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High cholesterol is a known risk factor for cardiovascular diseases. It contributes to the formation of fatty deposits in your blood vessels—which is linked to many problems such as coronary artery disease, stroke, aortic aneurysm (a balloon-like bulge in your major blood vessel), heart attack, and even death.
A growing body of research has shown that some dietary supplements may play a role in lowering cholesterol levels; however, the evidence is far from conclusive. Using the existing studies, this article provides some supplements that may be used to manage high cholesterol, the best types, the dosages, and potential side effects or drug reactions.
Can supplements lower cholesterol?
Cholesterol is transported in your body via two main proteins known as low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL is considered the “bad cholesterol” because high levels may increase the risk of heart disease. In contrast, HDL is considered the “good cholesterol” since it promotes a healthy heart.
A healthy diet and regular exercise are the most recommended lifestyle routines for improving cholesterol levels. A class of medicines known as statins reduce the amount of cholesterol in your blood. But what about supplements? A couple of studies have investigated the use of supplements for lowering cholesterol. Though more evidence is still needed and research is ongoing, some supplements were found effective for lowering cholesterol. These supplements work either by blocking cholesterol absorption or aiding its elimination in your stool.
“Supplements have been shown to decrease cholesterol more than taking a placebo or not taking any supplements,” says Laurie Thenedy, a registered dietitian and founder of Nutrition Renewed. “However, they are not as effective in lowering cholesterol as prescription statins.”
8 supplements for lowering cholesterol
These 8 supplements have been shown to improve cholesterol levels in clinical research. But, before you get started on any supplement, keep in mind that “supplements for cholesterol should only be recommended on an individualized basis taking into account the individual’s diet, medications, laboratory values, and medical history,” says Michelle Routhenstein, a preventive cardiology nutritionist and founder of Entirely Nourished.
1. Berberine
Berberine, a popular plant extract found in plants like Oregon grape, tree turmeric, and goldenseal, has cholesterol-lowering functions. Historically, berberine was used in traditional Chinese medicine for treating infectious and gastrointestinal diseases. It is used in modern medicine to treat cancers, diabetes, obesity, and psychiatric disorders.
More than that, it also has cholesterol-lowering effects. For instance, it activates cholesterol elimination through the liver, reduces cholesterol absorption in your gut, and enhances its removal when you defecate.
According to a 2016 study, 97 patients with mild hyperlipidemia (high cholesterol) were treated with 300 mg of berberine capsules for three months. At the end of the three-month trial, triglycerides, total cholesterol, and LDL cholesterol decreased while HDL cholesterol increased. This 2016 study suggests a dosage of 300 mg taken three times daily.
Per the Mayo Clinic, berberine may cause some side effects, including diarrhea, constipation, gas, nausea, or vomiting. Pregnant and lactating women should avoid berberine. Also, it should not be taken with medications such as anticoagulants (because it may increase the risk of bleeding).
2. Fiber
Soluble fibers such as pectin, gums, mucilage, and fructans are found naturally in fruit, oats, barley, and vegetables and are also available as supplements.
Experts suggest that soluble fibers may lower blood levels of cholesterol. Soluble fibers dissolve in water to form a highly viscous gel, increasing bile elimination in your stool. This highly viscous gel also decreases the reabsorption of bile acids into the body. Normally, bile acids are made from cholesterol and reabsorbed in the intestines.
Psyllium is a type of soluble fiber supplement, and research indicates that around 10 grams of psyllium helps lower LDL cholesterol over a median period of eight weeks. The National Lipid Association recommends 5 to 10 grams of soluble fiber daily, which may help reduce total and LDL cholesterol by 5 to 11 points.
3. Niacin
Niacin, or vitamin B3, may be used to manage high cholesterol. The right dose can lower total cholesterol levels by about 25%, LDL by 10% to 15%, and triglycerides by 20% to 50%. And it may increase HDL levels by 15% to 35%. The dosage may range from 1,000 to 3,000 mg daily but depends on a person’s overall condition.
Niacin may cause side effects including flushing, itching, nausea, and diarrhea. Niacin may also interact with certain drugs, including statins, blood pressure medications, and zinc.
4. Omega-3 fatty acids
A study in the Journal of Clinical Medicine and Research suggests that omega-3 fatty acid supplements may lower triglycerides and increase HDL cholesterol. Omega-3 fatty acids are essential fats in fish, fish oils, nuts, flax seeds, and vegetables.
“For improving cholesterol levels, I recommend that the first supplement people take is omega-3 fatty acid,” says Jenna Volpe, RDN, LD, founder of Whole-istic Living. “This is because it’s very difficult to get enough of these from food (even among those of us who eat fatty fish a few times a week), and omega-3’s are helpful in reducing inflammation in the body while balancing out all the omega-6 fatty acids in our modern-day food supply.”
Indeed, some studies support the use of omega-3 fatty acids in lowering triglycerides in high-risk patients. However, omega-3 fatty acids containing a combination of AHA and EPA have been found to lower triglycerides and increase LDL cholesterol. As such, omega-3 fatty acids containing purely EPA may be better for managing high triglycerides without increasing LDL.
According to the American Heart Association, 2 to 4 g daily of omega-3 fatty acids is for patients who need to lower triglyceride levels.
