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The informed patient Lower your cholesterol naturally! Psyllium

Lower your cholesterol - Dr. Falk Pharma · 2017-10-13 · Lipoprotein) and “bad” LDL cholesterol (Low Density Lipoprotein). Thus, cholesterol itself is always the same; its transport

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Page 1: Lower your cholesterol - Dr. Falk Pharma · 2017-10-13 · Lipoprotein) and “bad” LDL cholesterol (Low Density Lipoprotein). Thus, cholesterol itself is always the same; its transport

The informed

patient

Lower your

cholesterol– naturally!

Psyllium

Page 2: Lower your cholesterol - Dr. Falk Pharma · 2017-10-13 · Lipoprotein) and “bad” LDL cholesterol (Low Density Lipoprotein). Thus, cholesterol itself is always the same; its transport

Publisher

© 2006 Dr. Falk Pharma GmbHAll rights reserved. 2nd revised edition 2006

Product presentations, compositions and indications as referencedherein may differ from those in your country. Therefore, please contact Dr. Falk Pharma GmbH, Freiburg (Germany) or the local Falk partner.

Leinenweberstr. 5 Postfach 6529 79041 Freiburg Germany

DR. FALK PHARMA GmbH

Page 3: Lower your cholesterol - Dr. Falk Pharma · 2017-10-13 · Lipoprotein) and “bad” LDL cholesterol (Low Density Lipoprotein). Thus, cholesterol itself is always the same; its transport

The informed patient

Lower your cholesterol– naturally!Psyllium

Page 4: Lower your cholesterol - Dr. Falk Pharma · 2017-10-13 · Lipoprotein) and “bad” LDL cholesterol (Low Density Lipoprotein). Thus, cholesterol itself is always the same; its transport
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3

Contents

Foreword 4

What is cholesterol? 6

Why do we need cholesterol? 6

How much cholesterol do our bodies need? 7

How does the body take in cholesterol? 8

Cholesterol – a time bomb 10

What can happen when cholesterol 11levels are too high?

What can you do about it? 11

LDL and HDL – the mixture is important! 13

How do you reach the goal of 14“lowering LDL while raising HDL“?

Lowering LDL cholesterol using natural 17dietary fiber derived from psyllium

– How does psyllium, the active ingredient inMucofalk®, reduce the cholesterol levelin the blood?

– When is psyllium recommended for lowering LDL cholesterol?

– How is psyllium (Mucofalk®) taken?

– Psyllium – a multifaceted natural remedy

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Do you know the role of cholesterol in your body? Do you know how high your cholesterol level is?

The purpose of this brochure is to provide you witheverything you need to know about this subject, suchas the essential functions of cholesterol in your body,the negative effects that may occur when your cho-lesterol level is too high and, of course, your optionsfor preventing or lowering elevated cholesterol levelsin order to prevent any complications from occurring.

Diseases of the cardiovascular system (heart and circulation) claim nearly 400,000 lives every year inGermany and lead the list of causes of death. Manyof these deaths are due to arteriosclerosis (“harden-ing” or calcification of the arteries). Arteriosclerosiscan also exert a negative effect on other diseases.

Arteriosclerosis, however, is not a disease that hap-pens overnight. Instead, it develops silently overmany years and is too often the payback for a less-than-healthy lifestyle.

It is crucial to prevent the development of arterio-sclerosis or at least avoid its complications. Currentresearch shows that hardening of the arteries can to a certain extent be slowed or even reduced as aresult of adopting a healthy lifestyle.

The treatment of disorders of lipid metabolism hasshown extraordinary success over the past fewyears. This is the case not only in patients withmarkedly elevated cholesterol levels (hypercholes-

Foreword

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terolemia) but even in those with moderatelyincreased levels who at the same time have otherrisk factors such as smoking, high blood pressure(hypertension), overweight, inadequate exercise, diabetes mellitus or hereditary predisposition for diseases of the heart and circulation.

Besides increasing physical activity and adoptinghealthy dietary practices, elevated cholesterol levelscan be reduced with any of a number of effectiveagents. An especially well-tolerated alternative is theuse of natural, water-soluble dietary fiber, such asthat derived from psyllium (Mucofalk®).

