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Health Condition

High Triglycerides

  • Fish Oil

    Many double-blind trials have shown that fish oil containing EPA and DHA lowers triglycerides levels.

    Dose:

    3,000 mg daily omega-3 fatty acids
    Fish Oil
    ×
     

    Many double-blind trials have demonstrated that fish oils (also called fish-oil concentrates) containing EPA and DHA (mentioned above) lower TG levels.1 The amount of fish oil used in much of the research was an amount that provided 3,000 mg per day of omega-3 fatty acids. To calculate how much omega-3 fatty acid is contained in a fish oil supplement, add together the amounts of EPA and DHA. For example, a typical 1,000-mg capsule of fish oil provides 180 mg of EPA and 120 mg of DHA (total omega-3 fatty acids equals 300 mg). Ten of these capsules would contain 3,000 mg of omega-3 fatty acids. Other sources of omega-3 fatty acids, such as flaxseed oil, do not lower TGs. While flaxseed oil has other benefits, it should not be used for the purpose of reducing TGs.

    Cod liver oil, another source of omega-3 fatty acids, has also been found to lower TGs.2 Cod liver oil is less expensive than the fish oil concentrates discussed previously. However, cod liver oil also contains relatively large amounts of vitamin A and vitamin D; too much of either can cause side effects. In contrast, fish oil concentrates have little or none of these vitamins. Individuals wishing to use cod liver oil as a substitute for a fish-oil concentrate should consult a doctor.

    Omega-3 fatty acids from fish oil and cod liver oil have been reported to affect blood in many other ways that might lower the risk of heart disease.3 However, these supplements sometimes increase LDL cholesterol—the bad form of cholesterol. A doctor can check to see if fish oil has this effect on an individual. Research shows that when 900 mg of garlic extract is added to fish oil, the combination still dramatically lowers TG levels but no longer increases LDL cholesterol.4 Therefore, it appears that taking garlic supplements may be a way to avoid the increase in LDL cholesterol sometimes associated with taking fish oil. People who take fish oil may also need to take vitamin E to prevent the oil from undergoing potentially damaging oxidation in the body.5 It is not known how much vitamin E is needed to prevent such oxidation. The amount required would presumably depend on the amount of fish oil used. In one clinical trial, 300 IU of vitamin E per day prevented oxidation damage in individuals taking 6 grams of fish oil per day.6

  • Guggul

    Clinical trials indicate that guggul is effective in treating high triglycerides, in one trial, serum triglycerides fell by 30.3%.

    Dose:

    25 mg guggulsterones three times per day
    Guggul
    ×

    Guggul, a mixture of ketonic steroids from the gum oleoresin of Commiphora mukul, is an approved treatment of hyperlipidemia in India and has been a mainstay of Ayurvedic herbal approaches to preventing atherosclerosis. Clinical trials indicate that guggul is effective in the treatment of high TGs; in one trial, serum TGs fell by 30.3%.7

    However, these results have not been confirmed by large, controlled trials. The recommended daily intake of guggul is typically based on the amount of guggulsterones in the extract. The recommended amount of guggulsterones is 25 mg three times per day. Most extracts contain 5–10% guggulsterones. Guggul’s effect on TGs should be monitored for three to four months, and guggul may be taken long term if successful in lowering TGs.

  • Pantothenic Acid

    Pantethine, a byproduct of pantothenic acid (vitamin B5), has been shown to lower triglyceride levels in several clinical trials.

    Dose:

    300 mg pantethine three times per day
    Pantothenic Acid
    ×
     

    Pantethine is a byproduct of pantothenic acid (vitamin B5). Several clinical trials have shown that 300 mg of pantethine taken three times per day will lower TG levels.8,9,10 Pantothenic acid, which is found in most B vitamins, does not have this effect.

  • Vitamin B3 (Niacin)

    The niacin form of vitamin B3 is used by some doctors to lower triglycerides, however, the quantity needed to achieve reductions may cause side effects. Ask your doctor is niacin is right for you.

