Introduction to Popular Cholesterol Lowering Supplements
Explanation of Cholesterol
Cholesterol is a waxy, fat-like substance found in your body and many foods. While the body needs cholesterol to build healthy cells, having high levels of cholesterol in the blood can increase the risk of heart disease. Cholesterol travels through the bloodstream in small packages called lipoproteins. These lipoproteins are classified into two main types: low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL, often referred to as “bad” cholesterol, can build up in the walls of arteries, leading to atherosclerosis, whereas HDL, or “good” cholesterol, helps remove LDL cholesterol from the arteries.
Importance of Managing Cholesterol Levels
Managing cholesterol levels is crucial for maintaining heart health and reducing the risk of cardiovascular diseases such as heart attack and stroke. High levels of LDL cholesterol can lead to the accumulation of plaque in the arteries, restricting blood flow and increasing the likelihood of heart-related complications. On the other hand, maintaining high levels of HDL cholesterol is associated with a lower risk of heart disease.
Role of Supplements in Lowering Cholesterol
While lifestyle changes such as a healthy diet, regular exercise, and medication prescribed by a healthcare professional are the primary methods for managing cholesterol levels, supplements can also play a role in cholesterol management. Certain supplements have been studied for their potential to lower cholesterol levels by various mechanisms, offering additional support in conjunction with other interventions.
I have personally found success using these supplements and intend to try Bergamot in the near future:
- Plant Sterols and Stenols
- Omega 3 Fish Oil
- Soluble Fiber – As a part of a healthy diet; daily oatmeal, fruits and vegetables.
- Red Yeast Rice and CoQ10
As always, be sure to check with your healthcare provider before adding any supplements to your diet, as there may be side effects or drug interactions.
Understanding Cholesterol-Lowering Supplements
Factors to consider when selecting a supplement
Before starting any supplement regimen, it’s essential to consider the safety and efficacy of the product. While some supplements have been well-studied and shown to be effective in lowering cholesterol levels, others may have limited evidence or potential risks associated with their use.
When choosing a cholesterol-lowering supplement, it’s essential to consider factors such as quality, purity, dosage, formulation, potential interactions with medications, and possible side effects. Additionally, consulting with a healthcare professional before starting any new supplement regimen is advisable, especially for individuals with underlying health conditions or those taking medications.
Types of Popular Supplements
1. Berberine: Berberine is a compound found in many plants, including European barberry, phellodendron, Oregon grape, goldenseal, and goldthread. Taking berberine supplements regularly appears to lower total cholesterol, “bad” cholesterol, and triglycerides in people with high cholesterol. It works differently from today’s standard cholesterol medications, so it may help treat people who are resistant to other cholesterol-lowering drugs.
2. Plant Sterols and Stanols: These compounds, found naturally in plants, have been shown to reduce LDL cholesterol levels by blocking the absorption of cholesterol in the intestine.
3. Omega-3 Fatty Acids: Omega-3 fatty acids, commonly found in fish oil supplements, have been studied for their potential to lower triglyceride levels and reduce the risk of heart disease.
4. Soluble Fiber: Soluble fiber, found in foods such as oats, barley, and fruits, can help lower LDL cholesterol levels by binding to cholesterol in the digestive tract and removing it from the body.
5. Red Yeast Rice: Red yeast rice is a traditional Chinese culinary and medicinal product that contains compounds known as monacolins, which inhibit cholesterol synthesis in the liver.
6. Bergamot: Bergamot is a type of citrus fruit native to Italy. Essential oils from the peel and extracts from the juice are used to make medicines. It is used for fighting high cholesterol and lipids in the blood.
Mechanisms of Action
Each type of cholesterol-lowering supplement works through specific mechanisms in the body to reduce cholesterol levels. These mechanisms may include blocking cholesterol absorption, inhibiting cholesterol synthesis, promoting cholesterol excretion, or improving overall cardiovascular health.
