Supplement Smarts for Cholesterol and Triglycerides

Medically Reviewed by Jennifer Robinson, MD on July 18, 2023
3 min read

When you’re trying to lower cholesterol or triglycerides and prevent heart disease, you may end up in a vitamin shop, facing dozens of supplements. Which ones are worth a try? 

The purpose of managing hypertriglyceridemia and hypercholesterolemia is to reduce cardiovascular disease events and deaths.

Fish oil.  Omega-3 fatty acids have been promoted to help lower triglyceride levels The American Heart Association recommends that you eat non-fried fatty fish (salmon, anchovies, herring, mackerel, tuna, and sardines) at least twice a week. Your body can’t make the omega-3s contained in fatty fish like salmon, sardines, tuna, anchovies, and mackerel.

Over-the-counter omega-3 supplements are not regulated and studies are inconclusive as to their benefit. Prescription omega-3 (Epanova, Lovaza,  Omtryg or Vascepa) could be prescribed for adults with triglycerides 500 mg/dl or higher. These prescriptions are regulated by the FDA for quality and safety.  

Psyllium. Fiber is a great cholesterol-buster and part of a healthy diet. Fiber also helps lower triglycerides and total cholesterol, especially for people with type 2 diabetes. There is no substitute for getting enough fiber from foods like vegetables, fruits, and whole grains; however if your cholesterol is high despite a healthy diet, psyllium can help. 

It’ll whisk away cholesterol, but like other fiber, it can make you need to go to the bathroom more often or cause constipation if you don’t also increase your water intake. 

Soy protein supplements.Soy can lower total and LDL cholesterol levels a little. Eating soy protein instead of animal protein (like meat and full-fat dairy) will also help.

Coenzyme Q10. This powerful antioxidant can lower bad LDL cholesterol's ability to stick to the blood vessels of mice. However, scientists say that more research is needed to confirm whether it can work in humans.

So, what about it does work? If you’re taking a statin to lower your cholesterol and having muscle pain as a side effect, there is some proof that coenzyme Q10 can help ease it.

Garlic. Garlic supplements slightly lowered total and LDL cholesterol levels in a few small studies. But overall, the evidence doesn’t seem to support garlic as an effective way to lower cholesterol.

Niacin. This B vitamin can boost HDL “good" cholesterol and lower LDL “bad” cholesterol and triglycerides -- but only use it if your doctor advises you to. Only prescription-level doses impact cholesterol and triglycerides.  Prescription-strength doses have side effects, which is one reason it should be taken under a doctor's supervision.

Red yeast rice. This supplement has the same active ingredient found in cholesterol-lowering statin drugs. However, the FDA has classified it as a drug and has banned its sale as a supplement in the U.S., saying it needs more regulation because of side effects. If you find it in a store for sale without a prescription, it may not be the real thing. If you’re ordering online, beware! It can have the same side effects as medications and have negative interactions with other drugs.

Policosanol. There was a lot of hype that this mix of sugar cane and beeswax is a cholesterol-buster. But the positive studies were tied closely to a company that makes the product. Independent studies found no benefit.

Check with your doctor before you take any supplement or non-prescription treatment. Keep a medicine diary so that you can show your doctor and pharmacist what you’re taking. Or just bring all the meds and supplements you take with you to your next appointment.

Supplements are just one part of your total care plan. They’re called “supplements” for a reason. If you take them, it should only be as part of a larger effort to lower cholesterol and triglycerides. A healthy diet, regular exercise, weight loss, and meds, if prescribed by your doctor, should be the other parts of your plan.