Science-Backed Supplements That Help With Cholesterol, and When to Be Cautious

If you have high cholesterol, you may be wondering if a supplement can help. It depends. Supplements aren't tested to see how safe they are and how well they work. And they're not approved by the FDA to treat certain health conditions the way prescription medications are. Still, some supplements may help. Others should be used with caution.

Psyllium fiber, the active ingredient in some over-the-counter laxatives, comes from the seeds of the herb Plantago ovata. Research suggests it can lower LDL cholesterol by 5% to 9%, especially when combined with a low-fat diet. It might also help control blood sugar levels. Psyllium fiber is available in many forms, including powder, wafers, bars, and capsules.

Phytosterols are compounds found in plants. They look and act like cholesterol, and they can lower the amount your body absorbs. Studies show that 2 grams a day can cut "bad" LDL cholesterol by 8% to 10%. Researchers aren't yet sure how, but data suggests phytosterols signal your body to make more bile, which contains cholesterol and other compounds. Some of the foods they naturally occur in include almonds, ground flaxseed, and peanut butter. Cauliflower, olive oil, and Brussels sprouts are good sources, too. Phytosterols are sometimes added to certain foods, like breakfast bars, cereal, and milk. They're also available in tablet and capsule form.

Beta-glucan is a type of fiber that's soluble, or dissolves in water. It forms a gel-like substance in the gut and slows down digestion. Eating about 3 grams a day (think of a bowl of oatmeal at breakfast) can help lower cholesterol and your risk of disease in your heart and blood vessels.

This supplement comes from a fungus that grows on rice. Studies show it can lower LDL cholesterol between 15% and 25%. That's because it contains a compound called monacolin K that's similar to what's found in statins, prescription medicines used to lower high cholesterol. But red yeast rice isn't regulated by the FDA, so you can't be sure its supplements contain enough monacolin K to lower LDL cholesterol. Side effects are similar to those of statins and may include stomach pain, gas, headache, and dizziness.

Berberine is a chemical found in various plants. Studies show that it can significantly lower total cholesterol, LDL cholesterol, and triglycerides. It can also improve blood sugar levels and lower blood pressure. But it may also interfere with diabetes medications or immunosuppressants. Side effects include gut issues such as constipation, an upset stomach, and vomiting. Talk to your doctor before taking berberine supplements. Don't take them if you're pregnant or breastfeeding.

In one study, people with high cholesterol who ate 20 grams of raw garlic (about 4 cloves) and 1 tablespoon of lemon juice a day for eight weeks saw reduced LDL cholesterol levels. Those who took just one or neither ingredient saw no change in their cholesterol. But in another study, patients who took raw garlic or garlic supplements daily for six months saw no change in their LDL levels.

This B vitamin helps turn food into energy and keeps your digestive and nervous systems healthy, along with your skin. Studies show it can lower triglycerides and boost HDL (good) cholesterol by more than 30%, but there's no evidence that it reduces your risk of diseases in your heart and blood vessels, heart attacks, or strokes. Foods rich in niacin include yeast, milk, meat, and cereals. Taken in high doses, niacin can cause itching, digestive issues, liver damage, and diabetes.

Flaxseed comes from the seed of the flax plant. It's high in heart-healthy omega-3 fatty acid, alpha-linolenic acid, and fiber, which can help ease constipation. There's some evidence that flaxseed can lower total cholesterol and LDL cholesterol. Flaxseed can be whole or crushed into a powder and baked into foods or mixed into beverages. If you take it, drink plenty of water. Eating too much flaxseed can trigger bloating, gas, or loose stools. It may also interfere with blood-thinning medicines.

If you take statins to lower your cholesterol, you may deal with side effects like muscle pain and cramping. Doctors aren't sure why this happens, but they believe it's because statins can curb the body's natural levels of coenzyme Q10, or CoQ10. That's  an antioxidant that aids cell growth and energy production. Studies show that certain supplements, such as CoQ10, may help. More research is needed. There is no scientific evidence that taking vitamin D supplements prevents or reduces statin-related muscle pain.