Soluble Fiber and Plant Sterols
Soluble fiber from psyllium husk and oats, and plant sterol and stanol esters, are each named in an FDA heart health claim that sets a daily amount and requires a diet low in saturated fat and cholesterol. In pooled trials they lowered LDL cholesterol by modest amounts; those trials measured LDL, not heart events.
Bergamot: Small, Low-Certainty Trials
In a 2026 meta-analysis of 9 randomized trials in 615 adults, bergamot was linked with lower total and LDL cholesterol and triglycerides, but the authors rated the certainty of evidence low to very low and said the results do not establish clinical efficacy. Reported LDL changes range widely between studies. Bergamot may inhibit CYP3A4, which can raise blood levels of some statins, so ask a pharmacist before combining it with a prescription.
Red Yeast Rice: Monacolin K and Lovastatin
Red yeast rice contains monacolin K, which is chemically identical to lovastatin, a prescription statin ingredient. The US FDA treats products with enhanced or added lovastatin, or high monacolin K content, as unapproved new drugs, and the EU limits a daily portion to under 3 mg of monacolins. Testing found monacolin K varying more than 60-fold between US brands, and some products contained citrinin, a contaminant that can damage the kidneys. It can cause statin-type muscle and liver effects and drug interactions. Do not combine it with a statin, do not use it in pregnancy or breastfeeding, and talk to your doctor first.
Berberine: Studied in Diagnosed Conditions
Pooled trials found berberine lowered total and LDL cholesterol and triglycerides, but nearly everyone studied had a diagnosed metabolic or liver condition, the authors rated trial quality as limited, and no review counted heart events. Berberine slows drug-clearing liver enzymes and can raise blood levels of some statins and other medicines, so check with your doctor or pharmacist first, and do not use it in pregnancy or breastfeeding. Branded forms marketed as better absorbed have no published cholesterol trials of their own.
Niacin: A Prescription-Dose Use
At gram doses taken only under medical supervision, nicotinic acid lowers LDL cholesterol and triglycerides and raises HDL. In two large outcome trials, AIM-HIGH and HPS2-THRIVE, adding niacin to a statin did not reduce heart attacks, strokes or cardiovascular deaths, and HPS2-THRIVE found more serious adverse events, including disturbed diabetes control. Current guidelines do not recommend it as an add-on to statins. Flush-free forms do not share its lipid effect: nicotinamide does not change blood lipids, and an inositol hexanicotinate product did no better than placebo.
Omega-3s: Triglycerides, Not LDL
At about 4 g a day of EPA plus DHA, a dose used only with a doctor, triglycerides fall by 30% or more in people with very high levels; over-the-counter doses of 1 to 2 g a day gave smaller drops of about 11 to 15%. Omega-3s do not lower LDL cholesterol, and high-dose EPA plus DHA can raise it slightly in some people.
Smaller or Unproven Effects
Soy protein lowered LDL cholesterol by about 3 to 4 percent versus other proteins in the trials FDA reviewed, and FDA has proposed revoking its soy protein heart health claim. Garlic results differ by trial: aged garlic extract did not lower LDL in a six-month government-funded trial, while pooled trials found a small LDL drop. Pooled tocotrienol trials found no significant change in total or LDL cholesterol.
Branded Extracts With Little Direct Data
These branded ingredients have little or no published cholesterol research of their own. EVRol relies on evidence for plant sterols as a class, and no published cholesterol trial of VinCare or P40p is cited on their pages.
Frequently Asked Questions
Can supplements lower cholesterol as well as statins?
No supplement is a substitute for a prescribed statin. Statins have been tested in trials that counted heart attacks, strokes and deaths, while the supplement trials on this page mostly measured blood lipids such as LDL cholesterol. Some supplements lowered LDL more than placebo or control, usually by modest amounts: psyllium by about 13 mg/dL in a 28-trial meta-analysis, plant sterols by 6 to 12% at 0.6 to 3.3 g a day, and oat beta-glucan by 0.19 to 0.25 mmol/L. If you have heart disease or high cardiovascular risk, follow your doctor's treatment plan, and do not stop, reduce or replace a prescribed medicine on your own. Tell your doctor about any supplement you take, because some, such as red yeast rice and berberine, can interact with statins.
Is red yeast rice the same as a statin?
Monacolin K, the main monacolin in red yeast rice, is chemically identical to lovastatin, a prescription statin ingredient. For that reason the US FDA treats red yeast rice products with enhanced or added lovastatin, or high monacolin K content, as unapproved new drugs. Products differ widely: testing found monacolin K varying more than 60-fold between US brands and absent from some, and some products contained citrinin, a contaminant that can damage the kidneys. Products with meaningful monacolin K carry statin-type risks, including muscle and liver effects and drug interactions. Do not combine red yeast rice with a statin, do not use it in pregnancy or breastfeeding, and talk to your doctor before using it.
Does soluble fiber actually lower cholesterol?
Yes, by modest amounts. In a meta-analysis of 28 randomized trials, about 10.2 g a day of psyllium lowered LDL cholesterol by about 13 mg/dL versus control. Oat beta-glucan at 3 g a day or more lowered LDL by 0.19 to 0.25 mmol/L in two meta-analyses, with no change in HDL or triglycerides. Both are named in the FDA-authorized health claim for soluble fiber (21 CFR 101.81), which requires a diet low in saturated fat and cholesterol; for psyllium it is based on 7 g a day of its soluble fiber. These trials measured LDL, not heart events. Take psyllium with a full glass of water.
What about CoQ10 with statins?
Statins act on the same pathway the body uses to make CoQ10, which is why some people try it for statin-related muscle aches. The trials disagree: a meta-analysis of 12 trials in 575 statin users found less muscle pain, while a later meta-analysis of 7 trials in 389 statin users found a smaller pain reduction, with 4 trials positive and 3 not, and an NIH review judges the evidence unsupportive. Discuss it with the doctor who prescribes your statin, report any muscle symptoms, and never stop or reduce a statin because you started CoQ10.
Should I take fish oil for cholesterol?
Not for LDL. Omega-3s lower triglycerides, by 30% or more at about 4 g a day of EPA plus DHA in people with very high levels, a dose used only with a doctor, and they do not lower LDL cholesterol. In one large trial, icosapent ethyl, a prescription purified EPA drug taken at 4 g a day, lowered major cardiovascular events in statin-treated high-risk adults; that result does not transfer to over-the-counter fish oil, and a 4 g a day EPA plus DHA trial (STRENGTH) and 1 g a day supplement trials (VITAL, ASCEND) found no event benefit. Both 4 g a day trials found more atrial fibrillation. If your triglycerides are high, ask your doctor what to do.
When should I see a doctor about cholesterol?
See a doctor to have your cholesterol checked and your overall heart risk assessed, especially if you have a family history of early heart disease, other risk factors such as high blood pressure, diabetes or smoking, or a previous heart attack or stroke. FDA regulations describe LDL cholesterol of 130 to 159 mg/dL as borderline high and 160 mg/dL or above as high. If you have heart disease or high risk, follow your doctor's treatment plan; supplements are not a substitute for prescribed treatment. Tell your doctor about every supplement you take.
Recommended Products for High Cholesterol
These four products contain ingredients covered on this page. Plant sterols, bergamot and red yeast rice lowered LDL cholesterol in trials by amounts that vary by product and study, and fish oil lowers triglycerides, not LDL. No supplement is a substitute for a prescribed cholesterol medicine. If you take a statin or another prescription, or have heart disease or high cardiovascular risk, talk to your doctor before using any of them, and never take red yeast rice with a statin.