Want to Increase Your HDL Cholesterol by 50%? Sage Tea May Be the Answer

Common sage tea increases HDL and reduces LDL. (Photo by Kelly Johnson)

Salvia officinalis, also known as common sage or garden sage, has been used for hundreds of years both for cooking and healing purposes. It's the variety you can find in most grocery stores – not to be confused with the psychoactive herb Salvia divinorum.

While you might not get hallucinations from common sage, it does have a wide range of health benefits. For instance, sage is commonly used for its antibiotic and antispasmodic properties. In medieval times, sage was generally associated with longevity.

One less well known use for common sage is cholesterol. Nonetheless, a 2009 pilot trial with six healthy female volunteers (aged 40–50) looked at how drinking sage tea would affect their blood glucose regulation and lipid profiles (link). They also evaluated the antioxidant properties of sage tea.

To prepare the tea, 300 mL of boiling water was poured over 4 grams of dried Salvia officinalis plant material and allowed to steep for 5 minutes. Each participant drank the tea twice a day for four weeks.

The graphs above show total cholesterol (A) and HDL cholesterol levels (B) of the participants at baseline (white bar), after two weeks, after four weeks (grey bars) and after a two-week washout period (black bar).

While total cholesterol decreased only marginally after two and four weeks of drinking sage tea, there was a 16% drop in total cholesterol two weeks after the treatment ended. HDL cholesterol, on the other hand, increased after just two weeks. After four weeks, HDL levels were up by ~50%. Two weeks later, they were still ~38% higher than at baseline.

The graphs above show the LDL cholesterol levels and LDL/HDL ratios of the participants. There was a gradual reduction in LDL levels during and after treatment, with a ~20% drop seen after the two-week washout period. Consequently, the LDL/HDL ratio improved throughout the four weeks and remained significantly better after the washout period compared to baseline.

Although the sample size is very small, and this was a non-randomized crossover trial, the figures look very promising. I mean, a 50% increase in HDL in just four weeks? Where else are you going to see improvements like that in healthy people?

The authors also evaluated the antioxidant properties of sage tea by measuring erythrocyte antioxidant status. Both superoxide dismutase (SOD) and catalase (CAT) activity increased significantly after two weeks. Unlike the effect on cholesterol levels, however, there was no significant difference after four weeks compared to baseline. It would be interesting to see a comparison between drinking sage tea daily and cycling it. Who knows, maybe something like two weeks on, two weeks off would be better than drinking it constantly.

Although it has been suggested that sage improves glucose tolerance and insulin sensitivity, the results of oral glucose tolerance tests did not change after four weeks of drinking sage tea. While the participants were healthy, they did belong to a risk group for developing pre-diabetes based on their age. It may be that sage is helpful in those who are already pre-diabetic or diabetic but not in healthy people. On the other hand, the expression of the heat shock protein Hsp70, which is involved in insulin sensitivity, increased by 2.8-fold in lymphocytes after two weeks and remained elevated after the washout period.

For more information on improving HDL and reducing LDL, see these posts:

Hibiscus Tea Increases HDL, Lowers LDL and Triglycerides
Anthocyanins from Berries Increase HDL and Lower LDL
Low-Carb vs. Low-Fat: Effects on Weight Loss and Cholesterol in Overweight Men
Niacin Raises HDL, Lowers LDL, VLDL & Triglycerides

High HDL Cholesterol Reduces Risk of Dying in Men

Strawberry margarita – the perfect longevity drink. (Photo by bookgrl)

According to conventional wisdom, LDL is the "bad cholesterol" and HDL is the "good cholesterol". While there is plenty of evidence showing this is an oversimplification, it is generally agreed that the higher your HDL is, the better. In fact, I've never seen anyone suggest a "maximum" HDL level for a healthy person.

One of the many strange things you hear most doctors recommend is that you reduce your total cholesterol once it's above a certain level, despite what your LDL and HDL are. That is, even if HDL makes up most of your total cholesterol, you may still get a warning that your total cholesterol is "too high". But why would you want to reduce your HDL cholesterol?

