High Cholesterol - Supplements

About this treatment

What Are "Star" Ratings?

a7_3star Reliable and relatively consistent scientific data showing a substantial health benefit.

a7_2star Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

a7_1star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

Supplement	Amount	Why
Beta-Glucan	2,900 to 15,000 mg daily	Beta-glucan is a type of soluble fiber that has been shown to lower total and LDL (“bad”) cholesterol and raise HDL (“good”) cholesterol.
Beta-Glucan 2,900 to 15,000 mg daily Beta-glucan is a type of soluble fiber molecule derived from the cell wall of baker’s yeast, oats and barley, and many medicinal mushrooms, such as maitake. Beta-glucan is the key factor for the cholesterol-lowering effect of oat bran.¹³⁷^{, 138}^{, 139}^{, 140} As with other soluble-fiber components, the binding of cholesterol (and bile acids) by beta-glucan and the resulting elimination of these substances in the feces is very helpful for reducing blood cholesterol.¹⁴¹^{, 142}^{, 143} Results from a number of double-blind trials with either oat- or yeast-derived beta-glucan indicate typical reductions, after at least four weeks of use, of approximately 10% for total cholesterol and 8% for LDL (“bad”) cholesterol, with elevations in HDL (“good”) cholesterol ranging from zero to 16%.¹⁴⁴^{, 145}^{, 146}^{, 147}^{, 148} For lowering cholesterol levels, the amount of beta-glucan used has ranged from 2,900 to 15,000 mg per day. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Chromium	200 to 500 mcg daily	Chromium supplementation has reduced total cholesterol and LDL cholesterol and increased HDL cholesterol in double-blind and other controlled trials.
Chromium 200 to 500 mcg daily Chromium supplementation has reduced total cholesterol,¹⁴⁹^{, 150} LDL cholesterol¹⁵¹^{, 152} and increased HDL cholesterol¹⁵³^{, 154} in double-blind and other controlled trials, although other trials have not found these effects.¹⁵⁵^{, 156} One double-blind trial found that high amounts of chromium (500 mcg per day) in combination with daily exercise was highly effective, producing nearly a 20% decrease in total cholesterol levels in just 13 weeks.¹⁵⁷ Brewer’s yeast, which contains readily absorbable and biologically active chromium, has also lowered serum cholesterol.¹⁵⁸ People with higher blood levels of chromium appear to be at lower risk for heart disease.¹⁵⁹ A reasonable and safe intake of supplemental chromium is 200 mcg per day. People wishing to use brewer’s yeast as a source of chromium should look for products specifically labeled “from the brewing process” or “brewer’s yeast,” since most yeast found in health food stores is not brewer’s yeast, and does not contain chromium. Optimally, true brewer’s yeast contains up to 60 mcg of chromium per tablespoon, and a reasonable intake is 2 tablespoons per day. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Fenugreek	10 to 30 grams three times per day with meals	Fenugreek seeds contain compounds that inhibit both cholesterol absorption in the intestines and cholesterol production by the liver.
Fenugreek 10 to 30 grams three times per day with meals Fenugreek seeds contain compounds known as steroidal saponins that inhibit both cholesterol absorption in the intestines and cholesterol production by the liver.¹⁶⁰ Dietary fiber may also contribute to fenugreek’s activity. Multiple human trials (some double-blind) have found that fenugreek may help lower total cholesterol in people with moderate atherosclerosis or those having insulin-dependent or non-insulin-dependent diabetes.¹⁶¹^{, 162}^{, 163} One human double-blind trial has also shown that defatted fenugreek seeds may raise levels of beneficial HDL cholesterol.¹⁶⁴ One small preliminary trial found that either 25 or 50 grams per day of defatted fenugreek seed powder significantly lowered serum cholesterol after 20 days.¹⁶⁵ Germination of the fenugreek seeds may improve the soluble fiber content of the seeds, thus improving their effect on cholesterol.¹⁶⁶ Fenugreek powder is generally taken in amounts of 10 to 30 grams three times per day with meals. What Else Is This Supplement Used For?

Supplement	Amount	Why
Glucomannan	4 to 13 grams daily	Glucomannan is a water-soluble dietary fiber that has been shown to significantly reduce total blood cholesterol, LDL cholesterol, and triglycerides, and to raise HDL cholesterol.
Glucomannan 4 to 13 grams daily Glucomannan is a water-soluble dietary fiber that is derived from konjac root. Controlled¹⁶⁷^{, 168} and double-blind¹⁶⁹^{, 170} trials have shown that supplementation with glucomannan significantly reduced total blood cholesterol, LDL cholesterol, and triglycerides, and in some cases raised HDL cholesterol. Effective amounts of glucomannan for lowering blood cholesterol have been 4 to 13 grams per day. What Else Is This Supplement Used For?

