Several supplements may help lower a person’s cholesterol levels, reducing the risk of heart disease. Research indicates that some supplements may be helpful when people use them either alone or in combination with cholesterol-lowering medication.

This article lists seven supplements that may help someone lower their cholesterol. It looks at what the evidence says about their efficacy and safety and advises about risks and side effects.

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Phytosterols refer to the plant sterols and stanols that occur naturally in some foods. Manufacturers include phytosterols in tablet form as a supplement for lowering cholesterol.

A 2013 meta-analysis and review of eight clinical trials concluded that taking a dose of 1–3 grams (g) of phytosterols two or three times a day for 4–6 weeks decreased low-density lipoprotein (LDL) cholesterol by 12 milligrams (mg) per deciliter.

The National Center for Complementary and Integrative Health (NCCIH) advises that phytosterols are generally safe for most healthy people. However, side effects can include diarrhea or fat in the stool.

Additionally, high plant sterol levels in people with sitosterolemia may have links to an increased risk of premature atherosclerosis.

Red yeast rice is a traditional Chinese medicinal product.

Manufacturers make red yeast rice by fermenting cooked rice kernels with a type of mold called Monascaceae, which produces an active compound called monacolin K.

Monacolin K inhibits the enzyme 3-hydroxy-3-methyl-glutaryl-CoA reductase, which helps synthesize cholesterol.

A 2019 review indicates the daily consumption of monacolin K in red yeast rice reduces LDL cholesterol plasma levels between 15% and 25% within 6 to 8 weeks. The supplement also lowered markers for total cholesterol and inflammation.

Furthermore, the review suggested that consuming 3–10 mg of daily monacolin has minimal risks compared with statins. The researchers suggest that previous studies show that red yeast rice does not cause side effects, such as muscle aches, which some people experience with statins.

Learn more about the advantages and disadvantages of statins.

However, the Food and Drug Administration (FDA) prohibits retailers from selling red yeast rice products with more than trace amounts of monacolin. Additionally, the FDA warns that people may experience severe muscle problems leading to kidney impairment if they use red yeast rice.

Red yeast rice is bioidentical to the drug lovastatin (Mevacor), which may interact with certain medications.

The FDA also states that red yeast rice products containing lovastatin may interact with the following drugs:

They may also interact with other medications that lower cholesterol.

Additionally, the National Center for Complementary and Integrative Health (NCCIH) warns that four out of 11 red yeast rice supplement products may contain citrinin, a toxin that animal and laboratory studies show may cause genetic damage or kidney failure.

People who are pregnant, chestfeeding, or taking statins should avoid red yeast rice. People should also check with a doctor before consuming supplements if they are currently taking medication.

Beta-glucans are fibers within certain plants, such as mushrooms, oats, and barley. Research demonstrates that beta-glucans can decrease total and LDL blood cholesterol levels, according to a 2018 review.

This review states that beta-glucans may be more effective than statins because they promote the rebalancing of cholesterol levels compared with simply blocking the enzyme that produces cholesterol. However, the authors write that more research is necessary to clarify the best way to use beta-glucans for lowering cholesterol.

A study in 2017 found that supplementing flaxseed in people with peripheral artery disease reduced LDL cholesterol by 15% within 1 month. In addition, the researchers suggested that flaxseed had additional cholesterol-lowering capabilities when the study participants used it in combination with statins.

Another small study involving Japanese men indicated that 10 g of flaxseed oil daily reduced LDL cholesterol by 25.8% at 4 weeks and 21.2% at 12 weeks.

People can take flaxseed as an oil, ground seeds, or in capsule form, but they should check that the substance will not interact with any prescribed medications first.

The NCCIH warns that people should not take flaxseed during pregnancy because it may have hormonal effects. Additionally, the organization advises people to make sure they are well hydrated when taking flaxseed, as it may cause constipation or diarrhea.

Doctors often measure a person’s triglyceride levels when testing their cholesterol. Triglycerides are the body’s most common type of fat, storing the excess energy that the body does not use.

A high triglyceride level, also known as hypertriglyceridemia, is a risk factor for cardiovascular disease, especially in combination with low amounts of high-density lipoprotein (HDL) and elevated levels of LDL cholesterol.

Learn more about what doctors consider typical triglyceride levels.

According to a 2018 review, omega-3 supplements may help manage a person’s cardiovascular risk. In addition, the review suggests that omega-3 fatty acids can help reduce triglycerides and inflammation.

People can consume the omega-3 fatty acids docosahexaenoic acid and eicosapentaenoic acid by eating oily fish or taking supplements. Supplements include those that manufacturers derive from fish liver or plant-based forms they synthesize from algae.

However, fish oil supplements may interact with certain medications, such as warfarin. With this in mind, people should check with a doctor before taking these supplements.

Sources of soluble fiber, such as psyllium, can help clear cholesterol from the blood and eliminate it through the bowels, according to a 2017 review. This review indicated that among 24 studies, participants took an average of 10 g a day of psyllium and were able to lower their total cholesterol by 2–20% and LDL cholesterol by 6–24%.

The authors stated that people should introduce fiber supplements gradually to avoid side effects, such as bloating or cramping. They also suggested that individuals should speak with a doctor before taking fiber supplements if they are taking medication or have an existing condition affecting their digestive system.

According to a 2020 review of 31 trials, green tea lowered LDL cholesterol and total cholesterol in study participants who had moderate weight or were overweight. Green tea contains active compounds called catechins, which may help reduce the risk of cardiovascular disease, although more research is necessary.

People can purchase green tea extracts as a supplement in tablet form or consume green tea as a drink. However, green tea contains caffeine, so individuals sensitive to the substance should be mindful of how much they consume.

Supplements can interact with a person’s medication or cause side effects. In addition, some products may not have undergone regulation by the FDA.

Therefore, people should speak with a doctor or another healthcare professional before taking supplements, especially if they have a health condition or are taking medication. Additionally, many supplements are unsuitable for use during pregnancy or while chestfeeding.

Furthermore, if someone has concerns about their cholesterol levels, they can consult a doctor about diet and lifestyle strategies that could manage cholesterol, improve overall health, and lower their risk of heart disease.

Learn more about lowering cholesterol through diet and exercise.

Several supplements, such as red yeast rice, phytosterols, and beta-glucans, may help people lower their cholesterol. A person can get advice from a doctor about whether supplements are suitable for taking either alone or with cholesterol-lowering medication such as statins.

In addition, people can help improve their cholesterol profile by maintaining a moderate weight, eating a nutritious diet, and participating in regular exercise or activity.