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Hyperlipidemia & Nutrition

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Supplements for Controlling Cholesterol

Nina Ghamrawi, MS, RD, CDE
4
January 12, 2022

If you are already controlling your cholesterol with exercise and healthy eating, chances are you are already making improvements to your health. If your cholesterol is stuck or you’d like an extra boost for your health, there are several natural supplements that may benefit you, and others that may just be a waste of money. In this article, we will outline the supplements that are proven to work, those that are not, and those that have risks.

Regardless of what you are trying, all supplements have some risk, however slight. Keep in mind these risks, and always talk with your doctor before starting a supplement, especially when it may have a counter-effect to medications. Before you start reading, here are a few pieces of information to know:

  • High-density lipoprotein, or HDL, is the good cholesterol. If you take supplements, ideally you want ones that either raise, or maintain HDL.
  • Low-density lipoprotein, or LDL, is considered ‘bad’ cholesterol. Supplements and foods you eat should aim to lower this number.
  • Triglycerides are a type of free fatty acid in the blood. These can lead to plaque buildup in the arteries, known as atherosclerosis, and can also lead to increased cholesterol and heart complications. The lower, the better.

Supplements that are likely Safe and Effective at improving cholesterol

The following supplements may be safe, per Mayo clinic, and various other linked sources below.

Supplement What it might do Side effects
Berberine Lowers LDL
Lowers triglycerides
May cause diarrhea, constipation, gas, nausea or vomiting; may cause harm to babies during pregnancy and breastfeeding
Fish oil Lowers LDL
Lowers triglycerides
Raises HDL
May cause a fishy aftertaste, bad breath, gas, nausea, vomiting or diarrhea; may interact with some blood-thinning medications
Flaxseed, ground Lowers LDL
Raises HDL
May cause gas, bloating or diarrhea; may interact with some blood-thinning medications
Green tea or green tea extract Lowers LDL May cause nausea, vomiting, gas or diarrhea; may interact with blood-thinning medications
Niacin Lowers LDL,
lowers  triglycerides
Raises HDL
May cause itching and flushing, which are more common at the higher doses usually needed to have an effect on cholesterol
Plant stanols and sterols Lowers LDL May cause diarrhea

Supplements that May Not Work

Supplement What it might do Side effects
Garlic May slightly reduce cholesterol but studies have been conflicting May cause bad breath, body odor, nausea, vomiting and gas; may interact with some blood-thinning medications
Turmeric Lowers total cholesterol
Lowers LDL
Lowers triglycerides
Not enough studies have been done in humans to support use of this supplement for lowering cholesterol.
May reduce overall inflammation, pain, infections, intensity and duration of cold/flu; may interact with some blood-thinning medications
Not enough studies have been done in humans to support any of these claims.

Supplements that are Unsafe

Supplement What it might do Side effects
Red Yeast Rice Some red yeast rice products contain a substance (monacolin K) that is chemically identical to the active ingredient in lovastatin (Altoprev), a prescription medication that lowers cholesterol. Because there is variability in quality from manufacturer, the amount of monacolin K can vary widely from product to product. Products that contain monacolin K can cause damage to the muscles, kidneys and liver.

FDA has banned supplements that contain more than trace amounts of monacolin K.

Takeaways

While all of the above supplements come from natural sources, the tried and true methods of lowering cholesterol that remain most effective are still: quitting smoking, quitting alcohol, eating plenty of fruits and vegetables, eating enough fiber (25g for men and 35g for women), and getting regular exercise. As with any supplement, talk with your doctor and dietitian about which supplements, if any, are right for you. And remember, just because it is natural, that doesn’t mean it is safe (or necessary).