Supplement	Amount	Why
HMB	3 grams daily	Supplementing with HMB, or beta hydroxy-beta-methylbutyrate, is an effective way to lower total and LDL cholesterol.
HMB 3 grams daily The combined results of nine double-blind trials indicate that supplementing with HMB, or beta hydroxy-beta-methylbutyrate, effectively lowers total and LDL cholesterol.¹⁷¹ All trials used 3 grams per day, taken for three to eight weeks. What Else Is This Supplement Used For?

Supplement	Amount	Why
Pantothenic Acid	300 mg pantethine taken two to four times per day	Pantethine, a byproduct of vitamin B5 (pantothenic acid), may help reduce the amount of cholesterol made by the body.
Pantothenic Acid 300 mg pantethine taken two to four times per day Pantethine, a byproduct of vitamin B5 (pantothenic acid), may help reduce the amount of cholesterol made by the body. Several preliminary¹⁷²^{, 173}^{, 174}^{, 175}^{, 176} and two controlled¹⁷⁷^{, 178} trials have found that pantethine (300 mg taken two to four times per day) significantly lowers serum cholesterol levels and may also increase HDL. However, one double-blind trial in people whose high blood cholesterol did not change with diet and drug therapy, found that pantethine was also not effective.¹⁷⁹ Common pantothenic acid has not been reported to have any effect on high blood cholesterol. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Psyllium	5 to 10 grams per day with meals	Psyllium has been shown to be effective at lowering total and LDL (“bad”) cholesterol.
Psyllium 5 to 10 grams per day with meals Use of psyllium has been extensively studied as a way to reduce cholesterol levels. An analysis of all double-blind trials in 1997 concluded that a daily amount of 10 grams psyllium lowered cholesterol levels by 5% and LDL cholesterol by 9%.¹⁸⁰ Since then, a large controlled trial found that use of 5.1 grams of psyllium two times per day significantly reduced serum cholesterol as well as LDL-cholesterol.¹⁸¹ Generally, 5 to 10 grams of psyllium are added to the diet per day to lower cholesterol levels. The combination of psyllium and oat bran may also be effective at lowering LDL cholesterol.¹⁸² What Else Is This Supplement Used For?

Supplement	Amount	Why
Red Yeast Rice	1.2 to 2.4 grams (5 to 10 mg of monacolins) daily in divided amounts	One of the ingredients in red yeast rice appears to block the production of cholesterol in the liver.
Red Yeast Rice 1.2 to 2.4 grams (5 to 10 mg of monacolins) daily in divided amounts Researchers have determined that one of the ingredients in red yeast rice, called monacolin K, inhibits the production of cholesterol by stopping the action of the key enzyme in the liver (HMG-CoA reductase) that is responsible for manufacturing cholesterol.¹⁸³ Monacolin K is the same compound as lovastatin (Mevacor), a prescription drug used to treat high cholesterol. However, the amount of monacolin K in red yeast rice is small (5 mg per 2.4 grams of red yeast rice) when compared with the 20 to 40 mg of lovastatin typically used to lower cholesterol levels.¹⁸⁴ It appears that monacolin compounds present in red yeast rice work together with monacolin K to produce a greater cholesterol-lowering effect than would be expected from the small amount of monacolin K alone. The red yeast rice used in various studies was a proprietary product called Cholestin, which contains ten different monacolins. Note: Cholestin has been banned in the United States, as a result of a lawsuit alleging patent infringement. Other red yeast rice products currently on the market differ from Cholestin in their chemical makeup. None contain the full complement of ten monacolin compounds that are present in Cholestin, and some contain a potentially toxic fermentation product called citrinin.¹⁸⁵ Despite these concerns, other red yeast rice products are being widely used and both anecdotal reports and clinical research suggest that they have a similar safety and efficacy profile as that of Cholestin.¹⁸⁶ ^{, 187} ^{, 188} What Else Is This Supplement Used For?

Supplement	Amount	Why
Sitostanol	1.7 grams daily	Sitostanol, a synthetic molecule related to beta-sitosterol, is available in margarine form and has also been shown to lower cholesterol levels.
Sitostanol 1.7 grams daily A synthetic molecule related to beta-sitosterol, sitostanol, is available in a special margarine and has also been shown to lower cholesterol levels. In one controlled trial, supplementation with 1.7 grams per day of a plant-sterol product containing mostly sitostanol, combined with dietary changes, led to a dramatic 24% drop in LDL (“bad”) cholesterol compared with only a 9% decrease in the diet-only part of the trial.¹⁸⁹Other controlled and double-blind trials have confirmed these results.¹⁹⁰ ^{, 191} ^{, 192} ^{, 193} ^{, 194} ^{, 195} ^{, 196} A review of double-blind trials on sitostanol found that a reduction in the risk of heart disease of about 25% may be expected from use of sitostanol-containing spreads, a larger clinical effect than that produced by people reducing their saturated fat intake.¹⁹⁷ Supplementation with sitostanol in the amount of 1.8 grams per day for six weeks has also been shown to enhance the cholesterol-lowering effect of statin drugs.¹⁹⁸

