I get a lot of phone calls and letters from women who are confused about the results of their blood tests. Ten years ago, most of the confusion was about cholesterol. But most people now understand their cholesterol numbers quite well. The confusion now is over triglycerides.

Most everyone knows that high triglycerides are bad for you. But I've found that a lot of women don't know what triglycerides are or what constitutes high levels. And worse, very few know just how dangerous they are or how to lower them effectively without drugs.

Just like cholesterol, triglycerides are necessary to your health. They are fats your body stores for future energy. We all need a little extra stored energy. But if you're carrying excess weight around your tummy, thighs, buttocks, or other areas, you got more triglycerides than you need.

And this can be very dangerous. In fact, I believe high levels of triglycerides are much more dangerous than cholesterol. They not only contribute to heart disease, but also diabetes. And anyone can have high levels — even if you're physically fit and have normal cholesterol numbers.

If you're overweight, the triglycerides stored in your fat tissues are a useful warning that it's time to lose weight. But the triglycerides that remain in your bloodstream are the ones you really need to worry about. They are far more dangerous than those in your fat tissues. They turn into energy-producing fat particles that can slow down your circulation and stick to the walls of your arteries. This is how plaque is formed. And it's how high triglycerides lead to heart disease!

In the past, high triglycerides were just part of the total picture of high fats (cholesterol, HDL, LDL, and triglycerides) that increase your risk for cardiovascular disease. Now we know more. High triglycerides are actually an independent risk factor for heart disease — even when your cholesterol and its fractions are normal.

But there's even more you should know.

Triglycerides also cause your body to make too much insulin. This can lead to insulin resistance, which can progress to Syndrome X, then diabetes.

Look to the source

Excess triglycerides are almost always a consequence of a diet too high in fats, refined starches, and sugars. They also are produced when you overeat, and when you don't have enough antioxidants.

But, you can eat a healthy diet and still have high triglycerides. That's what happened to Susan Burke, a fitness enthusiast I saw for nutritional counseling some years ago.

"I don't understand this," Susan said, visibly upset that her blood test revealed abnormally high triglycerides. "I don't eat any white flour, white rice, or sugar. I don't eat sugar or even anything with honey. And I limit my alcohol to a small glass of wine some nights. What else can I do?"

I asked Susan to keep a two-week food diary, and found the culprit: fruit! Susan drank several large glasses of undiluted fruit juice and ate fruit throughout the day. I eliminated her fruit juice and lowered her intake of fruit to two pieces a day and her triglycerides quickly dropped.

Look at your most recent fasting blood test. Optimally, your triglycerides should be between 50 and 100 mg/dl. If they're pushing 200 or higher, it's time to take action. If you have high triglycerides, you're eating too much sugar.

Modify your diet

Begin by keeping a one-week food diary and circle in red all foods that contain refined carbohydrates or sugars. Sugars include white sugar, brown sugar, evaporated cane juice, honey, rice syrup, anything ending in "ose" (such as fructose or dextrose), and fruit/fruit juice. If you're adding a sweetener to your tea or coffee, breakfast cereal, or other food, cut down on the amount you're using. Use Stevia, the powdered leaf of a plant 100 times sweeter than sugar (you can find it in any health food store), instead. It doesn't affect blood sugar or triglyceride levels.

If your triglycerides are over 150, you may need to do more than change your diet. Many doctors prescribe statins to lower triglycerides along with cholesterol and LDL. However, as you know from some of my past articles, statins deplete your body's stores of Coenzyme Q10, an important nutrient for your brain and heart.

My preference is to use a combination of diet and supplements. Check with your doctor before taking any of them and ask him or her to monitor your triglyceride level.

Supplements lower triglycerides

Diet, exercise (burning up excess fats and stored triglycerides), and specific supplements all help lower your triglycerides. Here are some of my favorite supplement suggestions.

Chromium: This mineral is frequently low in people with high triglycerides. Study after study shows that just 200 mcg of chromium supplementation — the amount found in some multivitamins (such as Vitality Plus — 800-728-2288) — has significantly lowered triglycerides. But some people need much more. Talk with your doctor about taking 200 mcg two to three times a day for a few months. It's safe.

