The Strom Sports LIPIDMAX formula for cholesterol management

LipidMAX is the Strom solution to supporting cholesterol, with most benefit in reduction in LDL cholesterol related damage through a Pauling Protocol approach  (High dose Lysine and Vitamin C) but also general total cholesterol and LDL reduction, as well as HDL raising actions from the Citrus Bergamot, Grapeseed Extract, and CoQ10.
This is a formula we've tested with numerous patients using bloodwork at Strom, you can see the results of a semi-formal in house trial at the bottom of the page.

THE LIPIDMAX FORMULA 

Each tub of LipidMAX includes 40 servings and is available in Mango flavour.
Each serve includes the following:

• Lysine (5000mg)

• Vitamin C (1000mg)

• Citrus bergamot (500mg)

• Grapeseed Extract (500mg)

• CoQ10 Ubiquinone (250mg)

 Before we dive into their actions, first some important context. Our body regulates cholesterol levels by the three main actions of:

• intestinal absorption or excretion;

• liver uptake of LDL for conversion to bile acids;

• de novo synthesis.

Next important for context is the prescription medications statins, both in their role as a current medical standard of cholesterol management, but also as you'll read below, both Citrus bergamot and Grapeseed extract do have some statin like actions.

WHAT ARE STATINS, & HOW DO THEY WORK?

Statins are a group of lipid lowering pharmaceuticals, which are currently the medical standard for helping patients lower LDL and raise HDL measures. They can be effective and certainly a life changing tool, but they also come with a host of side effects that make them unusable for many people, and may have long term negative consequences. As such, there is certainly demand for alternatives. 

Statins work by binding to, and inhibiting the liver cell enzyme known as HMG-CoA Reductase, which catalyzes the conversion of HMG-CoA to Mevalonate. This is the first, and rate limiting step of cholesterol synthesis. Hence by competitively binding to HMG-COA Reductase total cholesterol synthesis is decreased significantly since most of circulating cholesterol comes from synthesis rather than diet. This reduced cholesterol concentration then sets off a signal cascade which results in increases in the number of LDL receptors. These in turn shuttle in more LDL and VLDL for processing into bile salts. These bile salts are then used for digestion in the gut, or excreted. 

As such, statins decrease cholesterol synthesis, as well as increasing VLDL and LDL conversion to bile acids. By downstream effects it also increases HDL. These are all very important successes for decreasing atherosclerosis risk in persons who  have exceedingly high total cholesterol, LDL and low HDL.

However because of the decreased production of mevalonate, of which is a precursor to CoQ10, CoQ10 synthesis is also decreased. CoQ10 is essential for energy production, hence this is a primary reason for statin side effects, and has been known to cause musculoskeletal tissue issues due to their high CoQ10 demands. For bodybuilders and athletes we expect this to be of extra concern due to increased loading. This may also be the cause of increased liver and kidney dysfunction resulting from statin use. The decreased cholesterol biosynthesis may also impact glucose transporters, hence increasing diabetes risk. Finally, long term statins use is associated with increased intestinal absorption due a feedback from the inhibited liver synthesis. As such can decrease effectiveness with time.
Thus statins are a valuable tool to correct high risk factors, but those sensitive to side effects may not be able to use them, and long term use will increase side effect health outcome risks.

With that discussion aside, now we'll dive into the demonstrated actions and goals for the ingredients within the LipidMAX formula.

PAULING THERAPY PROTOCOL FOR ARTERIAL HEALTH

Linus Pauling was, a renowned chemist,  who studied at Oregon State University and the California Institute of Technology, during his scientific career he won two individual Nobel Prizes for his work, among numerous other awards and accreditation.
The Pauling Therapy protocol for cholesterol involves the use of high doses of vitamin C and Lysine.  He suggested that a combination of vitamin C and lysine could help prevent the formation of plaque in the arteries.  

INCREASING LYSINE TO NEUTRALISE LIPOPROTEIN (A)

LDL cholesterol is what is often considered "bad" cholesterol, and in that context Lipoprotein (a) is a LDL that would be considered "very bad". It creates damage in your arterial walls due to a high number of attractive receptor sites which bind to the walls making it "sticky" to carry a high number of oxidised phospholipids. This is what is recognised to be the a primary reason Lipoprotein (a) is so damaging to arterial walls. In fact,  it was this work that led to the 1987 Nobel prize in medicine discovered that lysine binding sites is a cause the formation of atherosclerotic plaques.
Thankfully this leads to the simple concept that Pauling introduced, increasing Lysine concentrations significantly in order to fill up these receptors, making them less likely to bind to arterial walls. Think of a parking lot that has all its car parks full, there isn't any room for more to come in. This therefore reducing the damage caused by Lipoprotein A signficantly. 

