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horowitz
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Posted 3 Years, 10 Months ago Linkback
http://www.emediawire.com/releases/2004/4/ emw116061.htm

Canadian Authorities Now Require that Cholesterol-Lowering Drug
Advertisements Must Carry Warnings about the Dangerous Results of
Taking these Drugs.

The popular cholesterol-lowering prescription drugs called statins have grown into a huge business; statins are the most widely prescribed class of drugs in history. Unlike the U.S., Canadian regulatory authorities require several additional warnings regarding the statin drugs.

These hazards are clearly spelled out in the Canadian ads: Statins lower coenzyme Q10 (CoQ10) levels and they raise Lipoprotein(a)
[Lp(a)] blood levels. The world needs to know that scientists have discovered a perfectly safe and natural alternative statin.

(PRWE April 3 2004--Unlike the U.S., Canadian regulatory authorities require several warnings regarding statin cholesterol-lowering drugs.
These popular prescription drugs, including Lipitor and Zocor, lower coenzyme Q10 (CoQ10) levels and they raise Lipoprotein(a) (Lp(a))
blood levels.

Low CoQ10 is considered to be a primary cause of congestive heart failure, and elevated Lp(a) is a risk factor for cardiovascular disease that exceeds the risk of LDL cholesterol.

"Because the U.S. does not require such warnings in drug ads, few
American doctors are aware of these hazards," writes Owen Fonorow, director of the Houston-based Vitamin C Foundation. "Our doctors know that tiny amounts of artificial statin drugs can damage the liver, but they are not aware that these drugs also increase the risk of heart failure and the need for heart transplant."

In May of 2003, two citizen petitions were filed with the Food and
Drug Administration (FDA) requesting that the agency educate consumers about taking CoQ10 alongside the prescription medication. According to
Julian Whitaker, M.D., who filed the petitions, statin drugs block the endogenous biosynthesis of CoQ10. "A deficiency of CoQ10 is associated with impairment of myocardial function, with liver dysfunction and with myopathids, including cardiomyopathy and congestive heart failure," Whitaker writes.

All statins – natural or artificial -- lower cholesterol by blocking the same essential enzyme HMG-CoA reductase. In 1985, Harwood, et.
al., discovered that ascorbic acid (Vitamin C) is the human body's natural HMG-CoA reductase inhibitor, without the liver-destroying potential.

Fonorow writes,"People need to know that there is a perfectly safe and natural alternative statin - vitamin C." When vitamin C levels are low, the body compensates and manufactures more cholesterol. When serum levels are high, Vitamin C inhibits HMG-CoA reductase, which predictably lowers cholesterol.

"It appears from the studies and reports we have read that the proper dose of vitamin C is between 6000 and 8000 mg daily for 3 to 6 months in order to achieve a substantial cholesterol-lowering effect in those with high cholesterol," said Fonorow.

Unlike artificial statins, vitamin C protects the liver, increases
CoQ10 synthesis and reduces Lp(a) - which hundreds of studies have identified as the true culprit in cardiovascular disease.

It is estimated that 15 million Americans take statin drugs.
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Corpseknight
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Posted 3 Years, 10 Months ago Linkback
I pondered your post during the entire time on the treadmill this morning.

You are getting to the core issue of Kilmer McCully's work and theory on homocysteine. As you know, he lost his job at Harvard from this causal theory but drove an important wedge into the cholesterol theory. His work was later vindicated and he was offered his position back.

Do I think homocysteine causes atherosclerosis? I don't know. I do think the relationship important enough to battle my own atherosclerosis with 6,000% above FDA minimum requirements for B3, B6, B12, and folic acid (among other nutraceuticals). However, I also recognize that there may be an intermediate step not yet discovered; a link between homocysteine and atherosclerosis yet to be identified. If I don't see it with my own eyes (and I use high resolution digital ultrasound as my 'eyes' to measure atherosclerosis every day) then it is a struggle for me personally to accept it as causal.

As to what science I incorporate into my personal bias, I depend on statistical experts like you, Jim.
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Corpseknight
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Posted 3 Years, 10 Months ago Linkback
I don't know how much George takes.
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Corpseknight
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Posted 3 Years, 10 Months ago Linkback
I'm not certain if using cholesterol as a marker of your progression will give you a true answer whether or not the vitamin is working for you. A few points of cholesterol variation may be more of the accepted range of error for the blood test than a true reading anyway. Nonetheless, I would encourage that you shy away from short term management and settle into a therapeutic portfolio that suits your goals and personal preference. For example, in this study, a slowing of atherosclerosis progression as measured by carotid intima media thickness was found using VitE and C together.