Supplement	Amount	Why
Soy	25 grams soy protein per day	Soy supplementation has been shown to lower cholesterol. Soy contains isoflavones, which are believed to be soy’s main cholesterol-lowering ingredients.
Soy 25 grams soy protein per day Soy supplementation has been shown to lower cholesterol in humans.¹⁹⁹ Soy is available in foods such as tofu, miso, and tempeh and as a supplemental protein powder. Soy contains isoflavones, naturally occurring plant components that are believed to be soy’s main cholesterol-lowering ingredients. A controlled trial showed that soy preparations containing high amounts of isoflavones effectively lowered total cholesterol and LDL (“bad”) cholesterol, whereas low-isoflavone preparations (less than 27 mg per day) did not.²⁰⁰ However, supplementation with either soy²⁰¹ or non-soy isoflavones (from red clover)²⁰² in pill form failed to reduce cholesterol levels in a group of healthy volunteers, suggesting that isoflavone may not be responsible for the cholesterol-lowering effects of soy. Further trials of isoflavone supplements in people with elevated cholesterol, are needed to resolve these conflicting results. In a study of people with high cholesterol levels, a soy preparation that contained soy protein, soy fiber, and soy phospholipids lowered cholesterol levels more effectively than isolated soy protein.²⁰³ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Vitamin B3	1,500 to 3,000 mg daily under a doctor's supervision	High amounts (several grams per day) of niacin, a form of vitamin B3, have been shown to lower cholesterol.
Vitamin B3 1,500 to 3,000 mg daily under a doctor's supervision High amounts (several grams per day) of niacin, a form of vitamin B3, lower cholesterol, an effect recognized in the approval of niacin as a prescription medication for high cholesterol.²⁰⁴ The other common form of vitamin B3—niacinamide—does not affect cholesterol levels. Some niacin preparations have raised HDL cholesterol better than certain prescription drugs.²⁰⁵ Some cardiologists prescribe 3 grams of niacin per day or even higher amounts for people with high cholesterol levels. At such intakes, acute symptoms (flushing, headache, stomachache) and chronic symptoms (liver damage, diabetes, gastritis, eye damage, possibly gout) of toxicity may be severe. Many people are not able to continue taking these levels of niacin due to discomfort or danger to their health. Therefore, high intakes of niacin must only be taken under the supervision of a doctor. Symptoms caused by niacin supplements, such as flushing, have been reduced with sustained-release (also called “time-release”) niacin products. However, sustained-release forms of niacin have caused significant liver toxicity and, though rarely, liver failure.²⁰⁶ ^{, 207} ^{, 208} ^{, 209} ^{, 210} One partial time-release (intermediate-release) niacin product has lowered LDL cholesterol and raised HDL cholesterol without flushing, and it also has acted without the liver function abnormalities typically associated with sustained-release niacin formulations.²¹¹ However, this form of niacin is available by prescription only. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Vitamin C	1,000 mg daily	Vitamin C appears to protect LDL cholesterol from damage, and in some trials, cholesterol levels have fallen when people supplement with vitamin C.
Vitamin C 1,000 mg daily Vitamin C appears to protect LDL cholesterol from damage.²¹² In some clinical trials, cholesterol levels have fallen when people with elevated cholesterol supplement with vitamin C.²¹³ Some studies report that decreases in total cholesterol occur specifically in LDL cholesterol.²¹⁴ Doctors sometimes recommend 1 gram per day of vitamin C. A review of the disparate research concerning vitamin C and heart disease, however, has suggested that most protection against heart disease from vitamin C, is likely to occur with as little as 100 mg per day.²¹⁵ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Artichoke	Read details for more information	Artichoke has moderately lowered cholesterol and triglycerides in some trials.
Artichoke Read details for more information Artichoke has moderately lowered cholesterol and triglycerides in some,²¹⁶^{, 217} but not all,²¹⁸ human trials. One double-blind trial found that 900 mg of artichoke extract per day significantly lowered serum cholesterol and LDL cholesterol but did not decrease triglycerides or raise HDL cholesterol.²¹⁹ Cholesterol-lowering effects occurred when using 320 mg of standardized leaf extract taken two to three times per day for at least six weeks. What Else Is This Supplement Used For?

