How to Lower Cholesterol with Supplements That Actually Work

· ·

What are the whole-food equivalents of some of the most powerful cholesterol-lowering supplements?

Discuss
Languages

    Selecting a language opens the video on YouTube with captions enabled.

  • English
Republish

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Of all the cholesterol-lowering supplements, the best available evidence is for phytosterols, which I suggested trying in a recent three-video series, and red yeast rice, which I strongly suggested avoiding, in my last video. Also considered an A level of evidence is viscous soluble fiber, the sticky fiber that’s part of the Portfolio Diet, which recommends 20 grams a day from foods like oats, barley, eggplant, okra, apples, oranges, or berries. Each serving of those foods only has a few grams; so, getting 20 on a daily basis might be a challenge. That’s where psyllium can come in. Powdered psyllium seed husk has more than two grams of viscous fiber per teaspoon.

Based on dozens of randomized controlled trials, psyllium, also known as Plantago, can reduce LDL cholesterol by 13 or 14 points. The psyllium husk works best, reducing LDL by more like 16 or 17 points. Dose-wise, a tablespoon a day should get you about a 10% drop in LDL. Just make sure you follow the instructions and take it with lots of water.

Though even a three- or four-point drop in LDL could be considered clinically important, here’s all the dietary supplements found to lower LDL cholesterol by at least 10 points. As you can see, bergamot appears to lead the pack. There’ve only been a half dozen studies with a few hundred people, but bergamot resulted in a remarkable 55-point drop in LDL, thought to be because it seems to act like a PCSK9 inhibitor, which, if you’re curious, I detail in a previous video.

Any safety issues with bergamot? Well, bergamot contains bergamottin, which is one of the constituents of grapefruit that suppresses the detox enzymes in our liver and intestines, potentially increasing levels of certain drugs we may be taking. So, if you’re on any medications, make sure to talk to your doctor first.

There is a report of a case of Earl Grey tea intoxication. Earl Grey is just black tea flavored with bergamot. A man was drinking a gallon a day (3,785 ml), and ended up with muscle cramps and twitches thought to be due to a compound called bergapten; so, don’t drink a gallon of Earl Grey tea a day. Higher doses of bergamot extract supplements don’t necessarily have a greater effect; so, if you do want to try it, I would recommend the lowest effective dose of 500 mg a day. The latest study got away with only 375 mg a day, but only got half the effect.

Artichoke extracts are next on the list. Thirteen studies gave people 50 to 2700 mg of artichoke extracts for a few months, and saw drops in LDL of 17 or 18 points. Again, more is not necessarily better, with doses under 500 mg perhaps working better than higher doses, but looking at the graph, it looks pretty flat. Of course, this is assuming there’s actually artichoke in your artichoke supplement. One study found that only three out of seven dietary artichoke supplements contained as much of one of the purported active ingredients you’d expect. Another study found all sorts of issues, not only lower concentrations than expected, but nondisclosed fillers and other plants entirely. That’s the problem with dietary supplements. They are so poorly regulated that’s it’s hard to know what’s actually in them. In the very least, you should test your cholesterol before and after starting a purported cholesterol-lowering supplement to make sure you’re at least getting some benefit. Ideally though, we’d use the whole food. In the case of artichokes, that may be a hundred grams of artichoke hearts a day, which is about half a cup. I think they’re delicious—I could totally do that, but I haven’t been able to find any canned or jarred artichoke hearts without added salt. The solution? Frozen! Look for no-salt-added artichoke hearts in the frozen vegetables section in your local grocery store.

Please consider volunteering to help out on the site.

Motion graphics by Avo Media

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

Of all the cholesterol-lowering supplements, the best available evidence is for phytosterols, which I suggested trying in a recent three-video series, and red yeast rice, which I strongly suggested avoiding, in my last video. Also considered an A level of evidence is viscous soluble fiber, the sticky fiber that’s part of the Portfolio Diet, which recommends 20 grams a day from foods like oats, barley, eggplant, okra, apples, oranges, or berries. Each serving of those foods only has a few grams; so, getting 20 on a daily basis might be a challenge. That’s where psyllium can come in. Powdered psyllium seed husk has more than two grams of viscous fiber per teaspoon.