Review of Popular Cholesterol-Lowering Supplements
Berberine
Berberine, or berberine hydrochloride, is a compound in several plants. It may help to treat diabetes, high cholesterol, and high blood pressure, among other conditions.
High levels of low-density lipoprotein (LDL) cholesterol and triglycerides can increase the risk of heart disease and stroke. Some evidence suggests that berberine might help lower LDL cholesterol and triglyceride levels. According to one review, studies in both animals and humans indicate that berberine has cholesterol-lowering effects.
A literature review found that berberine combined with lifestyle changes is more effective than lifestyle changes alone in treating high cholesterol.
Researchers believe that the effects of berberine might be similar to those of cholesterol-lowering drugs, but without the same side effects.
Dosage and Quality
The suggested dose of berberine is 250 mg or 500 mg two or three times a day.
Potential Interactions and Side Effects
Berberine is considered safe for most people. However, it can have potential side effects, including:
- Digestive complications. For some, berberine can lead to digestion problems, such as constipation, diarrhea, and flatulence. However, these symptoms typically clear up within 4 weeks.
- Low blood pressure. Berberine’s blood pressure-lowering effects are helpful if you have high blood pressure. But for some people, this effect could cause blood pressure to drop too low, which can be dangerous.
Certain patients should not take Berberine:
- Pregnancy: Berberine should not be taken by pregnant mothers. It can cross the placenta and might cause harm to the fetus.
- Breast-feeding: It’s likely unsafe to take berberine if you are breast-feeding. Berberine can be transferred to the infant through breast milk, and it might cause harm.
- Children: It’s likely unsafe to give berberine to newborns and children. It can cause kernicterus, a rare type of brain damage that can occur in newborns who have severe jaundice. There isn’t enough reliable information to know if berberine is safe in older children.
Drug Interactions
There are several possible drug interactions. It is best to consult with your healthcare provider prior to taking Berberine.
Plant Sterols and Stanols
Plant sterols and stanols are naturally occurring compounds found in various plant-based foods such as vegetables, fruits, whole grains, and seeds, as well as certain vegetable oils. While these foods contain some amount of plant sterols, they typically don’t provide enough to significantly reduce LDL-C, commonly known as “bad” cholesterol. LDL-C elevation poses a risk factor for heart disease.
Including plant sterols and stanols in your diet can aid in lowering LDL-C levels. To achieve the recommended intake for cholesterol reduction, you may opt for foods fortified with added plant sterols and stanols or consider cholesterol-lowering supplements containing these compounds.
Research suggests that consuming at least 2-3 grams (2000-3000 mg) of plant sterols and stanols daily can lead to a reduction in LDL-C levels by approximately 7.5-12%. Achieving this intake level typically involves incorporating foods supplemented with added plant sterols and stanols into your meals or taking supplements alongside your regular diet. For optimal results, it’s advisable to consume these foods or supplements with meals at least twice a day.
The mechanism through which plant sterols and stanols lower cholesterol involves reducing the absorption of cholesterol in the intestines. By inhibiting cholesterol absorption, these compounds contribute to the overall reduction of LDL-C levels in the bloodstream, thereby supporting heart health.
Dosage and Quality
All cholesterol-lowering plant sterol and stanol supplements are not the same. Read the label to find out how many pills you need to take to reach 2-3 grams (2000-3000 mg) of each day. Look for the USP label on nutrition supplements to ensure quality, potency and purity.
Potential Interactions and Side Effects
· Plant sterols/stanols are generally safe for most healthy people. Side effects include diarrhea or fat in the stool. In people with sitosterolemia, high plant sterol levels have been associated with increased risk of premature atherosclerosis and plaque build-up in the arteries.
· There is no benefit with cholesterol lowering from taking in more than 3 grams of plant sterols and stanols each day.
· Eating plant sterols and stanols may lower the absorption of some vitamins. Be sure to eat at least 5 servings of fruits and vegetables each day, like spinach, kale, carrots, and sweet potatoes.