    Dose:

    500 mg three times per day
    Vitamin B3 (Niacin)
    ×

    The niacin form of vitamin B3 is used by doctors to lower cholesterol levels, but niacin also lowers TG levels.11 The amount of niacin needed to achieve worthwhile reductions in cholesterol and TG levels is several grams per day. Such quantities can cause side effects, including potential damage to the liver, and should not be taken without the supervision of a doctor. Some doctors recommend inositol hexaniacinate (a special form of vitamin B3) as an alternative to niacin. A typical amount recommended is 500 mg three times per day.12,13 This form of vitamin B3 does not typically cause a skin flush and is said to be safer for the liver than niacin. However, the alleged safety advantage of inositol hexaniacinate needs to be confirmed by additional clinical trials. Moreover, it is not clear whether inositol hexaniacinate is as effective as niacin at lowering cholesterol and TG levels.

  • Astaxanthin

    Astaxanthin has antioxidant and other properties that might support proper regulation of blood lipids.

    Dose:

    4 to 12 mg daily
    Astaxanthin
    ×
    Astaxanthin is a member of the carotenoid family that has antioxidant and other properties that might support proper regulation of blood lipids.14,15 One double-blind trial in normal weight people with high blood triglycerides found astaxanthin, taken in amounts of either 12 mg or 18 mg per day, lowered blood triglycerides.16 However, in another double-blind trial in overweight people with normal triglycerides, 20 mg per day of astaxanthin had no significant effect on blood triglycerides.17
  • Asteraceae

    Achillea wilhelmsii, an herb used in traditional Persian medicine, has been shown to significantly lower triglycerides in one trial.

    Dose:

    15 to 20 drops of tincture twice per day
    Asteraceae
    ×
     

    In a double-blind trial, people with moderately high triglycerides took a tincture of Achillea wilhelmsii, an herb used in traditional Persian medicine.18 Participants in the trial used 15–20 drops of the tincture twice daily for six months. At the end of the trial, participants experienced significant reductions in triglycerides compared to those who took placebo. No adverse effects were reported.

  • Calcium

    Calcium supplementation has been shown to reduce triglyceride levels.

    Dose:

    800 mg daily
    Calcium
    ×

    Caution: Calcium supplements should be avoided by prostate cancer patients.

    In a preliminary trial, supplementation with 800 mg of calcium per day for one year resulted in a statistically significant 35% reduction in the average TG level among people with elevated cholesterol and triglycerides.19 However, in another trial, calcium supplementation had no effect on TG levels.20 One of the differences between these two trials was that more people in the former trial had initially elevated TG levels.

  • Chromium

    Studies have shown that chromium supplementation may reduce triglycerides in people with type 2 diabetes.

    Dose:

    200 mg daily
    Chromium
    ×
     

    In a double-blind trial, 30 people with type 2 (non-insulin-dependent) diabetes received 200 mcg of chromium per day (as chromium picolinate) for two months and a placebo for an additional two months. The average TG level was significantly lower (by an average of 17.4%) during chromium supplementation than during the placebo period.21Some,22,23 but not all, trials24,25 support these findings. It is not clear whether chromium supplementation affects TG levels in non-diabetics, but some evidence suggests that it does not.26,27,28,29,23

  • Fenugreek

    Fenugreek has been shown to lower total and LDL cholesterol and triglyceride levels in people with high lipid levels in preliminary trials..

    Dose:

    100 grams seed daily or 25 to 50 grams defatted seed powder daily
    Fenugreek
    ×
     

    Fenugreek has been shown to lower total and LDL cholesterol and triglyceride levels in people with high lipid levels in preliminary trials.30 Bread made with 50 grams defatted fenugreek powder was used twice daily in the trial. Similar results have been seen at half that amount in people with diabetes and elevated blood levels of various lipids.31 A small randomized trial found similar results using 100 grams fenugreek seeds daily.32 One small clinical trial found that either 25 grams or 50 grams per day of defatted fenugreek seed powder were effective in reducing triglycerides over a 20-day period.33 Mild diarrhea and gas can accompany the first few days of fenugreek use, though it almost always fades as the person taking it adapts.

  • Fructo-oligosaccharides

    Several trials have shown that FOS supplementation lowers triglycerides in people with elevated levels.

