Dr. Ciccone Answers Your Questions

Q: How do you treat high cholesterol?

A: After a trial of diet and lifestyle modification, mainstream medicine will typically treat elevated lipids (cholesterol & triglycerides) with "statin" medication (Lipitor, Mevacor, Zocor, Crestor, etc) and Zetia (a cholesterol absorption blocker), either alone or in combination. No one can deny the effectiveness of these medications or their secondary benefits of inflammation control for cardiovascular (and more recently, stroke) control and prevention. But if lipid control is the primary concern, there are alternative therapies that are safer and just as effective.

Red yeast rice is a "natural" statin. It works the same way as do the statin medications, but without the potential adverse reactions associated with synthetic statin medication. Prescription statins can cause liver, muscle and kidney problems and need to be monitored with periodic blood work. Red yeast rice, sold over the counter (OTC), does not require monitoring - I personally believe that it should be since it works like the prescription statins. Although red yeast rice is considered extremely safe, I encourage caution, as this is not my first alternative choice.

Lipids can be lowered with fish oils (omega 3 fatty acids, particularly EPA and DHA). A common mistake is using OTC fish oils which are typically low in EPA / DHA content and usually not effective. EPA/DHA content should start at least around 3000 to 4000 mg. There is even a prescription omega 3 available called Omacor.

Beware: Omega 3's cause blood thinning and should be monitored if you are taking any medications or other supplements that do the same, like Coumadin (Warfarin), garlic, vitamin E, ginger, glucosamine, etc.

Niacin, a B vitamin, lowers lipids and actually increases good cholesterol (HDL) and lowers bad cholesterol (LDL). Niaspan is a prescription niacin which is time released and is promoted as liver safe with a reduction of flushing, an uncomfortable side effect.

Sytrinol, a natural citrus and palm fruit extract, is a promising contender. Garlic, lecithin, guggulipipds from guggul, soy (a story in itself), etc. are helpful, but in my experience, not very effective at the recommended doses or even in combination.

In summary, an integrative strategy could be:
  1. Dietary & lifestyle changes
  2. Omega 3's (fish oils ) & / or Niacin
  3. Sytrinol or Red Yeast Rice
  4. Zetia
  5. Statin Medication.
The order would vary according to the individual's medical condition(s). As always, these strategies are best implemented under the direction of a health care professional, familiar with mainstream and alternative care.

Snippets To Answer Some Proactive Readers Questions

Greg: Concerning Trigeminal Neuralgia: There are integrative alternatives for trigeminal neuralgia & neuropathic pain in general. For example: check out lipoic acid which can be taken orally or administered intravenously.

Marianne: I would need to see your bone scan & report to advise you about your diagnosis & treatment.

Anonymous: Concerning Hypoglycemia: Integrative medicine, as you can see, especially with diet, does take hypoglycemia seriously.

Anonymous: Concerning Breathing Treatments in Those With Normal Lung Function: Incentive spirometry (breathing treatments) helps maintain normal air-flow in hospital patients who have normal activity restricted.

Gail: Concerning Less Common/Unpublished Side Effects of Medications: According to the PDR, at least 0.3% of patients taking Tarka for blood pressure, can get upper respiratory tract Infections, so why not chronic sinusitis? Remember that each of is a biochemical individual, and can have any reaction to any meds, even if they are not listed in the PDR. Skin testing is not the only way to test for allergies. Elisa Act blood testing done in our office is more comprehensive and reliable than Rast blood testing.

Anonymous: "You Are What You Eat!!!" : Food choices do affect our moods. Julia Ross wrote a book titled "The Mood Cure". Very good reading. You may want to consider messenger chemical (neurotransmitter) testing through our office. Also, read "Food and Mood" and its companion, "The Food and Mood Cookbook" by Elizabeth Somer.

Anonymous: What Are Bioidentical Hormones?: Bioidentical hormones are engineered to match human hormones identically. There are as effective as mainstream prescription hormones and are much safer !!! They are available by prescription only and need to be obtained from a compounding pharmacy. Even though they are prescription, not all insurances will recognize them and pay for them.

Anonymous: Concerning Insurance Coverage: Our office accepts most major insurances, which would pay for office visits, EKG's, blood drawing, etc. Many alternative services like IV's, functional testing, supplements, etc. are not covered by insurance and require self payment.

Be Well,
Ronald P. Ciccone, M.D.

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