How to Lower Your Cholesterol Without Medication

August 30, 2024

Exploring Natural Alternatives: Discover how dietary changes, supplements, and lifestyle adjustments can help lower LDL cholesterol levels without medication

“How can I lower my cholesterol without medication?” This question often comes up in doctor’s offices. Many patients hope to avoid drugs and are curious about natural ways to lower cholesterol, like one Heart Letter reader who recently reached out.

She’s a fit 76-year-old who eats heart-healthy foods (primarily organic produce, grains, lean meats, no red meat or alcohol) to support her cardiovascular health. Her blood pressure and sugar levels are normal, but her LDL (“bad”) cholesterol is 157 mg/dL, which is slightly high.

Typically, the three main cholesterol-lowering alternatives to reach the LDL target of 100 mg/dL or less are diet modifications, supplements, or prescription drugs like statins. Here’s how Dr. Christopher Cannon, Heart Letter editor-in-chief, advises patients on natural remedies for high cholesterol.

Dietary Adjustments

Many people don’t know that only about 20% of blood cholesterol comes from food – your body makes the rest. For most folks, dietary cholesterol doesn’t impact levels much. However, most cholesterol in the average diet comes from animal foods like meat and dairy, which are also high in saturated fat. Saturated fat raises LDL and should be limited.

Your overall diet matters, too, for naturally lowering cholesterol. Replace saturated fats with unsaturated ones (found in vegetable oils, avocados, fatty fish, and omega-3 fatty acids). Eat many plant foods (like veggies, fruits, beans, and whole grains—especially oats and beta-glucan) rich in soluble fiber, which helps lower cholesterol by making it harder to absorb from your gut. Soy protein, garlic, and whey protein may also have cholesterol-lowering effects.

If you often eat burgers and ice cream but slowly switch to healthier foods, your LDL will likely drop. If you already eat well (like our reader), more changes might not help much. “I tell patients that while some see modest LDL drops after changing their diet, others don’t,” says Dr. Cannon. Still, he adds that a healthy diet has other heart benefits, even if LDL doesn’t fall much. For example, many compounds in whole plant foods help reduce inflammation, slowing plaque buildup.

Supplements to Lower Cholesterol

Several dietary supplements in the U.S. claim to boost heart health. However, only a few might help lower LDL cholesterol naturally, and even then, only slightly. These include fiber supplements, red yeast rice, plant sterols, garlic, niacin, guggulipid, and policosanol.

Psyllium husk. This fiber supplement comes from the Plantago ovata plant’s seeds and is commonly used for constipation (like Metamucil). It’s usually mixed with liquid to form a thick gel, but also comes in wafers, bars, and capsules. Psyllium is believed to absorb bile acids and cholesterol, which are then removed from the body. The recommended daily amount is 5 to 10 grams. A recent review in Nutrients found that taking psyllium daily for one to two months can reduce LDL by about 6 points on average.

Plant sterols and stanols. These compounds, called phytosterols, are naturally found in plant cell membranes like nuts, soybeans, peas, and canola oil. They have a structure similar to cholesterol and can limit how much cholesterol your body absorbs. Many foods are fortified with plant sterols, including margarine (like Benecol), mayonnaise, bread, snack bars, milk, and juice. They’re also available as capsules. Some studies show that 2 grams of plant sterols daily for at least eight weeks can lower LDL by up to 10%. However, the recent SPORT trial compared red yeast rice vs plant sterols and found only a 4.4% LDL reduction from plant sterols over four weeks.

Managing Your Cholesterol

Red yeast rice. This extract is made by steaming white rice with Monascus purpureus yeast. Red yeast rice benefits from monacolin K, the same active ingredient as the prescription drug lovastatin, making it a natural statin. Some studies suggest that 4-10 mg of monacolin K can lower LDL by 20-25%. However, the SPORT trial reported only a 6.6% LDL reduction from red yeast rice supplements. Red yeast rice side effects are similar to statins and may include muscle pain and liver damage at high doses. The typical red yeast rice dosage for cholesterol-lowering is 1200-2400 mg daily. Red yeast rice reviews are mixed, with some finding it effective and others not noticing much benefit.

Dr. Cannon notes, “Some of my patients have slightly lowered their LDL with psyllium, which is safe and affordable.” Like all supplements, the issue with plant sterols and red yeast rice extract is that the active ingredient amount isn’t regulated and may vary between batches. If you want to try these products as statin alternatives, do so under a doctor’s guidance and use brands tested by ConsumerLab.com, an independent testing company.

Other supplements sometimes used as natural remedies for high cholesterol include garlic, which may have a small cholesterol-lowering effect, omega-3 fatty acids to lower triglycerides, and ayurvedic medicine like guggulipid. However, evidence for these is limited compared to diet changes and proven supplements.

Statins

Unlike supplements, statins are drugs with a precise amount of active ingredients. This compound reduces the body’s cholesterol production and enhances the liver’s ability to remove cholesterol from the blood. Statins can lower LDL by 25% to 55%, making them the most effective way to lower cholesterol without drastic diet changes.

Dr. Cannon points out that high LDL alone doesn’t always warrant statin use. The main goal is reducing heart disease risk, which is influenced by age and other health conditions. He suggests using the American College of Cardiology’s risk calculator, which offers advice on managing LDL and other risk factors. You can then discuss these recommendations with your doctor. For our reader, the calculator might suggest a moderate-intensity statin as an alternative to natural remedies alone.

For those hesitant about statins, a coronary calcium score can help inform decisions. Our reader’s score of 116 indicates a small amount of plaque in her coronary arteries. Dr. Cannon explains, “Any score above zero means coronary artery disease.” This diagnosis calls for lowering LDL to 70 or less to prevent further plaque buildup. For someone with an LDL of 157, a statin is likely the most effective way to reach this goal if natural methods to lower cholesterol without medication are not sufficient.

Disclaimer:

No content on this site should ever be construed as a substitute for medical advice from your doctor or other health care provider.

Source:

Julie Corliss (August 1, 2024). Can you reduce your cholesterol without taking a drug? Harvard Health Publishing. https://www.health.harvard.edu/heart-health/can-you-reduce-your-cholesterol-without-taking-a-drug. Accessed August 30, 2024