Supplement Smarts for Cholesterol and Triglycerides

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.

Looks Good

Fish oil. These supplements help lower triglyceride levels by as much as 30%, thanks to omega-3s they have in them like EPA and DHA. Studies indicate that modest fish oil consumption (approximately 250 mg/day EPA+DHA) may reduce the risk of CHD death and sudden cardiac death, with little if any risk.

You’ll need a high dose - 2-4 grams of fish oils EPA and DHA per day. It may be tough to get that amount from supplements. If your triglycerides are very high, your doctor may recommend a prescription fish oil

Fish oil consumption in those with heart disease may reduce the risk of CHD death and sudden cardiac death 

Some people are concerned about high levels of mercury or other pollutants when picking out fish oil supplements. The actual amount of fish oil and how well it’s absorbed in your body is also important. Ask your doctor about safe and effective ones to try.

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 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.

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Mixed Picture

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 doctor 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.

Probably Not

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.

 

Don’t Forget!

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.

WebMD Medical Reference Reviewed by Carmen Patrick Mohan on May 22, 2017

Sources

SOURCES:

Anderson J. American Journal of Clinical Nutrition, June 200.

Permanente Medical Group: "Psyllium: Lower Your Cholesterol."

American Heart Association: "Fish and Omega-3 Fatty Acids.”

University of Wisconsin Health: “High Cholesterol: Eating Fish and Fish Oil.”

He, J. Circulation, publishedonline July 18, 2011.

National Center for Complementary and Alternative Medicine: “Garlic.”

University of Maryland Medical Center: “Omega-3 Fatty Acids,” Coenzyme-Q10,” “Red Yeast Rice.”

University of Rochester Medical Center: “Know About Niacin.”

NIH News: “NIH Stops Clinical Trial on Combination Cholesterol Treatment.”

Ponda, M. Arteriosclerosis, Thrombosis and Vascular Biology, published online Sept. 4, 2012.

USC Norris Cancer Hospital: “Natural and Alternative Treatment Study Report: Policosanol for High Cholesterol? Maybe Not.”  

American Heart Association: “Drug Therapy for Cholesterol.”

National Institutes of Health: “National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) - Final Report.”

The Lancet: “FDA Bans Red Yeast Rice Product.”

USDA Center for Nutrition Policy and Promotion: “Executive Summary - Dietary Guidelines for Americans, 2010.”

Oregon State University Linus Pauling Institute -- Micronutrient Research for Optimum Health: “Coenzyme Q10.”

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