A study reported in the Journal of the American College of Nutrition found that there was no toxicity from chromium when taken at several thousands of times the upper limits of estimated safety and adequate daily intake. I've given 500 mcg twice a day for three months, then 500 mcg once a day, to patients who were diabetic or had severe hypoglycemia. The results were excellent and no one experienced any symptoms of toxicity.

Fish oil and flax oil: These essential fats can lower your triglycerides up to 65%, so include them in your daily supplements. Since it's difficult to find fish that don't come from polluted waters, and it's possible to buy fish oil capsules containing no pesticides or other toxins, you may want to get most of your essential fats from supplements. Take one to two capsules of a toxin-free fish oil each day. You can find them in health food stores, or included in Vitality Plus packets.

Padma Basic: This herbal remedy from Tibet containing 22 natural ingredients was originally used to increase circulation and improve peripheral artery disease. The result is reduced leg pain and cramps that come from walking. Now we're finding that Padma does much more. A side effect of this antioxidant-rich formula was that it significantly lowers triglycerides (two tablets taken two times a day). Padma Basic isn't in many stores, but you can get it by calling 800-728-2288. Give it a three-month trial.

Garlic: This popular herb is known for its ability to lower cholesterol and triglycerides. However, you should know that it could take three to four months before you see a significant drop. Be patient and try it for six months. Eating raw garlic, and taking one of the many garlic products available may lower your triglycerides. But be aware that garlic supplements vary in their chemical makeup. If you're going to take a garlic supplement to lower your triglycerides, I suggest you use Kwai — the brand used in most studies. You can find it in all health food stores. The dose most commonly used was one tablet, three times a day.

Usually a change in diet and the right supplements are all you need to lower your triglycerides to a safe level. This is one of the best ways to avoid a heart attack and diabetes.

Natural Solutions for a Common, Annoying, Viral Infection

They're unsightly, painful, and very common. In fact, around 90% of the population has them at least once in their lives. Many people get outbreaks every year. You may have thought of them as just being an annoyance, but they're more. They're a reminder that you need to take better care of yourself. And they can even be signs of a suppressed immune system.

The first time you get one, you may think you're coming down with the flu with accompanying fever, fatigue, and neck pain. After the first bout, however, it tends to suddenly appear out of nowhere, without much warning. Actually, it's been lying dormant in your nerve cells all along, waiting to become reactivated by something in your lifestyle.

I'm talking about cold sores — those weeping blisters that appear on your lips, often in the same area. If you have a strong immune system, they usually disappear in 7-10 days. If it's compromised, they could take much longer. You'll never get completely rid of them because they're caused by a herpes virus. As you may know, there's no way to get this virus out of your body once it gets in. But it is possible to keep it inactive, or to greatly shorten the length of time it takes for its symptoms, like cold sores, to disappear.

More than sore lips

A particular herpes simplex virus called HSV-1 causes cold sores. This virus has more serious consequences than just giving you a sore lip. HSV-1 can also cause eye infections that could lead to scarring in the cornea and blindness. If you have a cold sore, never touch it and then touch your eyes!

What causes herpes?

Sunlight: UVB radiation from sunlight and tanning booths not only causes sunburn, it activates the virus that causes cold sores. Your risk for all sun-related damage increases if you ski or hike along snowy mountain areas. This is because there is less ozone at high altitudes and ozone absorbs UV radiation. Since both snow and water reflect UV light, increase your sunscreen protection if you're exposed to either.

Ever wonder why so many lip moisturizers contain sunscreen? It's because the skin on your lips is thinner than exposed skin anywhere else on your body. This makes it especially sensitive to the UVB rays of the sun. Use a lip moisturizer with PABA, zinc oxide, or titanium dioxide for the best protection against cold sores. Apply it half an hour before you go into the sun, and reapply every two hours. Never share your lip balm with anyone else. You may be sharing herpes! All Terrain Lip Armor is one of the natural lip moisturizers available in many health food stores that contain zinc oxide. I prefer it to PABA, which has been associated with liver problems.