Supplement	Amount	Why
Asteraceae	15 to 20 drops of tincture twice per day for six months	In one trial, people who took a tincture of Achillea wilhelmsii had significant reductions in total cholesterol, LDL cholesterol, and triglycerides and an increase in HDL cholesterol.
Asteraceae 15 to 20 drops of tincture twice per day for six months In a double-blind trial, people with moderately high cholesterol took a tincture of Achillea wilhelmsii, an herb used in traditional Persian medicine.²²⁰ Participants in the trial used 15 to 20 drops of the tincture twice daily for six months. At the end of the trial, participants experienced significant reductions in total cholesterol, LDL cholesterol and triglycerides, as well as an increase in HDL cholesterol compared to those who took placebo. No adverse effects were reported.

Supplement	Amount	Why
Berberine	500 mg twice per day	Berberine, a compound found in certain herbs such as goldenseal, barberry, and Oregon grape, has been found to lower serum cholesterol levels.
Berberine 500 mg twice per day Berberine, a compound found in certain herbs such as goldenseal, barberry, and Oregon grape, has been found to lower serum cholesterol levels. In a study of people with high cholesterol levels, 500 mg of berberine taken twice a day for three months lowered the average cholesterol level by 29%. No significant side effects were reported, except for mild constipation.²²¹

Supplement	Amount	Why
Beta-Sitosterol	0.8 to 3.2 grams daily	Beta-sitosterol blocks cholesterol absorption and has been shown in studies to reduce blood levels of cholesterol.
Beta-Sitosterol 0.8 to 3.2 grams daily Soy contains phytosterols. One such molecule, beta-sitosterol, is available as a supplement. Beta-sitosterol alone, and in combination with similar plant sterols, has been shown to reduce blood levels of cholesterol in preliminary and controlled trials.²²² ^{, 223} ^{, 224} ^{, 225} This effect may occur because beta-sitosterol blocks absorption of cholesterol.²²⁶ In studying the effects of 0.8, 1.6, and 3.2 grams of plant sterols per day, one double-blind trial found that higher intake of sterols tended to result in greater reduction in cholesterol, though the differences between the effects of these three amounts were not statistically significant.²²⁷ What Else Is This Supplement Used For?

Supplement	Amount	Why
Calcium	800 to 1,000 mg daily	Some trials have shown that supplementing with calcium reduces cholesterol levels.
Calcium 800 to 1,000 mg daily Caution: Calcium supplements should be avoided by prostate cancer patients. Some preliminary²²⁸ and double-blind²²⁹ ^{, 230} trials have shown that supplemental calcium reduces cholesterol levels. Possibly the calcium is binding with and preventing the absorption of dietary fat.²³¹ However, other research has found no substantial or statistically significant effects of calcium supplementation on total cholesterol or HDL (“good”) cholesterol.²³² Reasonable supplemental levels are 800 to 1,000 mg per day. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Charcoal	4 to 32 grams per day	Activated charcoal has the ability to attach (adsorb) cholesterol and bile acids present in the intestine, preventing their absorption.
Charcoal 4 to 32 grams per day Activated charcoal has the ability to adsorb (attach to) cholesterol and bile acids present in the intestine, preventing their absorption.²³³ ^{, 234} Reducing the absorption of bile acids results in increased cholesterol breakdown by the liver. In controlled studies of people with high cholesterol, activated charcoal reduced total- and LDL-cholesterol levels, when given in amounts from 4 to 32 grams per day. Larger amounts were more effective: reductions in total and LDL cholesterol were 23% and 29%, respectively, with 16 grams daily, and 29% and 41% with 32 grams daily.²³⁵ Similar results were reported in other controlled²³⁶ and preliminary²³⁷ studies using 16 to 24 grams per day, but one small double-blind trial found no effect of either 15 or 30 grams per day in patients with high cholesterol.²³⁸ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Copper	3 to 4 mg daily	Copper deficiency has been linked to high blood cholesterol, supplementing with it may correct a deficiency and lower cholesterol.
Copper 3 to 4 mg daily Deficiency of the trace mineral copper has been linked to high blood cholesterol.²³⁹ ^{, 240} In a controlled trial, daily supplementation with 3 to 4 mg of copper for eight weeks decreased blood levels of total cholesterol and LDL cholesterol, in a group of people over 50 years of age.²⁴¹ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Cranberry	500 mg three times per day after meals	Supplementing with a cranberry extract has been shown to help lower total and LDL ("bad") cholesterol in people with type 2 diabetes taking hypoglycemic medication.
Cranberry 500 mg three times per day after meals In a double-blind trial, supplementation with a cranberry extract (500 mg three times per day after meals) for 12 weeks significantly lowered serum total cholesterol and LDL cholesterol levels compared with placebo in patients with type 2 diabetes who were taking oral hypoglycemic medication.²⁴² What Else Is This Supplement Used For?