· Some studies suggest that phytosterols may be tied to a higher risk of heart disease for some users. However, more research is needed.
Omega-3 Fatty Acids
Fish oil is an excellent source of omega-3s, which is good for the heart and the brain. However, getting your omega-3s from fish is healthier. If you don’t eat fish, fish oil supplements are a good alternative.
Studies indicate that individuals who consume fish regularly tend to have lower incidences of heart disease. Fish consumption is associated with various benefits for heart health, particularly due to the presence of omega-3 fatty acids in fish oil.
Fish oil has been shown to have several positive effects on cardiovascular health, including:
- Lowering cholesterol levels
- Reducing triglyceride levels
- Decreasing blood pressure
- Preventing the formation of arterial plaques, which can lead to hardening of the arteries
Research suggests that omega-3 fatty acids, found in abundance in fish oil, may play a role in reducing the severity of heart disease and decreasing mortality rates associated with it. However, the evidence regarding the potential benefits of omega-3 in preventing strokes or reducing stroke-related mortality is still considered moderate, and further research is necessary to establish a clearer association in this regard.
Dosage and Quality
Omega-3s come in several forms, most commonly as triglycerides. Some fish oils that are more processed may contain omega-3 ethyl esters, which don’t seem to be absorbed as well.
Most of the health benefits associated with omega-3 fish oil supplements are attributed to two specific fatty acids: docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). However, the concentration of DHA and EPA can vary significantly among different omega-3 supplements. Therefore, it’s important to evaluate and compare supplements based on their levels of DHA and EPA, rather than focusing solely on the total fish oil content.
Although there isn’t an established recommended daily value (RDA) or adequate intake level (AI) specifically for DHA and EPA, most health experts suggest that healthy adults should aim for a daily intake of at least 250-500 mg of combined DHA and EPA. This recommendation ensures sufficient consumption of these beneficial fatty acids for optimal health benefits.
Omega-3s are prone to going rancid. Once they go bad, they’ll have a foul smell and become less potent or even harmful. Always check the date, smell the product, and see if it contains an antioxidant like vitamin E.
To make sure that you choose a safe, pure omega-3 fish oil supplement. Look for a supplement that’s certified by International Fish Oil Standards (IFOS).
Potential Interactions and Side Effects
Fish oil is likely safe for most people in doses of 3 grams or less daily. Taking more than 3 grams daily might increase the chance of bleeding. Side effects of fish oil may include heartburn, loose stools, and nosebleeds. These effects can often be minimized by taking fish oil supplements with meals or by freezing them prior to consumption.
Consuming large quantities of fish oil from dietary sources may pose safety concerns. Some types of fish may contain contaminants such as mercury and other chemicals. However, fish oil supplements typically undergo purification processes that remove these harmful substances, making them a safer alternative to dietary sources of fish oil.
Some people who are allergic to seafood such as fish might also be allergic to fish oil supplements.
Be cautious of potential interactions with blood-thinning medications and monitor for any gastrointestinal discomfort or allergic reactions.
Fish oil can interact with a number of medications, including, but not being limited to, the following:
· Medications for high blood pressure (Antihypertensive drugs) interacts with FISH OIL
· Birth control pills (Contraceptive drugs) interacts with FISH OIL
· Orlistat (Xenical, Alli) interacts with FISH OIL
· Cyclosporine (Neoral, Sandimmune) interacts with FISH OIL
· Sirolimus (Rapamune) interacts with FISH OIL
· Tacrolimus (Prograf) interacts with FISH OIL
If you are on medications, be sure to check their specific interactions with fish oil before use.
Soluble Fiber
Soluble fiber, found in various plant-based foods, is a type of fiber that remains undigested in the intestine. It has the unique ability to bind with cholesterol in the intestine and facilitate its removal from the body. Consuming 5 to 10 grams of soluble fiber daily has been shown to effectively reduce both total and LDL-cholesterol levels by approximately 5 to 11 points, and sometimes even more.