Stress: Either physical or emotional stress can trigger cold sores. This includes colds, flu, and a nutritionally poor diet. All suppress your immune system, needed to fight viral infections. Cold sores are often the first warning sign that you're under too much stress. Unfortunately, that's when we tend to eat poorly. Improve your diet and take a good, strong multivitamin/mineral.

Include daily meditation or prayer, and regular exercise. Consider taking adaptogens — nutrients that help regulate stress. I recommend Eleutherococcus, Rhodiola, and medicinal mushrooms. I've talked about them in past articles that you can find on my website.

My favorite cold sore remedies

Modify your diet to specifically prevent cold sores by increasing foods high in lysine and lowering foods high in arginine.

Arginine: This amino acid, found in greatest quantities in chocolate, nuts, seeds, grains, gelatin, and raisins, promotes the growth of herpes simplex viruses. Lower your intake of these foods at the first sign of a cold sore outbreak. At the same time, increase lysine-rich foods.

Lysine: Lysine blocks the activity of all herpes viruses. Foods high in lysine include potatoes, beans, eggs, brewer's yeast, meat, fish, and chicken. Consider taking supplemental lysine. The suggested dose is 500 mg daily to prevent herpes, or 1,000 mg (one gram) three times a day at the first sign of an outbreak until the cold sores are gone. Lysine can stimulate your liver to produce more cholesterol. Monitor your cholesterol levels if you take lysine supplements for more than a few months.

Lemon balm: Acyclovir (Zovirax) is one of many popular pharmaceuticals in topical anti-virals designed to reduce the pain and itching from cold sores. They address its symptoms; they don't prevent outbreaks. My favorite remedy does. It contains the extract of Melissa officinalis, known as lemon balm. This herb was tested in a 1999 study and found effective in reducing the symptoms of herpes when applied four times a day as soon as sores appeared.

I use it at the first sign of a prodrome, that little tingling that precedes a blister. While I used to get frequent cold sores, now I can either prevent them completely or reduce any blistering to one or two days. Topical creams with Melissa extract are usually available in health food store. My favorite one is Cold Sore Relief, formerly Herpalieve, made by PhytoPharmica (800-376-7889), costing less than $10.

Prunella: This herb, indigenous to China and parts of Europe, was tested on both HSV-1 and HSV-2 in laboratory animals. One formula, Herpasil, contains Prunella in a base of comfrey and Melissa. It completely stopped infection from both viruses within the cells, indicating that it might prevent future outbreaks. I haven't tried this formula, but you can get it from DAK Pharmaceuticals (866-475-4424). A two-ounce jar is $29.95.

Vitamin C: Ascorbic acid is the cheapest and oldest remedy for cold sores. You can take it orally or apply it topically. To do this, simply make a paste with ascorbic acid powder (or crush a vitamin C tablet) and add a little water. Apply the paste to the sore several times a day. If you like, you can cover this with a bandage. Studies have shown that if you use vitamin C topically at the first sign of an outbreak, you can often prevent cold sores.

The Popular Herb Reduces Anxiety, Helps You Sleep, and Soothes Your Burns

The ancient Greeks, Romans, and Persians used it as an antiseptic to disinfect their hospitals and sick rooms. They also added it to their baths and laundry to purify both body and spirit. If you travel to Tibet today, you may be surprised to find it's being used to treat psychoses and insanity.

We know it best as a decorative garden herb that reduces anxiety and improves sleep. It's become one of the most frequently used fragrances in bath and body products. I'm talking about lavender, an herb known as much for its beauty as its perfume. Now it's being used increasingly for its medicinal qualities.

Of about 20 species of lavender, the most studied is Lavandula angustifolia, English lavender. Here are some of its uses.

Relieves fatigue: Spritzing lavender water on your face, or smelling its aroma, can perk you up whether you've just had a hard day or are fatigued from illness. A group of patients with advanced cancer and debilitating fatigue were given oil of lavender to smell. Then they soaked their feet for three minutes in warm water containing lavender oil. Finally, they were given a 10-minute foot rub with lavender-infused massage oil. All of them felt revitalized for up to four hours. Add a few drops of lavender oil to a vegetable oil and massage your hands or feet with it.

