Moderate-HighGBS: 82 (High Risk)nutrition

Cholesterol Optimization (Without Statins)

Developer: Stephen Sinatra, Mark Houston, functional cardiology

3-6 months to see lipid changes

Protocol Overview

Comprehensive natural protocol to optimize lipid panel without statins, emphasizing LDL particle number, inflammation, and oxidized LDL. Addresses root causes of dyslipidemia.

Conditions Treated

High cholesterol

high LDL

low HDL

dyslipidemia

Protocol Steps

Advanced lipid testing: Not just standard lipid panel - measure LDL particle number (LDL-P), Apo B, Lp(a), HDL particle number, triglycerides, inflammation (CRP, Lp-PLA2), oxidized LDL - these are better predictors than LDL-C

Targets: LDL-P <1000, Apo B <90, triglycerides <100, HDL >60, TG:HDL ratio <2, CRP <1

Diet: Mediterranean pattern (proven in PREDIMED - reduces CV events despite no LDL lowering), emphasize: omega-3 fish, olive oil, nuts, vegetables, fruits, whole grains

Avoid: Trans fats (ban them), excessive refined carbs/sugar (raises TG, lowers HDL), oxidized fats (fried foods)

Saturated fat: Controversial - replace with MUFA (olive oil) and omega-3, not refined carbs. Moderate intake from whole foods (eggs, dairy, meat) likely OK for most

Soluble fiber: 10-25g daily (oats, psyllium, beans, apples) - lowers LDL 5-15%

Plant sterols: 2g daily (in fortified foods or supplements) - lowers LDL 10% by blocking absorption

Niacin (vitamin B3): 1000-2000mg daily (flush form) - raises HDL 15-35%, lowers triglycerides 20-50%, modestly lowers LDL. Start low, titrate up. Take with food, aspirin reduces flush. Monitor liver enzymes

Red yeast rice: 1200-2400mg daily (contains monacolin K = lovastatin) - lowers LDL 15-25%. Works like statin, monitor liver. Use CoQ10 with it

Berberine: 500mg 3x/day with meals - lowers LDL 20-25%, triglycerides, raises HDL via upregulation of LDL receptors (like statin)

Omega-3: 2-4g EPA/DHA (lowers triglycerides 25-30%, modest LDL increase but shifts to large particles, raises HDL)

CoQ10: 100-300mg ubiquinol (especially if using red yeast rice or statin, improves mitochondrial function)

Bergamot: 500-1000mg daily (improves lipid profile, reduces small-dense LDL, improves HDL function)

Aged garlic extract: 1200mg daily (Kyolic - modest LDL reduction, reduces plaque)

Vitamin D: Optimize 50-80 ng/ml (low D associated with dyslipidemia and CV risk)

Vitamin K2: MK-7 180-360mcg (keeps calcium out of arteries, complements D)

Pantethine: 600-900mg daily (lowers LDL, triglycerides, raises HDL)

Curcumin: 1-2g daily (reduces oxidized LDL, anti-inflammatory)

Exercise: 150+ min/week - raises HDL, lowers triglycerides, improves LDL particle size

Weight loss: If overweight, 5-10% weight loss improves all lipid parameters

Alcohol: Moderate intake (1-2 drinks/day) raises HDL, but excessive worsens triglycerides

Thyroid: Optimize (hypothyroidism causes high cholesterol)

Inflammatory/root causes: Address insulin resistance, metabolic syndrome, gut dysbiosis, oxidative stress, chronic inflammation

Statins: If very high LDL-P (>2000), familial hypercholesterolemia, or established CAD, consider statin + lifestyle (discuss with cardiologist - benefits may outweigh risks)

Key Resources

The Great Cholesterol Myth by Jonny Bowden & Stephen Sinatra, "What Your Doctor May Not Tell You About Heart Disease" by Mark Houston, berberine and lipid studies

Contraindications & Risks

Niacin: Flushing (start low), liver toxicity at high doses (monitor), can raise glucose slightly. Red yeast rice is a statin (same side effects). Berberine lowers blood sugar (caution in diabetes)

Important Notes

Cholesterol controversy: LDL-C (standard cholesterol number) is weak predictor of CV risk. Better markers: LDL particle number (LDL-P), ApoB (each LDL particle has one ApoB), small-dense LDL pattern. Can have "normal" LDL-C but high particle number (dangerous) or vice versa. Advanced testing crucial (NMR LipoProfile or Cardio IQ). Inflammation and oxidized LDL drive atherosclerosis, not just LDL level. Mediterranean diet reduces CV events despite minimal LDL lowering (PREDIMED trial) - quality of diet matters more than LDL alone. Niacin (flush form) is most effective natural lipid improver - raises HDL 15-35% (statins barely affect HDL), lowers TG significantly, modestly lowers LDL, improves LDL particle size. But recent trials (AIM-HIGH, HPS2-THRIVE) showed no additional CV benefit when added to statin (controversial - niacin monotherapy not tested). Red yeast rice is natural statin (monacolin K = lovastatin) - works but has statin side effects. Berberine is exciting - multiple mechanisms including upregulating LDL receptors (statin-like), improves insulin sensitivity. Soluble fiber and plant sterols modest but proven effects. Omega-3 lowers TG dramatically, shifts LDL to large particles. Saturated fat controversy: Not as bad as previously thought if from whole foods, but replacing with MUFA (olive oil) or omega-3 improves lipids. Triglycerides and TG:HDL ratio may be better predictors than LDL. Lp(a) is independent genetic risk factor - niacin lowers it (only intervention that does substantially). Many can optimize lipids naturally but some need statins (familial hypercholesterolemia, very high LDL-P, established CAD). Risk assessment should include inflammation, insulin resistance, advanced lipids, family history - not just LDL-C.CV-004

Also Effective For

High Cholesterol

Key Supplements & Herbs in This Protocol

Supplements

Berberine

Herbs

Garlic

Allium sativum

Critical Safety Warning

This protocol is documented for educational purposes only. The Gabriel Bullshit Score (GBS) of 82 reflects significant institutional response and controversy. Some alternative health protocols have resulted in serious harm or death.

Always consult with qualified healthcare professionals before beginning any treatment. Do not delay or forego proven medical care.

Quick Overview

Evidence LevelModerate-High

GBS Score82 / 100

Categorynutrition

DeveloperStephen Sinatra, Mark Houston, functional cardiology

Duration3-6 months to see lipid changes

About GBS Score

The Gabriel Bullshit Score reflects the magnitude of institutional response, controversy, and documented concerns. Higher scores indicate greater institutional pushback, not necessarily inefficacy. This is a research tool, not medical advice.