To ensure an adequate intake of soluble fiber, aim to incorporate foods into your diet that contain 1 to 3 grams of soluble fiber per serving. It’s important to note that increasing fiber intake may require consuming more water to aid in digestion and prevent any potential discomfort.
If for some reason you cannot include enough soluble fiber in your diet, you can resort to fiber supplements. Fiber supplements typically include two main types of fiber: soluble and insoluble fiber. Soluble fiber can be categorized further into non-viscous and viscous types.
Viscous soluble fiber undergoes a transformation into a thick gel-like substance upon contact with liquids in the digestive system. This gel-like property enables it to effectively bind with cholesterol in the small intestine. Consequently, cholesterol absorption into the bloodstream is inhibited, facilitating its removal through fecal elimination.
In contrast, insoluble fiber and non-viscous soluble fiber lack the ability to bind to cholesterol in the small intestine. You will want to check the label of your supplement to find out what kind of fiber it contains.
- Psyllium and Methylcellulose are two fiber supplements that are thought to lower LDL cholesterol levels.
- Flax and chia seeds are also thought to be helpful for heart health. You will want ground flax seeds as they are better absorbed than whole seeds.
Dosage and Quality
The USDA recommends adults over age 50 consume 23 grams of fiber daily for women, and 28 grams a day for men. It is preferable to achieve these levels through a healthy, high fiber diet. If you are unable to get enough fiber into your diet, taking a supplement may seem like a good solution. However, you should not rely exclusively on supplements for fiber.
Determine the gap in your diet to determine a dosage of soluble fiber for cholesterol management and for the sake of convenience, choose formulations that are easy to mix into foods or beverages.
Potential Interactions and Side Effects
Fiber supplements are widely considered to be both safe and beneficial for health. However, they can cause potential side effects, such as:
· Gas
· Cramping
· Bloating
· Diarrhea or constipation if taken in excess
· Lowering of blood sugar levels, which may necessitate adjustments to diabetes medication dosages
Some side effects, like gas, cramping, and bloating, often decrease as your body gets used to the higher fiber intake.
Fiber supplements can increase bulk in the intestinal tract, which may interfere with the absorption of certain medications or supplements, including:
- Bile acid sequestrants such as Questran (cholestyramine) and Colestid (colestipol)
- Diabetes medications like Diabeta (glyburide) and Glucophage (metformin)
- Tricyclic antidepressants such as Elavil (amitriptyline) and Tofranil (imipramine)
- Tegretol (carbamazepine), an anti-seizure drug
These drug interactions can vary in significance. Therefore, it is crucial to consult with a healthcare provider before starting fiber supplements to ensure they are safe and appropriate for you.
Red Yeast Rice
Several studies have demonstrated that red yeast rice can lower LDL (“bad”) cholesterol levels, which in turn reduces the risk of heart disease. Red yeast (Monascus purpureus) works by inhibiting an enzyme in the body that is involved in cholesterol production.
Red yeast rice contains compounds called monacolins, one of which is monacolin K. Monacolin K has the same chemical structure as lovastatin (Mevacor), a prescription cholesterol-lowering drug. Some researchers believe this similarity explains why red yeast rice is effective at lowering cholesterol. However, others argue that the amount of monacolin in red yeast rice is less than that in the prescription drug, suggesting that other substances in red yeast rice may also contribute to its cholesterol-lowering effects. Further research is needed to clarify these mechanisms.
Quality and Purity
Ensure that red yeast rice supplements are standardized for monacolin content and free from contaminants such as citrinin.
Dosage and Formulation: Follow the recommended dosage guidelines provided by healthcare professionals or product labels, and choose formulations that are well-tolerated.
Potential Interactions and Side Effects: I would recommend this article, from Mount Sinai, to read more about side effects and drug interactions.