Improves concentration: If your job or hobby requires constant concentration, you may want to refresh yourself with lavender. Three-dozen young men were given computer work requiring a great deal of concentration. They worked for an hour in each of five sessions. In between each session they were given half an hour off. During these recesses some were exposed to lavender, some to jasmine, and some to nothing. Those who smelled the lavender had the best concentration. For periods of mental fatigue, try sniffing a little lavender.

Acts as a sedative: Lavender not only relieves fatigue, it can relax you and help you sleep. In Germany, it is a medicinal tea given for nervous stomachs and sleep disorders. Apparently, the people at Traditional Medicinals knew this. Last year, they added Organic Chamomile with Lavender tea to their line. This is a light, delicate tea you may want when you're feeling a bit queasy or would like a warm beverage before bed. Look for it in your health food store or phone Natural Resources (800-747-0390).

Dementia anxiety: Up to 65% of people with dementia become agitated. The most common treatment is to sedate them with drugs. A study published in the International Journal of Geriatric Psychiatry suggests that this may not be necessary. People with severe dementia were placed in a room for two hours where diffusers emitted lavender oil fragrance into the air. Sixty percent of the people improved. If smelling lavender can quiet down someone with severe dementia, it should work beautifully with someone with mild to moderate dementia. Try rubbing a drop of lavender essential oil on the hand of someone who is agitated and see what it does.

Antidepressant: In a study of more than four-dozen outpatients with major depression, adding tincture of lavender (20 drops a day) to imiprimine (100 mg a day) made the drug more effective. Lavender may reduce minor to moderate depression even without drug therapy. But don't stop taking antidepressants without your doctor's knowledge Instead, discuss the possibility of using lavender either alone or in conjunction with your medication. Tinctures of lavender can be found in many health food stores, or ordered through HerbPharm (800-348-4372).

Soothes burns: Its antimicrobial and antibacterial activities make lavender oil an excellent choice for cuts, bruises, insect bites, and burns. One study found it had a strong anesthetic activity. Another found that both water and ethanol extracts of lavender reduced inflammation. Consider adding a drop or two of lavender essential oil, or 10 drops of a tincture to a small spray bottle of water and spray on any inflammation or irritation.

Anti-fungal: In a laboratory cell study, lavender oil (2%) killed 100% of the yeast Candida albicans in 15 minutes. If you have a yeast overgrowth, or want to ward one off, you may want to add a drop of lavender essential oil to a cup of herb tea and drink it once or twice a day. Or add a few drops of the oil to a douche. Do this in addition to any anti-candida program you're using.

Using lavender

External use: Add one to five drops of essential oil to your bath, massage oil, or aromatherapy diffuser. There are many types of diffusers, but try using an ordinary vaporizer. Put several drops of lavender essential oil in the little depression often used for menthol. You'll soon fill the room with its scent.

Internal use: Make a tea with one to two teaspoons of lavender blossoms or leaves, or put one to four drops of essential oil on a sugar cube or in one teaspoon of honey.

Quality: Only buy lavender pructs that are organic and say "angustifolia" on them. This assures you of a high-quality product.

Consider growing your own: If you have the space, and you live in a temperate climate, plant some lavender. Save the blooms and some of the leaves when you cut them back each fall, and you'll have a ready supply of this useful and fragrant herb.

Health Detective

Can Chiropractic Manipulation Cure Deafness?

You probably didn't know that the first chiropractic adjustment, given in 1895, was said to cure the patient's deafness after just one treatment. Now, more than 100 years later, we're finding that chiropractic manipulations may help certain people hear better.

A group of 15 hearing-impaired patients were evaluated using a Welch Allyn AudioScope 3, the same instrument used in many schools to screen students' hearing. The patients, who all had a greater impairment in their right ears, were tested at three standard decibel levels before and immediately after a single chiropractic treatment. At 40dB, six had their hearing restored, seven had improved hearing, and two experienced no change. At a lower decibel, 25dB, none had their hearing restored, but 11 patients experienced improvement.

It seems to me that anyone with a mild hearing loss in their right ear might want to explore chiropractic, especially since there was improvement after a single treatment.