Supplement	Amount	Why
Garlic	600 to 900 mg a day of a standardized herbal extract	Taking garlic may help lower cholesterol and prevent hardening of the arteries.
Garlic 600 to 900 mg a day of a standardized herbal extract Reports on many double-blind garlic trials performed through 1998 suggested that cholesterol was lowered by an average of 9 to 12% and triglycerides by 8 to 27% over a one-to-four month period.²⁴³ ^{, 244} ^{, 245} Most of these trials used 600 to 900 mg per day of garlic supplements. More recently, however, several double-blind trials have found garlic to have minimal success in lowering cholesterol and triglycerides.²⁴⁶ ^{, 247} ^{, 248} ^{, 249} ^{, 250} One negative trial has been criticized for using a steam-distilled garlic “oil” that has no track record for this purpose,²⁵¹ while the others used the same standardized garlic products as the previous positive trials. Based on these findings, the use of garlic should not be considered a primary approach to lowering high cholesterol and triglycerides.²⁵²Part of the confusion may result from differing effects from dissimilar garlic products. In most but not all trials, aged garlic extracts and garlic oil (both containing no allicin) have not lowered cholesterol levels in humans.²⁵³ ^{, 254} Therefore, neither of these supplements can be recommended at this time for cholesterol lowering. Odor-controlled, enteric-coated tablets standardized for allicin content are available and, in some trials, appear more promising.²⁵⁵ Doctors typically recommend 900 mg per day (providing 5,000 to 6,000 mcg of allicin), divided into two or three admininstrations. What Else Is This Supplement Used For?

Supplement	Amount	Why
Green Tea	3 cups daily	Green tea has been shown to lower total cholesterol levels and improve people’s cholesterol profile.
Green Tea 3 cups daily Green tea has been shown to lower total cholesterol levels and improve people’s cholesterol profile, decreasing LDL cholesterol and increasing HDL cholesterol according to preliminary studies.²⁵⁶^{, 257}^{, 258}^{, 259} However, not all trials have found that green tea intake lowers lipid levels.²⁶⁰ Much of the research documenting the health benefits of green tea is based on the amount of green tea typically drunk in Asian countries—about three cups per day, providing 240 to 320 mg of polyphenols. What Else Is This Supplement Used For?

Supplement	Amount	Why
Green Tea Enriched with Theaflavins	75 mg of theaflavins, 150 mg of green tea catechins, and 150 mg of other tea polyphenols daily	An extract of green tea, enriched with a compound present in black tea (theaflavins), has been found to lower serum cholesterol in people with moderately high cholesterol levels.
Green Tea Enriched with Theaflavins 75 mg of theaflavins, 150 mg of green tea catechins, and 150 mg of other tea polyphenols daily An extract of green tea, enriched with a compound present in black tea (theaflavins), has been found to lower serum cholesterol in a double-blind study of people with moderately high cholesterol levels. The average reduction in total serum cholesterol during the 12-week study was 11.3%, and the average reduction in LDL cholesterol was 16.4%. The extract used in this study provided daily 75 mg of theaflavins, 150 mg of green tea catechins, and 150 mg of other tea polyphenols.

Supplement	Amount	Why
Guggul	25 mg guggulsterones three times per day	Guggul appears to be helpful in lowering cholesterol and raising HDL (“good”) cholesterol.
Guggul 25 mg guggulsterones three times per day Guggul, a mixture of substances taken from a plant, is an approved treatment for elevated cholesterol in India and has been a mainstay of the Ayurvedic approach to preventing atherosclerosis. One double-blind trial studying the effects of guggul reported that serum cholesterol dropped by 17.5%.²⁶¹ In another double-blind trial comparing guggul to the drug clofibrate, the average fall in serum cholesterol was slightly greater in the guggul group; moreover, HDL cholesterol rose in 60% of people responding to guggul, while clofibrate did not elevate HDL.²⁶² A third double-blind trial found significant changes in total and LDL cholesterol levels, but not in HDL.²⁶³ However, in another double-blind trial, supplementation with guggul for eight weeks had no effect on total serum cholesterol, but significantly increased LDL-cholesterol levels, compared with a placebo.²⁶⁴ Daily intakes of guggul are based on the amount of guggulsterones in the extract. The recommended amount of guggulsterones is 25 mg taken three times per day. Most extracts contain 5 to 10% guggulsterones, and doctors familiar with their use usually recommend taking guggul for at least 12 weeks before evaluating its effect. What Else Is This Supplement Used For?