    Dose:

    8 to 20 grams daily
    Fructo-oligosaccharides
    ×
     

    Several double-blind trials have evaluated the efficacy of fructo-oligosaccharides (FOS) or inulin (a related compound) for lowering blood cholesterol and triglyceride levels. These trials have shown that in individuals with elevated total cholesterol or triglyceride levels, including people with type 2 diabetes, FOS or inulin (in amounts ranging from 8 to 20 grams daily) produced significant reductions in triglyceride levels; however, the effect on cholesterol levels was inconsistent.34,35,36,37 In people with normal or low cholesterol or triglyceride levels, FOS or inulin produced little effect.38,39,40

  • Garlic

    Supplementing with garlic may help keep triglyceride levels in check.

    Dose:

    600 to 900 mg daily of a concentrate standardized for 5,000 to 6,000 mcg of allicin
    Garlic
    ×
     

    Reports on many clinical trials of garlic performed until 1998 suggested that triglycerides were lowered by an average of 8–27% and cholesterol by 9–12% over a one- to four-month period.41,42,43 Most of these trials used 600–900 mg per day of a garlic supplement standardized to alliin content and allicin potential. More recently, however, three double-blind clinical trials have found garlic to have minimal success in lowering triglycerides and cholesterol.44,45,46 One negative trial has been criticized for using a steam distilled garlic “oil” that has no track record for this purpose,47 while the others used the same standardized garlic products as the previous positive clinical trials. Based on these findings, the use of garlic should not be considered a primary approach to lowering high triglycerides and cholesterol.48

    Odor-controlled, enteric-coated garlic tablets standardized for allicin content can be taken in the amount of 900 mg daily (providing 5,000–6,000 mcg of allicin), divided into two or three daily portions.

  • Inositol Hexaniacinate (Vitamin B3)

    Some doctors recommend inositol hexaniacinate (a special form of vitamin B3) as an alternative to niacin, which can have negative side effects.

    Dose:

    500 mg three times per day
    Inositol Hexaniacinate (Vitamin B3)
    ×
    The niacin form of vitamin B3 is used by doctors to lower cholesterol levels, but niacin also lowers TG levels. The amount of niacin needed to achieve worthwhile reductions in cholesterol and TG levels49 is several grams per day. Such quantities can cause side effects, including potential damage to the liver, and should not be taken without supervision of a doctor. Some doctors recommend inositol hexaniacinate (a special for of vitamin B3) as an alternative to niacin. A typical amount recommended is 500 mg three times per day.50,51 This form of vitamin B3 does not typically cause a skin flush and is said to be safer for the liver than niacin. However, the alleged safety advantage of inositol hexaniacinate needs to be confirmed by addition clinical trials. Moreover, it is not clear whether inositol hexaniacinate is as effective as niacin at lowering cholesterol and TG levels.
  • Krill Oil

    Supplementing with krill oil may decrease triglycerides in people with elevated levels.

    Dose:

    2 to 3 grams per day
    Krill Oil
    ×
    In a double-blind study of people with elevated blood levels of cholesterol and triglycerides, supplementation with 2 to 3 grams per day of krill oil from Antarctic krill (a zooplankton crustacean) for three months decreased levels of triglycerides. However, 1 to 1.5 grams per day was not effective. Krill oil was significantly more effective than either a placebo or small amounts of regular fish oil containing 900 mg per day of omega-3 fatty acids.52
  • L-Carnitine

    Supplementing with L-carnitine may help normalize triglyceride levels.

    Dose:

    1 to 3 grams daily
    L-Carnitine
    ×
     

    L-carnitine is another supplement that has lowered TGs in several clinical trials.53,54 However, the effect of carnitine is unpredictable, and some individuals have experienced an increase in triglyceride levels after receiving this supplement.55 Some doctors recommend 1–3 grams of carnitine per day, in the form known as L-carnitine.

  • Policosanol

    Policosanol may be helpful in normalizing triglyceride levels.

    Dose:

    10 to 20 mg daily
    Policosanol
    ×
     

    The effect of policosanol on serum triglycerides has been inconsistent, ranging from no effect up to as much as a 19% reduction.56,57,58,59,60,61,62,63,64,65 Several controlled studies have compared policosanol with cholesterol-lowering medications, such as statins, and have found policosanol similarly effective.66,67,68,69,70,71,72 Policosanol extracted from beeswax or other sources differs from the sugar-cane-derived preparation in the proportions of long-chain alcohols, and whether these types of policosanol are as effective as sugar-cane-derived policosanol is unknown.