Based on dozens of randomized controlled trials, psyllium, also known as Plantago, can reduce LDL cholesterol by 13 or 14 points. The psyllium husk works best, reducing LDL by more like 16 or 17 points. Dose-wise, a tablespoon a day should get you about a 10% drop in LDL. Just make sure you follow the instructions and take it with lots of water.

Though even a three- or four-point drop in LDL could be considered clinically important, here’s all the dietary supplements found to lower LDL cholesterol by at least 10 points. As you can see, bergamot appears to lead the pack. There’ve only been a half dozen studies with a few hundred people, but bergamot resulted in a remarkable 55-point drop in LDL, thought to be because it seems to act like a PCSK9 inhibitor, which, if you’re curious, I detail in a previous video.

Any safety issues with bergamot? Well, bergamot contains bergamottin, which is one of the constituents of grapefruit that suppresses the detox enzymes in our liver and intestines, potentially increasing levels of certain drugs we may be taking. So, if you’re on any medications, make sure to talk to your doctor first.

There is a report of a case of Earl Grey tea intoxication. Earl Grey is just black tea flavored with bergamot. A man was drinking a gallon a day (3,785 ml), and ended up with muscle cramps and twitches thought to be due to a compound called bergapten; so, don’t drink a gallon of Earl Grey tea a day. Higher doses of bergamot extract supplements don’t necessarily have a greater effect; so, if you do want to try it, I would recommend the lowest effective dose of 500 mg a day. The latest study got away with only 375 mg a day, but only got half the effect.

Artichoke extracts are next on the list. Thirteen studies gave people 50 to 2700 mg of artichoke extracts for a few months, and saw drops in LDL of 17 or 18 points. Again, more is not necessarily better, with doses under 500 mg perhaps working better than higher doses, but looking at the graph, it looks pretty flat. Of course, this is assuming there’s actually artichoke in your artichoke supplement. One study found that only three out of seven dietary artichoke supplements contained as much of one of the purported active ingredients you’d expect. Another study found all sorts of issues, not only lower concentrations than expected, but nondisclosed fillers and other plants entirely. That’s the problem with dietary supplements. They are so poorly regulated that’s it’s hard to know what’s actually in them. In the very least, you should test your cholesterol before and after starting a purported cholesterol-lowering supplement to make sure you’re at least getting some benefit. Ideally though, we’d use the whole food. In the case of artichokes, that may be a hundred grams of artichoke hearts a day, which is about half a cup. I think they’re delicious—I could totally do that, but I haven’t been able to find any canned or jarred artichoke hearts without added salt. The solution? Frozen! Look for no-salt-added artichoke hearts in the frozen vegetables section in your local grocery store.

Please consider volunteering to help out on the site.

Motion graphics by Avo Media

Doctor's Note

This is the 11th video in an extended series on the critically important topic of how to lower LDL cholesterol, the primary driver of our primary killer. In this series, we take a deep dive into ways we may lower our cholesterol through diet. We’ll explore the Portfolio Diet, plant sterols, and cholesterol-lowering supplements, foods, herbs, and spices, before concluding with my Portfolio Plus Powder recipe “cooking” video.

If you don’t want to wait for all the videos to be released over time, we’ve compiled all the information into my latest book, Lower LDL Cholesterol Naturally with Food, available as a softcover, ebook, and audiobook.

If you missed the previous videos in this series, see:

If you haven't yet, you can subscribe to our free newsletter. With your subscription, you'll also get notifications for just-released blogs and videos. Check out our information page about our translated resources.

Subscribe to our free newsletter and receive the the Maximally LDL-Lowering Daily Dozen checklist from Dr. Greger's Lower LDL Cholesterol Naturally with Food book.

Previous Video

Friday Favorites: Dietary Cholesterol and Inflammation from Abdominal Obesity

Pin It on Pinterest

Share This