From the Guidelines
The most effective over-the-counter (OTC) supplements to increase high-density lipoprotein (HDL) and lower low-density lipoprotein (LDL) cholesterol are plant sterols and stanols, which can lower LDL by up to 15% when taken at 2 grams per day, as supported by the American Heart Association 1. Several other OTC supplements can also help improve cholesterol levels, including:
- Omega-3 fatty acids (fish oil) at 1-4 grams daily, which reduce triglycerides and may modestly increase HDL
- Red yeast rice containing natural statins (typically 1200-2400 mg daily), which can significantly lower LDL cholesterol
- Soluble fiber supplements like psyllium husk (7-10 grams daily), which bind to cholesterol in the digestive system and remove it from the body
- Niacin (vitamin B3) at 1-3 grams daily, which can raise HDL and lower LDL but should be started at low doses to minimize flushing side effects These supplements work through different mechanisms, such as blocking cholesterol absorption, affecting liver production of cholesterol, or enhancing cholesterol removal from the bloodstream. For best results, these supplements should complement lifestyle changes like:
- Regular exercise
- Weight management
- A heart-healthy diet low in saturated fats and high in fruits, vegetables, and whole grains, as recommended by the American Heart Association 1 and the Diabetes Care journal 1.
From the FDA Drug Label
Niacin extended-release tablets are indicated to reduce elevated TC, LDL-C, Apo B and TG levels, and to increase HDL-C in patients with primary hyperlipidemia and mixed dyslipidemia The best OTC supplement to increase HDL and lower LDL is Niacin.
- Key benefits:
- Reduces elevated TC, LDL-C, Apo B, and TG levels
- Increases HDL-C in patients with primary hyperlipidemia and mixed dyslipidemia
- Important note: Niacin should be taken at bedtime, after a low-fat snack, and doses should be individualized according to patient response 2
From the Research
Best OTC Supplements to Increase HDL and Lower LDL
To increase high-density lipoprotein (HDL) and lower low-density lipoprotein (LDL) cholesterol, several over-the-counter (OTC) supplements can be considered. The following are some of the most effective options:
- Plant Sterols: Plant sterols, also known as phytosterols, have been shown to lower LDL cholesterol levels by up to 10% 3, 4, 5, 6. They can be found in foods such as nuts, seeds, and vegetable oils, or taken as a supplement.
- Omega-3 Fatty Acids: Omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have been shown to lower triglycerides and LDL cholesterol levels 3, 7. They can be found in fatty fish, flaxseeds, and walnuts, or taken as a supplement.
- Dietary Fiber: Increasing dietary fiber intake can help lower LDL cholesterol levels by up to 10% 4. Foods high in fiber include fruits, vegetables, whole grains, and legumes.
- Soy Protein: Soy protein has been shown to lower LDL cholesterol levels by up to 10% 4. It can be found in foods such as soybeans, tofu, and edamame, or taken as a supplement.
Mechanisms of Action
The mechanisms by which these supplements lower LDL cholesterol and increase HDL cholesterol are complex and multifaceted. Plant sterols, for example, work by inhibiting the absorption of cholesterol in the gut 6. Omega-3 fatty acids, on the other hand, have anti-inflammatory properties that can help reduce inflammation in the blood vessels, which can contribute to high cholesterol levels 3.
Important Considerations
It's essential to note that while these supplements can be effective in lowering LDL cholesterol and increasing HDL cholesterol, they should not be used as a replacement for a healthy diet and lifestyle. Additionally, individuals with high cholesterol levels should consult with their healthcare provider before starting any new supplements, as they may interact with other medications or have adverse effects in certain individuals 5.