Does this include the beta sitosterol that is in most prostate supplements?

How can I get tested for sitosterolemia?

I know for a fact that Costco sells 5000+ bottles of CholestOff every WEEK! The stuff is a blend of sterols.

Yeah costco also has "sterol" oatmeal bars.

I try to stick to the freezer and wine section.

I like how you state plainly it's "rare," and now your followers are going to start to believe themselves to have this ailment. I like your blog, but as of late, you're war on heart disease is imitating the ad baculum aspects of America's war on terror.

Excellent article. I've had the same exact thoughts and that's why I don't take supplementary plant sterols.

It's pretty comical. When people supplement with sterols, all they are doing is swapping some of their cholesterol in LDL particles with sterols. The sterols essentially take the place of the cholesterol in the blood. But both have the proclivity to cause atherosclerosis.

So, the cholesterol lowering effect is just an illusion.

I'm not so sure Apo E4 would even be considered 'rare' amongst those who have heart disease problems... or who are considered high risk.

E4/E4 is quite rare, but E3/E4 isn't really. I think it's around 25% of the population, if I recall correctly. And I'd expect amongst those with heart issues, it'd be higher than that.

So what do you eat if you are disp. to Apo E4. If I eat sat. fat my LDP
rocket up. If I eat more veg. and fruit and lean mead it rocket dovn.
Am I on the track??

Hi, Kathy--

Yes, it does.


Lucy--

In general, testing for sitosterolemia is not something I would recommend except in specific situations, in which case the various sterols in the blood can be measured.

That was not the point of the discussion, but the far more common Apo E4 that affects 25% of the population, who thereby potentially hyperabsorb sterols.

For those wanting to follow up on the role of Apo E4 here is an interesting article.
APOE-4: The Clue to Why Low Fat Diet and Statins may Cause Alzheimer's by Stephanie Seneff

I tracked it down after reading
Nutrition and Alzheimer's disease: The detrimental role of a high carbohydrate diet
I never thought I would read in a peer reviewed paper the words The strong influence of Ancel Keys, beginning in the 1960s, has led to dietary avoidance of fats and cholesterol along with over-zealous prescription of cholesterol-reducing medications over the same decades in which there has been a parallel rise in AD prevalence."

Ted,
I can do you one better. This prospective cohort study (n=1137) found "Higher levels of HDL-C (>55 mg/dL) were associated with a decreased risk of both probable and possible AD and probable AD compared with lower HDL-C levels (hazard ratio, 0.4; 95% confidence interval, 0.2-0.9; P = .03 and hazard ratio, 0.4; 95% confidence interval, 0.2-0.9; P = .03). In addition, higher levels of total and non–HDL-C were associated with a decreased risk of AD in analyses adjusting for age, sex, education, ethnic group, and APOE e4 genotype." Here's the link to the abstract:  http://archneur.ama-assn.org/cgi/content/abstract/67/12/1491.
Makes you wonder the REAL reason behind statin drugs.

I used beta-sitosterol for over a year.  I used it because I didn't want to take a 5-alpha reductase inhibitor such as Proscar.  But I developed the same side effects that Procar is known to cause:  Poor libido, gynecomastia and generalized muscle weakness.  I don't track cholesterol so I don't know what the beta-sit might have done to it.  Six months off the beta-sit and I'm just now starting to feel like a normal man again:  morning wood, etc.

That was my reason for asking... because I'm a 3/4

Both links are to the second study.
The correct link for the first study is:

Alterations in cholesterol absorption/synthesis markers characterize Framingham offspring study participants with CHD

Fructose Alters Brain Metabolism
One of the competing theories to explain the obesity epidemic is a rise in fructose consumption causing alterations in hormone levels that increase appetite. UCSF med school prof Robert Lustig has a pretty good rant-lecture on the evils of fructose. Well, here's another study on part of the mechanism in the brain of how fructose might be causing increased obesity.

PORTLAND, Ore. – The dietary concerns of too much fructose is well documented. High-fructose corn syrup has become the sweetener most commonly added to processed foods. Many dietary experts believe this increase directly correlates to the nation's growing obesity epidemic. Now, new research at Oregon Health & Science University demonstrates that the brain – which serves as a master control for body weight – reacts differently to fructose compared with another common sweetener, glucose. The research is published in the online edition of the journal Diabetes, Obesity and Metabolism and will appear in the March print edition.

In humans the cortical brain control areas of the brain were inhibited by the influx of fructose.

Functional MRI allows researchers to watch brain activity in real time. To conduct the research, nine normal-weight human study subjects were imaged as they received an infusion of fructose, glucose or a saline solution. When the resulting brain scans from these three groups were compared, the scientists observed distinct differences.

