THE BEST SUPPLEMENTS FOR LOWERING CHOLESTEROL

Many natural supplements can help lower cholesterol levels and improve the balance between “bad” LDL cholesterol and “good” HDL cholesterol.

The best cholesterol-lowering supplements include plant sterols, beta-glucans, bergamot orange, garlic, lycopene, glucomannan, green tea polyphenols, and olive leaf extracts or infusions.

These supplements are often safe to take alongside statins to boost their effect, but always consult your doctor before combining them with any medication.

Plant Sterol Supplements Lower Cholesterol

If you can’t or don’t want to take statins, or if your statin isn’t as effective as your doctor would like, plant sterols are a great alternative for lowering cholesterol.

Plant sterols are the cholesterol equivalent found in the plant world. Their structure is so similar to human cholesterol that they block the absorption of cholesterol in the intestines without being absorbed themselves.

They reduce the intake of cholesterol from your diet (typically limited to no more than 300 mg per day on a low-cholesterol diet) and also block the absorption of the larger amount of cholesterol (about 800 mg daily) produced by your liver and secreted into your intestines via bile.

By preventing cholesterol from entering the bloodstream, more is excreted through the intestines, along with most of the plant sterols. Plant sterols and stanols (which have a similar effect) are often added to spreads and yogurts designed to help maintain normal blood cholesterol levels.

A diet rich in plant sterols can reduce LDL cholesterol by around 15%. A review of 124 studies on plant sterol supplements showed an average LDL cholesterol reduction of 12% at a dose of 3g per day.

In the EU, approved health claims state that plant sterols can reduce blood cholesterol levels:

• By 7%–10% with a daily intake of 1.5g to 2.4g

• By 10%–12% with a daily intake of 2.5g to 3g

Supplements typically contain 800 mg of plant sterols per tablet. Taking 3 tablets daily can significantly reduce cholesterol levels within 2–3 weeks.

Olive oil is a natural source of plant sterols that block cholesterol absorption in the gut. Extra virgin olive oil, which is high in polyphenols, also boosts HDL (“good”) cholesterol production in the liver and improves cholesterol balance.

Olive leaf extract contains 30 times more beneficial polyphenols than extra virgin olive oil. It helps lower blood pressure, reduce unwanted blood clotting, and improve circulation.

Garlic Supplements Reduce Cholesterol

Garlic contains powerful sulfur-based antioxidants like allicin, which gives crushed garlic its distinctive smell. Allicin reduces cholesterol production in the liver and acts on cell receptors to decrease cholesterol uptake.

Data from 39 clinical trials involving 2,300 adults showed that garlic extracts can reduce total and LDL cholesterol by 10% if taken for at least two months. Garlic extracts also lower triglycerides, another type of blood fat, by up to 27%.

They also help reduce blood pressure. In 20 trials involving 970 people, garlic extracts lowered blood pressure by an average of 5.1/2.5 mmHg, and in people with hypertension, by 8.7/6.1 mmHg.

Garlic also reduces blood stickiness, dilates blood vessels, and can reduce the risk of arterial hardening by up to 25%.

If you need to lower both cholesterol and blood pressure, garlic extracts are an excellent option. Also, use fresh garlic in your cooking, add it toward the end of cooking for maximum benefits.

Beta-Glucan Supplements Reduce Cholesterol

Eating oats or barley can lower cholesterol in two ways. These grains contain beta-glucans, a type of soluble fiber that helps reduce natural cholesterol production in the liver. They also contain insoluble fiber that acts like a sponge, binding cholesterol and slowing its absorption in the intestines.

Beta-glucans from oats and barley are added to cholesterol-lowering foods and are also available as supplements. A daily intake of at least 3g of oat beta-glucans can reduce total and LDL cholesterol by 5% to 10%.

Beta-glucans also have immune-boosting effects, which some supplements emphasize more than their cholesterol-lowering benefit. As with most natural cholesterol-lowering supplements, they can be used with or without statins, but consult your doctor first. Include oats (e.g., porridge, sugar-free muesli) and barley products in your diet.

Grapefruit and Bergamot Supplements Reduce Cholesterol

Citrus fruits contain pectin, a soluble fiber that lowers cholesterol, and some also have bitter polyphenols with cholesterol-lowering properties.

Daily consumption of grapefruit juice can lower LDL cholesterol by 7% to 15%, with red grapefruit showing the strongest effect. However, grapefruit polyphenols can interact with some medications.

For example, drinking grapefruit juice while taking lovastatin can raise blood levels of the drug to the same level as taking 12 tablets with water. This effect lasts for at least 24 hours and can lead to overdose symptoms.

Always read the medication leaflet and speak to your doctor or pharmacist before consuming grapefruit or grapefruit extracts if you’re on medication.

Bergamot juice contains polyphenols that block cholesterol absorption in the intestines. It helps lower LDL and raise HDL cholesterol, improving the overall balance.

In a study of 77 people with high LDL and triglycerides, those who took bergamot extracts alone reduced their total cholesterol by 31%, compared to 30% with low-dose statins. Combining low-dose statins with bergamot led to a 38% reduction, slightly better than high-dose statins alone (37%). The placebo group saw no significant changes.