High HDL is generally believed to be associated with longevity, at least to a degree. For example, centenarians and supercentenarians tend to have higher HDL than the general population. To my knowledge, large population studies on HDL and longevity are relatively rare, however – which is why I found this new paper from the American Journal of Cardiology pretty interesting (link).

The study (which began in 1979) looked at the probability of 652 men, aged 65 years, to reach 85 years of age. The authors hypothesized that men with higher HDL cholesterol levels in middle age would be less likely to die before 85 years of age than men with lower HDL levels.

For the analysis, participants were categorized into three groups based on their HDL cholesterol: <40, 40–50 and >50 mg/dL. Converted to mmol/L, the ranges are <1, 1–1.3 and >1.3 mmol/L. To me, these categories seem like they're in the lower range of the healthy spectrum, but then again, average HDL levels in men in the US are said to be 40-50 mg/dL. According to the American Medical Association, less than 40 mg/dL is undesirable and higher than 60 mg/dL is desirable.

The age-adjusted hazard ratios for death before 85 years of age in the three groups were as follows:  1.00 for those with HDL < 40 mg/dL, 0.99 for those with HDL between 40–50 mg/dL, and 0.77 in those with HDL > 50 mg/dL. In the fully adjusted model (which accounted for age, LDL, hypertension, smoking, BMI, etc), the hazard ratios were 1.00, 1.01 and 0.72, respectively. That is, men with HDL higher than 50 mg/dL had a ~28% lower risk of dying than those with HDL lower than 50 mg/dL.

Immediately we can see that it doesn't make much difference whether the participants' HDL was below 40 or between 40 and 50 mg/dL – the risk of dying before 85 years of age was pretty much the same for both groups. Only once their HDL cholesterol levels were above 50 mg/dL was there a significantly lower risk.

Furthermore, when the authors analyzed the data further, they found that each 10-mg/dL increment in HDL cholesterol was associated with a 14% decrease in risk of dying before 85 years of age. In other words, the higher their HDL, the higher the survival rate.

This is all very good news. Reaching a HDL level of, say, 80 mg/dL (~2.1 mmol/L) is not at all impossible as long as you plan your diet properly, and would give you a significantly lower risk of dying from cardiovascular disease – which is the number one killer in the 65–85 age group.

The baseline characteristics of the participants reveal some interesting things too. First, the LDL cholesterol was pretty much the same in all groups: around 160–168 mg/dL. Body mass index, on the other hand, was inversely correlated with HDL levels: those with the lowest HDL levels had a mean BMI of 27.5, while those with the highest HDL levels had a mean BMI of 25.8.

While alcohol is known to increase triglycerides in the short term, it also increases HDL. Indeed, alcohol consumption was positively correlated with HDL levels. The percentage of participants who drank at least 2 alcoholic beverages per day was ~14% in those with the lowest HDL, ~18% in those with average HDL and ~38% in those with the highest HDL. This might explain, in part, why moderate alcohol consumption is associated with increased longevity.

So, if your total cholesterol is high and it's mostly due to high LDL, that may be a potential cause for worry – although it's good to keep in mind that there are several types of LDL, some more harmful than others. However, if you have high cholesterol due to high HDL, well then you should be happy!

For more information on HDL cholesterol and how to increase it, see these posts:

Hibiscus Tea Increases HDL, Lowers LDL and Triglycerides
Refined vs Red Palm Oil and Cholesterol
What a "Heart-Healthy" Diet Does to Your Cholesterol Levels
Anthocyanins from Berries Increase HDL and Lower LDL

Biotin Goes Back on the Menu

Is there evidence behind biotin and hair growth? (Photo by Martin Neuhof)

Long-time readers of the blog may remember that one of the earliest experiments I did was with biotin, also known as vitamin B7. The purpose was to see whether taking a biotin supplement would affect nail and hair strength.

I wrote back then that although a lot of people seemed to believe biotin is good for hair and nails, there were no studies showing it really did anything except in rare cases when the subject was biotin deficient. After two weeks, I posted a quick update. When I'd been taking 5 mg for a month, I concluded the experiment. As you might expect, I didn't see any results.

I've since learned that one month is way too short for any kind of results when it comes to hair growth experiments. In most cases, six months would be the minimum, otherwise you're just wasting money without really learning anything new.

