Non-Sweetened Metamucil with Grapefruit and Orange Juice

With my cholesterol, triglycerides and blood pressure higher last month, I needed to try to salvage things before my doctor(s) advise statins and/or blood pressure medication. Step one: a lo-co lifestyle exercise and diet review (and correction):

  • Exercise. I’d let my exercise habit lapse in the past six months, so have recently re-started exercising daily. Of course today I pulled my hamstring. Sigh. But I am determined to at least walk daily, because ‘Study Proves Exercise Staves Off Bad Cholesterol.’
  • Diet – General. While I don’t eat a lot of red meat, I do eat a lot of carbs (pasta and bread) and sugar (M&Ms and wine). So I’m cutting down on pasta, pizza and sticking with 1 glass of rose per night. And M&Ms, well…not sure how they got back into my diet but it ends now.
  • Diet – Supplements. As with exercise, I had stopped my daily dose of Metamucil. Which is lame, because Metamucil both lowers cholesterol and helps with diverticulosis, which I also have. So I tossed my very expired Metamucil and bought a new, huge jar of Orange Smooth Metamucil, with sugar.

Metamucil_SugarThen I got to thinking about that Metamucil. I chose Orange Smooth Metamucil (with sugar) because I both despise aspartame and believe it to be unhealthy. As all the sugar-free Metamucil products have aspartame, that left me with the Metamucil with sugar. But with sugar-sensitive high triglycerides and a desire for a nightly glass of wine, it seemed sugared Metamucil might not be a great choice.

Metamucil_OriginalSmoothSo I dug a bit more and found ONE Metamucil product with neither sugar nor aspartame. Called Metamucil Original Smooth, it was just what I was looking for. Oh, except for the taste. While I did not despise the ‘wheat-y’ taste as much as others on the internet seem to, it was certainly not a flavor I wanted to wake up to every morning.

So I started thinking about how Going Lo-Co reader Eileen makes a cholesterol-loweirng grapefruit juice / Metamucil smoothie: info here.) Smoothies are too much work for me, so I looked around on the web and found many who said they mixed the Original Smooth with juice. Which is what my Mom does too – she mixes Metamucil with diluted orange juice. But OJ is just a lot of sugar with no cholesterol-lowering benefit so that did not appeal. Then it hit me: what if I combined grapefruit and orange juice?**

This morning, I stirred up an inaugural glass of Going Lo-Co Metamucil Elixir. To make it, I combined 1 teaspoon of Metamucil Original Smooth with 4 ounces of grapefruit juice, splashed in some (about 1 oz) orange juice to cut the tartness of the grapefruit juice, then topped it off with about 2 oz of water.  After a vigorous stir, I guzzled it.

I am pleased to say that I really liked it. Well, as much as one likes these things.

The taste is decent AND unlike sugared Metamucil, my version delivers potassium AND the blood pressure, cholesterol, and triglyceride lowering properties of grapefruit juice (see Grapefruit Pros and Cons for more info.)

Then I estimated the nutritional value for my Going Lo-Co Metamucil Elixir. My concoction does have more calories and sugar than sugared Metamucil, but I’m willing to accept those extra 30 calories and 4 grams of sugar for the better taste AND potassium AND the cholesterol-lowering benefits of grapefruit juice. Here’s how they compare:

Metamucil Grapefruit OJ
If you don’t take ANY medications, give my Going Lo-Co Metamucil mix a whirl. If you do take medication – any medication – read message below: and do NOT try this unless you’ve consulted with your doctor.

** VERY IMPORTANT:  do NOT try this ‘recipe’ — in fact, do NOT drink any grapefruit juice — if you are on statins or other medications. Specifically, do NOT eat grapefruit or drink grapefruit juice if you take Lipitor or any other statin medication to lower cholesterol without speaking first to your doctor.  Same grapefruit warning exists if you take other types of medications that can also interact with grapefruit juice, including drugs for blood pressure, heart rhythm, depression, anxiety, HIV, immunosuppression, allergies, impotence, and seizures.  It is dangerous to start eating grapefruit (or drinking grapefruit juice) if you take any of these medications – unless you speak to your doctor first.


Statins Reduce Flu Vaccine Effectiveness

If you take a cholesterol-lowering statin medication like Lipitor, you are likely familiar with statin side effects, including muscle issues and potential liver damage.

But did you know that taking a statin reduces the effectiveness of the flu vaccine?

