By Alli Meinert, Student Pharmacist and Karen Kier, Pharmacist
On behalf of the ONU HealthWise team

Robert Frost’s 20-line narrative poem The Road Not Taken was published in the August 1915 issue of Atlantic Monthly. He released a collection of his poetry in 1916 titled Mountain Interval. In the poem, there are two equal paths covered in leaves and one must decide their path.

The Food and Drug Administration (FDA) has two paths for approving an over the counter (OTC) supplement. Is there a difference? ▶︎

OTC supplements are different from prescription drugs. Prescription drugs are approved by the FDA and they need to show they are safe to take and prove they work to treat the health problem. OTC supplements can be approved through a similar route as prescriptions, but this can be expensive for manufacturers. The FDA has a second route for OTC products based on an FDA monograph or set standards published by the government.  This process highlights safety and may not need as much evidence to prove the product works. 

There are many OTC products claiming to lower cholesterol or improve heart health such as fish oil, cinnamon, garlic, turmeric, plant sterols and red yeast rice. How do they actually work and do they really make a difference? The truth is many of these products have not been well studied to actually prove they work.  

So, how can you tell if a treatment to lower your cholesterol actually works? One way is by checking the levels of your LDL also known as bad or lousy cholesterol in your blood. When the LDL in the blood increases, it can clog arteries, which can cause heart problems like a heart attack or stroke. 

This clogging of the arteries eventually lays permanent atherosclerotic plaque into the blood vessels blocking blood flow to the heart. This can be described as a hardening of the arteries. This is why it is important to reduce heart disease risk by lowering cholesterol. 

In most patients without heart disease risk, the goal for LDL is to be less than 100 mg/dL. In patients with existing heart disease, the LDL goal had been to lower to less than 70 mg/dL. In 2022, the American College of Cardiology released an expert consensus decision pathway to change the LDL goal to less than 55 mg/dL from the previous recommended 70 in those with heart disease.  

These changes take a more aggressive approach to treating existing heart disease and reducing the risk of another heart attack or stroke. It is always best to have a personal goal for LDL cholesterol in consultation with your primary care provider. 

Considering the newest expert advice, most individuals would need at least a 50% reduction in LDL cholesterol. The evidence suggests only prescription cholesterol medication is capable of this extensive decrease.  

In proving this point, a study compared using a prescription rosuvastatin (Crestor) versus common OTC supplements claiming to lower LDL. The study found some supplements decreased LDL by 1.3 to 6.6%, but cinnamon and garlic actually increased LDL. Rosuvastatin lowered LDL by 37.9%. Rosuvastatin lowered LDL better than the supplements, while showing similar safety. The prescription medications work better than common supplements. 

Taking control of your cholesterol does not have to be a challenge. One of the most effective and safe solutions is the use of prescription medications.

ONU Healthwise is offering the and COVID-19 vaccine clinics Monday - Friday from 2:00-6:00 p.m.

ONU HealthWise Pharmacy
419-772-3784
www.onuhealthwisepharmacy.com