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Dyslipidemia

High Cholesterol: Symptoms, Causes and Treatment

Type of Cholesterol, symptoms and causes

Definition and Facts about High Cholesterol

  • Cholesterol is a waxy, fat-like substance that the body needs to function normally. Cholesterol is used as a building block for many structures as well as other chemicals and hormones that are essential for the body’s activities.
  • The body does not need that much cholesterol, and excess amounts can be deposited along the lining of artery walls, decreasing the amount of blood flow to different parts of the body.
  • High cholesterol is one of the risk factors that can lead to atherosclerotic cardiovascular disease (ASCVD), including heart attack, TIA, stroke and peripheral artery disease.

Examples of foods high in cholesterol:

  • Egg yolks
  • Shellfish like shrimp
  • Processed meats like bacon
  • Baked goods such as pies and cakes made with animal fats like lard and butter.

Cholesterol and triglycerides represent the fats or lipids in the human body. A high level of lipids, in the blood, is known as hyperlipidemia.

Types of Cholesterol

There are two main types of cholesterol carried by different types of lipoproteins. Low-density lipoproteins (LDL) are sometimes called “bad” cholesterol. High levels of LDL cholesterol can build up in your arteries, causing heart disease.

High-density lipoproteins (HDL) are referred to as “good” cholesterol. HDL cholesterol carries cholesterol from other parts of your body back to the liver. Your liver then processes the cholesterol out of your body. It’s important to have healthy levels of both types of cholesterol :

  1. Dietary, derived from food-stuffs.
  2. Serum or blood, present in the blood.

Since cholesterol does not dissolve in the bloodstream, it requires transport system in from carriers known as lipoproteins. Low-density lipoprotein (LDL) and high-density lipoprotein (HDL) carry cholesterol in the body. In layman’s language, cholesterol is again seen in two distinct categories :

  1. Good: High-density cholesterol (HDL)
  2. Bad: Low-density cholesterol (LDL)

The total cholesterol count is estimated by performing lipid-profile in the laboratory.

If your cholesterol levels are too high, deposits can occur in your arteries. These fatty deposits on the walls of your blood vessels can harden and narrow the blood vessels. This is a condition called atherosclerosis. Narrower vessels transport less oxygen-rich blood. If oxygen can’t reach your heart muscle, you can have a heart attack. If that happens in your brain, you can have a stroke.

Worried about Cholesterol? Consult our specialists :

Some Facts About Cholesterol

If blood or serum cholesterol is on the higher side, this condition is known as hypercholesterolemia or dyslipidemia. Cholesterol resembles fat, but the structures are entirely different.

Cholesterol performs several anatomical and physiological functions in the body to enable the human body to function properly. High cholesterol is a risk factor for diabetes, heart attacks and angina.
According to a study conducted by Indian Council of Medical Research (ICMR), three-fourth of the Indian population has higher or abnormal levels of cholesterol. In the last two years, the incidence of heart-diseases has increased dramatically in Indian population. Studies have demonstrated that Indians become heart patient at a younger age as compared to the population in the west.

According to a study conducted in 2,042 in cities like Tamil Nadu, Maharashtra, Jharkhand and Chandigarh demonstrated that four out of every five people in urban and rural areas had disturbed lipid levels. The study further reported that more than one in ten persons, people had high cholesterol levels, and more than one in five had high levels of triglycerides.

33.5% of the American population have high levels of bad cholesterol. Usually, 1 out of every 3 adults with high bad cholesterol has condition under control. According to one estimate, less than half of adults with high bad cholesterol are able to get medical supervision. According to experts, the population having high level of total cholesterol has twice the tendency of getting heart disease.

Ayurvedic Pathology of Heart Disease

In Ayurvedic practice, heart disease is known as “Hridroga”. Wrong-diet, emotional stress, mental trauma, increased salt intake, anxiety and overweight are major causes of heart diseases. Sometimes, heart disease is associated with arthritis or liver-ailments.

Ayurveda recognises five types of “Hridroga”

Vata Hrid Roga (Angina pectoris)
Pitta Hrid Roga (Myocarditis)
Kapha Hrid Roga (Organic disorders)
Tridosha Hrid Roga
Krimija Hrid Roga (Valvular heart disease)

According to Sushruta, the great Indian surgeon, Hrid Badha represents heart disease. Sushruta considers vitiation of Rasa, the first dhatu as primary factor responsible for heart disease.

Saptdhatu (seven tissues)

Concept of dhatus in ayurveda

Saptdhatu theory is the fundamental principle of Ayurvedic philosophy. Saptdhatu are composed of five elements (mahabhutas) and lives in a state of equilibrium in the human body. Imbalance in equilibrium of saptdhatu results in disease.

