Reducing Cholesterol: Your Questions Answered

Dec. 13, 2007 — -- Last night on "World News With Charles Gibson," ABC News' Medical Editor Dr. Tim Johnson talked to Charles Gibson about reducing cholesterol.

We invited you to post additional questions about cholesterol on our message boards, then sent your questions to ABC News' contributor, Dr. John Messmer, associate professor of family and community medicine at Penn State Hershey Medical Center. His expert answers appear below.

Question: What foods or natural health remedies are good for lowering cholesterol?

Messmer: One of the more commercially available ways is through the use of plant sterols. Of course, most plants have very low levels of sterols in them, so even if you are a vegetarian it is not enough to get your cholesterol levels down significantly. But these chemicals have been isolated and concentrated in products like Benecol, Heart Smart and Promise. Two to four tablespoons a day can drop you cholesterol maybe 12 to 15 percent.

Question: I am taking Organic Apple Cider Vinegar with "Mother," Brazil Live Coral Calcium, Non Synthetic d-alpha Vitamin E, and natural Vitamin C. Could you please speak to these items and their relatively inexpensive nature compared to expensive Statin drugs?

Messmer: Unfortunately, products like these don't lower cholesterol, and they are fairly common out there. You can make a lot of claims and, until the FDA shuts you down, you can make a lot of money from it. If these things were effective and useful, we would tell people to use them. We use prescription drugs because we know people will get from them exactly what we've prescribed them for.

Question: How long will it take before a diet and exercise program would begin to show a decrease in cholesterol? What about a drug program?

Messmer: If your high cholesterol is solely a result of being overweight and sedentary, you should be able to see some improvement in three months -- if you follow a good diet, weight control measures and exercise effectively. But, there are a substantial number of people with high cholesterol because of a genetic predisposition. For people in that situation, if they follow a good diet and exercise regularly they can make a dent in it. But their livers are just churning out too much cholesterol, and they'll probably eventually need medication.

Question: I have been an avid runner for seven years. After taking Vytorin, I have had a series of muscular injuries. Could these be caused by my cholesterol medicine?

Messmer: Some statin drugs can cause muscle aches in some patients. But at this time, it doesn't look like that's the same thing as muscle injury. I can't say for sure, but I would say that it would be unlikely that this is the cause.

Question: Vytorin caused side effects for my husband, whose doctor then told him to switch to Crestor. That also caused side effects. Are there other medications he can try? Does he have to take statins if he is concerned about side effects?

Messmer: Every statin has a relative potency. So if you switch from a high dose Vytorin to a low-dose Crestor, you may not be getting the same therapeutic effect. So yes, when switching you may see drops and even elevations in cholesterol if the doses are not equivalent.

Question: Are generic cholesterol pills as good as Lipitor, Crestor, etc?

Messmer: To my experience so far, they are. In an effort to save people money, I have switched patients to generics, and these people seem to be getting the same results as they were on brand-name drugs.

Question: What is the relationship between a person's likelihood to have a heart attack and cholesterol levels?

Messmer: This is hard to say exactly because heart disease is multifactorial. There are five common modifiable risk factors for heart disease. These, in order of importance, are smoking, being sedentary, weight, having diabetes and high cholesterol. In terms of severity, cholesterol is fifth in relation to other things. So if you are a smoker who has high cholesterol and doesn't exercise, you should probably be working on quitting smoking and starting to exercise first.