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6

The body uses cholesterol

● As a building block for all the body’s cells

● To produce bile acids essential for the digestion of fats

● To produce vitamin D, which is required forbuilding strong bones

● To produce steroid and sex hormones

Cholesterol (Greek cholé = bile and sterós = hard,solid) is a substance similar to fat that is found infoods of animal origin such as meat, poultry, giblets,sausage, whole milk and dairy products, butter andeggs. Of these foods, giblets and eggs have the highest amounts of cholesterol. One egg yolk or 120 grams of butter are enough to supply practicallythe entire recommended daily allowance of 300 mg.

Cholesterol is essential for life. Thus, the body doesnot depend on dietary intake of cholesterol but is alsoable to produce it. Cholesterol is a component of cellmembranes and the basic building block in the pro-duction of certain hormones and bile acids, the latterof which are necessary for digestion. The main site ofproduction and, at the same time, the primary store-house of cholesterol is the liver.

What is cholesterol?

Why do we need cholesterol?

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How much cholesterol do ourbodies need?

In adults ingesting a diet moderately rich in choles-terol, daily cholesterol production stands at about11–13 mg per kilogram of body weight. This meansthat our body does not require dietary cholesterolintake, since the liver produces cholesterol and isable to cover the body’s requirements even when we consume a diet that is practically cholesterol free.

In the Western industrial nations, the average dailyintake of cholesterol ranges from 500 to 750 mg per person. Because the small bowel can absorb nomore than 300–500 mg of dietary cholesterol per day,it is necessary to reduce dietary cholesterol intake to less than 300 mg per day in order to exert any significant effect on a person’s cholesterol levels.

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Because of its fat-like chemical structure, cholesterolis not soluble in water. In order for it to be absorbedinto the blood, it must be surrounded by special pro-teins known as apoproteins.

This combination of apoproteins and lipids (fats)results in the formation of lipoproteins. Based ontheir physical characteristics, these molecules areclassified according to their respective densities. The inclusion of cholesterol into different kinds oflipoproteins is the basis for the distinction betweenthe so-called “good” HDL cholesterol (High DensityLipoprotein) and “bad” LDL cholesterol (Low DensityLipoprotein). Thus, cholesterol itself is always thesame; its transport form is actually responsible forwhether it is primarily useful or dangerous for thebody.

When the cholesterol level in your blood is checked,testing includes the proportions of HDL and LDL cholesterol.

How does the body take in cholesterol?

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The pathways of cholesterol in the human organism

VLDL

HDL HDL

LDL

LDL

Dietary cholesterol is partially absorbed in the small bowel. It is transported intothe body as chylomicrons and as HDL and LDL. LDL transports cholesterol to thetarget organs while HDL transports unused cholesterol from the target organsback to the liver, where it is used for the production of bile acids or excreted withthe bile into the gut.

HDL = High density lipoproteinLDL = Low density lipoproteinVLDL = Very low density lipoprotein

Feces

Portal vein

Gallbladder

Bile acidsLiver

Cholesterol biosynthesis

Deposits

Deposits

CholesterolBile acids

Body cells

Blood stream Blood stream

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High concentrations of cholesterol in the blood aresneaky. You do not see them or feel them. Only by testing the level of cholesterol in the blood and an evaluation of other risk factors can quantify theurgency of taking action.

“Too much” in terms of cholesterol usually meanstoo much LDL - the “bad” cholesterol. Reasonsinclude heredity, environmental and dietary factors,as well as metabolic diseases. However, women may show very high levels of HDL - the so-called“good” cholesterol. Thus, an elevated total choles-terol level does not automatically point to excessiveLDL.

Other causes of high cholesterol levels include unbalanced diet, smoking, overweight, diabetes mellitus and inadequate exercise.

Cholesterol – a time bomb

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As the concentration of LDL in the blood increases,due, for example, to a high-fat or high-cholesteroldiet, a point comes where the normal capacity of the body to metabolize and dispose of excess LDLcholesterol is exceeded. As a result, LDL cholesterolmay be deposited on the inner walls of arteries, forming a so-called atherosclerotic plaque.