Follow-Up on Why Echinacea Doesn't Always Work

Using echinacea supplements to ward off a cold, or to shorten its duration, has become so popular it's almost mainstream. Some people swear by this herb, while others say it doesn't give them much, if any, relief. There are numerous studies on each side of the debate. I reported on one of these studies in the January issue and wanted to update you on some new information I've received.

First, not all supplements work for everyone all of the time. But when it comes to echinacea, the issue becomes complicated because there are three different species that are being used medicinally (E. angustifolia, E. purpurea, and E. pallida). This is important, because different species have different properties.

Next, various parts of the plant are used. Some supplements contain the root, the flowers, the leaves, or the whole plant. Once again, each part of the plant has varying amounts of differing properties.

Finally, there are numerous ways to prepare echinacea. It can be extracted in water, in alcohol, or simply dried and ground up.

Not all of these variations on a theme have been tested, so it's difficult to know which echinacea supplements will work best. I've found two that work for me: Echinacea Plus herb tea by Traditional Medicinals (in your health food store ) was tested and found effective in a study published in the Journal of Alternative and Complementary Medicine. All 95 participants had positive results. I also like the echinacea tinctures from HerbPharm (800-348-4372).

Echinacea is a safe herb to take. Use it at the first sign of a cold for best results. And if one brand or formula doesn't work for you, try another. When it works, it works well.

Ask Dr. Nan

Q: I have brittle fingernails that tear, split, and layer. I eat a good diet and have taken various vitamin formulas with nutrients to help my nails, but nothing has helped. What do you suggest? — A.D., e-mail

A: It's frustrating when you're doing everything right and still have a problem like this. Brittle fingernails can be a sign of a nutrient deficiency, toxicity, genetics, or dryness.

A number of studies found that taking large amounts of the B vitamin biotin resulted in firmer, harder fingernails. A group of people with brittle fingernails was given 2.5 mg of biotin a day for two to six months. Ninety-one percent of them had better fingernails. All of the participants felt that the biotin treatment was effective to some degree.

The amount of biotin in many multivitamins, such as Vitality Plus, is around 300 mcg. Country Life, a vitamin company whose products are in many health food stores, has biotin tablets that are 500 mcg. Take five a day in divided doses (two with breakfast and three with dinner). It's 99% absorbed orally and there are no toxic side effects even at higher amounts.

Q: How can you tell how well any tablet or capsule is being absorbed? Will putting the tablet or capsule in a glass of water to see how well it dissolves give any indication? I'm particularly interested in calcium absorption, since osteoporosis runs in my family. — G.D., Gray, ME

A: Calcium, magnesium, and iron are three minerals that require acid in order to be broken down and absorbed. A glass of water contains no acid; your stomach does. The test you describe will tell you nothing. If you have good digestion and take vitamins and minerals that are high quality, they will break down and get absorbed.

If your digestion is poor, take your supplements with a little lemon water.

Calcium citrate and calcium amino acid chelate are two excellent forms of calcium that are easily absorbed. Be sure you take enough magnesium. It helps the calcium get into your bones, not into your joints or arteries.

Q: I'm a vegetarian. I used to take vegetarian digestive and metabolic enzymes. They worked like magic for me. When I switched to an extra strength formula, they stopped working. The original formula didn't work, either. No enzymes work as well as they did at first. Can you help me? — C.T., e-mail

A: The only difference between digestive and metabolic enzymes is how you use them. Digestive enzymes are taken with meals to help you digest the foods you eat. They need to match the composition of your food. If you're eating protein, you need to take enzymes that digest protein (proteolytic enzymes). If you want help in digesting carbohydrates, you need amylase or amylitic enzymes.

Metabolic enzymes are taken in between meals and act like pac-men (or women) to clean up undigested debris. Again, they need to be the right type of enzymes.

Your problem may not be with the specific enzymes, but with the pH, or acidity, in your stomach. Try eating more alkaline foods (like fruits and vegetables) and then go back to the original enzymes. Vegetarian enzymes made from aspergillis, a fungus that leaves no remaining fungi after enzyme production, are often stronger than pancreatic enzymes. So you're on the right track. For more information, see The Complete Book of Enzyme Therapy by Dr. Anthony Cichoke.