Supplement	Amount	Why
Inositol Hexaniacinate (Vitamin B3)	500 to 1,000 mg of inositol hexaniacinate three times daily under medical supervision	Inositol hexaniacinate, a special form of vitamin B3, has been reported to lower serum cholesterol, and apparently without the toxicity of high levels of niacin.
Inositol Hexaniacinate (Vitamin B3) 500 to 1,000 mg of inositol hexaniacinate three times daily under medical supervision In an attempt to avoid the side effects of niacin, alternative health practitioners increasingly use inositol hexaniacinate, recommending 500 to 1,000 mg, taken three times per day, instead of niacin.²⁶⁵ ^{, 266} This special form of niacin has been reported to lower serum cholesterol but so far has not been found to cause significant toxicity.²⁶⁷ Unfortunately, compared with niacin, far fewer investigations have studied the possible positive or negative effects of inositol hexaniacinate. As a result, people using inositol hexaniacinate should not take it without the supervision of a doctor, who will evaluate whether it is helpful (by measuring cholesterol levels) and will make sure that toxicity is not occurring (by measuring liver enzymes, uric acid and glucose levels, and by taking medical history and doing physical examinations).

Supplement	Amount	Why
Krill Oil	1 to 3 grams krill oil daily	In one study of people with high cholesterol or triglycerides, supplementing with krill oil lowered total cholesterol, LDL cholesterol, and triglycerides, and increased HDL-cholesterol.
Krill Oil 1 to 3 grams krill oil daily In a double-blind study of people with elevated blood levels of cholesterol and triglycerides, supplementing with 1 to 3 grams per day of krill oil from Antarctic krill (a zooplankton crustacean) for three months decreased total and LDL cholesterol levels and increased HDL cholesterol levels. Krill oil was significantly more effective than either a placebo or small amounts of regular fish oil containing 900 mg per day of omega-3 fatty acids.²⁶⁸ What Else Is This Supplement Used For?

Supplement	Amount	Why
Royal Jelly	50 to 100 mg daily	Supplementing with royal jelly may lower cholesterol levels.
Royal Jelly 50 to 100 mg daily Royal jelly has prevented the cholesterol-elevating effect of nicotine²⁶⁹ and has lowered serum cholesterol in animal studies.²⁷⁰ Preliminary human trials have also found that royal jelly may lower cholesterol levels.²⁷¹^{, 272} An analysis of cholesterol-lowering trials shows that 50 to 100 mg per day is the typical amount used in such research.²⁷³ What Else Is This Supplement Used For?

Supplement	Amount	Why
Tocotrienols	200 mg daily	Tocotrienols may lower cholesterol levels. Tocotrienols inhibited cholesterol synthesis in test-tube studies, and two trials found that tocotrienols reduced cholesterol levels by 13–15%.
Tocotrienols 200 mg daily Tocotrienols, a group of food-derived compounds that resemble vitamin E, may lower blood levels of cholesterol, but evidence is conflicting. Although tocotrienols inhibited cholesterol synthesis in test-tube studies,²⁷⁴^{, 275} human trials have produced contradictory results. Two double-blind trials found that 200 mg per day of either gamma-tocotrienol²⁷⁶ or total tocotrienols²⁷⁷ were more effective than placebo, reducing cholesterol levels by 13–15%. However, in another double-blind trial, 200 mg of tocotrienols per day failed to lower cholesterol levels,²⁷⁸ and a fourth double-blind trial found 140 mg of tocotrienols and 80 mg of vitamin E (d-alpha-tocopherol) daily resulted in no changes in total cholesterol, LDL cholesterol, or HDL cholesterol levels.²⁷⁹ What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Alfalfa	Refer to label instructions	Saponins in alfalfa seeds may block cholesterol absorption and prevent the formation of atherosclerotic plaques.
Alfalfa Animal studies indicate that saponins in alfalfa seeds may block absorption of cholesterol and prevent the formation of atherosclerotic plaques.²⁸⁰ However, consuming the large amounts of alfalfa seeds (80 to 120 grams per day) needed to supply high doses of these saponins may potentially cause damage to red blood cells in the body.²⁸¹ What Else Is This Supplement Used For?

Supplement	Amount	Why
Chitosan	Refer to label instructions	Chitosan is a fiber-like supplement that has been shown to lower cholesterol and raise HDL (“good”) cholesterol).
Chitosan The fiber-like supplement chitosan appears to reduce the absorption of bile acids or cholesterol; either of these effects may cause a lowering of blood cholesterol. ²⁸² This effect has been repeatedly demonstrated in animals, and a preliminary human study showed that 3 to 6 grams per day of chitosan taken for two weeks resulted in a 6% drop in cholesterol and a 10% increase in HDL ("good") cholesterol.²⁸³ Another preliminary trial showed a 43% lowering of total cholesterol in people being treated for kidney failure with dialysis who took 4 grams per day of chitosan for 12 weeks. These people also appeared to have improved kidney function and less severe anemia after chitosan treatment. ²⁸⁴ In a double-blind trial, however, administration of 2.4 grams of chitosan per day for three months to people with high cholesterol had no effect on their cholesterol levels. ²⁸⁵ Another study also found no cholesterol-lowering effect of chitosan when taken in amounts up to 6.75 grams per day for 8 weeks.²⁸⁶ Chitosan in large amounts, given with vitamin C, has been shown to reduce dietary fat absorption in animals fed a high-fat diet.²⁸⁷ ^{, 288} ^{, 289} However, the absorption of minerals and fat-soluble vitamins was also reduced by feeding animals large amounts of chitosan.²⁹⁰ In studies in humans, chitosan did not reduce the absorption of dietary fat.²⁹¹ ^{, 292} What Else Is This Supplement Used For?