Meda dhatu represents fatty or adipose tissue of the body. Meda dhatu is an important constituent of the brain, spinal cord and nervous tissue. It maintains internal temperature of the body.

In Ayurveda principles and practices of medicine, obesity is being fully recognized as a health issue. Chapter 39 of the Bhaisajya Ratnavali deals with Medo Roga describing the treatment of obesity and its complications.

Meda dhatu and Kapha, the biological humor, are allied in properties and mutually dependent. Factors that increase or aggravate Kapha results in an increase in Meda dhatu resulting in obesity.

The incidence of Santarpanottha Vikara (diseases arising due to excessive nutrition) has increased in current times. Medodushti (disorders of fat metabolism) is one of the important etiological factors in lifestyle diseases like Ischemic Heart Disease.

Ischemic Heart Disease has been identified as a leading cause of morbidity and mortality in both developing as well as developed countries. Deposition of serum lipids and reduced oxygen supply to the coronary arteries is the underlying cause, ultimately resulting in Coronary Heart Disease (CHD).

Lekhaniya Dravya and Meda Dhatu

Charaka has prescribed single Gana of 10 drugs. These are better known as Lekhaniya Gana.  The drugs which have a depleting effect on the body are known as Lekhaniya dravya. Chirbilva (Holoptelia intergrifolia) and Hemvati (Iris germanica) are typical examples. These can be compared with anti-obesity drugs. Medohara dravya can better be compared with hypolpidemic agents.

Vata, the biological humors, is responsible for clarity among the channels of circulation, Shoshana of three biological humors and enkindling of the biological fire, Agni. Drugs having katu vipaka (post-digestion effect) are generally said to be lekhaniya because of predominance of Akasha (ether), Vayu (air) and Agni (fire). After the action of Dhatvagni and Bhutagni is over, lekhaniya dravya reduces Kapha, the water humour and coresponding dhatu.

Yava is considered to be having lekhana property, so they are highly useful in obesity. Ayuvedic dietetics recommends use of yava as a dietary solution to obesity. Yava is best lekhana dravya. Owing to these properties, yava helps to stabilize the biological fire, Agni in kostha, cleans the channels of circulation obstructed by Meda dhatu. On account of this, person suffering from voracious appetite in medo roga feels normal hunger. Charaka has indicated guru and aptarpana chikitisa for obesity treatment.

Black piper (Piper nigrum) and Vaca (Acorus calamus) are other examples which remove blockage from channels of circulation ad from Ayurvedic pharmacology point of view, dravya this action are known as Pramathi dravya.

Lekhana Basti has been designed for Apatarpana (emaciation) of the body. In a clinical trial, 19 out of a total of 22 patients completed the course of Lekhana Basti.

Group A was treated with Lekhana Basti and group B was administered the standard control drug, i.e., Triphala Guggulu, for 21 days. In patients treated with Lekhana Basti, serum cholesterol, serum low density lipoprotein and serum apolipoprotein B were decreased by 4.99%, 9.13% and 0.36%, respectively.

A single blinded, controlled study was undertaken to investigate the efficacy of Ooshakadi Lekhana in reducing serum lipids. Ooshaka or Kshara Mrittika (alkaline sand) was used in the study. 45 patients were randomized into three groups, each containing 15 patients. The satin, atrovastatin was used as a control. Average mean reduction of lipids were found statistically significant (p<0.05) in the experimental groups over the control group in all types of lipids except HDL which has presented increase pattern.

Ayurvedic Treatment Options to Reduce Cholesterol

  • Ayurveda recommends the use of Guggul as treatment of high levels of lipids in the blood (hyperlipidemia). One tablet, twice a day is recommended for six months for reducing high cholesterol levels in blood.
  • In a study the pharmacological effects of Guggul was compared with clofibrate. Ether extract of Guggul (1.5 gms/day) was given to 41 patients. On the other hand, clofibrate (92 gms/day) was prescribed to 10 patients. It was concluded that both the drugs were equally effective in controlling serum cholesterol and triglycerides. Incidence of reported side-effects was less with Guggul
  • Fifty patients with a history of coronary artery disease, hyperlipidemia and obesity were treated with daily doses of 10-15 rams of Guggul for three months. After completion of the study, 25 percent reduction in serum cholesterol and 30 percent reduction in serum triglyceride were observed.
  • Benefits of guggulu :
    • Guggulu supports normal cholesterol levels
    • Helps maintain normal weight
    • Supports normal lipid levels and metabolism
    • Supports normal immune system function

Dosage: 01 capsule twice a day before meals.

