Definition
Western
Cholesterol is a complex organic compound that occurs naturally in the body or one could acquire it from food consumed. High cholesterol is therefore a medical condition in which the amount of cholesterol in one’s bloodstream exceeds the recommended level. When excessive amounts of cholesterol are present in the body, they may deposit on the inner lining of arteries, leading to a range of cardiovascular disorders. Abnormal cholesterol levels such as high LDL (low-density lipoproteins) cholesterol or low HDL cholesterol are a major risk factor for majordiseases, such as stroke [12-13].
Traditional Chinese Medicine (TCM)
Though there is no clear term or definition for cholesterol in TCM, it is usually associated with the dysfunctioning of the Spleen and Liver systems. Disruptions to the functions of these organs due to poor lifestyle and diets will affect the accumulation of cholesterol in the body.
Classifications & Symptoms Displayed in TCM Context
Poor digestive system
Inability to digest efficiently may affect how cholesterol is processed or stored in the body.
Blood and fluid circulation
Circulation determines the amount of cholesterol and how it is to be stored in the body. Slower circulation will encourage more or larger deposits. This is often associated with individuals having difficulty in weight losing programmes. Poor blood circulation is also seen in many types of arthritic disorders as well as some types of cardiovascular diseases [20].
Excretory System Dysfunction
The relationship between the liver and bile production is critical to ensure cholesterol is eliminated efficiently when bile is released [15].
Causes and Risk Factors
Heredity
Can be passed down in generations. Risk increases if a male family member is affected by early heart disease before age 55 or a female family member is affected by early heart disease before age 65.
Physical activities
Increased physical activity helps to lower LDL- cholesterol and raise HDL-cholesterol (the "good" cholesterol) levels, as well as ensure smooth circulation in the body.
Diets
Uncontrolled intake of food, overweight and obesity may have effects on the levels of HDL and LDL in the bloodstream. Diets that are especially high in saturated fats, such as fats from animal sources raise total and LDL-cholesterol to undesirable levels in the bloodstream.
Age
Tendency to rise in cholesterol levels with age due to slower circulation.
Gender
Decrease in plasma oestrogen levels after menopause may play a significant role in the reduction of the clearance of LDL cholesterol in postmenopausal women.
Treatments
Herbs commonly used in prescriptions:
1. Shan Zha – 山楂
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English/ Common name
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Hawthorn fruit
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Latin species
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Crataegus pinnatifida
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Park of plant used
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Fruit
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Action/s
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Helps to lower blood lipids [1-2, 17, 19]. Useful in treating certain cardiovascular diseases [3].
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Precaution/s
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Individuals with excessive gastric acid production or weak stomach should use with caution. Not recommended for pregnant women.
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2. Hong Qu – 红曲
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English/ Common name
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Red yeast rice
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Latin species
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Yeast strain Monascus purpureus on rice
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Park of plant used
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Traditionally used to invigorate the body, aid in digestion and revitalise the blood [4] and to lower LDL-cholesterol [5].
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Action/s
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Users should be watchful if other blood thinning medications are also taken. Should seek professional advice before consuming.
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Precaution/s
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Red yeast rice
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3. Jue Mng Zi – 决明子
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English/ Common name
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Semen Cassiae, Cassia seeds
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Latin species
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Cassia obtusifolia L. or Cassia tora L. (Fam. Leguminosae).
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Park of plant used
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Seeds
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Action/s
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Helps to improve vision and promote bowel movements [19]. Recent studies showed inhibiting hyperlipidemic formation [17] and reduce weight gain with nutritive obesity [18].
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Precaution/s
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Users with weak stomach or low blood pressure should consume with caution.
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4. Yi Yi Ren –薏苡仁
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English/ Common name
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Semen coicis, Coix Seed, Job’s tears
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Latin species
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Coix lacryma-jobi Linn.