A pubmed search on biotin and hair growth still doesn't come up with any interesting studies. The only thing biotin seems to be proven to do is help with uncombable hair syndrome (link):

We report a family affected to the fourth generation by uncombable hair syndrome. This syndrome is characterized by unruly, dry, blond hair with a tangled appearance. The family pedigree strongly supports the hypothesis of autosomal dominant inheritance; some members of the family had, apart from uncombable hair, minor signs of atopy and ectodermal dysplasia, such as abnormalities of the nails. The diagnosis was confirmed by means of extensive scanning electron microscopy. A trial with oral biotin 5 mg/day was started on two young patients with excellent results as regards the hair appearance, although scanning electron microscopy did not show structural changes in the hair. After a 2-year-period of follow-up, hair normality was maintained without biotin, while nail fragility still required biotin supplementation for control.

In this study, 5 mg biotin was taken daily. Even much smaller doses seem to be helpful for uncombable hair syndrome, however (link):

Three children are reported with uncombable hair syndrome, consisting of slow-growing, straw-colored scalp hair that could not be combed flat. The hairs appeared normal on light microscopy but on scanning electron microscopy were triangular in cross section, with canal-like longitudinal depressions. Oral biotin, 0.3 mg three times a day, produced significant improvement after 4 months in one patient, with increased growth rate and with strength and combability of the hair, although the triangular shape remained. The other two patients were unique in having associated ectodermal dysplasia. Their hair slowly improved in appearance and combability over 5 years without biotin therapy.

These studies confirm the fact that biotin does play a part in hair growth, and that it's possible to affect even the growth rate through biotin supplementation. Although the cause of uncombable hair syndrome is unknown, a biotin deficiency (perhaps due to genetic reasons) may play a part. On the other hand, the syndrome often improves by itself with age.

Studies like this do not really warrant supplementing with biotin if you're suffering from androgenic alopecia or just want to make your hair grow thicker and faster. And yet a lot of people seem to believe biotin will do the trick. They keep saying there's "a lot of evidence" for biotin and hair growth, but the references are missing. The actual studies are always about biotin deficiencies or like the ones I quoted above.

However, a while ago I came across one study from 1992 that actually looked at the effect of biotin supplements on hair loss. It's no wonder I didn't find it earlier, since it's not indexed in pubmed. Nor do I have access to the full paper, but here's the abstract:

An examination of the effect of biotin on alopecia and hair quality.

The effect of a daily oral dose of 2,5 mg biotin was studied in 93 patients with the symptoms hair-loss (mostly androgenetic alopecia) and reduced hair quality. The mean duration of treatment was 7,9 +/- 2,8 months. An obvious improvement of hair-loss was reported in 64%, and a slight improvement in 9%. Hair quality was clearly improved in 70% and slightly in 12%. Brittle finger nails as an additional complaint were improved in 80%. If alopecia, decreased hair quality and brittle finger nails occurred in combination, improvement was observed frequently collectively. The study allows - as already shown in a previous investigation concerning brittle finger nails - to suggest biotin as an effective and well tolerated therapy in cases of alopecia and decreased hair quality.

The majority of subjects had improvements in hair loss and hair quality from taking 2.5 mg biotin daily. Sounds good, right? Makes you wonder why nobody has attempted to repeat the experiment if the results are real. Another thing that strikes me as odd is the duration of the experiment. Why a mean duration of 7.9 months with standard deviation? Weren't all the subjects taking biotin for the same duration? Did they just quit whenever they felt like it? That just sounds like bad study design, which makes me somewhat skeptical of the results.

Still, it's intriguing enough to make me add biotin back on the supplement menu for the time being. Although a "it can't hurt and might help" mentality may be dangerous in some cases, I'm unaware of any negative side effects from taking 5 mg biotin daily. This time I'm aiming for at least six months instead of just one.

For more information on hair growth, see these posts:

Soy Isoflavones and Chili Pepper for Hair Growth – Experiment Update
Emu Oil vs. Hair Again® Topical Gel: Hair Growth Battle Conclusion
Do Flax Lignans Reduce Hair Loss from MPB?
2% Nizoral Shampoo Increases Hair Growth More than 2% Minoxidil

Sometimes I just wanna...