Lycopene Supplements Reduce Cholesterol

Lycopene is a red plant pigment (a carotenoid) that reduces cholesterol and helps prevent hardening of the arteries.

It’s found in tomato skins, but cooking tomatoes makes lycopene five times more bioavailable than in raw tomatoes. Canned tomatoes contain about 3mg of lycopene per 100g, while ketchup contains around 17mg/100g.

Lycopene is also found in pink guava, watermelon, red/pink grapefruit, tangerines (where it's 8.5 times more bioavailable than tomato juice), and papaya, where it’s stored in a liquid-crystalline form that’s easily absorbed.

Twelve studies found that taking at least 25mg of lycopene daily can lower LDL cholesterol by around 10%.

High lycopene levels are also linked with reduced arterial wall thickness and have benefits for prostate health.

Glucomannan (Konjac) Supplements Reduce Cholesterol

Glucomannan is a soluble fiber from the root of the konjac plant.

It swells in the intestines when in contact with water, which promotes satiety and weight loss, supports regular bowel movements, and reduces cholesterol, fat, and sugar absorption.

As a soluble fiber, it binds cholesterol in the intestines, reducing its absorption, both from food and bile secreted by the liver.

Twelve studies with 370 people found that 3g of konjac glucomannan daily reduced LDL cholesterol by about 10%.

In the EU, there are approved health claims that:

• As part of a low-calorie diet, 1g of konjac glucomannan taken three times daily with 1–2 glasses of water before meals contributes to weight loss.

• A daily dose of 4g contributes to maintaining normal cholesterol levels.

It’s important to drink plenty of water to prevent choking, especially for people with swallowing difficulties.

If you want to lower cholesterol and lose weight, konjac glucomannan is a great option.

Red Yeast Rice Supplements Reduce Cholesterol

Red yeast rice is made when the yeast Monascus purpureus ferments moist rice, turning it dark red on the outside and bright red inside.

It can be eaten as a delicacy or dried and ground into powder or paste, often used to color Asian dishes like Peking duck.

It contains monacolin K, a natural compound identical to the statin drug lovastatin. Monacolin K works in the liver to block the enzyme HMG-CoA reductase, reducing cholesterol production.

Results from 21 clinical trials involving 4,558 people show that red yeast rice significantly lowers total and LDL cholesterol, but doesn’t have a notable effect on blood pressure, triglycerides, or HDL cholesterol compared to placebo.

Ten studies comparing red yeast rice to statins found no significant differences in outcomes.

In the EU, red yeast rice supplements containing 10mg of monacolin K per day are approved for helping maintain normal cholesterol levels.

However, in some countries, red yeast rice is considered a medicine if it contains 5mg (Germany) or more than 10mg (Belgium) of monacolin K. In the UK, its classification depends on the product.

Some red yeast rice supplements have had their statin content removed, but still retain other cholesterol-lowering components.

Note: If you're intolerant to statins, you may also react to red yeast rice. If you choose a supplement that contains monacolin K, consider also taking Coenzyme Q10 and vitamin D to help reduce possible statin-like side effects.

Green Tea Supplements Reduce Cholesterol

Over 30% of the dry weight of green tea leaves is made up of powerful antioxidant flavonoids like epicatechins. These block cholesterol absorption and increase the liver’s excretion of bile salts and fatty acids containing cholesterol.

Green tea antioxidants also help break down triglycerides and have beneficial effects on blood pressure and blood stickiness.

Studies suggest green tea supplements are more effective than green tea itself for lowering cholesterol and triglycerides. Benefits are noticeable in just 3–4 weeks.

Green tea supplements are also often used to support weight loss and metabolic health.

What are the target cholesterol levels?

What defines an “ideal” cholesterol level isn’t always clear, and acceptable thresholds are regularly revised, usually downward. The following cholesterol levels are currently considered desirable for otherwise healthy adults.

U.S. Guidelines: Your target for non-HDL cholesterol should be 30 mg/dL higher than your target for LDL cholesterol. So, if your LDL target is 100 mg/dL, your non-HDL target would be 130 mg/dL.

If you have diabetes, a history of heart attack, or are at high risk for cardiovascular disease, a lower target may be recommended, for example: Total cholesterol: below 4 mmol/L, LDL cholesterol: below 2 mmol/L. Your doctor will determine what target cholesterol levels are right for your personal health profile.

Total Cholesterol to HDL Cholesterol Ratio

Your total cholesterol to HDL cholesterol ratio is an important marker when assessing cardiovascular risk, as it considers all non-HDL cholesterol.

To calculate this ratio, divide your total cholesterol by your HDL cholesterol. Ideally, this number should be less than 4.

For example: If your total cholesterol is 4.5 mmol/L and your HDL is 1.2 mmol/L, your ratio is 4.5 ÷ 1.2 = 3.75.

A ratio above 4.0 is considered a risk factor for heart disease.

This ratio is used, alongside other lifestyle and health risk factors, to calculate your QRISK2 score, a tool used in the UK to estimate your 10-year risk of developing cardiovascular disease.

If your 10-year risk of a heart attack or stroke is 10% or higher, your doctor may recommend starting a statin medication.