You may be able to take supplements to lower your cholesterol levels. Common ones include niacin, fiber, and artichoke leaf. These and other supplements have varying degrees of support from medical science.
When your levels of low-density lipoprotein (LDL) (“bad cholesterol”) are high, it increases your risk of heart disease and stroke. You'll likely be prescribed medicine and told about lifestyle changes that can help, but you may want to take supplements, as well.
This article covers which herbs and supplements may help lower “bad” cholesterol and raise “good” cholesterol. It also discusses other ways to reduce high cholesterol and your heart disease risk.
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Supplements for Lower Cholesterol
Researchers are still working to confirm the usefulness of supplements in treating high cholesterol. For this reason, it remains unclear who can benefit most from them.
In general, they're considered safer for younger people with no history or risk factors for heart disease. Always talk to your healthcare provider before starting any supplement regimen.
Common Supplements to Lower Cholesterol | |||
---|---|---|---|
Supplement | Benefits | Risks and Side Effects | Typical Adult Dosage |
Niacin | May raise good cholesterol and lower bad cholesterol and triglycerides | Flushing or hot flashes, nausea, indigestion, gas, diarrhea, or gout | Varies; ask your healthcare provider |
Soluble fiber | May reduce bad cholesterol | Bloating, cramping, or gas | 5-15 grams per day |
Plant sterols and stanols | May reduce bad cholesterol | Diarrhea | 1.3 grams per day as part of a low-fat, low-cholesterol diet |
Artichoke leaf | May reduce bad cholesterol and increase good cholesterol | Bloating or gas, belching, upset stomach, or diarrhea | 250 to 2,700 mg per day |
Niacin (Vitamin B3)
Niacin, a form of vitamin B3 also called nicotinic acid, is used to lower cholesterol. It appears that niacin lowers bad cholesterol and triglycerides (another form of fat), while raising good cholesterol, also known as high-density lipoprotein (HDL).
Niacin also appears to significantly lower levels of lipoprotein A, another risk factor of atherosclerosis.
Niacin is available in prescription form and as an over-the-counter (OTC) dietary supplement. The American Heart Association says you should only use the prescription form of niacin for lowering cholesterol.
Side Effects
Niacin can increase the effect of high blood pressure medication. It also may cause:
- Nausea
- Indigestion
- Gas
- Diarrhea
- Gout
It can also:
- Worsen peptic ulcers
- Trigger liver inflammation
- Cause high blood sugar
The most common side effects of high-dose niacin are:
- Skin flushing
- Hot flashes
These are caused by the widening of blood vessels. Most people only notice this when they initially start taking niacin. The flushing symptoms may ease if you take niacin with meals.
Some research suggests high doses of niacin might help lower cholesterol when combined with drugs called statins. However, other studies have shown no clinical benefit and the possibility of some harm.
Because the science is inconclusive and it can cause side effects, you should only take niacin for high cholesterol under the close supervision of a healthcare provider.
Soluble Fiber
Soluble fiber appears to lower bad cholesterol by making your intestines absorb less cholesterol from food. Soluble fiber binds with cholesterol so that it is excreted from the body.
Research suggests that between 5 grams (g) and 15 g of soluble fiber a day can lower LDL cholesterol by between 5% and 10%. The Food and Drug Administration (FDA) allows soluble fiber products to indicate that they are “heart-healthy” on the labels.
You can find soluble fiber in OTC dietary supplements such as:
- Psyllium powder
- Acacia fiber
- Nopal cactus (prickly pear)
It's also in foods including:
- Oats, barley, rye
- Legumes (peas, beans)
- Apples, prunes, and berries
- Carrots, broccoli, and yams
- Carob
- Shirataki noodles
- Flaxseeds
Plant Sterols and Stanols
Plant stanols and sterols, such as beta-sitosterol, are naturally occurring substances found in certain plants. Stanols are also found as dietary supplements. Some are added to:
- Margarine
- Orange juice
- Salad dressings
Research suggests plant stanols and sterols may help lower cholesterol. Their chemical structure is similar to cholesterol, so it may block cholesterol absorption.
In studies, people taking stanols or sterols with statin drugs had better results than people on statins alone.
The FDA allows companies marketing phytosterols and sterols to make a claim on their labels that the product may work with a low-cholesterol and saturated-fat diet to reduce the risk of heart disease.
Suggested dosages are:
- Sterols = 0.65 grams (g) twice a day with meals
- Stanols = 1.7g twice a day with meals
Artichoke Leaf
Some research suggests artichoke leaf extract (Cynara scolymus) may help lower cholesterol. Artichoke leaf extract may work by limiting how much cholesterol your body produces.
Artichokes also contain a compound called cynarin. It is believed to increase bile production in the liver and speed the flow of bile from the gallbladder. Both of these actions may help clear cholesterol from your body.
Other Supplements
Other supplements that have been suggested for cholesterol have less evidence of being useful, so more and better-quality evidence is needed. They include:
- Garlic
- Policosanol, derived from sugarcane
- Coenzyme Q10
- Catechin compounds in green tea
- Soy
- Red yeast rice, which has a potential danger because it contains a naturally occurring form of lovastatin, a prescription drug
Modifying Risk Behaviors
High cholesterol is usually treated based on total cholesterol, LDL cholesterol, and HDL cholesterol levels, plus the presence of additional risk factors for heart disease.
While some risk factors cannot be changed, others can. Heart attack risk factors may include:
- Previous heart attack
- Diabetes
- Tobacco use
- High blood pressure
- Physical inactivity
- Overweight and obesity
- Family history of early heart disease
- Being postmenopausal
- Being over 45 for those assigned male at birth (AMAB)
Modifiable risk factors include not using tobacco, being active, eating a healthy diet, and losing excess weight. You can also take medications to keep high blood pressure and/or diabetes under control.
Using Alternative Medicine
Before you decide to use alternative medicine for high cholesterol:
- Talk to your healthcare provider before starting any supplements.
- Make sure your healthcare provider knows all the supplements and medications you are taking.
- Don’t stop taking any of your existing prescription medications unless your healthcare provider says to.
Remember alternative medicine hasn’t been tested for safety. Get medical advice before giving them to children or taking them while pregnant or nursing.
Discuss with your provider whether it's safe for you based on your diagnoses and medications.
Summary
Some people use herbs and supplements to help lower their “bad” LDL cholesterol and raise their “good” HDL cholesterols, either on their own or with prescription medications. While many natural remedies are not well supported by research, there are exceptions.
Among the supplements with some proven benefits are niacin, soluble fiber, and phytosterols. Others popularly promoted as “cholesterol-lowering”—such as artichoke leaf extract, garlic, coenzyme Q10, green tea, policosanol, and red yeast rice—lack the scientific evidence to support their use.
Speak with your doctor before using any herb or supplement to treat high cholesterol. In addition to managing your cholesterol with pills, make an effort to eat a healthier diet, exercise regularly, quit cigarettes, and lose weight if needed. Doing so can reduce your overall risk of heart disease.
Cholesterol Healthcare Provider Discussion Guide
Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.
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