This process, especially in connection with other risk factors such as smoking, high blood pressure(over 140/90 mmHg), overweight or diabetes, canultimately lead to changes in the lumen (the interiorchannel) of the blood vessels. The growth of plaquesby itself rarely blocks a vessel; more commonly, theplaque ruptures, followed by formation of a bloodclot, which may partially or completely occlude thevessel. Serious complications include coronary heartdisease, stroke or severely reduced circulation to alimb or organ.

What can happen when cholesterollevels are too high?

Because the amount of cholesterol in the body isdetermined by both the amount of cholesterol in thediet and the body’s own production, simply reducingdietary intake of cholesterol is inadequate to producea meaningful change. Reducing cholesterol intakesimply causes the body to produce more cholesterolin the liver and vice-versa.

What can you do about it?

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Much more important are measures that influencethe factors responsible for the absorption of cholesterol from the blood. First and foremost aresaturated fats, which occur almost exclusively infoods derived from animal sources, including meat,sausage, cheese, cream, butter, lard, milk, cream-filled pastries and milk chocolate. The consumption of these foods should be reduced.

Soluble dietary fiber promotes the excretion of bileacids. An increased intake of soluble fiber results inreduction in LDL cholesterol and an increase in theHDL level.

Your goal should be:

Reduce LDLandIncrease its “opponent” — HDL!

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LDL transports cholesterol to the various organs ofour body. It “docks” at the cell membrane and“hands over” the cholesterol to the cells. If there is too much LDL in the blood and the cells are ade-quately supplied with cholesterol, LDL may depositon the inner walls of the blood vessels. The result:The vessel becomes increasingly narrow and circula-tion gets progressively poorer. This is known as arteriosclerosis, or “hardening of the arteries”.

Thus, to a certain degree:The less LDL, the better!

HDL, on the other hand, possesses the useful abilityto remove cholesterol deposited on vessel walls and transport it back to the liver. HDL can to somedegree protect against the formation of athero-sclerotic deposits in the blood vessels.

Thus: The more HDL, the better!

LDL and HDL – the mixture isimportant!

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How do you reach the goal of“lowering LDL while raising HDL“?

Reducing overweight

Calculating the so-called body-mass index (BMI) ormeasuring your waistline (over 88 cm for women and over 102 cm for men) are simple ways of determining whether you are overweight. The BMI is calculated using the following formula:

Body weight in kgBMI = __________________

(Height in m)2

Normal: 19–25Overweight: 25–30Obesity: over 30

In many cases simply normalizing body weight canreturn cholesterol levels to normal.

Regular exercise is also very effective because itincreases the HDL concentration. Best results are obtained from endurance sports such as hiking, walking, jogging, dancing, cycling or swimming one-half hour three to four times a week.

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Adjusting your diet

Changing one’s habits is quite difficult for many people. However, “changing your diet” does not necessarily require many changes. Especially effec-tive is the so-called “Mediterranean” diet, consistingof little meat, fish twice a week, a lot of high fibervegetables and fruit. The amount of fat is also lowand consists primarily of high-quality vegetable fats,such as olive oil, with a high proportion of mono-unsaturated fatty acids. Finally, don’t forget the freshherbs and spices!

Moderate fat intake

Although our diet contains an average 130 grams offat per day, the recommended daily fat intake shouldnot exceed 60–80 grams. Of this, no more than oneto two tablespoons of high-quality margarine (such as diet margarine) and one to two tablespoons ofhigh-quality vegetable oil such as olive or rape-seedoil should be taken.

Dietary intake of high-quality mono- and polyunsaturated fatty acids

You should limit as far as possible your intake of animal fats (e.g. meat, sausage, milk, eggs, butter)and substitute unsaturated vegetable fats (e.g. mono-unsaturated fatty acids such as olive and rape-seed oil). Especially favorable for your health are polyunsaturated fatty acids, especially the eico-sanoids or omega-3 fatty acids found in linseed oil,rape-seed oil, soy products and nuts as well as in fish high in fat such as salmon, herring and mackerel.

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Low-cholesterol foods

For many patients, a transition to low-cholesterolfoods will not have much of an effect because theirbody answers the change with an increase in theliver’s own production of cholesterol. Nevertheless, it is advisable to limit daily cholesterol intake to 300 mg or less. Nearly all high-cholesterol foods arealso high in saturated fats; hence, low-fat foods areusually also low in cholesterol.

