Endocrine Notes: Ask the Expert featuring Paul S. Jellinger, MD, MACE

Do herbs like red yeast rice help to lower the cholesterol?

Red yeast rice does lower cholesterol to a modest degree although these products may vary in their composition. Some may contain statins, which are the same drugs available by prescription to lower cholesterol, or derivatives of statins. Statin side effects, although uncommon and generally not severe, may sometimes be seen with red yeast rice usage. Although red yeast rice lowers cholesterol, unlike statins there are no clinical trials showing that it reduces heart attacks or strokes.

Why do some obese individuals not get complications like diabetes and heart disease while others do?

Good question. Obese individuals with “insulin resistance” or “metabolic syndrome” are the persons particularly predisposed to developing diabetes and heart disease. That represents 75 to 80 percent of obese persons. Metabolic syndrome consists of abnormal lipids, high blood pressure, elevated blood sugar and weight gain around the waist. There are some “healthy” obese, but the majority of obese individuals are at risk.

Some people have said that eating cinnamon can lower blood glucose levels. Is this true?

Cinnamon has very mild blood sugar lowering properties and may be minimally effective in early diabetes. It should never be used as therapy by itself for clearly elevated blood sugars. Its overall effectiveness remains questionable.

What is A1c, and how is it different from testing blood glucose?

HbA1c or “A1c” is not a blood glucose (sugar) measurement. It measure a protein found in the red blood cell that is formed in proportion to the blood glucose level. Since the red blood cell lives in our bodies for approximately 120 days, the A1C measurement reflects the average level of blood sugar control over the past two to three months. Measurement of a single blood glucose reflects just one point in time, while the A1c much more accurately reflects long-term control over the previous 60-90 days. The A1c is considered the “gold standard” in assessing control of diabetes, while an individual blood glucose level may be important in making immediate adjustments to diabetes medications or daily routines. Non-diabetic individuals have an A1c level of 8.0 percent. AACE and the American College of Endocrinology believes that for many but not all persons with diabetes, an appropriate A1c goal is <6.5 percent. Your individual goal should be discussed with your endocrinologist or other diabetes specialist.