Vit. C is certainly inexpensive too.
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teleny
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Posted 3 Years, 10 Months ago Linkback
Is there any contraindication for taking Vitamin C with a statin? I take 10mg Crestor and 10mg Altace along with a multi vitamin, 400IU (natural sources) and 1000mg vitamin C and 1g salmon oil capsules.
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llwydnos
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Posted 3 Years, 10 Months ago Linkback
Since 1995 I've taken Folic 3.2mg , B6 100mg, and B12 500mcg, 1x daily, all in powdered capsule form 20 minutes before breakfast. It lowered my homocysteine level dramatically.
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teleny
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Posted 3 Years, 10 Months ago Linkback
As far as I know there is no standard or even a recommendation for using CoQ10 for people on Statins.

Dr. Chung what is your opinion on taking CoQ10 for patients taking
Statins?
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HighlyAcidic
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Posted 3 Years, 10 Months ago Linkback
The key word above is _start_ (while on anticoagulants). If the diet or supplement program is _changed_ while on anticoagulants in such way that it could affect bleeding time or other related tests, frequent follow-up is needed to _adjust_ the anticoagulant dose to the changed conditions.

If supplements have been started before anticoagulants, the anticoagulant dose will be adjusted to supplements from the start.
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Corpseknight
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Posted 3 Years, 10 Months ago Linkback
If it might comment on this...

If you can imagine a direct measurement of 'hardening of the arteries', or atherosclerosis (and my personal bias is that carotid intima media thickness is the best direct measurement of atherosclerosis currently available) then it is that measurement to base your fundamental understanding of the treatment for it.

What are markers then? It is my opinion that a 'marker' is a statistical signal of the disease, either something caused by atherosclerosis or something that causes atherosclerosis. Knowing the difference between cause and effect (does cholesterol cause atherosclerosis or is it an effect of atherosclerosis?) is simply not possible with our current technology and politicalization of the scientific method.

In other words, if homocysteine is low, and because of the statistical link to atherosclerosis appears strong http://tinyurl.com/39pvd , do therapies statistically linked to lowering homocysteine actually effect atherosclerosis first, and homocysteine second.

Understanding cause and effect will provide an important tool to see right through misguided efforts of risk factor management for atherosclerosis.
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horowitz
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Posted 3 Years, 10 Months ago Linkback
Thanks Dr. Blanchard. Both you and Dr. Chung are terrific at plain language explanations. It is so much appreciated.
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zwik
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Posted 3 Years, 10 Months ago Linkback
Maybe you could give us a brief rundown on the common statins and what to avoid while on them. I see grapefruit universally for all statins.
Is this true fro Vitamin E as well?
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Corpseknight
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Posted 3 Years, 10 Months ago Linkback
Mitochondrial encephalomyopathies may be related to a primary or secondary ubiquinone deficient status

.. interesting. perhaps this is where all the confusion about statins originates
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HighlyAcidic
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Posted 3 Years, 10 Months ago Linkback
More evidence about the causality:

Wald DS, Law M, Morris JK.
Homocysteine and cardiovascular disease: evidence on causality from a meta-analysis.
BMJ. 2002 Nov 23;325(7374):1202.

Schnyder G, Roffi M, Flammer Y, Pin R, Hess OM.
Effect of homocysteine-lowering therapy with folic acid, vitamin B12, and vitamin B6 on clinical outcome after percutaneous coronary intervention: the
Swiss Heart study: a randomized controlled trial.
JAMA. 2002 Aug 28;288(8):973-9.

Schnyder G, Roffi M, Pin R, Flammer Y, Lange H, Eberli FR, Meier B,
Turi ZG, Hess OM.
Decreased rate of coronary restenosis after lowering of plasma homocysteine levels.
N Engl J Med. 2001 Nov 29;345(22):1593-600.