VITAMIN C TO REDUCE PLAQUE BUILD UP

When cholesterol becomes oxidized, it can form plaque on the arterial walls, leading to atherosclerosis and an increased risk of heart disease. By acting as an antioxidant, vitamin C helps neutralise free radicals and reduce oxidative stress in the body. This can help prevent the oxidation of cholesterol and inhibit the formation of plaque. Additionally, vitamin C has been shown to have anti-inflammatory properties. Chronic inflammation plays a role in the development of atherosclerosis and plaque formation. By reducing inflammation, vitamin C may further contribute to the prevention of plaque buildup in the arteries. Vitamin C is also a necessary component in making the other potent antioxidant "CoQ10" which performs similar functions. This ingredient is discussed further below. 

VITAMIN C & LYSINE FOR COLLAGEN

An additional value point of both Lysine and Vitamin C is that both are critical in the process of building collagen, which is required for the maintaining and repair of arterial walls. This will help recover after damage has been done, before it goes too far. 

PAULING: NOT A CURE ALL, BUT STILL DAMN GOOD.

Together, lysine and vitamin C are thought to work synergistically to support the health of blood vessels, reduce oxidative stress, and inhibit the formation of arterial plaque. This is the primary principle of the original Pauling therapy protocol, however since the late 90's further improvements have been made.

The Pauling approach is not an absolute cure-all, with some more recent evidence around other mechanisms regarding lipoprotein A, it may not be as significant a cure as he claimed. Quite frankly, Linus Pauling started making some outrageous claims as his career continued on. However in real world experimentation with the Pauling protocol alone we have seen good outcomes specifically for LDL related harm reduction. The safety profile of both ingredients is excellent making risks negligible, and both ingredients are certainly valuable in other ways.

Understanding that cholesterol related health concerns do have multiple factors that will extend beyond Pauling's hypothesis,  LipidMAX utilises multiple other efficacious ingredients to work on these various issues, including the Citrus Bergamot, Grape Seed Extract, and CoQ10 of which all have their own value independently shown in modern clinical research. These are discussed below. 

CITRUS BERGAMOT

Citrus Bergamot is a fruiting tree, primarily cultivated in a small coastal region of Italy. While exact lineage is still to be officially confirmed, its commonly regarded as a cross species of citrus aurantium (bitter orange) and citrus limon (lemon). As such it does produce many of the same flavonoids as these other two citrus fruits (naringin, neohesperidin, & neoeriocitrin), however what makes it unique is their significantly high concentration, and presence of  two new molecules identified as 3-hydroxy-3-methylglutaric acid (HMG) conjugates of neohesperidin and naringin, these being Brutieridin and melitidin. These five compounds what we'll focus on, being the main components with demonstrated cholesterol related action.

BERGAMOT CONTAINS STATIN LIKE COMPOUNDS

That was a lot of chat on statins, here's why. Citrus bergamot is now well documented to contain two key flavanoids. These being Brutieridin and melitidin, both of which have the HMG molecules built into them, and have documented actions inhibiting HMG CoA Reductase, such that it could now be considered a general consensus. So yes, bergamot has statin-like actions through these two, and likely also Naringin itself through less direct AMPK actions. 
So do we see the same side effects as a result? Not as of yet. Part of this will be with respect to potency, and that medical statins have far greater potency via stronger binding activity to HMG-CoA reductase. At lower dosing the side effects associated with statins are very uncommon, and we believe this is similar to what will be occurring with brutieridin, melitidin, and naringin actions. Dose is key, dosing above current clinical trial ranges may lead to the same side effects - however precisely what dosing is yet to be confirmed.

While Bergamot can achieve similar lipid modulation outcomes as statins, it is not purely through its statin like mechanisms, and this is likely why it doesn't come with the same side effect profile. 

