, FCCP

  • department of pharmacy practice, University of Connecticut

Disclosures: White reports no relevant financial disclosures.

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