  • Psyllium

    Psyllium seeds and husks have shown a modest ability to lower blood triglyceride levels in some clinical trials.

    Dose:

    15 grams daily
    Psyllium
    ×
     

    Psyllium seeds and husks have shown a modest ability to lower blood triglyceride levels in some,73,74 but not all,75 clinical trials. Further research is needed to assess the effect of psyllium on triglyceride levels more closely, as much of the study so far has focused on lowering cholesterol levels.

  • Red Yeast Rice

    Although primarily used to lower high serum cholesterol, red yeast rice extract, high in monacolins, has been found to significantly lower serum triglyceride levels.

    Dose:

    13.5 mg total monacolins daily
    Red Yeast Rice
    ×

    Although primarily used to lower high serum cholesterol, red yeast rice extract, high in monacolins, has been found to significantly lower serum triglyceride levels.76 People in the trial took 1.2 grams (approximately 13.5 mg total monacolins) of a concentrated red yeast rice extract per day for two months. The sale of Cholestin has been banned in the United States, as a result of a lawsuit alleging patent infringement. Other red yeast rice products currently on the market differ from Cholestin in their chemical makeup. None contain the full complement of 10 monacolin compounds that are present in Cholestin, and some contain a potentially toxic fermentation product called citrinin. 77 Until further information is available, red yeast rice products other than Cholestin cannot be recommended.

  • Creatine Monohydrate

    One trial found that supplementing with significantly lowered serum total triglycerides in both men and women.

    Dose:

    Refer to label instructions
    Creatine Monohydrate
    ×

    A double-blind trial found that a supplement of 5 grams of creatine plus 1 gram of glucose taken four times per day for five days followed by twice a day for 51 days significantly lowered serum total triglycerides in both men and women.78 However, another double-blind trial found no change in any of these blood levels in trained athletes using creatine during a 12-week strength training program.79 Creatine supplementation in this negative trial was lower—only five grams per day was taken for the last 11 weeks of the study.

  • Green Tea

    Drinking green tea may have a positive effect on triglyceride levels.

    Dose:

    Refer to label instructions
    Green Tea
    ×
     

    Intake of three cups or less of green tea daily has been shown not to affect blood triglyceride levels.80 Intake of four or more cups per day has been correlated with lower triglyceride levels.81 Overall, the evidence is unclear on how much of an effect high levels of intake of green tea has on triglyceride levels.

  • Maitake

    Studies suggest that the mushroom maitake may lower fat levels in the blood.

    Dose:

    Refer to label instructions
    Maitake
    ×
     

    Animal studies suggest the mushroom maitake may lower fat levels in the blood.82 However, this research is still preliminary and requires confirmation by controlled human trials.

What Are Star Ratings
×
Reliable and relatively consistent scientific data showing a substantial health benefit.
Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

References

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2. Von Schacky C, Fischer S, Weber PC. Long-term effects of dietary marine omega-3 fatty acids upon plasma and cellular lipids, platelet function, and eicosanoid formation in humans. J Clin Invest 1985;76:1626-31.

3. Leaf A, Weber PC. Cardiovascular effects of n-3 fatty acids. N Engl J Med 1988;318:549-57 [review].

4. Adler AJ, Holub BJ. Effect of garlic and fish-oil supplementation on serum lipid and lipoprotein concentrations in hypercholesterolemic men. Am J Clin Nutr 1997;65:445-50.

5. Haglund O, Luostarinen R, Wallin R, et al. The effects of fish oil on triglycerides, cholesterol, fibrinogen and malondialdehyde in humans supplemented with vitamin E. J Nutr 1991;121:165-9.

6. Oostenbrug GS, Mensink RP, Hornstra G. A moderate in vivo vitamin E supplement counteracts the fish-oil-induced increase in in vitro oxidation of human low-density lipoproteins. Am J Clin Nutr 1993;57:827S.

7. Agarwal RC, Singh SP, Saran RK, et al. Clinical trial of gugulipid new hypolipidemic agent of plant origin in primary hyperlipidemia. Indian J Med Res 1986;84:626-34.