Brain activity in the hypothalamus, one brain area involved in regulating food intake, was not affected by either fructose or glucose. However, activity in the cortical brain control areas showed the opposite response during infusions of the sugars. Activity in these areas was inhibited when fructose was given but activated during glucose infusion.

This is an important finding because these control brain areas included sites that are thought to be important in determining how we respond to food taste, smells, and pictures, which the American public is bombarded with daily.

The result increases the plausibility of fructose as a causal agent.

"This study provides evidence in humans that fructose and glucose elicits opposite responses in the brain. It supports the animal research that shows similar findings and links fructose with obesity," added Purnell.

If you want to reduce your weight also consider other theories for the cause of obesity including grains as a possible major cause.

By Randall Parker 2011 February 09 05:42 PM  Brain Appetite

Hi, Peter--

Thanks for catching that.

Now fixed.

Foods with naturaly occuring levels of Beta-sisterol: fruits like avocado, nuts like pecan & cashew, seeds like flax & pumpkin,
legumes like soya & peanut, grains like wheat germ & rice bran, oils like corn & soy, plus herbs like Saw Palmetto & Pygeum. Once again it is good to recall that if something is good for you that doesn't automaticly mean more is better for you.

@Anon about naturally occurring sitosterol levels -

As an APO E4 person, should I be concerned about my intake of avocado, flax seed, and tofu?

couldn't leaky gut syndrome cause increased sterols in the bloodstream?

So... how much sterols?
For example almonds and other nuts are high in sterols. Lot of vegetables are high in sterols. In this blog nuts have been recommended often as well as a plant based diet. So does this change that?
What should apoe4 people eat? They can't eat fat, now they can't eat vegetables? Is starving to death the only way to avoid heart disease?

Also tofu and soy has been promoted which have esterols...

Another benefit to total avoidance of plant oils!

Miniscule n-6 means miniscule fat soluble sitosterols.

Are you ready to advocate an animal-fat based diet for ApoE4 and the 45 total reported cases of sitosterolemia?

If you worry about LDL, ApoE4 needs to be "low fat", but if you worry about early death and AD, I think high animal fat is the way to go for these folks.

Isn't the problem for APOE4 the way the molecule degrades? Quite recently fish oil Omega 3 has been cited for allaying APOE4's side effects. The Omega 3 balances out the metabolite (an APOE4 protein fragment) that otherwise messes with the lipid structure of the mitochondria(s) membrane(s); it (fish oil) prevents dysfunction.

http://m.npr.org/news/front/139889533

I heard a report on this study on NPR yesterday.  It's important to note who sponsored the study in the first place.

re: " Her dose: 6000 mg of a standard 1000 mg capsule (6 capsules) to provide 1800 mg EPA + DHA, the effective omega-3 fatty acids."

Excellent blog entry! On fish oil, this dose seems to be very high. Do you recommend this as a typical regimen?

On another related topic, your views on common statins (eg lipitor, crestor, zocor, etc) would be appreciated. I'm getting strong warnings from knowledgable friends that statins are dangerous for liver function and can cause irreversiable damage. On the other hand I personally have found them to be very effective in bringing my cholesteral numbers in line, more than anything else I've tried. TIA

John--
No. This dose is for treatment of high triglycerides or postprandial disorders. Our usual starting dose is 4000 mg (1200 mg EPA+DHA).

Regarding the statin issue. I'd refer you to an article I wrote for Life Extension magazine  archived on their website, www.lef.com. The article, entitled Cholesterol and Statin Drugs: Separating Hype from Reality, can be accessed at http://search.lef.org/cgi-src-bin/MsmGo.exe?grab_id=0&page_id=1044&query=davis%20statin&hiword=DAVI%20DAVID%20DAVIE%20DAVIES%20DAVIN%20DAVIO%20DAVISON%20DAVISS%20DAVIT%20STATI%20STATING%20STATINS%20STATIS%20davis%20statin%20

I just read your article that you referred to in your previous comment answer.

I was on statins several years ago. Not only did I experience muscle and joint pains, I also had serious memory problems, depression and sleep problems. I also found that my long-standing "restless legs syndrome" became much much worse. I've also talked to many people who have experienced serious PND (peripheral nerve disorders).

What I also experinced was a rather significant drop in HDL cholesterol.

Thoughts?

"But Phyllis is not terribly good at following advice. She likes to wander off and follow her own path. She noticed that the healthy bread sold at the grocery store and containing flaxseed boasted "900 mg of omega-3s per slice!". So she ate two slices of the flaxseed-containing bread per day and dropped the fish oil."

Allow me to defend Phyllis. If all she had been told was to take a given amount of omega-3s, then she was following the prescribed path. She should have been educated as to what the various omega-3s are and which type she needed to consume.