  • Garlic or Lashuna is excellent for preventing as well as curing heart disease. One capsule, thrice a day is effective in reducing high blood cholesterol and triglycerides.
  • Allicin is produced when garlic is crushed for medicinal or culinary use. It is produced by enzymatic reduction of alliin in the presence of an enzyme allinase. Allicin is a highly unstable compound. When allicin is cooked in water, it produces diallyl sulfide. This change is considered to be useful as allicin is known to cause gastritis.
  • Allicin has been demonstrated to inhibit cholesterol biosynthesis in liver. It is postulated that allicin forms bonds with sulphydryl compounds (they are involved in biosynthesis of cholesterol) as a result of which cholesterol biosynthesis is stopped. Garlic has been shown to be as effective as bezafibrate in lowering cholesterol levels.
  • Arjuna: For angina pectoris, Arjuna is the drug of choice. Arjunarishta is a standard Ayurvedic remedy for strengthening the heart. Six teaspoonfuls (30 ml) of the preparation mixed with equal water, twice a day, should be given for six months. Arjuna tablets are very effective in reducing high levels of blood cholesterol.
  • Clinical studies with Arjuna have shown beneficial effects in congestive cardiac failure and Mitral Regurgitation.
  • Arjun is a rich source of coenzyme Q-10 which has the LDL lowering effect.
  • Rabbits having high levels of lipids were fed Amalaki juice for twelve weeks. The lipid levels of the animals fed with officinalis were significantly lower as compared to the control group.
  • The effect on total serum cholesterol and its lipoprotein fractions of supplementation of the diet with amalaki was studied in normal and hypercholesterolaemic men in the age group of 35-55 years. Amalaki was given in raw form for twenty-eight days. A decrease in cholesterol levels was observed in normal and hypercholesterolaemic patients. However, when, amalaki was withdrawn after weeks, rise in total serum cholesterol levels of the hypercholesterolaemic subjects was observed to rise to initial levels.

Sarpagandha is the drug of choice in the treatment of hypertension. Half teaspoonful (2.5 g) of the powder, thrice a day is highly efficacious in reducing the blood pressure. Some companies are marketing tablets of the medicinal herb also. One or two tablets, twice a day, are recommended in treating hypertension.

Precautions and Diet

In case of coronary heart disease, in addition to medicine, lifestyle changes are must in proper management of coronary heart disease. With exertion, slow down or take rest in the breaks. After a heavy meal, avoid large meals and rich foods that leave feeling stuffed.

To avoid stress, try to avoid situations that make patient upset or stressed. Eat a healthy diet to prevent or reduce high blood pressure and high blood cholesterol and obesity. Quit smoking. Exercise as directed by your doctor. Lose weight if you are obese. If there is a history of high blood sugar, follow the doctor’s advice and take all medications as directed.

In case of high blood pressure, salt, spice and licorice should be avoided. Adequate rest should be ensured. Ghee and butter should be avoided. Garlic and ginger should be consumed in moderate amounts.

Diet to Balance high cholesterol
  • Ensure to consume 6 – 8 glasses of water on a daily basis.
  • The routine should be started with oatmeals, a rich source of fibre.
  • Consuming fish like salmon and tuna are beneficial in maintaining optimal levels of cholesterol.
  • Ensure minimal consumption of dairy products as they are rich in dietary cholesterol. Use double toned milk.

Some Additional Tips for Lowering Cholesterol

  • Saturated fats, found primarily in red meat and full-fat dairy products, raise your total cholesterol.
  • Decreasing your consumption of saturated fats can reduce your low-density lipoprotein (LDL) cholesterol — the “bad” cholesterol.
  • Trans fats, sometimes listed on food labels as “partially hydrogenated vegetable oil,” are often used in margarine and store-bought cookies, crackers and cakes.
  • Trans fats raise overall cholesterol levels therefore avoid having them.
  • Avoid the isue of partially hydrogenated vegetable oils.
  • Omega-3 fatty acids don’t affect LDL cholesterol.
  • Have more omega-3 fat as they have other heart-healthy benefits, including reducing blood pressure.
  • Foods with omega-3 fatty acids include salmon, mackerel, herring, walnuts and flaxseeds.
  • Soluble fibre can reduce the absorption of cholesterol into your bloodstream.
  • Soluble fibre is found in such foods as oatmeal, kidney beans, Brussels sprouts, apples and pears.

Conclusion

So are you ready for the lifestyle changes ? Following Ritucharya, Dincharya and other Ayurvedic regimens are helpful in alleviating high levels of blood cholesterol.

More so, cost-effective, efficacious and standardised Ayurvedic medicines can control cholesterol after professional consultation.