Supplement	Amount	Why
Chondroitin Sulfate	Refer to label instructions	Chondroitin sulfate has lowered serum cholesterol levels in preliminary trials.
Chondroitin Sulfate Chondroitin sulfate has lowered serum cholesterol levels in preliminary trials.²⁹³^{, 294} Years ago, this supplement dramatically reduced the risk of heart attacks in a controlled, six-year follow-up of people with heart disease.²⁹⁵ The few doctors aware of these older clinical trials sometimes tell people with a history of heart disease or elevated cholesterol levels, to take approximately 500 mg of chondroitin sulfate three times per day. What Else Is This Supplement Used For?

Supplement	Amount	Why
Creatine Monohydrate	Refer to label instructions	One trial found that supplementing with creatine significantly lowered serum total cholesterol and triglycerides in people with high cholesterol.
Creatine Monohydrate A double-blind trial found that 20 grams per day of creatine taken for five days, followed by ten grams per day for 51 days, significantly lowered serum total cholesterol and triglycerides, but did not change either LDL or HDL cholesterol, in both men and women.²⁹⁶ However, another double-blind trial found no change in any of these blood levels in trained athletes using creatine during a 12-week strength training program.²⁹⁷ Creatine supplementation in this negative trial was lower—only 5 grams per day were taken for the last 11 weeks of the study. What Else Is This Supplement Used For?

Supplement	Amount	Why
Fo-Ti	Refer to label instructions	Preliminary Chinese research has found that high doses of the herb fo-ti may lower cholesterol levels.
Fo-Ti Preliminary Chinese research has found that high doses (12 grams per day) of the herb fo-ti may lower cholesterol levels. Double-blind or other controlled trials are needed to determine fo-ti’s use in lowering cholesterol. A tea may be made from processed roots by boiling 3 to 5 grams in a cup of water for 10 to 15 minutes. Three or more cups should be drunk each day. Fo-ti tablets containing 500 mg each are also available. Doctors may suggest taking five of these tablets three times per day. What Else Is This Supplement Used For?

Supplement	Amount	Why
L-Carnitine	Refer to label instructions	Some preliminary trials report that L-carnitine reduces serum cholesterol and raises HDL cholesterol.
L-Carnitine L-carnitine is needed by heart muscle to utilize fat for energy. Some,²⁹⁸^{, 299} but not all, preliminary trials report that carnitine reduces serum cholesterol.³⁰⁰ HDL cholesterol has also increased in response to carnitine supplementation.³⁰¹^{, 302} People have been reported in controlled research to stand a greater chance of surviving a heart attack if they are given L-carnitine supplements.³⁰³ Most trials have used 1 to 4 grams of carnitine per day. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Lecithin (Phosphatidyl Choline)	Refer to label instructions	Taking lecithin supplements may be a useful way to lower cholesterol.
Lecithin (Phosphatidyl Choline) Although lecithin has been reported to increase HDL cholesterol and lower LDL cholesterol,³⁰⁴ a review of the research found that the positive effect of lecithin was likely due to the polyunsaturated fat content of the lecithin.³⁰⁵ If this is so, it would make more sense to use inexpensive vegetable oil, rather than take lecithin supplements. However, an animal study found a cholesterol-lowering effect of lecithin independent of its polyunsaturate content.³⁰⁶ A double-blind trial found that 20 grams of soy lecithin per day for four weeks had no significant effect on total cholesterol, LDL cholesterol, HDL cholesterol, or triglycerides.³⁰⁷ Whether taking lecithin supplements is a useful way to lower cholesterol in people with elevated cholesterol levels remains unclear. What Else Is This Supplement Used For?