Soy Isoflavones and Chili Pepper for Hair Growth – Experiment Update

Spicy peppers contain capsaicin, which should promote hair growth. (Photo by Jonathon W)

Several readers have been asking for an update on my hair growth experiment with soy isoflavones and capsaicin. I admit it's long overdue, so here goes!

First some background on the experiment. Why soy isoflavones? I know there are a lot of people who think soy is the ultimate poison, and while I'm not a big fan of soy as a food, the science behind isoflavones and hair growth is strong enough for me to give it a go. Soy isoflavones have been shown to increase IGF-1 in the skin, which in turn promotes hair growth. Although soy also reduces DHT in rats and in humans, the effects on IGF-1 seem to be the primary way through which isoflavones grow hair.

Capsaicin seems to have a similar effect on IGF-1, and in both mice and humans, the combination of soy isoflavones and capsaicin appears to be more effective than capsaicin alone. I have not seen a direct comparison of soy isoflavones and soy isoflavones + capsaicin, however, so it's unclear how important capsaicin really is. Nevertheless, I chose to take both for the experiment.

The participants in the study were given a capsaicin supplement, but I decided to take the natural route and just add cayenne pepper or chili powder into my food instead. It's difficult to determine just how much capsaicin I've been ingesting this way, since the capsaicin content depends on a lot of variables. As I wrote when the experiment began:

The only problem is that it's pretty difficult to estimate the amount of capsaicin; a tablespoon of ground chili will contain anywhere between 0.8 mg and 480 mg of capsaicin. In the study, 7 mg per day was consumed, so if I manage to eat a tablespoon, I should have decent odds of ingesting at least as much capsaicin.

The amount of isoflavones I've been eating, on the other hand, has been easy to measure. One capsule contains 60 mg of isoflavones, which is 15 mg less than in the study.

And what about the results? I've not taken any pictures, since unlike in the retinol experiment, there's not much visible going on. I haven't cut my hair in years, and the length of my hair is still the same as it was before (the maximum length of your hair is genetically determined), so it's safe to say that isoflavones and capsaicin haven't done anything in that department.

I also haven't seen any increase in the rate of hair growth, which is perhaps a bit surprising, since you might expect an increase in IGF-1 to increase the speed at which hairs grow. But then again, I have no reliable way of measuring my IGF-1 levels either. I've simply been looking at a few hairs and measuring how much they grow each month.

The one thing I noticed during this experiment is something of a shed in the beginning. There's no way to be sure it's the isoflavones and capsaicin working, but I haven't noticed anything similar with the other experiments. After a few months, I seemed to not only shed more hairs in general, but especially from the front of the scalp. Moreover, many of these hairs had not grown to their full length yet.

As most of you probably know, that can be a good or a bad sign. A lot hair growth drugs, including finasteride, cause an initial shed, after which the hairs grow back stronger and healthier. Then again, inflammation also causes hairs to shed earlier than they should, only they grow back weaker every time.

At this point, it's still too early to tell, since the new hairs are still growing. At least on the surface they look fine. What's funny is that there are some spots where several hairs are pretty much the exact same length. The two possible reasons is that those hairs were shed at the same time and now regrowing, or that the isoflavones and capsaicin increased the number of hair follicles. I suspect the former, but I can't be sure.

So what's the next step? I've already ordered a second bottle of isoflavone capsules, and since I like to use chili in my food anyway, I'll pretty much keep doing what I've been doing so far. If I see any dramatic changes, I will post about them, but if not, I will just consider the isoflavones and capsaicin thing a preventative measure and move on to more interesting experiments.

That's it for today. I hope you found this update useful, and if you have further questions or you've done a similar experiment of your own, please let us know in the comment section.

For more information on hair growth, see these posts:

Topical Retinoids Increase Hair Growth in Most People
BioSil, JarroSil & Beer – Silicon Experiment Conclusion
Zinc Pyrithione Reduces Shedding and Moderately Promotes Hair Growth
Eclipta Alba Extract Grows Hair Quicker than Minoxidil