BERGAMOT INCREASES RATE OF BILE ACID EXCRETION

When subjects consume citrus bergamot juices or extracts, the amount of bile acids and cholesterol absorbed through the intestine is reduced, and hence excreted in stool. Naringin is a primary compound with this demonstrated effect, being demonstrated in isolation as well as a part of the whole Bergamot extract.
The conversion of cholesterol to bile acids is the major pathway of cholesterol elimination, and it can account for about 50% of daily cholesterol excretion. Cholesterol 7R-hydroxylase, the rate-limiting enzyme for conversion of cholesterol to bile acids, is mainly regulated by feedback inhibition of bile acids reabsorbed from the intestine. The increase in the excretion of bile acids therefore causes an increase in cholesterol 7R-hydroxylase activity, upregulating the conversion of liver cholesterol to bile acids, which are later excreted. This leads to a decrease in liver cholesterol content, which in turn stimulates also LDL receptor expression (much like statins), encouraging further conversion to bile acids, having a net effect of lowering blood cholesterol levels.

BERGAMOT IMPROVES ANTIOXIDANT ACTIVITY

Oxidative stress is one of the causative factors that link high cholesterol with cardiovascular disease outcomes. Bergamot has demonstrated some antioxidant actions from multiple mechanisms with end outcomes of lowered concentration of oxidized LDL. Naringin in isolation has demonstrated actions in stimulating Super Oxide Dismutase (SOD), Catalase, and Glutathione Reductase (GR), leading to a reduction in reactive oxygen species in the liver, which is an attributable factor to decreased lipid oxidation.
At this time, there is some variability in outcomes, but at minimum some weak activity between 10 - 20% improvements have been recorded. It is for this reason the antioxidant activity may be considered a factor involved in Bergamot, but is not the primary appeal. CoQ10, included in the LipidMAX formula, is more effective in this role and is discussed below.

These complimentary antioxidant and bile excretion actions, alongside the mild statin like actions, is proposed to create the additive effect that allows for a total lipid modulation similar to that in normal dosages of prescribed statins, but with lesser side HMG-CoA reductase related effects. 

COQ10

CoQ10 is a naturally occurring compound, similar to vitamin K in its chemical structure, but it is not considered a vitamin because it is synthesized in the body. In fact CoQ10 is made in every tissue of the body due to it's critical role in facilitating the mitochondrial electron transport chain. So everywhere you'll find mitochondria, you'll find CoQ10. In fact over 40% of the total stores in the human body is estimated to be localised in the mitochondria inner membrane. The other key role CoQ10 plays is as a general antioxidant buffer throughout tissues, either regenerating other antioxidants or acting directly. As such it has follow on effects in protecting stability, fluidity, and permeability of cell membranes, stimulating cell growth, and inhibiting cell death. 
The oxidized state of CoQ10 is known as Ubiquinone, and the reduced Ubiquinol. 

So if CoQ10 is so ubiquitously present and produced in the body, why would we want to supplement with an additional source? In general, the human body cannot synthesize a sufficient amount of CoQ10 in some pathological conditions, such as metabolic syndrome, hypertension, diabetes, and dyslipidemia, ie. abnormal amounts of lipids in circulation. By this point it should hopefully be clear that this is the exact use case for LipidMAX, and so supplementing with an essential compound that has known deficiency for this use case just makes sense. And thankfully, because CoQ10 has been a focus of research for over three decades now, we have an abundance of human clinical trials to draw insight onto what occurs when supplemental CoQ10 is applied to a person with elevated lipids.

COQ10'S EFFECTS ON ELEVATED LIPIDS

Let's take some data straight from the research literature: In 2022 a comprehensive meta analysis of 50 randomised human clinical trials, encompassing 2794 participants demonstrated a strong effect in decreasing Total Cholesterol, Triglycerides, LDL, and increasing HDL levels. [8] For context of the scale, at the 250mg dose of Ubiquinone CoQ10 used in LipidMAX, the mean cholesterol decrease could be calculated to be an average of 10%.

Besides modulating total lipids, CoQ10 supplementation is also shown to reduce markers of oxidative stress in the liver and increase CoQ10 concentrations in LDL and HDL, thereby being available to reduce oxidised phospholipids carried by the lipoproteins and as such neutralise their potential to damage arterial walls. Remembering that this process of damage to arterials walls by oxidised compounds is the key reason for concern in persons with elevated lipids. See the section on Pauling Therapy above if you need a reminder.

