NMU – 227 Raising the Good Cholesterol (HDL) with Gum Guggul

Nutrition/Natural Medicine Update No 227 (January 19, 2022)

with Dr. James Meschino

Topic: Raising the Good Cholesterol (HDL) with Gum Guggul

Source: Cardiovascular Drug Reviews (2007)

In a recent Lifestyle Medicine Update, I explained that many people with high LDL-cholesterol (the bad cholesterol) and low HDL-cholesterol (the good cholesterol) can often lower their LDL-cholesterol into the safe range for cardiovascular disease by dietary and lifestyle changes, including reducing intake of foods high in saturated fats, trans-fats, cholesterol, deep-fried and breaded foods, and by increasing intake of cholesterol-lowering soluble fiber foods like beans, peas, oats, and some low glycemic fibrous fruits and vegetables like non-sweet apples and the white rind of citrus fruits (high in pectin), as well as the consumption of ground flaxseeds and/or psyllium husk fiber. Endurance exercise and weight loss are also helpful to lower the bad cholesterol – LDL-cholesterol However, strategies that lower the LDL don’t always raise the HDL. In fact, some of the strategies I already mentioned, like eating less saturated fat may, in some cases, further lower the HDL. This is important because studies like the Veterans Affairs High-Density-Lipoprotein Cholesterol Intervention Trial showed that the rate of coronary heart disease (rate of narrowing of your coronary arteries) is reduced by raising HDL, as an independent risk factor.  So, it’s vital to get your LDL into safe range, but it’s also important to raise your HDL level if it is low, as HDL helps to remove plaque from the artery wall.

In a recent update, I provided studies showing that you can usually raise your HDL to a mild to moderate degree, depending on the individual, (wide range of response from one person to the next probably due to genetic factors) by reducing waist circumference, quitting smoking, performing more aerobic exercise, and eating a handful of cashews, using extra virgin olive oil and consuming avocadoes frequently. But, in addition to this, there are two supplements that have also shown an ability to further elevate HDL levels in human clinical trials. These include the Indian-based herbal agent known as Gum Guggul and the more well-known Artichoke Leaf Extract. Today I want to focus on the Gum Guggul studies and next week we will look at Artichoke Leaf Extract more closely. Studies in Asia and India over many years have shown that Gum Guggul supplementation lowers LDL-cholesterol in 70-80% of individuals with high total cholesterol and LDL levels. On average, it appears to lower LDL cholesterol by about 30%, which is highly significant. About 20-30% of individuals fail to respond to Gum Guggul supplementation, likely due to strong genetic factors accounting for their high cholesterol problem. But, in the 70-80% of high cholesterol patients who respond to Gum Guggul, there is also an associated increase in HDL of 4%, on average, meaning that for many individuals Gum Guggul reduces their LDL-cholesterol while also raising their HDL-cholesterol.

That is very good news for people with stubbornly low HDL. How does it work? To the best of our knowledge the active ingredient in Gum Guggul, known as Guggulsterone, prompts the liver to clear more of the bad cholesterol (LDL) from the bloodstream. Once the LDL-cholesterol enters the liver cells, Gum Guggul also stimulates the conversion of that cholesterol into bile acids, which are then excreted through the bile duct into the intestine, allowing your body to expel it from the body with each bowel movement. So, the cholesterol floating around right now in your LDL particles in your blood, can be taken up your liver cells, converted into bile acids, flushed through the bile duct into your intestinal tract, and then excreted from your body when you have a bowel movement. This is how Gum Guggul is shown to reduce LDL-cholesterol levels. But it also appears to prompt liver cells to synthesize more HDL and send it out into the bloodstream, where it removes cholesterol from the artery wall and returns it back to the liver, where it can also be converted into bile acids and excreted from the body.

So, in some cases, Gum Guggul can be a great natural addition to an LDL-lowering and HDL-raising program. Very conveniently, it also provides some anti-inflammatory effects, which may also be helpful in cardiovascular health and may help to relieve some joint pain along the way. Gum Guggul is a resin derived from the Mukul myrrh tree in India. The most common side effect of Gum Guggul is that it causes in a skin rash in about 9% of users, which usually occurs in the first week to 10 days of use. There is no way to know in advance if you might be susceptible to this side effect, unfortunately. It’s really trial and error. If the rash occurs, you simply discontinue using it and the rash disappears. I like to provide patients with a supplement that contains both Gum Guggul and Artichoke Leaf Extract, as these two natural agents work synergistically to lower LDL and raise HDL in many cases.

In the next Lifestyle Medicine Update, I will cite the evidence for the use of Artichoke Leaf Extract so you can better appreciate how these natural agents work together to improve cholesterol readings, both LDL and HDL – and even triglycerides for that matter. The effective therapeutic dosage of Gum Guggul is 3 gm per day with a supplement that is standardized to 2.5% guggulsterone content. It is one more natural and effective way to help lower LDL and raise HDL for many people.

I have included a key reference for this information in the text below.

Reference:

Deng R. Therapeutic effects of gum guggul and its constituent guggulsterone: cardiovascular benefits. Cardiovascular Drug Reviews.2007; 25(4): 375-390 https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1527-3466.2007.00023.x

Eat Smart, Live Well, Look Great,

Dr. Meschino