Two new studies recently made that discovery. The studies were not small: four countries were involved, including the US, and almost 7,000 adults were evaluated. These two research studies concluded that adults who take statin medications had significantly reduced immune responses to the flu shot, compared with those who do not take statins. As well, the effectiveness at preventing serious respiratory illness was lower among adults taking statins.

In Medical News Today’s Flu Vaccine Effectiveness Reduced by Use of Statins article, the author explains:

“Statin users were found to have a significantly reduced immune response to vaccination compared with those not taking statins, as measured by the level of antibodies to the flu vaccine strains in patients’ blood 3 weeks after vaccination.

The effect was most dramatic in patients on synthetic rather than naturally derived statins.”

As millions of Americans over age 65 take cholesterol-lowering statins – and the flu can be very dangerous for older adults –  this diminished effectiveness of the flu vaccine is a significant, widespread concern.

Of course, this new finding does NOT mean that if you take a statin medication like Lipitor that you should not bother with the flu shot. Rather, it means you should do everything you can to enhance the flu shot’s effectiveness — for example, get the flu shot early in the season, and take extra precautions – don’t assume that since you got the flu shot that you can’t get the flu!

So if you must take a statin because you have had a cardiac event or you and your doctor have calculated your risk and statins are indicated (more info at Why You Should Use the New Cholesterol Guideline Calculator), please be careful this flu season.

But if you are on the fence about statin use for your particular medical situation, perhaps this newly discovered additional downside to statins is something to discuss with your doctor.



Eileen’s Going Lo-Co Inspired Grapefruit-Metamucil Smoothie

In honor of Thanksgiving week, I’d like to thank (see what I did there?) Going Lo-Co reader Eileen S. for sharing both her experience and the cholesterol-lowering recipe she invented. Inspired in part by my post, Grapefruit Pros and Cons (which will forevermore be dubbed, ‘the post that keeps on giving’ as I wrote about grapefruit way back in 2013 and Eileen ran across it two years later!), Going Lo-Co blog reader Eileen S recently invented a new cholesterol-lowering recipe.

As you may recall, Grapefruit Pros and Cons is about the amazing fact that grapefruit – plain old grapefruit – actually lowers cholesterol…so anyone who wants to lower LDL (bad) cholesterol naturally should add grapefruit to their diet** (as long as they are not taking a statin medication or any other medication that interact with grapefruit.)

You may also recall that at the end of that post, I wondered if you could mix cholesterol-lowering grapefruit with cholesterol-lowering Metamucil. But as grapefruit is too tart for me, I never tried the double-shot cholesterol-lowering Grapefruit-Metamucil mix.

But Going Lo-Co blog reader Eileen did!

She emailed me with her experience and the recipe she created – and I felt hers was such a clever idea (and I was so tickled to have been an inspiration for that idea) that I wanted to share her emails in case you have a similar experience and/or just want to try grapefruit mixed with Metamucil:

Eileen email #1 – about trying to incorporate Metamucil into her daily life to lower LDL (bad) cholesterol naturally, and how frustrated Eileen was with the sugar/sugar-free Metamucil options:

Hi Karen!

I came across your blog today about grapefruit and lowering cholesterol. At the very end you wondered if you could mix it with your Metamucil. Such a coincidence! I started taking Metamucil couple months ago to try to lower my LDL’s so that I don’t need to take a statin medication. After going through a whole container with artificial sweetener followed by a whole container with real sugar I realized I wanted neither and tried an unflavored unsweetened version. YUCK! Just yesterday I came across a recipe to throw red grapefruit into a blender with a little honey. Just this morning I decided to try the grapefruit with the Metamucil and the honey altogether. I’ll be going to the store today and trying the concoction tomorrow morning. Did you ever try this? I can let you know how it goes if you are still interested.


Eileen’s second email — she invented a naturally sweetened Grapefruit – Metamucil Smoothie (I assume it’s smooth so have dubbed it so) and the ‘recipe’ is included here:

Hi again!

So tonight after dinner I scooped out the inside of one grapefruit and put it in my Ninja along with a bit of honey and a few ice cubes.  Once that was blended I added a round teaspoon of plain psyllium husks and a couple ounces of cold water and blended it again. Not bad at all! Now I have a double whammy for lowering my  LDL without artificial sweeteners and colors that is much more palatable!  A win/win deal.  I would love to know if anyone else tries this.


