Best Supplements for High Cholesterol: What Helps LDL?

The human body needs fats, or lipids, to function. There are two main types of fats in the body: 

• Cholesterol: This is a waxy-type of fat in the blood that is formed by your liver to help make cells, hormones, and digest foods. 
• Triglycerides: This is a type of fat that your body uses to store excess energy from the foods you eat. 

Both of these lipids cannot travel in the blood by themselves, so they use lipoproteins to help. Lipoproteins are particles of fat and protein that transport cholesterol and triglycerides throughout your bloodstream. 

Low-density lipoprotein (LDL) cholesterol, or “bad” cholesterol, brings cholesterol into your cells. Cells require some cholesterol to function, but a high concentration of LDL in the bloodstream can cause cholesterol to build up on the coronary arteries and other blood vessels in the body. This can lead to coronary heart disease and other serious health issues. 

High-density lipoprotein (HDL), or “good” cholesterol, removes excess cholesterol from your arteries and carries it to the liver to be flushed out of your body. Together, your LDL and HDL levels make up your total cholesterol count, which is measured in milligrams per deciliter of blood (mg/dL).

A normal total cholesterol level is any number less than 200mg/dl. The lower the number, the lower the risk of complications or disease. Total cholesterol levels of 200-239mg/dl are considered borderline elevated, whereas a total cholesterol count of 240 mg/dL or more is considered high and significantly increases the risk of heart disease. Roughly 25 million adults in the U.S. have high cholesterol. 

We’ll discuss why maintaining a balanced cholesterol count and low LDL level is vital to your overall health, and how taking medication and supplements together can help you reach your cholesterol goals.

LDL vs. Triglycerides vs. Total Cholesterol

When discussing the impact of cholesterol and triglycerides on your overall health, it’s important to understand the distinction between different cholesterol types and levels. A full lipid panel will check for several levels, including:

• Low-density lipoprotein (LDL): LDL is “bad” cholesterol because it transports cholesterol into cells and tissues, and is the primary source of plaque buildup and artery blockage. Elevated levels of LDL are directly associated with atherosclerotic cardiovascular disease, which can lead to heart attack and stroke. 
• Very-low-density lipoprotein (VLDL): VLDL is another “bad” cholesterol, but it transports mainly triglycerides instead of cholesterol from the liver to tissues throughout the body. 
• High-density lipoprotein (HDL): HDL, or “good” cholesterol, carries cholesterol away from the arteries and helps the body flush it out and lower your overall levels.  The more HDL you have, the lower your risk for heart disease and stroke. Likewise, if your HDL levels are low, it can increase your risk of complications from high cholesterol.
• Triglycerides: Triglycerides are the most common type of fat in the body. They come from foods like butter and oils, as well as extra calories you consume that your body does not use immediately. High triglyceride levels can also contribute to increased risk of cardiovascular disease, and severely high levels can cause other conditions, such as pancreatitis. 
• Total cholesterol: Total cholesterol is a measurement of the total amount of LDL and HDL in your blood. On its own, it counts both the “good” and “bad” levels of cholesterol in your body, and sometimes can mask elevations if the total number is within the normal range (less than 200mg/dl). This is why it is important to look at both components that make up your total cholesterol to see if there are any abnormalities.  
• Non-HDL: Another measurement, non-HDL, is calculated by subtracting the HDL level (“good” cholesterol), from the total cholesterol level. This reveals the total amount of “bad” cholesterol in the blood. This level includes LDL and VLDL levels, and can be used to help better calculate risks of cardiovascular disease. 

As an example, this table shows healthy cholesterol levels for men and woman ages 20 and older:

Optimal cholesterol and triglyceride levels depend on your risk factors for complications, including your age, race, weight, blood pressure, and medical history. If any of these levels are too high, your doctor may recommend lowering your cholesterol through a combination of medication, lifestyle changes, and dietary supplements. 

