Heart & Lipid Balance

Written by Dr. Ryan Kneessi, ND

The mechanisms this protocol supports

Cholesterol comes partly from what we absorb in the gut and partly from what the liver makes. Plant sterols compete with cholesterol for absorption, while plant polyphenols such as those from bergamot influence how the liver handles lipids.

Blood vessels are lined by the endothelium, which stays healthiest when oxidative stress and vascular inflammation are kept in balance. LDL particles that become oxidized are more likely to contribute to plaque, and stiffer blood vessels are one way the cardiovascular system shows aging.

Research has linked plant sterols with healthier LDL levels and omega-3 fats with lower triglycerides, and smaller clinical trials of limited quality have linked bergamot polyphenols with healthier lipid profiles. I left out red yeast rice on purpose because it contains a natural statin compound.

What is in the protocol

The exact products and directions are listed in the Fullscript plan, and here is what each one is commonly used to support.

• CholestePure from Pure Encapsulations provides plant sterols, which compete with cholesterol for absorption in the gut and are one of the most consistently studied nutritional approaches to LDL balance.
• ProOmega from Nordic Naturals provides the omega-3 fats EPA and DHA, which have been linked with lower triglyceride levels and a balanced inflammatory response in blood vessels.
• Super Ubiquinol CoQ10 with PQQ from Life Extension provides the active form of CoQ10, which supports mitochondrial energy in heart muscle, along with PQQ.
• BergaCor Plus from Xymogen combines bergamot polyphenols, which have been linked in clinical trials with healthier lipid levels, with amla, which supports endothelial function. When it is backordered, Bergamot BPF from Ortho Molecular Products may be used as an alternative.

Related protocols you may find helpful include Blood Pressure Support and Metabolic Flexibility.

How to use it thoughtfully

Please talk with your provider before starting, especially if you take medications, are pregnant or nursing, or have a health condition. This page does not list amounts, so follow the label or the specific guidance your provider gives you. When you can, add one product at a time so it is easier to notice how you feel. Sleep, nourishing food, daily movement and stress care are the foundation, and supplements are meant to build on them.

If you take a statin or another lipid medication, please talk with your prescriber before combining it with these products. Fish oil may affect bleeding, so tell your provider if you take a blood thinner or have surgery planned. Plant sterols can lower the absorption of some fat-soluble nutrients, so a varied, colorful diet matters. Statin medications can lower the body’s CoQ10 levels, which is one reason CoQ10 is included here.

What the research shows

This protocol has not been tested as a whole in a clinical trial, so the studies below cover its main ingredients.

Plant sterols have strong evidence for LDL cholesterol. A 2014 meta-analysis by Ras and colleagues pooled 124 randomized studies and found that 0.6 to 3.3 grams a day of plant sterols or stanols lowered LDL by about 6% to 12%, with the effect leveling off near 3 grams a day. These studies measured cholesterol, not heart attacks or strokes.

Omega-3 research depends heavily on the form and dose. In the REDUCE-IT trial, 8,179 adults already on statins, with heart disease or diabetes plus risk factors and elevated triglycerides, took 4 grams a day of a purified prescription EPA or a placebo for a median of 4.9 years. Major heart events occurred in 17.2% of the EPA group compared with 22.0% on placebo (hazard ratio 0.75). This was a high-dose prescription product in high-risk patients, and the trial also saw more atrial fibrillation, so its results should not be applied to over-the-counter fish oil.

Frequently asked questions

Sources

• Ras RT, Geleijnse JM, Trautwein EA. LDL-cholesterol-lowering effect of plant sterols and stanols across different dose ranges: a meta-analysis of randomised controlled studies. Br J Nutr 2014. PMID: 24780090. https://pmc.ncbi.nlm.nih.gov/articles/PMC4071994/
• Skulas-Ray AC, et al. Omega-3 Fatty Acids for the Management of Hypertriglyceridemia: A Science Advisory From the American Heart Association. Circulation 2019. PMID: 31422671. https://pubmed.ncbi.nlm.nih.gov/31422671/
• Lamiquiz-Moneo I, et al. Effect of bergamot on lipid profile in humans: A systematic review. Crit Rev Food Sci Nutr 2020. PMID: 31670973. https://pubmed.ncbi.nlm.nih.gov/31670973/
• Gordon RY, et al. Marked variability of monacolin levels in commercial red yeast rice products: buyer beware! Arch Intern Med 2010. PMID: 20975018. https://pubmed.ncbi.nlm.nih.gov/20975018/
• Littarru GP, Langsjoen P. Coenzyme Q10 and statins: biochemical and clinical implications. Mitochondrion 2007. PMID: 17482884. https://pubmed.ncbi.nlm.nih.gov/17482884/

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