So if you are looking for a more palatable way to take Metamucil and the idea of mixing it with cholesterol-lowering Metamucil appeals**, try Eileen’s Going Lo-Co Inspired Grapefruit-Metamucil Smoothie!  I’ve included a ‘recipe’ version on the Going Lo-Co recipe page.

A big thanks to Eileen for sharing (and giving me permission to post).  Comment or email if you try this or other cholesterol-lowering recipes: Eileen and I would love to know your experience and ideas.

** VERY IMPORTANT:  do NOT eat grapefruit if you take Lipitor or any other statin medication to lower cholesterol without speaking first to your doctor.  Same grapefruit warning exists if you take other types of medications that can also interact with grapefruit juice, including drugs for blood pressure, heart rhythm, depression, anxiety, HIV, immunosuppression, allergies, impotence, and seizures.  It is dangerous to start eating grapefruit if you take any of these medications – unless you speak to your doctor first.


Statin Medications – A Primer

I am not a proponent of taking a statin to lower cholesterol IF one’s only heart disease risk factor is high cholesterol (see my post, Statin Statin, Do You Really Need A a Statin?) That said, there are millions for whom statin meds are a literal lifesaver. So if you are taking a statin because you have several heart disease risk factors, you might be hankering for some information about the different statin meds on the market. Here’s an overview of the top selling statins in the US.

The most common statins prescribed in the US include: Atorvastatin (Lipitor), Rosuvastatin (Crestor), Simvastatin (Zocor), Lovastatin (Mevacor), Pravastatin (Pravachol), and Fluvastatin (Lescol).

Lipitor (Atorvastatin)

Available in the US since 1977, Pfizer’s Lipitor is probably the best known and most widely prescribed drug to lower cholesterol. Indeed, in 2010, Lipitor was the #1 selling drug sold in the United States (not #1 cholesterol drug, #1 of ALL drugs), with $7.2 billion in sales. Sales of branded Lipitor declined dramatically after it went off patent in late 2011 (in fact, in 2013 Lipitor fell out of the top 100 drugs sold). That said, millions of Americans still take Lipitor (or have switched to generic Atorvastatin) to lower their cholesterol, and it is a fine statin for many who need to take it.

KEY TO KNOW:  It’s vital that anyone taking Lipitor or Atorvastatin avoid eating grapefruit and drinking grapefruit juice. That is because grapefruit boosts absorption of this drug into the bloodstream, which in turn increases the likelihood of potentially serious side effects. Do NOT ingest grapefruit if you take a statin unless you’ve discussed with your doctor.

Crestor (Rosuvastatin)

You probably have figured out that the next big branded cholesterol drug (now that Lipitor is off-patent) is Crestor – their advertising budget appears to be enormous. And it’s working. In 2013, AstraZeneca’s Crestor was the top-selling statin, and the #4 drug sold in the US.  But what you might not know is that Crestor is the most potent of all the statin medications. And that means there is a higher likelihood of potentially serious muscle damage risk with Crestor than with other statins. If you take Crestor, it’s extremely important to immediately report any muscle pain or weakness to your doctor.

Zocor (Simvastatin)

Merck’s Zocor was one of the top 10 selling drugs in the US through 2006, when it went off patent. Sales of Zocor fell off dramatically as soon as it went off-patent, and they fell even further in June 2011 when the FDA issued new warnings about the dangers of high-dose Zocor or Simvastatin.  The warning: that at high doses, this drug is more likely to cause muscle damage. The FDA also issued restrictions for even mid or low-dose simvastatin. The response was that many doctors who used to prescribe Simvastatin have switched their patients to other statins – which explains why Zocor is now out of the top 100 drugs sold, and Simvastatin doesn’t even make that list. Net, Zocor and Simvastatin are likely the right statin for many, but it might be a good time to review statin options with your doctor if you’ve been taking Zocor or Simvastatin for a long time.

Also, key to note that Zocor and Simvastatin also interact with grapefruit, so as with Lipitor, grapefruit and grapefruit juice must be avoided by those taking this statin.

Mevacor (Lovastatin)

Lovastatin’s claim to fame is that it was the first statin approved for human consumption. The compound was first introduced by Merck scientists in 1978; after Lovastatin they went on to develop Simvastatin, a close chemical derivative of Lovastatin. (Merck branded Simvastatin as Zocor as explained above – and they marketed it more than Mevacor because it had a later patent expiration date.) Lovastatin is not widely prescribed any longer – and has been out of the top 200 in sales in the US since 2005 – but its relevance in the world of statin meds is that it was very the first statin medication.