Next, we’ll discuss supplements your provider may suggest to complement the prescription medication you take to lower your cholesterol.

Supplements vs. Prescription Treatments

Dietary supplements can be an inexpensive, over-the-counter (OTC) addition to prescription medication for high cholesterol. Unlike medication, the Food and Drug Administration (FDA) does not approve or clear supplements to treat or cure medical conditions. However, many supplements have been thoroughly researched and are commonly used alongside medical treatments and lifestyle changes.

Before taking any dietary supplement, make sure to check with your healthcare provider and audit your current health conditions and medications because some supplements may cause adverse effects. A healthcare provider can help vet your medical history to ensure the supplement(s) you want to take will not interfere with your current medications or exacerbate any existing medical conditions. 

Top Supplements To Support Lower Cholesterol

Decades of research have shown a wide range of supplements can benefit people with high LDL, triglyceride, and total cholesterol levels. While these supplements may not lower cholesterol on their own, they can complement prescription medication and lifestyle changes for reaching and maintaining healthy cholesterol levels.

Soluble Fiber

Fiber is an important component of the diet that is beneficial to health, digestion, and disease prevention. There are two types of fiber: soluble and insoluble, which refer to how it is absorbed during digestion. 

Found exclusively in plant-based foods, soluble fiber is not absorbed in the intestine, but instead forms a gel-like substance that helps slow digestion and absorption of cholesterol. It also allows the fiber to bind to bile acids in the intestine, helping clear extra cholesterol in the stool. The World Health Organization recommends an average daily intake of 25g of total fiber per day, including soluble and insoluble forms. Eating 5 to 10 grams of soluble fiber per day can lower LDL.

The most common sources of soluble fiber can be found in oats, legumes, whole grains, fruits, seeds, and vegetables. Natural fiber supplements like psyllium are also available.

Phytosterols

Phytosterols are natural compounds that originate from plant-based foods. They are structurally similar to cholesterol and help block cholesterol absorption in the intestine, which reduces LDL levels and improves overall heart health. The most common dietary sources include unrefined vegetable oils, nuts, seeds, legumes, and whole grains. Studies show people who consume just 2-3 grams of phytosterols per day have reported a reduction of 6-12% in their LDL levels. 

Omega-3s

Omega-3 fatty acids are healthy polyunsaturated fats that promote heart health, facilitate cellular function, and reduce inflammation. There are three main types of omega-3 fatty acids that vary by structure and food source: ALA, EPA, and DHA. DHA and EPA fatty acids are found in seafood, such as salmon and fish oils, and ALA fatty acid originates from plant sources, such as canola oil and flaxseeds. Your body does not produce enough omega-3 fatty acids on its own, so getting this essential nutrient from your diet is critical. 

Omega-3 fatty acids are mainly known and taken to help lower triglycerides rather than LDL levels. High doses (3-4g/day) of DHA and EPA supplementation have shown to reduce triglycerides by 20-40% and help increase HDL levels, but sometimes can slightly raise LDL levels. Supplementation with omega-3 fatty acids, when taken alone or with other lipid-lowering medication, can help reduce the risk of coronary artery disease.  

In addition to foods you consume, you can get the omega-3 fatty acids you need through supplements with fish oil, krill oil, or cod liver oil. The average fish oil supplement with a 1-gram dose contains about 180 mg of EPA omega-3 fatty acid and 120 mg of DHA omega-3 fatty acid. Vegetarian versions of these supplements are also available. Always make sure to check with your provider prior to starting any supplementations. 

Berberine

Berberine is a naturally occurring plant alkaloid widely used in traditional medicine to help with weight loss, lower cholesterol, and control blood sugars. It activates enzymes to burn fat and regulate energy more efficiently, and also inhibits other enzymes to help the liver remove LDL from your bloodstream. Common sources of berberine include barberry, goldenseal, Oregon grape, and tree bark turmeric, which may be used in berberine supplements. 