8. Arsenio L, Bodria P, Magnati G, et al. Effectiveness of long-term treatment with pantethine in patients with dyslipidemia. Clin Ther 1986;8:537-45.

9. Avogaro P, Bon B, Fusello M. Effect of pantethine on lipids, lipoproteins and apolipoproteins in man. Curr Ther Res 1983;33;488-93.

10. Maggi GC, Donati C, Criscuoli G. Pantethine: a physiological lipomodulating agent, in the treatment of hyperlipidemias. Curr Ther Res 1982;32:380-6.

11. Brown WV. Niacin for lipid disorders. Postgrad Med 1995;98:183-93 [review].

12. Head KA. Inositol hexaniacinate: a safer alternative to niacin. Alt Med Rev 1996;1:176-84 [review].

13. Murray M. Lipid-lowering drugs vs. Inositol hexaniacinate. Am J Natural Med 1995;2:9-12 [review].

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17. Choi HD, Youn YK, Shin WG. Positive effects of astaxanthin on lipid profiles and oxidative stress in overweight subjects. Plant Foods Hum Nutr 2011;66:363-9.

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21. Lee NA, Reasner CA. Beneficial effect of chromium supplementation on serum triglyceride levels in NIDDM. Diabetes Care 1994;17:1449-52.

22. Abraham AS, Brooks BA, Eylath U. The effects of chromium supplementation on serum glucose and lipids in patients with and without non-insulin-dependent diabetes. Metabolism 1992;41:768-71.

23. Thomas VL, Gropper SS. Effect of chromium nicotinic acid supplementation on selected cardiovascular disease risk factors. Biol Trace Elem Res 1996;55:297-305.

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25. Uusitupa MI, Kumpulainen JT, Voutilainen E, et al. Effect of inorganic chromium supplementation on glucose tolerance, insulin response, and serum lipids in noninsulin-dependent diabetics. Am J Clin Nutr 1983;38:404-10.

26. Offenbacher EG, Pi-Sunyer FX. Beneficial effect of chromium-rich yeast on glucose tolerance and blood lipids in elderly subjects. Diabetes 1980;29:919-25.

27. Offenbacher EG, Rinko CJ, Pi-Sunyer FX. The effects of inorganic chromium and brewer's yeast on glucose tolerance, plasma lipids, and plasma chromium in elderly subjects. Am J Clin Nutr 1985;42:454-61.

28. Roeback JR Jr, Hla KM, Chambless LE, Fletcher RH. Effects of chromium supplementation on serum high-density lipoprotein cholesterol levels in men taking beta-blockers. A randomized, controlled trial. Ann Intern Med 1991;115:917-24.

29. Wilson BE, Gondy A. Effects of chromium supplementation on fasting insulin levels and lipid parameters in healthy, non-obese young subjects. Diabetes Res Clin Pract 1995;28:179-84.

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31. Sharma RD, Sarkar DK, Hazra B, et al. Hypolipidaemic effect of fenugreek seeds: A chronic study in non-insulin dependent diabetic patients. Phytother Res 1996;10:332-4.

32. Sharma RD, Raghuram TC, Rao NS. Effect of fenugreek seeds on blood glucose and serum lipids in type I diabetes. Eur J Clin Nutr 1990;44:301-6.

33. Prasanna M. Hypolipidemic effect of fenugreek: A clinical study. Indian J Pharmacol 2000;32:34-6.

34. Yamashita K, Kawai K, Itakura M. Effect of fructo-oligosaccharides on blood glucose and serum lipids in diabetic subjects. Nutr Res 1984;4:961-6.

35. Jackson KG, Taylor GRJ, Clohessy AM, Williams CM. The effect of the daily intake of inulin on fasting lipid, insulin and glucose concentrations in middle-aged men and women. Br J Nutr 1999;82:23-30.

36. Roberfroid M. Dietary fibre, inulin and oligofructose. A review comparing their physiological effects. Crit Rev Food Sci Nutr 1993;33:103-48 [review].

37. Davidson MH, Synecki C, Maki KC, Drennen KB. Effects of dietary inulin in serum lipids in men and women with hypercholesterolaemia. Nutr Res 1998;3:503-17.

