Nearly 40% of American adults have high cholesterol. Lowering your cholesterol levels can decrease risks for heart disease, heart attack, and stroke.
This can be accomplished through medications, as well as diet, exercise, and lifestyle changes.
Some patients with high cholesterol also turn to dietary and natural supplements to help.
But do they really work to lower cholesterol levels and, more importantly, how safe are they?
In this article, I’ll explain what cholesterol is, and what it means when your levels are high.
I’ll then talk about some of the natural supplements that have been tried for lowering cholesterol levels, and discuss whether they’re effective. I’ll also outline their potential side effects.
Finally, I’ll tell you when you should talk to a doctor about your cholesterol levels, and how K Heath can help.
What is Cholesterol?
Cholesterol is often discussed in negative terms, but it is actually essential for human health.
You need cholesterol to produce bile acids, which help you digest fat from your diet and fat-soluble vitamins.
You also need cholesterol for making steroid hormones like estrogen, testosterone, and vitamin D.
Even if you ate a zero-cholesterol diet, your liver would still make it because without cholesterol, you would not be able to survive.
Cholesterol moves through your blood by attaching to proteins, becoming what is called a lipoprotein.
There are two types: low-density lipoprotein (LDL) and high-density lipoprotein (HDL).
LDL is considered “bad” cholesterol, whereas HDL cholesterol is considered “good.”
When there is an excess of LDL in the blood, these cells can form deposits of fat in the arteries called plaque which narrows the arteries and limits blood flow.
These plaque build ups can also burst and cause blood clots.
HDL, high-density lipoprotein, is “good” cholesterol.
It carries cholesterol from the bloodstream back to the liver where it can be flushed from the body.
This is what makes it the “protective” and “better” type of cholesterol.
Higher levels of HDL are associated with lower risks of heart disease and stroke.
The ratio of HDL to LDL cholesterol is often what’s considered to be most important when it comes to cardiovascular risk factors.
You want your HDL to be high, and your LDL to be lower.
Most people tend to have higher levels of LDL, especially if they are overweight or consume diets high in saturated fats.
When your total cholesterol levels are 240 mg/dL or more, you have “high” cholesterol.
High cholesterol can be the result of genetics, diet, lifestyle, and other factors.
Natural Supplements to Lower Cholesterol
Many supplements have been studied for their effectiveness in lowering cholesterol.
While some have promising evidence, none have been proven to have the same effect as medications that manage cholesterol.
Still, there are some that may have the potential to support your other efforts for balanced cholesterol.
Consult your doctor or primary care provider before starting any supplements.
They may interact with prescription medications, other supplements, and even foods.
While supplements are often viewed as safe because they are “natural,” the FDA does not regulate the supplement industry for effectiveness or safety.
They will remove products that are overtly harmful and linked to serious issues, but for the most part, the supplements industry is highly unregulated.
Dosages for supplements are not measured or verified the same way that prescriptions are, so choose brands that you trust, or supplements that have been verified by third-party testing.
Niacin, which is also known as vitamin B3, is a water-soluble nutrient that supports more than 400 enzyme reactions in the body.
The most notable of these processes is the conversion of the carbohydrates, fats, and proteins that you eat into adenosine triphosphate (ATP), the form of energy that your cells can use.
Without enough niacin, your body’s ability to process energy can be reduced.
Niacin may also help to normalize cholesterol and triglyceride levels.
Niacin can support balanced cholesterol levels in two ways:
- When HDL is too low, niacin can increase it by preventing its removal by liver cells, allowing the body to retain more of it.
- When LDL is too high, niacin can reduce the number of fatty acids that are culled from fat tissue storage, cutting down on how much LDL is made.
While these are impressive benefits, niacin does not erase all risk for cardiovascular disease, even if it helps to normalize lipid levels.
This is because even as it helps to balance lipids, it may increase insulin resistance and contribute to potential blood glucose imbalance.
In addition, the niacin dose needed to reduce cholesterol is much higher than the dose available in over-the-counter supplements, and can cause significant side effects.
Plant sterols provide structural components for plant membranes, similar to how cholesterol provides structure to human cells.
Plant sterols have been shown to reduce cholesterol when consumed in foods that naturally contain them.
Supplements are also available that provide sterols, but evidence supporting their effectiveness is more limited.
Foods that naturally contain plant sterols include:
Research on supplemental sterols has found that clinically significant reductions in LDL are possible, but the sample size studied was only 300 people.
There is definitely a potential benefit, but with such a small sample size, there are no guarantees.