Research shows that people who take berberine may notice a decrease in LDL concentration by as much as 50 mg/dL and a drop in triglycerides by as much as 55 mg/dL. Additional studies suggest berberine can play a role in reducing body mass index and waist size. 

Coenzyme Q10

Coenzyme Q10 (CoQ10) is a fat-soluble compound your body naturally produces that acts as an antioxidant and plays a role in energy production. Prescription statin medication, taken to help lower cholesterol levels, has been shown to decrease your body’s production of CoQ10. Low levels of CoQ10 has led to the common muscle-ache side effect associated with statin medication use. CoQ10 is not recommended for lowering cholesterol, nor is it a substitute for cholesterol medication. Instead, taking it as a supplement while also taking statin medication can help replenish your levels and prevent muscle aches associated with low CoQ10. 

CoQ10 is safe to take and has minimal side effects. While there is no established optimal regimen, most current guidelines recommend the optimal CoQ10 dose for adults is 200-400mg/day. If you are taking a statin medication to help lower your cholesterol and want to help prevent or treat muscle-related side effects, talk to your provider to see if CoQ10 supplementation is right for you. 

Turmeric

Turmeric is a member of the ginger family widely used in cooking. Its active compound, curcumin, has demonstrated multiple health benefits and cardioprotective properties through its evidence to lower lipid levels. Turmeric and curcumin itself is hard for the body to absorb, but bioavailable formulations are commonly used to help increase absorption. Studies have shown that turmeric supplementation can reduce triglycerides, total cholesterol, and LDL levels, while also helping to slightly increase HDL levels.  However, more research is needed to establish how turmeric promotes healthy cholesterol levels, and American Heart Association guidelines do not endorse it as lipid-lowering therapy. 

Curcumin supplements can be a natural way to complement medication, diet, and exercise that promotes healthy cholesterol levels, but should not be a replacement for high cholesterol treatment. While using turmeric in cooking and foods is generally safe and healthy, concentrated supplements can sometimes cause adverse effects and interact with certain medications, like blood thinners and diabetes medications. Always talk to your provider before adding supplements to your diet.

Proceed With Caution

Any dietary supplement you take has the potential to interact with other medications and cause side effects ranging from uncomfortable to serious. The supplements listed below are considered particularly high-risk for potential interactions and side effects. Always consult with your healthcare provider before adding any supplements to your diet.

Red Yeast Rice

Red yeast rice may be marketed as a dietary supplement to support cholesterol levels because it contains monacolin K, a compound that is chemically identical to lovastatin, a prescription low-dose statin medication used to lower cholesterol. Red yeast rice supplementation has been an alternate treatment option for those who cannot take statins for high cholesterol. 

Studies have shown that red yeast rice can lower LDL levels up to 34%, and that a dose of 1,200 mg to 2,400 mg of red yeast rice per day is well-tolerated and delivers the same effects as low-dose statin medication. It is contraindicated in pregnancy and breastfeeding.

However, there are notable risks associated with this supplement because monacolin K carries similar side effects as statin medications. These include muscle pain and weakness, liver strain, and digestive issues. Red yeast rice also contains citrinin, which is a toxic substance that can damage the kidneys when consumed in large amounts. 

Unlike prescription statin medications, red yeast rice supplements are not regulated by the FDA, so market products may have varying levels of citrinin. This is why it is important to use high-quality and purified supplements and weigh the risks versus benefits of starting any supplement with your provider.

Niacin, or Vitamin B3

Historically, doctors commonly recommended niacin, or vitamin B3, to manage high cholesterol. Niacin supplements work by inhibiting LDL production in the liver, which helps lower LDL cholesterol and triglyceride levels while raising HDL cholesterol. Studies have shown that niacin can decrease total and LDL cholesterol by 10% to 20%, triglycerides by 30% to 70%, and increase HDL by up to and an average 20% to 35%.