Increase your intake of dietary fiber

Dietary intake of fiber has decreased significantlyover the past 50 years. In earlier times, daily fiberintake stood at about 100 grams, compared to onlyabout 20 grams today. Remember that a high-fiberdiet can reduce the LDL level and increase HDL levels.

What are the benefits of weight reduction andchanges in your diet?

The above-described measure often suffice to reduceserum LDL cholesterol levels by as much as 15%. If this is not adequate to normalize cholesterol levels,there are safe and effective medications that mayhelp.

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The seed shells of Plantago ovata, also known as psyllium, contain large amounts of natural bulkingsubstances and dietary fiber. Plantago ovata is native to Iran and India and is also cultivated in those countries. This plant has been used for centuries to regulate bowel function. More recently, the choles-terol-lowering properties of psyllium have receivedincreasing attention.

Lowering LDL cholesterol using natural dietary fiber derived frompsyllium (Plantago ovata seed shells)

Plantago ovata

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How does psyllium, the active ingredient inMucofalk®, reduce the cholesterol level in theblood?

Soluble bulking agents bind a portion of the bile acidsin the small intestine and prevent their re-absorptioninto the portal circulation.

As a result, the liver is forced to continuously absorbcholesterol from the circulating blood as the basicbuilding block for the production of new bile acids,thus reducing the serum concentration of cholesterol.

Fiber directly binds lipids (fats) and dietary cholesterolin the gut, prevents its absorption into the blood, andpromotes its excretion with the stool.

Psyllium reaches the colon unchanged.

Soluble bulking agents are metabolized by the intes-tinal flora to short-chain fatty acids. These substancesare absorbed into the blood and transported to theliver, where they may reduce cholesterol synthesis.

The intake of Plantago ovata seed shells (psyllium)can reduce the serum cholesterol level by about10–15%.

The efficacy of psyllium in reducing LDL cholesterolhas been investigated in over 30 studies.

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When is psyllium recommended for lowering LDL cholesterol?

The first step is to attempt to reduce LDL cholesterolby means of adjusting the patient’s lifestyle anddietary habits.

Depending on the individual patient’s risk profile, atypical “target” level for LDL cholesterol lies in therange of 100–130 mg/dl. In certain high-risk patients(e.g. those with coronary heart disease or diabetes)levels under 100 mg/dl may be advisable. Anyone can estimate their individual risk of heart attack usinga simple computer program, such as the Procam riskcalculator available on the Internet at www.chd-task-force.de. Your personal risk is calculated using datasuch as gender, age, serum lipids, blood pressureand factors such as number of cigarettes smoked,diabetes and a family history of cardiovascular dis-ease. The higher your risk, the more urgent the needto do something about it!

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Generally recommended levels for serum lipids:

Parameter Value in mg/dl (mmol/l) Commentary

Total cholesterol < 200 (< 5.16) Recommended200–239 (5.16–6.16) Borderline elevated

>_ 240 (>_ 6.19) High

LDL cholesterol < 100 (< 2.58) In CHD or a ten year-risk > 20%*and/or diabetes mellitus

< 130 (< 3.35) With two or morerisk factors

< 160 (< 4.13) No or only one riskfactor

HDL cholesterol < 40 (< 1.03) Low

>_ 40 (>_ 1.55) Normal

Triglycerides < 150 (< 1.69) Normal150–199 (1.69–2.25) Borderline elevated

>_ 200 (>_ 2.26) High

*Procam Risk Calculator (www.chd-taskforce.de)

Risk factors with elevated cholesterol levels:● Cigarette smoking● Hypertension (high blood pressure) over

140/90 mmHg● Diabetes mellitus● Overweight● Positive family history for coronary heart disease

(Men under 60 years, women under 70 years)● Low HDL cholesterol < 40 mg/dl (< 1.1 mmol/l)● Sex and age: Men > 45 years,

Women > 55 years or early menopause

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Psyllium, the active substance in Mucofalk®, is especially suitable in persons with mild to modera-tely elevated LDL cholesterol levels (about 130–160mg/dl) for prophylaxis of arteriosclerosis.

