EP55: Talking About Supplements

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Podcast Summary: EP55 - Talking About Supplements Dr. Warwick Bishop is a practicing cardiologist and author dedicated to improving patient care through education about heart health. In this episode, he addresses common patient questions about supplements for cholesterol management, specifically discussing bergamot and other natural alternatives to traditional statin therapy. The discussion centers on how to safely and effectively incorporate supplements into a cardiovascular health regimen based on individual risk assessment. Key Takeaways: Bergamot, a citrus-based plant containing flavonoids, has demonstrated cholesterol-lowering effects in research, with studies showing reductions of 0.5-1 millimole per litre and improvements in carotid artery thickness. The effectiveness of any supplement depends on the patient's individual cardiovascular risk level; high-risk patients (those who have had heart attacks) require aggressive LDL lowering and may need statins combined with supplements, while low-risk patients may benefit from supplements alone. When using supplements like bergamot, it is critical to use formulations that actually work—Dr. Bishop recommends using the specific proprietary preparation (BurgerVit) tested in research and monitoring cholesterol levels to verify effectiveness. Red yeast rice, which naturally contains the chemical precursor to statins, can be a supportive option for cholesterol management but may be insufficient as a standalone treatment for high-risk patients. Berberine appears to have lipid-lowering effects that partially replicate PCSK9 inhibitors (newer injectable cholesterol medications) and may have a role in comprehensive cholesterol management. Nicotinic acid (niacin), a B-group vitamin, can modestly lower LDL cholesterol, raise HDL cholesterol, and lower triglycerides, with particular benefit shown in the HATS trial for patients with low HDL cholesterol. Any supplement use should be done in collaboration with a cardiologist or healthcare provider who can monitor its effectiveness, check for side effects, and ensure it doesn't negatively impact organs like the kidneys and liver. Dr. Bishop recommends patients work with both a knowledgeable naturopath and their cardiologist when using supplements, as he acknowledges he cannot stay current with all formulations and proprietary preparations available. Statins remain the gold standard for cholesterol lowering in high-risk patients, but supplements can be valuable additions to a structured, supervised treatment plan when appropriate. The overall approach should balance the patient's actual cardiovascular risk with the intensity of treatment needed, rather than applying one-size-fits-all solutions to cholesterol management.