However, taking niacin hasn’t demonstrated any evidence of cardiovascular benefit and modern guidelines have shifted its recommendations. It has been associated with serious side effects and health risks such as severe facial flushing, liver damage, heart rhythm changes, low blood pressure, and GI side effects. Because of its low tolerability and adverse effects, doctors today generally favor prescription-strength statin medications for lowering cholesterol. Statin medications generally produce milder side effects and are better tolerated. As a result, providers typically reserve niacin as a cholesterol-lowering treatment for people who are intolerant or don’t adequately respond to statin drugs. 

Do Vitamins Lower High Cholesterol?

Vitamins like niacin can lower total cholesterol, LDL cholesterol, and triglycerides. However, these vitamins are associated with serious — and possibly life-threatening — side effects. Doctors today generally recommend other courses of treatment for high cholesterol that don’t carry the same risks, such as prescription-strength statin medications and non-vitamin supplements like soluble fiber, phytosterols, and omega-3 fatty acids.

Lifestyle Changes With The Biggest Impact For High Cholesterol

Healthy lifestyle and dietary changes are integral to treating high cholesterol alongside prescription medication. Your provider’s guidance is based on individual factors like your age and medical history, but lifestyle changes for lowering and managing cholesterol often include the following. 

• Limit saturated fats. Saturated fats are found in animal-based foods like pork, beef, and full-fat dairy products. Palm and coconut oils also contain a high concentration of saturated fat. Foods high in saturated fat can increase the amount of LDL, or bad cholesterol, in your blood. The American Heart Association recommends limiting your saturated fat intake to no more than 6% of your daily diet, which is less than about 13 grams per day. 
• Avoid trans fats. Trans fat is a type of unsaturated fat. They can be naturally occurring or artificially put in our foods. Considered the most unhealthy type of dietary fat, trans fats are commonly found in fried food, baked goods, and snack items. People with high cholesterol are advised to prioritize foods that are low in trans fats, such as lean proteins, seafood, whole grains, and low- or non-fat dairy products. The FDA has long recognized the health risks of partially hydrogenated oils, the primary source for artificial trans fats, and food manufacturers have been banned from using them in their products since 2015. However, some items still contain trace amounts of artificial trans fat, and naturally occurring trans fats are still found in butter, milk, cheese, and red meat.
• Eat more soluble fiber. A high fiber diet has been linked to many health benefits, such as blood sugar control, helping digestion, decreasing cancer risk, and preventing heart disease. Like soluble fiber supplements, many high-fiber foods can lower LDL and raise HDL by preventing cholesterol from being absorbed in the intestine. These foods include oatmeal, beans, and fresh fruits and vegetables. In addition to soluble fiber, plant stanols and sterols can block cholesterol from being absorbed into the digestive tract and lower your LDL levels.
• Exercise. Regular exercise can help lower your weight, which in turn can reduce LDL levels and manage your blood pressure. The current recommendation for adults is at least 2 hours and 30 minutes of moderate physical activity per week. For people with elevated cholesterol, a weekly combination of moderate aerobic exercise and moderate- to high-intensity resistance training can raise HDL while lowering LDL and triglyceride levels.

When You Need More Help: Getting the Right Treatment

Ordering medication online allows you to manage and treat symptoms of high cholesterol and other health conditions without waiting for your doctor to approve a medication you’ve already been successfully taking.

Digital pharmacy platforms like TelyRx are often comparable to brick-and-mortar pharmacies in terms of medication availability and safety protocols, but with the added convenience of home delivery. For example, TelyRx carries many of the most common FDA-approved cholesterol treatments and boasts LegitScript third-party certification, full pharmacy licensure, and HIPAA-level privacy protocols.

Your Next Steps

Before adding any dietary supplements as part of your treatment for high cholesterol, review your current medications, medical history, and other factors to determine the best and lowest-risk options and be sure to check with your provider before starting any new supplement. Even natural supplements may have adverse effects. If your cholesterol is high, adding a heart-focused supplement to complement your prescribed medication and lifestyle changes can help lower those numbers.