With significantly increased cholesterol levels andadditional risk factors a combination therapy is oftena final step toward exhausting all options. Althoughthis has not yet been proven in studies, the additionof psyllium in these cases may be useful, especiallywhen one considers the high tolerability of this natu-ral remedy.

How is psyllium (Mucofalk®) taken?

The daily ingestion of 10–20 grams of Plantago ovataseed shells (psyllium) with meals is recommended as a suitable dose for reducing cholesterol.

This corresponds to 1–2 pouches of Mucofalk® threetimes daily.

Psyllium – a multifaceted natural remedy

Psyllium is helpful not only in patients with elevatedlevels of cholesterol in their blood. The seed shells of Plantago ovata are a highly effective bulking agent:In the gut, they absorb water and their soluble bulk-ing substances increase the volume of the stool. The stool increases in amount, becoming soft and pliable, which facilitates bowel movement.

In addition, as a “pre-biotic”, psyllium, by serving as a nutrient, promotes the growth of the normal intestinal bacterial flora. The bacteria, in turn, pro-vide important nutrients for the intestinal mucosal membrane. This process also increases the stool volume and the bowel returns to regular activity.

The informed patient

21

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These special properties make Mucofalk® an especially effective and well-tolerated remedy forchronic constipation and irritable bowel syndrome, as well as at times when easier bowel movementswith soft stool are required, such as in patients withanal fissures (tears of the mucous membrane of theanus), hemorrhoids or surgical procedures involvingthe rectum.

Finally, psyllium serves to absorb excess fluid in the bowel and is a successful supportive therapy inpatients with diarrhea.

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Page 26: Lower your cholesterol - Dr. Falk Pharma · 2017-10-13 · Lipoprotein) and “bad” LDL cholesterol (Low Density Lipoprotein). Thus, cholesterol itself is always the same; its transport
Page 27: Lower your cholesterol - Dr. Falk Pharma · 2017-10-13 · Lipoprotein) and “bad” LDL cholesterol (Low Density Lipoprotein). Thus, cholesterol itself is always the same; its transport

Lower your cholesterol – naturally

Psyllium

Mucofalk®

Mucofalk®. Active ingredient: Indian isphagula husk, ground (Plantago ovata seed shells).Composition: 5 g of granules (1 sachet) contains: active ingredients: 3.25 g of Indian isphagula husk,ground. Excipients: dextrin, sodium alginate, sodium chloride, saccharin sodium, sucrose (saccha-rose), citric acid, sodium citrate 2 H2O, orange flavouring. Indications: chronic constipation; diseasesin which easier bowel movements with soft stools are desirable, e.g. anal fissures, haemorrhoids, fol-lowing surgery in the rectum area. As supportive treatment in diarrhoea of various causes. Diseasesin which an increase in daily dietary fiber intake is recommended, e.g. in patients with irritable bowelsyndrome, and those with mild to moderately increased serum cholesterol levels in addition to diet.Contraindications: hypersensitivity to Isphagula or any of the excipients; excessively hard stools;abdominal complaints and pain, nausea and vomiting prior to assessment by a physician; suddenchanges in bowel habits (persisting over two weeks); after use of a laxative without subsequent bowelmovement; unassessed rectal bleeding; difficulty swallowing and nausea; stenoses of the esophagus,the gastroesophageal junction or elsewhere in the gastrointestinal tract; threatened or existing intes-tinal obstruction or megacolon syndrome, disturbances of water and electrolyte metabolism, disordersassociated with a decreased fluid intake; poorly controlled diabetes mellitus. Children under the ageof 12 years. Side effects: during the first few days of treatment, possible increase in bloating andfeelings of fullness; these decrease in the course of treatment.Very rarely, hypersensitivity reactions ranging in severity up toanaphylactoid reactions. Bronchospasm was reported in onepatient. In these cases, the patient should stop taking the medi-cine and consult a doctor. Interactions: See patient informationleaflet. Dosage information: See patient information leaflet.Date of information: 9/2005.

Leinenweberstr. 5Postfach 652979041 FreiburgGermany

DR. FALK PHARMA GmbH

Mucofalk ®

-15%

-10%

-5%

Lowering ofcholesterol

4 8 20 24 Weeks1612

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Leinenweberstr. 5Postfach 652979041 FreiburgGermany

DR. FALK PHARMA GmbH

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