38. Luo J, Rizkalla SW, Alamowitch C, et al. Chronic consumption of short-chain fructooligosaccharides by health subjects decreased basal hepatic glucose production but had no effect on insulin-stimulated glucose metabolism. Am J Clin Nutr 1996;63:939-45.

39. Pedersen A, Sandstrom B, van Amelsvoort JMM. The effect of ingestion of inulin on blood lipids and gastrointestinal symptoms in healthy females. 1997;78:215-22.

40. van Dokkum W, Wezendonk B, Srikumar TS, van den Heuvel EG. Effect of nondigestible oligosaccharides on large-bowel functions, blood lipid concentrations and glucose absorption in young healthy male subjects. Eur J Clin Nutr 1999;53:1-7.

41. Warshafsky S, Kamer R, Sivak S. Effect of garlic on total serum cholesterol: A meta-analysis. Ann Int Med 1993;119(7)599-605.

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43. Neil HA, Silagy CA, Lancaster T, et al. Garlic powder in the treatment of moderate hyperlipidaemia: A controlled trial and a meta-analysis. J R Coll Phys 1996;30:329-34.

44. McCrindle BW, Helden E, Conner WT. Garlic extract therapy in children with hypercholesterolemia. Arch Pediatr Adolesc Med 1998;152:1089-94.

45. Isaacsohn JL, Moser M, Stein EA, et al. Garlic powder and plasma lipids and lipoproteins. Arch Intern Med 1998;158:1189-94.

46. Berthold HK, Sudhop T, von Bergmann K. Effect of a garlic oil preparation on serum lipoproteins and cholesterol metabolism. JAMA 1998;279:1900-2.

47. Lawson L. Garlic oil for hypercholesterolemia—negative results. Quart Rev Natural Med Fall 1998;185-6.

48. Lawson LD. Garlic powder for hyperlipidemia—analysis of recent negative results. Quart Rev Natural Med Fall, 1998;187-9.

49. Brown WV. Niacin for lipid disorders. Postgrad Med 1995;98:183-93 [review].

50. Head KA. Inositol hexaniacinate: a safer alternative to niacin. Alt Med Rev 1996;1:176-84 [review].

51. Murray M. Lipid-lowering drugs vs. Inositol hexaniacinate. Am J Natural Med 1995;2:9-12 [review].

52. Bunea R, El Farrah K, Deutsch L. Evaluation of the effects of Neptune Krill Oil on the clinical course of hyperlipidemia. Altern Med Rev 2004;9:420-28.

53. Pola P, Savi L, Grilli M, et al. Carnitine in the therapy of dyslipidemic patients. Curr Ther Res 1980;27:208-16.

54. Abdel-Aziz MT, Abdou MS, Soliman K, et al. Effect of carnitine on blood lipid pattern in diabetic patients. Nutr Rep Int 1984;29:1071-9.

55. Anonymous. Carnitine, clue or cure? Lancet 1982;2:1027-8.

56. Gouni-Berthold I, Berthold HK. Policosanol: clinical pharmacology and therapeutic significance of a new lipid-lowering agent. Am Heart J 2002;143:356-65 [review].

57. Mirkin A, Mas R, Martinto M, et al. Efficacy and tolerability of policosanol in hypercholesterolemic postmenopausal women. Int J Clin Pharmacol Res 2001;21:31-41.

58. Castano G, Mas R, Fernandez L et al. Effects of policosanol 20 versus 40 mg/day in the treatment of patients with type II hypercholesterolemia: A 6-month double-blind study. Int J Clin Pharmacol Res 2001;21:43-57.

59. Mas R, Castano G, Illnait J, et al. Effects of policosanol in patients with type II hypercholesterolemia and additional coronary risk factors. Clin Pharmacol Ther 1999;65:439-47.

60. Torres O, Agramonte AJ, Illnait J, et al. Treatment of hypercholesterolemia in NIDDM with policosanol. Diabetes Care 1995;18:393-7.

61. Canetti M, Moreira M, Mas R, et al. A two-year study on the efficacy and tolerability of policosanol in patients with type II hyperlipoproteinaemia. Int J Clin Pharmacol Res 1995;15:159-65.