GRAPESEED EXTRACT

Grapeseed extract is a jack of all, master of none type ingredient. Currently has documented minor effects in reducing plasma lipid profiles by inhibiting specific cholesterol transporters such as the Niemann-Pick C1-like cholesterol transporter, as well as pancreatic lipase, cholesterol esterase, cholesterol micellisation and bile acid binding. Among all these mechanisms, only weak action has been documented.
The primarily influential component of Grapeseed extract is likely the naturally occurring proanthocyanidin content, of which have potent antioxidant and direct free radical scavenging actions, helping prevent oxidation of cholesterol. This is consistent with the trend of outcomes where Grapeseed extract favorably decreases LDL and triglycerides, but not total cholesterol or improving HDL measures. 

As you might then expect, the primary role for Grapeseed extract in LipidMAX is in it's role to neutralize oxidised cholesterol, regarded as significantly exceeding the established vitamin C and Vitamin E free radical scavenging potency, thereby mitigating the primary mechanism of damage due to high cholesterol concentrations.

SUMMARY OF LIPIDMAX ACTIONS

From the above discussion, the following conclusions can be drawn about the mechanisms for lipid management we're seeking to work on with LipidMAX:

• Pauling Therapy Protocol: Occupying lipoprotein Lysine binding sites, thereby reducing the amount of oxidised cholesterol able to be transported, and availability to bind to arterial walls, thereby by reducing damage. Then neutralising free radicals and hence oxidative stress and inflammation with Vitamin C related actions

• Bergamot, and to a lesser degree grape seed extract directed "statin-like" HMG CoA reductase inhibtion actions to reduce cholesterol synthesis.

• Bergamot, and to a lesser degree grape seed extract directed bile acid excretion, thereby increasing turnover of cholesterol through simulating synthesis of more bile acids.

• Bergamot, and to a lesser degree grape seed extract directed cholesterol absorption inhibition, thereby reducing total amounts entering circulation.

• Bergamot directed increases in antioxidant function, primarily through stimulation of SOD, Catalase, and GR to facilitate free radical buffering.

• CoQ10 and grape seed extract mediated direct antioxidant activity by buffering of free radicals.

See our Strom Sports Nutrition LipidMAX in store here.

AN "IN-HOUSE" TRIAL OF LIPIDMAX

To see the results of our in-house trial of LipidMAX on LDL and HDL measures click through to the Stromucation page on LipidMAX, at the bottom of the aritcle is an image link that will take you through to the pdf. It was a small sample group, and with athlete specific variables in place. However the results were still damn convincing we think, and since this trial, hundreds of athletes getting bloodwork have confirmed successful outcomes consistent with it's performance.

https://www.stromucation.com/lipidmax.html

REFERENCE MATERIAL

[1] Naringin alters the cholesterol biosynthesis and antioxidant enzyme activities in LDL receptor-knockout mice under cholesterol fed condition (2004, Kim)
[2] Hypolipidemic Effects of Citrus bergamia Risso etPoiteau Juice in Rats Fed a Hypercholesterolemic Diet (2007, MiCeli)
[3] Statin-like Principles of Bergamot Fruit (Citrus bergamia): Isolation of 3-Hydroxymethylglutaryl Flavonoid Glycosides (2009, Di Donna)
[4] On the Inhibitor Effects of Bergamot Juice Flavonoids Binding to the 3-Hydroxy-3-methylglutaryl-CoA Reductase(HMGR) Enzyme (2010, Leopoldini)
[5] Hypolipemic and hypoglycaemic activity of bergamot polyphenols: From animal models to human studies (2011, Mollace)
[6] Hypocholesterolaemic activity of 3-hydroxy-3-methyl-glutaryl flavanones enriched fraction from bergamot fruit (Citrus bergamia): ‘‘In vivo’’ studies (2014, Di Donna)
[7] Effect of bergamot on lipid profile in humans: A systematic review (2019, Lamiquiz-moneo)
[8] Effects of Coenzyme Q10 Supplementation on Lipid Profiles in Adults: A Meta-analysis of Randomized Controlled Trials
[9] Red Grape Seed Extract Improves Lipid Profiles and Decreases Oxidized Low-Density Lipoproteinin Patients with Mild Hyperlipidemia (2013, Razavi)
[10] Effects of grape seed extract on dyslipidaemia: a systematic review and dose–response meta-analysis of randomised controlled trials (2020, Anjom-Shoae)
[11] Oregon State: Linus Pauling Biography (Accessed 2024)
[12] The Cure for Heart Disease: Condensed (2004, Fonorow)
[13] Oregon State: Pauling Recommendation on Vitamin C 

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27.06.2024 -This article was originally published at stromucation.com, with additional media graphics.

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