Do any herbal supplements reduce Low-Density Lipoprotein (LDL) cholesterol?

From the Guidelines

Plant sterols and stanols have been shown to reduce LDL cholesterol by 5-15% at doses of 2-3 grams daily, making them a viable option for individuals with elevated LDL cholesterol levels. According to the most recent and highest quality study 1, consuming 1.6-3 g/day of plant stanols or sterols can modestly reduce total and LDL cholesterol. The study also notes that plant sterol and stanol esters block the intestinal absorption of dietary and biliary cholesterol, and that the efficacy of the two forms of plant sterols has been reported to be comparable.

Some key points to consider when using plant sterols and stanols to reduce LDL cholesterol include:

• The recommended daily intake is 2-3 grams per day
• They can be found in supplements or fortified foods
• They work by blocking the intestinal absorption of dietary and biliary cholesterol
• They have been shown to reduce LDL cholesterol by 5-15%
• They are generally safe, but may interact with medications, so consulting a healthcare provider before starting them is important, especially for those already on cholesterol medications.

It's also worth noting that other herbs and supplements, such as red yeast rice, soluble fiber supplements, berberine, fish oil supplements, and garlic supplements, may also have a positive effect on LDL cholesterol levels, but the evidence for these supplements is not as strong as it is for plant sterols and stanols 1.

From the Research

LDL Cholesterol Reduction

The reduction of low-density lipoprotein (LDL) cholesterol is a key aspect of managing cardiovascular risk. Several studies have investigated the effects of various herbs and supplements on LDL cholesterol levels.

• Plant sterols and stanols have been shown to lower LDL cholesterol concentrations, with meta-analyses indicating that consuming approximately 2.5 g per day can lower serum LDL-C concentrations up to 10% 2.
• Higher intakes of plant sterols and stanols, up to 9 g/d, have been found to reduce LDL-C concentrations up to 17% 2.
• A meta-analysis of randomised controlled studies found that plant sterols and stanols can lower LDL cholesterol concentrations, with the effect increasing up to intakes of approximately 3 g/d to an average effect of 12% 3.

Comparison of LDL Cholesterol Reduction Methods

While statins are the primary treatment for lowering LDL cholesterol, other options are being explored.

• Statins have been shown to reduce relative risk of cardiovascular disease by 24-37% 4.
• Proprotein convertase subtilisin/kexin type 9 inhibitors may be used for patients who are not able to achieve LDL-C goals with conventional agents 5.
• Bempedoic acid and other promising agents under development may add to the armamentarium of lipid-lowering drugs available for clinicians to help patients meet their treatment goals 5.

Herbal and Supplement-Based Approaches

There is evidence to suggest that certain herbs and supplements may be effective in reducing LDL cholesterol levels.

• Plant sterols and stanols are naturally occurring constituents of plants and can be consumed as part of a daily diet to help reduce LDL-C concentrations 2, 3.
• However, there is limited evidence on the effectiveness of other herbal and supplement-based approaches in reducing LDL cholesterol levels.