Pravachol (Pravastatin)

Discovered by Sankyo scientists in Japan in 1979 and launched in Japan in 1989, Pravachol is a statin that is a modified version of Lovastatin. People with muscle disease who can’t tolerate statins can sometimes tolerate Pravachol. That said, Simvastatin and Atorvastatin are far less expensive options, so Pravachol and Pravastatin are now rarely prescribed in the US.

Key to note: Pravachol and Pravastatin also interact with grapefruit, so as with Lipitor, grapefruit and grapefruit juice must be avoided by those taking this drug.

Lescol (Fluvastatin)

Lescol or Fluvastatin was introduced by Novartis in the US in 1993.  It is the least potent statin – so it’s a good choice for those committed to making lifestyle changes to lower cholesterol but who still need a statin because they have several heart disease risk factors.  Also since it’s one of the more mild statins, it is the medication that is often prescribed when a patient cannot tolerate the side effects with other statin medications.


If you have multiple heart disease risk factors and need a statin to reduce cholesterol, ask your doctor why he/she has prescribed that particular statin. They have different potencies and whether you use a generic or branded statin can make a huge difference to your wallet. With any statin, be sure to discuss ALL medications you take with your doctor as these statins react not only with grapefruit (some of them) but also with a wide array of other medications.

Statins can have side effects – sometimes serious. Serious side effects can include liver damage, type 2 diabetes, and muscle problems – which can range from myositis, which is essentially muscle inflammation, to rhabdomylysis, which is extreme muscle inflammation and muscle damage. If you take any statin, be sure to go to your follow up appointments where your liver will be checked — and tell your doctor if you have any muscle pain.

If you are currently taking a statin and you are not sure if you really need it, do some research and then discuss your heart disease risk and medication plan with your doctor. (Of course, you should never stop taking a medication without discussing with your doctor.) For more about calculating heart disease risk, see my Calculate Your Heart Attack Risk Online post.


Chewable Lipitor – Pfizer Targeting Kids with Cholesterol

Lipitor, Pfizer’s blockbuster cholesterol-lowering statin medication, has been approved for use in children with heterozygous familial hypercholesterolemia in the US since 2002, according to Pharmafile. (FH is an “inherited disorder that leads to aggressive and premature cardiovascular disease”). And those with FH are likely in great need of Lipitor.

But FH is a pretty rare disease.  And Pfizer’s putting a lot of effort into chewable Lipitor.


Is Pfizer is positioning itself to profit – at the expense of children – by inducing pediatricians to more broadly prescribe Lipitor for children?

Perhaps.  And that is very distressing.

Pfizer gained approval in the EU to market a grape-flavored, lower-dose, chewable form of Lipitor — in exchange for patent extension of regular Lipitor (read, short-term profit). Indeed, according to Andrew Jack of the Financial Times,

“Pfizer could earn $800m after European Union countries extended exclusive rights to sell its top-selling drug Lipitor until summer next year, in exchange for tests that will provide a slightly modified form of the medicine to just a few thousand children.”

So Pfizer used the EU’s controversial pediatric regulations, “which were introduced in 2007 with the offer of extended exclusivity as a financial incentive to encourage drug companies to ensure they expanded testing of experimental medicines to include children,” for short-term financial gain.

Typical big pharma move. Totally legal. Much debate about ethics.

More worrisome is what could come down the road.

For there is potential for Pfizer to use the same agressive marketing tactics they have employed to induce over-medication of adult Americans with high cholesterol and no other heart disease risk factors…now with KIDS.

Of course, for those with FH who have a serious need for a statin to reduce cholesterol, that a chewable, grape-flavored version of Lipitor is available in the EU is good news.

But if chewable Lipitor for kids gets approved in the US, who will make sure that Pfizer won’t repeat the marketing strategy that’s been so successful with adults? Who will make sure they don’t resort to scare tactics to convince people – parents of KIDS with high cholesterol — that Lipitor is indicated when it perhaps is not?

Let’s hope if chewable Lipitor ever arrives in the US (and if it stays in the EU) that it’s limited to those who really need it – those with FH.  And that Pfizer will not look to profit on the backs of children who have high cholesterol but no other risk factors.

For more information on the risks and guidelines for cholesterol for children, see my recently published article on, High Cholesterol in Children.