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Park of plant used
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Seeds
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Action/s
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Traditionally used to improve digestion and useful in the treatment of arthritis pain, edema, difficulty in urination and lung abscess [19]. Recent studies shown to have hypolipidemic [6-7] and anti-cancer effects [7].
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Precaution/s
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Use with caution during pregnancy. Processed coix seed should not be used for users with loose stools.
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5. Fou Shou – 佛手
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English/ Common name
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Finger citron fruit, Buddha Fruit
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Latin species
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Citrus medica L. var. sarcodactylis Swingle
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Park of plant used
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Fruit
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Action/s
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Traditionally used to treat tightness in chest, nausea, poor digestion, lack of appetite and chronic coughs [19]. Also showed promising results in lowering blood cholesterol [8].
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Precaution/s
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No significant side effects but may experience increase bowel movements during initial use.
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Tests & Diagnosis
Blood Test: [16]
Assess cholesterol levels by conducting simple blood test called a lipoprotein profile which evaluates the following:
- LDL (low density lipoprotein cholesterol, also called "bad" cholesterol)
- HDL (high density lipoprotein cholesterol, also called "good" cholesterol)
- Triglycerides (also called very low density lipoprotein)
- Total cholesterol levels.
Home Remedies
Hawthorn and Cassia Seeds (Jue Ming Zi) Tea
a) Put dried hawthorn and cassia seeds in a teapot/cup.
b) Pour in boiling water.
c) Cover and steep for 10-15 minutes.
d) Add honey to taste. Serve hot or chilled. .
References
1. Kuo DH, Yeh CH, Shieh PC, Cheng KC, Chen FA, Cheng JT.:Effect of shanzha, a Chinese herbal product, on obesity and dyslipidemia in hamsters receiving high-fat diet .J Ethnopharmacol. 2009 Jul 30;124(3):544-50. Epub 2009 May 18.
2. Lin Y, Vermeer MA, A Trautwein E.: Triterpenic Acids present in Hawthorn Lower Plasma Cholesterol by inhibiting Intestinal ACAT Activity in Hamster. Evid Based Complement Alternat Med. 2009 Feb 19
3. Pittler MH, Guo R, Ernst E. : Hawthorn extract for treating chronic heart failure. Cochrane Database Syst Rev 2008 Jan 23 (1): CD005312.
4. Erdogrull O, Azirak S. : "Review of the studies on the red yeast rice (Monascus purpureus)". Turkish Electronic J Biotech. 2004, 2: 37-49.
5. Edwards JE, Moore RA.: "Statins in hypercholesterolaemia: a dose-specific meta-analysis of lipid changes in randomised, double blind trials" BMC Fam Pract Dec 2003 4: 18.
8. Dr med. Carl-Hermann Hempen, Dr med. Dr sc. nat. Toni Fischer. A Materia Medica for Chinese Medicine (First Edition), 2009, Pages 466-513
11. Glomset JA: The plasma lecithins: Cholesterol acyltransferase reaction. J Lipid Res. 1968 Mar,9(2): 155-67
13. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults: Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001 May 16;285(19):2486-97.
16. AllRefer Health – Coronary risk profile. Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. Feb 5, 2009. http://health.allrefer.com/health/coronary-risk-profile-info.html
17. Li HB, Fang KY, Lü CT, Li XE.: Study on lipid-regulating function for the extracts and their prescriptions from Semen Cassiae and fructus crataegi. Zhong Yao Cai. 2007 May;30(5):573-5. Chinese.
18. Junbao Y, Long J, Jiangbi W, Yonghui D, Tianzhen Z, Songyi Q, Wei L.: Inhibitive effect of Semen Cassiae on the weight gain in rats with nutritive obesity. Zhong Yao Cai. 2004 Apr;27(4):281-4. Chinese.
19. 高学敏主編《中藥學》中国中医药出版社, 2002年9月。
Gao Xue Min, ed. Chinese Medicine, China Chinese Medicine Publication. 2002. ISBN 7-80156-318-2/R.318
20. 周仲英主編《中医内科學》中国中医药出版社, 2007年2月