Thank you for passing on your article 'Statin Drugs: Separating Hype from Reality'... very informative I must say! Just a quick heads up on your comment about folic acid (ie “always take folic acid and vitamin B12 with niacin to protect against disruption of healthy methylation patterns”), although studies are not conclusive, apparently folate therapy (taking a combination of folic acid, vitamin B6, and vitamin B12) may be harmful after stent placement and probably should be avoided. For those who have this condition it’s advised instead, to try to get enough vitamin B by eating a balanced diet. [ref: Lange H, et al. (2004). Folate therapy and in-stent restenosis after coronary stenting. New England Journal of Medicine, 350(26): 2673–2681]

I have to chime in here regarding Cindy's comment on statins:

I dutifully tried for nearly two years to tolerate the various statins prescribed by my doctor.  The deep muscle aches and spasms were nearly unbearable... getting far worse when my "numbers" still weren't right and he decided to DOUBLE my dosage of Vytorin (Zocor + Zetia) from 10/20 to 10/40.  What resulted was a true nightmare for me.  I terminated this med when I had such severe muscle aching, spasms and dis-coordination that navigating up a flight of stairs was nearly impossible.  Not only that, but my memory was (fortunately temporarily) impaired, and I can remember little from a three month period of time.  Interestingly my CK was never elevated and this all happened while taking 200mgs. daily of a very reputable Co -Q10 formulation.  Cessation of the Vytorin saw the aches subside within 2 or 3 days and full mental clarity resumed within a week.  I was lucky.

My doctor stated that there were three other statins we hadn't yet tried... fat chance doc!

What chaps me is that the pharmaceutical companies continue to state that there is only a small percentage of patients who have side effects.  In practice, LOTS of people have problems tolerating statins, BUT these things never are reported, certainly mine wasn't by my doctor.

Side effects can be reported to the UCSD Statin Study, and to the FDA.  The FDA form is unduly cumbersone and frankly, unless you nearly died, it probably isn't worth the time.  The UCSD Statin Study questionnaire is very thorough... and as soon as I get some time I'm planning to report my experiences with statins to them.

I am not optimistic that doing either of the above will change the statistical misinformation out there on statin side effects.  The pharmaceutical giants have too many billions at stake to ever allow this information to attain credibility.  Their advertising billions shout otherwise...

Great meds, IF they work for you without problems.  For me they appear to be deadly, so I think I'll just stick with the other strategies, including niacin, fish oil, etc., etc. that I've learned through TYP.

madcook

I have to chime in here regarding Cindy's comment on statins:

I dutifully tried for nearly two years to tolerate the various statins prescribed by my doctor.  The deep muscle aches and spasms were nearly unbearable... getting far worse when my "numbers" still weren't right and he decided to DOUBLE my dosage of Vytorin (Zocor + Zetia) from 10/20 to 10/40.  What resulted was a true nightmare for me.  I terminated this med when I had such severe muscle aching, spasms and dis-coordination that navigating up a flight of stairs was nearly impossible.  Not only that, but my memory was (fortunately temporarily) impaired, and I can remember little from a three month period of time.  Interestingly my CK was never elevated and this all happened while taking 200mgs. daily of a very reputable Co -Q10 formulation.  Cessation of the Vytorin saw the aches subside within 2 or 3 days and full mental clarity resumed within a week.  I was lucky.

My doctor stated that there were three other statins we hadn't yet tried... fat chance doc!

What chaps me is that the pharmaceutical companies continue to state that there is only a small percentage of patients who have side effects.  In practice, LOTS of people have problems tolerating statins, BUT these things never are reported, certainly mine wasn't by my doctor.

Side effects can be reported to the UCSD Statin Study, and to the FDA.  The FDA form is unduly cumbersone and frankly, unless you nearly died, it probably isn't worth the time.  The UCSD Statin Study questionnaire is very thorough... and as soon as I get some time I'm planning to report my experiences with statins to them.

I am not optimistic that doing either of the above will change the statistical misinformation out there on statin side effects.  The pharmaceutical giants have too many billions at stake to ever allow this information to attain credibility.  Their advertising billions shout otherwise...

Great meds, IF they work for you without problems.  For me they appear to be deadly, so I think I'll just stick with the other strategies, including niacin, fish oil, etc., etc. that I've learned through TYP.

madcook

RE: Madcook's comment "Side effects can be reported to the UCSD Statin Study, and to the FDA. "

I'm wondering if the 'UCSD Statin Study' provide summary reports on submission findings?

BTW, his note is a very interesting personal account which echos mine to a certain extent, albeit I'm seemingly in the early stages. I'm starting to have pretty severe shoulder pain coming out of nowhere after six mths on Zocor. I've started taking Q-10 (re: your rec) to see if it helps. Previously my reaction to Lipidor was almost immediate with severe skin rash symptoms.