Cholesterol-lowering supplements may be helpful

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Diet and exercise are proven ways to reduce cholesterol. Cholesterol-lowering supplements may help, too.

By Mayo Clinic Staff

If you’re worried about your cholesterol level and have started exercising and eating healthier foods, you might wonder if a dietary supplement could help. With your doctor’s OK, here are some cholesterol-improving supplements to consider.

Cholesterol-improving supplement
What it might do
Side effects and drug interactions

Berberine
May reduce low-density lipoprotein (LDL, or “bad”) cholesterol and triglycerides
May cause diarrhea, constipation, gas, nausea or vomiting; may cause harm to babies during pregnancy and breastfeeding

Fish oil
May reduce triglycerides
May cause a fishy aftertaste, bad breath, gas, nausea, vomiting or diarrhea; may interact with some blood-thinning medications

Flaxseed, ground
May reduce LDL cholesterol
May cause gas, bloating or diarrhea; may interact with some blood-thinning medications

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

Green tea or green tea extract
May lower LDL cholesterol
May cause nausea, vomiting, gas or diarrhea; may interact with blood-thinning medications

Niacin
May lower LDL cholesterol and triglycerides; may improve high-density lipoprotein (HDL, or “good”) cholesterol
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
May reduce LDL cholesterol, particularly in people with a genetic condition that causes high cholesterol (familial hypercholesterolemia)
May cause diarrhea

Red yeast rice — Natural doesn’t mean safe

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 the same types of side effects as lovastatin, which include damage to the muscles, kidneys and liver. In the United States, the Food and Drug Administration has ruled that dietary supplements that contain more than trace amounts of monacolin K are unapproved drugs and can’t be sold legally as dietary supplements.

Dietary supplements may not be enough

While dietary supplements can help, you might also need prescription medications to get your cholesterol numbers to a safe level. Be sure to tell your doctor if you take any type of dietary supplement, because some can interact with medications you may be taking.

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Cholesterol management at a glance. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/cholesterol-management-at-a-glance. Accessed Dec. 8, 2020.
Tangney CT, et al. Lipid management with diet or dietary supplements. https://www.uptodate.com/contents/search. Accessed Dec. 8, 2020.
Berberine. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Dec. 8, 2020.
Fish oil. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Dec. 8, 2020.
Flaxseed. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Dec. 8, 2020.
Garlic. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/garlic. Accessed Dec. 8, 2020.
Garlic. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Dec. 8, 2020.
Green tea. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/green-tea. Accessed Dec. 8, 2020.
Green tea. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Dec. 8, 2020.
Rosenson RS. Low density lipoprotein cholesterol lowering with drugs other than statins and PCSK9 inhibitors. https://www.uptodate.com/contents/search. Accessed Dec. 9, 2020.
Niacin. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Dec. 8, 2020.
Plant sterols. Natural Medicines. https://naturalmedicines.therapeuticresearch.com. Accessed Dec. 8, 2020.
Red yeast rice. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/red-yeast-rice. Accessed Dec. 8, 2020.

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