Q: I am a 59-year-old woman. I have high cholesterol. My total cholesterol level is 8.03mmol/L, my low-density lipoprotein (LDL) cholesterol level is 5.48mmol/L, my high-density lipoprotein (HDL) cholesterol level is 1.79mmol/L and my triglyceride level is 1.67mmol/L.
I have not started taking Western medicine as my doctor told me that once I start doing so, I have to take the medication for the rest of my life.
Is there any traditional Chinese medicine (TCM) that I can take to lower my cholesterol level?
A: High cholesterol is a condition in which the amount of cholesterol in one's bloodstream exceeds a normal level. The cholesterol may then be deposited on the inside lining of arteries, leading to heart disease.
Your HDL level is good and your triglyceride level is normal. However, your LDL and total cholesterol levels far exceed the norm. I would suggest you take Western medicine immediately to bring them down.
Once your cholesterol levels are normal - when the LDL level is less than 3.37mmol/L and the total cholesterol level is less than 5.18mmol/L - you can choose to combine TCM with Western medicine. This can help reduce your dosage of the Western medicine.
In TCM, high cholesterol is probably due to deficiencies in the stomach, spleen, kidneys and liver, and weak qi (energy) and blood circulation. A good flow of blood and qi, and a balance of yang (linked to heat and dryness) and yin (linked to coldness and moisture) are required for good health.
The stomach receives and digests food. The spleen absorbs and converts the nutrients into qi and blood. When the stomach receives too much food and the spleen is unable to absorb the nutrients in time, the excess nutrients will be stored in the muscles.
This will trigger high cholesterol with symptoms such as becoming hungry and thirsty easily, excessive eating and drinking, a love for greasy food, dry stool and yellowish urine.
When the spleen is weak - due to ageing, a weak constitution, chronic disease, alcohol consumption and a poor diet of raw, oily and spicy food - it will convert the nutrients into phlegm and "dampness".
These will block the arteries and trigger high cholesterol with shortness of breath, coughing with phlegm, palpitations, numb and heavy limbs and a bloated stomach.
The kidneys regulate the body's water metabolism. If yang in the kidneys is insufficient - due to ageing, chronic disease and a weak constitution - it will lead to water retention and accumulation of "dampness".
This will trigger high cholesterol with water retention in the face and limbs, soreness and aching of the back or knees, fear of the cold, a bloated stomach and loose stool.
The liver controls qi circulation. When the liver is weak - due to ageing and negative emotions such as depression, fear and anger - qi will stagnate within it, creating "fire".
The "fire" can dry up the yin in the liver, triggering high cholesterol with dizziness, insomnia, a dry mouth, hot hands and feet, and high blood pressure. The "fire" can also further weaken the spleen.
Chinese medicine, acupuncture and cupping can help to improve your condition by strengthening your organs. In cupping, fire and cups are used to create a vacuum on the skin to enhance blood and qi circulation.
Chinese medicine such as rhubarb, officinal magnolia bark, cape jasmine fruit, baical skullcap root and figwortflower picrorhiza rhizome clear the stomach.
Indian bread, orange fruit, snakegourd fruit, pinellia tuber and atractylodes rhizome strengthen the spleen.
Cassia twig, Asiatic cornelian cherry fruit, prepared common monkshood daughter root, processed rehmannia root, common yam rhizome and oriental waterplantain rhizome strengthen the kidneys.
Gambir plant, tree peony bark, white peony root, Chinese angelica, tall gastrodia tuber, barbary wolfberry fruit and glossy privet fruit strengthen the liver.
Safflower, hawthorn fruit, peach seed, red peony root and red sage root enhance qi and blood circulation.
You should eat more vegetables, fruit, mushrooms, barley and oats to increase the yin in your stomach.
Avoid eating animal fat and organs, shellfish, prawns, crabs, cakes, sweets and desserts to reduce phlegm and "dampness".
Abstain from alcohol, smoking and negative emotions, which create "fire" in the liver and internal "heat" and "dampness". These damage the blood vessel walls, making them more prone to fatty deposit build-up.
Keep your home environment quiet with fresh air and reduce noise level to enhance your qi circulation. Doing exercise, such as swimming, brisk walking and taiji, for 30 minutes on five or more days a week will help enhance qi circulation and reduce excess weight.
Ms Lim Lay Beng
Traditional Chinese medicine practitioner at YS Healthcare TCM Clinic
People's cholesterol levels are influenced by a combination of factors that include genetic predisposition, diet, exercise and other co-existing medical conditions.
An elevated level of low-density lipoprotein (LDL) cholesterol, or "bad" cholesterol, is linked to an increased risk of heart disease.
So the aim is to lower the level of LDL cholesterol in those whose level is high.
The target total cholesterol and LDL cholesterol for each individual will depend on his risk factors for heart disease, such as whether he has high blood pressure, diabetes mellitus and a history of smoking.
Even for individuals at very low risk of heart disease, the LDL cholesterol should be less than 4.1mmol/L, and ideally less than 3.4 mmol/L.
At 5.48mmol/L, your LDL cholesterol level is quite high.
At 1.79mmol/L, your high-density lipoprotein (HDL) cholesterol level is high, exceeding the desirable minimum level of 1.6mmol/L, and that is good. Hopefully, this will afford you some protection from heart disease.
Nevertheless, the major determinant of coronary heart disease is still a high LDL cholesterol level. The contribution of a high LDL cholesterol level to the risk of coronary heart disease is greater than that of a high triglyceride level, that of a high total cholesterol level and that of a low HDL cholesterol level.
Hence, you should certainly try to lower your LDL cholesterol level to minimise your risk of future cardiac events, such as heart attacks.
In general, people can improve their cholesterol levels with effective diet control and regular exercise by up to 10 to 20 per cent, on average.
However, these lifestyle measures have to be maintained to sustain the cholesterol-lowering effects.
People can also take medication to lower their cholesterol level.
As the raised risk of heart disease will be present throughout the life of a person with high cholesterol, medication that he takes to lower cholesterol will also be long-term for it to reduce his lifetime risk of heart disease.
The most common and effective types of medication that doctors prescribe to lower cholesterol are from a class of drugs called statins (or HMG Co-A reductase inhibitors).
The common types available include lovastastin, simvastatin, atorvastatin and rosuvastatin.
For patients who cannot tolerate statins, alternatives include fibrates (for example, gemfibrozil or fenofibrate), or other types of medication, such as bile acid sequestrant (cholestyramine) and ezetimibe.
Your LDL cholesterol level will need to be reduced by 30 to 40 per cent to reach the target level.
This will be very difficult to achieve with just exercise and diet alone.
Hence, you will probably require medicine, such as statins, which will be effective in achieving target cholesterol levels.
I would certainly not recommend combining such medication with traditional Chinese medicine (TCM).
TCM or certain supplements contain medicinal ingredients similar to those in statins, and may lower cholesterol levels as well.
Hence, combining these with medication may cause drug interaction.
I would recommend that you first adopt healthy lifestyle measures, such as modifying your diet.
Reduce your intake of dietary fat and oil - for example, meat, dairy products and fried food - while increasing your consumption of vegetables and fruit.
You should also exercise regularly - at least 30 minutes a day, five times a week.
You should consult your family physician to evaluate your risk for heart disease and determine the ideal target cholesterol levels you should achieve.
Dr Stanley Chia
Cardiologist at the Asian Heart & Vascular Centre at Mount Elizabeth Medical Centre
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