Thambyrajah J, Landray MJ, Jones HJ, McGlynn FJ, Wheeler DC,
Townend JN.
A randomized double-blind placebo-controlled trial of the effect of homocysteine-lowering therapy with folic acid on endothelial function in patients with coronary artery disease.
J Am Coll Cardiol. 2001 Jun 1;37(7):1858-63.

Schnyder G, Roffi M, Pin R, Flammer Y, Lange H, Eberli FR, Meier B, Turi ZG,
Hess OM.
Decreased rate of coronary restenosis after lowering of plasma homocysteine levels.
N Engl J Med. 2001 Nov 29;345(22):1593-600.
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horowitz
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Posted 3 Years, 10 Months ago Linkback
I believe he said 1,000 mg daily. I don't use it, but would be willing to give it a try if it was not harmful at high dose, and if I could get some direction on proper use. My idea would be to use it for a period of three months or so to see if it affected my cholesterol level; which I have stated here I do not expect to be corrected by
*any* means (that I would consider applying) more than a couple points, perhaps from 12 to 11 or 10, including Vit C diet and exercise. Exercise will be the big one. Thank you for any advice you would be willing to offer.
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teleny
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Posted 3 Years, 10 Months ago Linkback
What doseage and frequency?
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horowitz
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Posted 3 Years, 10 Months ago Linkback
Also, Drs. Chung and Dr. Blanchard, what is the point of taking folate to lower homocysteine? Isn't an elevated homocysteine just a marker of something? If I lower the homocysteine, does whatever caused it to elevate go away? Seriously. Isn't it just a marker? Help me out here.
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Corpseknight
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Posted 3 Years, 10 Months ago Linkback
Is it possible then with this interpretation that atherosclerosis itself may cause elevated homocysteine? If so, then the vitamins may be working through a completely different pathway than homocysteine metabolism, correct?
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Corpseknight
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Posted 3 Years, 10 Months ago Linkback
This is not Gregg Fonarow, M.D., of the UCLA CHAMP program, BTW.
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Corpseknight
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Posted 3 Years, 10 Months ago Linkback
Interesting references, thanks.

It appears that ubiquinone can either donate or scavange electrons, classifying it as both a oxidizer and antioxidizer, correct?
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Corpseknight
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Posted 3 Years, 10 Months ago Linkback
Anyone know about ubiquinone (co-q10) metabolism? Since there is a shortage on this compound, how can the body reliably make it?
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phlailin1
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Posted 3 Years, 10 Months ago Linkback
x-no-archive: yes and .... remember NO Grapefruit or Grapefruit juice if you're on a statin !
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phlailin1
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Posted 3 Years, 10 Months ago Linkback
x-no-archive: yes Hi Dr Chung .. my friend Good to see you always online : )
I'll never forget the CPK test you recommended !
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Corpseknight
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Posted 3 Years, 10 Months ago Linkback
I think this perspective is very important. Many people take a cautionary view against taking nutritional ingredients that augment prescription drugs.
The cart is before the horse!

Put the cart where it belongs, behind safer alternatives.
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zwik
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Posted 3 Years, 10 Months ago Linkback
I was looking for a little more about any meaningful differences in one over the other. Which have a better/worse record for side effects, etc.?
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NealNool
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Posted 3 Years, 10 Months ago Linkback
B12 was / is hard to obtain. By this I mean not purchase but enable your body to use it. It used to be via sublingual (SP?) . Weird vitamin that is important .
Maybe I'm confused.

How ever I'm glad L is about.
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horowitz
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Posted 3 Years, 10 Months ago Linkback
Much to ponder. And I will. Yes, Sonos I agree with what you have said about short term management and do practise this.
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zwik
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Posted 3 Years, 10 Months ago Linkback
How much CoQ10 should one supplement when using statins? What's your take on the Vitamin C claim?
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phlailin1
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Posted 3 Years, 10 Months ago Linkback
x-no-archive: yes Good memory there, my friend .
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horowitz
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Posted 3 Years, 10 Months ago Linkback
Here. Knock yourselves out:
http://sites.huji.ac.il/malaria/maps/ ubiquinonemetpath.html
Malaria Parasite Metabolic Pathways Ubiquinone Metabolism
http://www.stdgen.lanl.gov/stdgen/images/KEGG/ 00130.html
Ubiquinone biosynthesis
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horowitz
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Posted 3 Years, 10 Months ago Linkback
Thanks so much Dr. Chung.
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