National Center for Complementary and Alternative Medicine (NCCAM)

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Cholesterol Management

People with high blood levels of cholesterol have an increased risk of a heart attack or stroke. Key approaches to lower blood cholesterol levels include eating a healthful diet, managing your weight, not smoking, engaging in physical activity, and, when necessary, taking prescription drugs like statins. Although statins are generally well tolerated, some people have uncomfortable side effects (such as muscle pain). Some may try dietary supplements to help with cholesterol control.

Bottom Line:

  • Research suggests that foods such as certain spreads and salad dressings to which manufacturers have added stanols and sterols (substances that occur naturally in small amounts in many plants) may help lower blood cholesterol.
  • Some research suggests that soy products may help lower blood cholesterol.
  • Other research suggests that garlic, chromium, vitamin C, and artichoke extract may not be helpful in strategies to lower cholesterol.
  • Certain red yeast rice products, promoted for their cholesterol-lowering properties, were found to contain monacolin K, a chemical identical to the active ingredient in the cholesterol-lowering drug lovastatin. The U.S. Food and Drug Administration has determined that red yeast rice products with more than trace amounts of monacolin K are unapproved new drugs and can’t be sold legally as dietary supplements.
  • There are no studies on red yeast rice products with little or no monacolin K, so their effect on blood cholesterol is unknown.

Safety:

  • Red yeast rice products may be contaminated with citrinin, a substance that may cause kidney damage.
  • It’s important to follow your health care provider’s instructions for treating high blood cholesterol. Don’t use unproven products or practices to replace conventional treatment.
  • To use dietary supplements safely, read and follow the label instructions, and recognize that “natural” does not always mean “safe.” Be aware that an herbal supplement may contain dozens of compounds and that all of its ingredients may not be known.
  • Some dietary supplements may interact adversely with medications or other dietary supplements or pose risks if you have certain medical problems or are going to have surgery. Most dietary supplements have not been tested in pregnant women, nursing mothers, or children.