62. Aneiros E, Calderon B, Más R, et al. Effect of successive dose increases of policosanol on the lipid profile and tolerability of treatment. Curr Ther Res1993;54:304-12.

63. Pons P, Rodríquez M, Más R, et al. One-year efficacy and safety of policosanol in patients with type II hypercholesterolemia. Curr Ther Res 1994;55:1084-92.

64. Castano G, Canetti M, Moreira M, et al. Efficacy and tolerability of policosanol in elderly patients with type II hypercholesterolemia: a 12-month study. Curr Ther Res 1995;56:819-23.

65. Castano G, Tula L, Canetti M, et al. Effects of policosanol in hypertensive patients with type II hypercholesterolemia. Curr Ther Res 1996;57:691-5.

66. Fernandez JC, Mas R, Castano G, et al. Comparison of the efficacy, safety and tolerability of policosanol versus fluvastatin in elderly hypercholesterolaemic women. Clin Drug Invest 2001;21:103-13.

67. Castano G, Mas R, Fernandez JC, et al. Efficacy and tolerability of policosanol compared with lovastatin in patients with type II hypercholesterolemia and concomitant coronary risk factors. Curr Ther Res 2000;61:137-46.

68. Alcocer L, Fernandez L, Campos E, Mas Ferreiro R. A comparative study of policosanol Versus acipimox in patients with type II hypercholesterolemia.Int J Tissue React 1999;21:85-92.

69. Crespo N, Illnait J, Mas R, et al. Comparative study of the efficacy and tolerability of policosanol and lovastatin in patients with hypercholesterolemia and noninsulin dependent diabetes mellitus. Int J Clin Pharmacol Res 1999;19:117-27.

70. Castano G, Mas R, Arruzazabala ML, et al. Effects of policosanol and pravastatin on lipid profile, platelet aggregation and endothelemia in older hypercholesterolemic patients. Int J Clin Pharmacol Res 1999;19:105-16.

71. Ortensi G, Gladstein J, Valli H, et al. A comparative study of policosanol versus simvastatin in elderly patients with hypercholesterolemia. Curr Ther Res 1997;58:390-401.

72. Benitez M, Romero C, Mas R, et al. A comparative study of policosanol versus pravastatin in patients with type II hypercholesterolemia. Curr Ther Res 1997;58:859-67.

73. Jenkins DJA, Wolever TMS, Vidgen E, et al. Effect of psyllium in hypercholesterolemia at two monounsaturated fatty acid intakes. Am J Clin Nutr 1997;65:1524-33.

74. Ganji V, Kies CV. Pysllium husk fiber supplementation to the diets rich in soybean or coconut oil: Hypocholesterolemic effect in healthy humans. Int J Food Sci Nutr 1996;47:103-10.

75. Davidson MH, Maki KC, Kong JC, et al. Long-term effects of consuming foods containing psyllium seed husk on serum lipids in subjects with hypercholesterolemia. Am J Clin Nutr 1998;67:367-76.

76. Wang J, Lu Z, Chi J, et al. Multicenter clinical trial of the serum lipid-lowering effects of a Monascus purpureus (red yeast) rice preparation from traditional Chinese medicine. Curr Ther Res 1997;58:964-77.

77. Heber D, Lembertas A, Lu QY, et al. An analysis of nine proprietary Chinese red yeast rice dietary supplements: implications of variability in chemical profile and contents. J Altern Complement Med 2001;7:133-9.

78. Earnest CP, Almada AL, Mitchell TL. High-performance capillary electrophoresis-pure creatine monohydrate reduces blood lipids in men and women. Clin Sci 1996;91:113-8.

79. Volek JS, Duncan ND, Mazzetti SA, et al. No effect of heavy resistance training and creatine supplementation on blood lipids. Int J Sport Nutr Exerc Metab 2000;10:144-56.

80. Tsubono Y, Tsugane S. Green tea intake in relation to serum lipid levels in middle-aged Japanese men and women. Ann Epidemiol 1997;7:280-4.

81. Imai K, Nakachi K. Cross sectional study of effects of drinking green tea on cardiovascular and liver diseases. BMJ 1995;310:693-6.

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