Plant sterols are safe for most healthy people to consume and do not come with significant risks.
Side effects may include diarrhea or mild gas and bloating.
Soluble fiber is an indigestible nutrient found in oatmeal, seeds, beans, fruits like apples, and vegetables like broccoli, peas, and brussel sprouts.
It can also help decrease the amount of cholesterol in your bloodstream and reduce your LDL cholesterol.
Adult men should aim to eat 30-38 grams of fiber per day. Women should try to eat 21-25 grams daily.
In addition to getting your daily fiber from food, soluble fiber can be consumed in supplement form.
But these can come with more side effects: If you don’t drink enough water with fiber supplements, you may experience constipation and abdominal cramps.
While soluble fiber can help balance cholesterol, the overall effect is small and should be combined with other lifestyle supports.
Psyllium husk, a form of soluble fiber found in supplements, has been thoroughly studied for cholesterol benefits.
While it is frequently found in products aimed at resolving constipation, psyllium has been shown to reduce LDL cholesterol primarily by absorbing it and removing it from the body via bowel movements.
If you decide to take a psyllium fiber supplement, start slowly.
If you are not used to higher amounts of fiber, a sudden, dramatic increase can result in digestive discomfort, bloating, cramping, and constipation.
Drink plenty of water with the psyllium fiber and throughout the day.
Red yeast rice
Red yeast rice is a Chinese medicine that has been praised in alternative medicine circles for its dramatic effect on lowering cholesterol.
While the evidence seems favorable for red yeast rice, the FDA has warned that most red yeast rice actually contains another substance called monacolin K.
This compound is chemically identical to lovastatin, a prescription medication used to treat cholesterol.
By taking this supplement, you are actually getting an unregulated pharmaceutical drug.
Some red yeast rice also contains other contaminants that can be toxic for the kidneys, or can interact with other drugs.
Among the many potential supplements for naturally supporting cholesterol, this one is best skipped due to the risks.
The effects of soy on cholesterol levels do not exceed the benefits of cholesterol-lowering drugs, and it should not replace any prescribed medication.
However, soy protein has been found to reduce other cardiovascular risk factors.
Soy isoflavones do not reduce cholesterol on their own, but when paired with exercise and other aspects of a healthy lifestyle, they may increase the total effect.
Soy should not be consumed by those who have soy allergies.
Soy isoflavone supplements may also be risky for women who have had breast cancer and may increase the risk of developing endometrial hyperplasia.
Soy foods do not carry these risks.
Omega-3 fatty acids are anti-inflammatory and have been thought to support heart health, though these benefits may not be as substantial as once thought.
Fish oil supplements typically contain one or more forms of omega-3 fatty acids, often sourced from salmon or sardines.
Omega-3 fatty acids are thought to protect heart health in several ways:
- Reducing heart rate
- Supporting healthy blood pressure
- Promoting healthy blood vessels
- Reducing risk of heart failure
Fish oil supplements may not reduce cardiovascular risk factors in those who have the highest risk of heart attack or stroke.
Purity may also be a factor, since the supplement industry is not dose-regulated.
When consumed in higher amounts, fish oil supplements may even increase LDL cholesterol.
If you want to support cholesterol by consuming omega-3s, eating fatty fishes like salmon could be more effective than relying on supplements alone.
Talk to your doctor to determine the right kind of omega-3 supplement and an appropriate dose.
Fish oil supplements may interact with blood thinners, since they have a mild anticoagulant effect.
Possible Side Effects
All supplements can interact with other supplements, medications, and foods.
Supplements that are designed to help lower cholesterol levels may cause minor side effects including flushing, itching, and digestive upset.
Others carry more severe risks like liver damage or toxicity.
Speak with your doctor and pharmacist about the supplements you take to ensure that you are taking them correctly and that they are not interfering with other medications or medical conditions.
When to See a Doctor
If you want to find natural ways to support your cholesterol levels, your doctor can help you set a plan that will be appropriate for your health.
This may include a combination of pharmaceutical management, dietary suggestions, lifestyle adjustments, and dietary supplements.
Your healthcare provider will recommend a plan that is tailored for your needs.
How K Health Can Help
Ready to tackle the concerns you have over cholesterol? You can see a primary care physician through K Health right at home … without the waiting room.
Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.
Frequently Asked Questions
K Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references.
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Time- and dose-dependent effect of psyllium on serum lipids in mild-to-moderate hypercholesterolemia: a meta-analysis of controlled clinical trials. (2008).
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