5. Plant sterols and stanols
Plant sterols and stanols, also known as phytosterols, are cholesterol-like substances found naturally in margarine, vegetable oils, nuts, and seeds. They are also present in food supplements and may lower cholesterol by blocking its absorption into the body. A dosage of 1.5 to 3 grams daily has been shown to lower LDL cholesterol by 7.5% to 12%.
Experts recommend taking these supplements with a main meal (such as a heavy breakfast, lunch, or dinner). Usually, the cholesterol-lowering effects are facilitated when the supplements are ingested along with your meal.
6. Vitamin C
In addition to its function as an immune booster, vitamin C may also reduce total cholesterol. In a 2008 meta-analysis, 500 mg of vitamin C taken daily for four to 24 weeks was found to LDL cholesterol levels by 5%, triglycerides by 9%, and only a modest improvement in HDL cholesterol.
Most trials in the analysis included doses of 500 to 1000 mg of vitamin C per day. It may be worth supplementing with vitamin C since there are no reported side effects or toxicity following its use.
7. Flaxseed
Flaxseed is a non-marine source of alpha-linolenic acid (ALA). ALA is a type of omega-3 fatty acid with heart-healthy benefits.
A few studies have shown the positive effects of flaxseed on lowering LDL and total cholesterol. 30 g of flaxseed daily for three months decreased total cholesterol by 7% and LDL cholesterol by 10% in postmenopausal women with high cholesterol. In another study, people who took 600 mg of a supplement derived from flaxseed for eight weeks had their total cholesterol lowered by 22% and LDL cholesterol by 24%.
There’s no standard dosage, but 30 g daily is a common dosage in studies. Opt for flaxseed oil or ground flaxseed to get the most benefits. Generally, flaxseed is well tolerated in therapeutic doses. However, there are possible interactions with blood pressure, estrogen, and anticoagulant medications. If you are pregnant or breastfeeding, avoid taking flaxseed supplements.
8. Artichoke leaf
Artichoke leaf is a vegetable that originated from the Mediterranean area. The extract is commonly used as a supplement that is available in capsules. Some studies suggest artichoke leaf supplements can be used to treat hypercholesterolemia. One large study pooled findings from nine trials that included 702 people, and the result from the research showed a significant reduction in total cholesterol, LDL cholesterol, and triglycerides. However, side effects such as gas, bloating, diarrhea, and allergic reactions may occur.
What are the best supplements to lower cholesterol?
From the list above, the following supplements for lowering cholesterol have the most available research:
- Berberine
- Vitamin C
- Plant stanols and sterols
- Soluble fiber
It’s important to consult a healthcare provider when choosing the best treatment option for high cholesterol levels. Before using a supplement, tell your healthcare provider about any medical conditions or medications you are taking.
What supplements are bad for your cholesterol?
The following supplements are not good for cholesterol levels.
1. Steroids
Steroids are known as performance-enhancing supplements used to increase muscle mass and strength. Steroids may be bad for cardiovascular health. They raise LDL by about 50% and lower HDL cholesterol by about 90%, according to a study published in the International Journal of Sports and Exercise Medicine. The good news is that your cholesterol levels can improve if you stop using steroids.
2. Retinoids
Retinoids are found in topical and oral supplements. They are vitamin A derivatives for treating acne, pigmentation irregularities, and skin wrinkles. Studies suggest that retinoids may raise triglycerides in 30% to 44% of cases and cholesterol in 31%. Still, it doesn’t mean you have to avoid retinoids completely; instead, work with your healthcare provider to monitor your cholesterol levels.
How to choose a supplement?
“Before using supplements, you want to make sure it doesn’t cause more harm to your body,” Routhenstein says. “It is important that you speak with your doctor and registered dietitian who specializes in heart disease to discuss supplement use to assess optimal risk versus benefit to protect your heart health.”
Additionally, you should try the following tips when choosing a supplement.
Always read the label. Some things to look out for include the active ingredient, dosages, how to use it, side effects, potential drug interactions, and allergen disclaimers. Research any ingredients you don’t recognize. This information is important to know exactly what the supplements do and do not contain—for your safety.
According to the National Institute of Health, here are some questions to ask your healthcare provider about the ingredients:
- What are the potential health benefits for me?
- Does it have any safety risks?
- What is the proper dose to take?
- How, when, and for how long should I take it?
Ensure you’re choosing from a trusted brand. You can ask your healthcare provider for recommendations. Since the FDA does not always regulate supplements, look for a seal of quality assurance from independent organizations such as ConsumerLab.com, NSF International, and U.S. Pharmacopeia. These organizations offer quality testing that shows a supplement contains only the labeled ingredients and doesn’t pose any potential risk.
Check the brand’s website to verify its authenticity. It’s also a great opportunity to find out if the experts involved in the formulation are reputable.
Check the expiration date. This will help ensure the product is still effective and safe to use.
In summary, it’s always a good idea to remember that supplements do not replace your prescribed medications or substitute receiving medical care from a healthcare professional. Also, a balanced diet rich in fruits, vegetables, fish, lean meat, nuts, and legumes and regular physical exercise may help manage your risk for health problems.