Pros and Cons: I would recommend this article to cover fully the pros and cons. I take this supplement, but do take CoQ10 as well as statins can lower CoQ10 levels in the body.
Bergamot
The bergamot, a citrus fruit primarily found in Southern Italy’s Calabria region, has a long history in traditional Italian medicine for treating fever and infections.
Recently, research has found the fruit may provide health benefits due to its antioxidant and anti-inflammatory actions, demonstrating its potentially beneficial cholesterol-lowering properties.
Clinical trials have demonstrated that orally administered bergamot in various forms may reduce total cholesterol and low-density lipoprotein cholesterol. Lab studies suggest that bergamot’s polyphenols may influence specific enzymes related to cholesterol metabolism. 1
A systematic review of 12 studies found that bergamot supplementation resulted in the following:
- Total cholesterol decrease: ranged from 12.3% to 31.3%
- LDL cholesterol decrease: ranged from 7.6% to 40.8%
- Triglycerides decrease: ranged from 11.5% to 39.5%
Quality and Purity: Look for bergamot supplements that are standardized for polyphenol content and free from contaminants.
Dosage and Formulation
Bergamot can be taken as a juice, fruit extract or supplement. Dosages in studies have varied widely, from 150 mg to 1500 mg per day. Therefore, follow the recommended dosage guidelines provided by healthcare professionals or product labels.
Potential Interactions and Side Effects
Some people experience side effects like skin sensitivity to sunlight, dizziness, muscle cramps, and heartburn when they take bergamot with food.
Bergamot may cause your blood sugar to drop. If you have diabetes, your blood sugar might reach unsafe levels. It’s important to monitor those levels if you choose to use bergamot supplements.
Bergamot can interact with medications. Be sure to check with your healthcare provider for specifics.
Even if you don’t have diabetes, bergamot could make it harder for doctors to control your blood sugar during surgery. Experts recommend that you stop using bergamot supplements two weeks before you have surgery.
Be cautious of potential interactions with medications, particularly statins, and monitor for any adverse reactions such as gastrointestinal upset or drug interactions.
Pros and Cons
Certain patients are advised to abstain from bergamot supplements, such as pregnant or nursing women, children, those sensitive to sunlight, and those taking certain medications, especially statins.
Conclusion
Recap of Top-Rated Cholesterol-Lowering Supplements
Healthy eating and a healthy lifestyle are the key to heart health. This includes a high fiber, whole foods diet which minimizes the use of processed foods. Of course, exercise is also key to maintaining optimal health.
For those that follow a healthy lifestyle, but still suffer from high cholesterol, it is imperative you consult with your primary health care provider. If your cholesterol levels are not high enough to warrant the use of statins, you may want to consider natural supplements.
Importance of Consulting a Healthcare Professional
Be sure to consult with your healthcare professional before starting any new supplement regimen, especially for individuals with pre-existing health conditions or those taking medications that may interact with cholesterol-lowering supplements. Many doctors today are willing to looking at natural supplements as a strategy to support heart health.
Final Recommendations for Managing Cholesterol Levels
The best strategy for managing cholesterol levels is an active, healthy lifestyle. This includes getting plenty of exercise and eating a low fat, whole food diet, low in saturated fats. However, supplementing the diet with effective cholesterol lowering supplements can be a capstone to a healthy lifestyle and an integral part of a comprehensive approach to cardiovascular health. Consider selecting a supplement that is natural and has minimal of side effects as a place to start.
Expert Sources
- Is Berberine Good for the Heart?
- Phytosterols: What Are They, and Do They Have Downsides?
- Omega 3 Supplement Guide: What to Buy and Why
- Fish Oil: Uses, Side Effects and More
- Adding Soluble Fiber to Lower Your Cholesterol
- Do Fiber Supplements Lower Cholesterol Levels?
- Red Yeast Rice – Mount Sinai
1. Can Bergamot Lower Cholesterol?