Supplement	Amount	Why
Magnesium	Refer to label instructions	In a preliminary study, magnesium supplementation lowered total cholesterol and increased HDL ("good") cholesterol levels.
Magnesium Magnesium is needed by the heart to function properly. Although the mechanism is unclear, magnesium supplements (430 mg per day) lowered cholesterol in a preliminary trial.³⁰⁸ Another preliminary study reported that magnesium deficiency is associated with a low HDL cholesterol level.³⁰⁹ Intravenous magnesium has reduced death following heart attacks in some, but not all, clinical trials.³¹⁰ Though these outcomes would suggest that people with high cholesterol levels should take magnesium supplements, an isolated double-blind trial reported that people with a history of heart disease assigned to magnesium supplementation experienced an increased number of heart attacks.³¹¹ More information is necessary before the scientific community can clearly evaluate the role magnesium should play for people with elevated cholesterol. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Maitake	Refer to label instructions	The mushroom maitake may lower fat levels in the blood and be useful in lowering cholesterol.
Maitake Animal studies suggest that the mushroom maitake may lower fat levels in the blood.³¹² This research is still preliminary and requires confirmation with controlled human trials. What Else Is This Supplement Used For?

Supplement	Amount	Why
Policosanol	Refer to label instructions	Policosanol may affect cholesterol levels by inhibiting cholesterol production by the liver but most research has casted doubt on its effectiveness.
Policosanol Test tube and animal studies indicate that policosanol is capable of inhibiting cholesterol production by the liver.³¹³ ^{, 314} Extensive preliminary and double-blind research in Cuba and other countries in Latin America has demonstrated that taking 10 to 20 mg per day of policosanol extracted from sugar cane results in significant changes in blood cholesterol levels, including total cholesterol (17 to 21% lower on average), LDL cholesterol (21 to 29% lower), and HDL cholesterol (7 to 29% higher).³¹⁵ ^{, 316} ^{, 317} ^{, 318} ^{, 319} ^{, 320} ^{, 321} ^{, 322} ^{, 323} ^{, 324} ^{, 325} However, virtually all of this research was conducted by a single research group from Cuba. Follow-up double-blind studies performed in the United States,³²⁶ ^{, 327} Canada,³²⁸ Italy,³²⁹ and Germany³³⁰ found that sugar cane-derived policosanol in amounts of 10 to 80 mg per day taken for 12 weeks had no effect on serum cholesterol levels in people with initially high cholesterol levels. Therefore, it seems doubtful that policosanol has a beneficial effect on serum cholesterol levels. What Else Is This Supplement Used For?

Supplement	Amount	Why
Pycnogenol	150 mg per day	Preliminary research suggests that Pycnogenol may lower LDL cholesterol and raise HDL cholesterol in people with normal cholesterol levels.
Pycnogenol 150 mg per day A preliminary study reported that 150 mg per day of Pycnogenol lowered LDL cholesterol and raised HDL cholesterol in two-thirds of a group of people with normal cholesterol levels.³³¹ Double-blind research is needed to confirm these findings. What Else Is This Supplement Used For?

Supplement	Amount	Why
Vitamin E	Refer to label instructions	In one trial, supplementing with vitamin E increased levels of protective HDL cholesterol.
Vitamin E In one double-blind trial,³³² vitamin E increased protective HDL cholesterol, but several other trials,³³³ ^{, 334} ^{, 335} found no effect of vitamin E. However, vitamin E is known to protect LDL cholesterol from damage.³³⁶ Most cardiologists believe that only damaged LDL increases the risk of heart disease. Studies of the ability of vitamin E supplements to prevent heart disease have produced conflicting results,³³⁷ but many doctors continue to recommend that everyone supplement 400 IU of vitamin E per day to lessen the risk of having a heart attack. What Else Is This Supplement Used For? See Drug Interactions

Supplement	Amount	Why
Wild Yam	Refer to label instructions	Wild yam has been reported to raise HDL (“good”) cholesterol in preliminary research.
Wild Yam Wild yam has been reported to raise HDL cholesterol in preliminary research. Doctors sometimes recommend 2 to 3 ml of tincture taken three to four times per day, or 1 to 2 capsules or tablets of dried root taken three times per day. ³³⁸ What Else Is This Supplement Used For?

References

Last Review: 05-11-2011

Learn more about Aisle7, the company.

The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2011.

© 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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High Cholesterol - Supplements

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About this treatment

What Are "Star" Ratings?

Beta-Glucan

Chromium

Fenugreek

Glucomannan

HMB

Pantothenic Acid

Psyllium

Red Yeast Rice

Sitostanol

Soy

Vitamin B3

Vitamin C

Artichoke

Asteraceae

Berberine

Beta-Sitosterol

Calcium

Charcoal

Copper

Cranberry

Garlic

Green Tea

Green Tea Enriched with Theaflavins

Guggul

Inositol Hexaniacinate (Vitamin B3)

Krill Oil

Royal Jelly

Tocotrienols

Alfalfa

Chitosan

Chondroitin Sulfate

Creatine Monohydrate

Fo-Ti

L-Carnitine

Lecithin (Phosphatidyl Choline)

Magnesium

Maitake

Policosanol

Pycnogenol

Vitamin E

Wild Yam