Should You Take Supplements to Reduce Cholesterol?

by Patty Onderko Health Writer

There's a lot of bad info out there about how to lower your cholesterol with supplements. Have you heard the one about garlic pills? Truth is, there are no shortcuts to staving off heart disease. It's all about making smart lifestyle changes and seeking doctor-directed treatment when needed. Here are the four biggest myths about using supplements to lower your cholesterol, and what you should be doing instead.

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Supplement Myth #1: Fish Oil Does Wonders for Heart Health

While some physicians recommend the omega-3 fatty acids found in fish oil capsules for patients, several recent clinical trials have put the supplement’s star status into question, says Seth Martin, M.D., a cardiologist and associate professor at John Hopkins Medicine in Baltimore. Results showed that fish oil “failed to reduce cardiovascular risk and actually increased the risk of atrial fibrillation, an irregular heartbeat that can lead to stroke over time,” says Martin.

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What You Can Do: Eat More Omega-3-Rich Fish

“I advise my patients to eat real fish instead of taking a supplement,” says Dr. Martin. The quality of OTC fish-oil supplements can vary, he says, and some may contain unwanted ingredients or contaminants. Meanwhile, fish is a good source of lean protein. Dr. Martin’s recommendation: Aim to eat about four ounces of oily fish such as tuna, salmon, or anchovies twice a week. Handy fact: A four-ounce fish filet will be around the size of your palm.

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Supplement Myth #2: There Are All-Natural Alternatives to Statins

Red yeast rice extract—known commonly as “RYRE”—contains the same chemical, monacolin K, that is used in lovastatin, a prescription statin drug that prevents the body from producing cholesterol. As such, says Robert Eckel, M.D., an endocrinologist at the University of Colorado School of Medicine and former president of the American Heart Association, it should be treated as one and only used, if at all, under your doctor’s supervision. Unlike prescription statins, the amounts of the active ingredient in RYRE products can vary widely between different brands and manufacturers.

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What to Do Instead: Talk to Your Doctor About a Prescription Statin

Though taking a “natural” remedy may sound appealing, the better bet is to try an FDA-approved version of, essentially, the same thing. Why? Too much monacolin K can lead to muscle and organ damage, while too little will not help lower your cholesterol. Though a 25% to 30% reduction in cholesterol is possible with high amounts of red yeast rice extract, a prescribed statin is much more effective with a 50% reduction. More importantly, says Dr. Eckel: Statins are safer and more predictable.

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Supplement Myth #3: A Garlic Pill Will Lower My Cholesterol (Without the Bad Breath!)

Unfortunately, high levels of garlic and its active ingredient allicin do not reduce overall cholesterol levels in any meaningful way, says Dr. Eckel. Though allicin has been shown to inhibit the synthesis of cholesterol in lab tests, the same effect has not been replicated in humans. In fact, one rigorous study from Stanford found garlic had “zero impact” when it came to lipid profiles. As for the bad breath, it’s actually caused by the allicin. So when manufacturers advertise garlic pills with no taste or odor, that means they’ve stripped the herb of exactly what might have made it beneficial in the first place.

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What to Do Instead: Spice Up Your Diet (and Grab a Mint!)

No, cooking with garlic won’t do a thing for your cholesterol, but it can bestow other health benefits when it’s part of an overall healthy diet of fruits, vegetables, grains, and lean animal protein. Garlic is a potent antioxidant that can help protect your cells from damage and the spicy cloves have high levels of important nutrients, too, including potassium, calcium, and magnesium. Last, and definitely not least, it tastes good! (Try one of our favorite garlic-heavy recipes, Mediterranean Eggplant Shakshuka.) If you’re struggling to get control of your cholesterol, though, talk to your doctor.

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Supplement Myth #4: There’s No Harm in Trying Different Supplements to Lower My Cholesterol

While fish oil, red yeast rice extract, and garlic are a few of the supplements cardiologists get asked about most often by their patients, you will likely hear about plenty of other over-the-counter products that claim to naturally reduce cholesterol. There’s berberine (a chemical plant extract), green tea extract, artichoke extract, soy protein, psyllium (a form of fiber), and many more. At best, says Dr. Eckel, some of these supplements may be “minimally effective” at controlling cholesterol. At worst, they cause unwanted side effects (berberine, for example, is notorious for causing gastric distress—yikes!) and prevent you from getting effective treatment.

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What to Do Instead: Make Lifestyle Changes

The only proven way to reduce cholesterol naturally is to adopt lifelong healthy habits and ditch the not-so-great ones, says Dr. Martin. Stop smoking. Try a Mediterranean diet. Skip processed, high-in-saturated-fat foods as much as possible. Find a form of exercise you can be consistent with (walking counts!). The American Heart Association is a good place to start for tips and ideas, but talk to your doctor about what will work for you. Sometimes, diet and exercise can only go so far; you may need prescription statins to help get your cholesterol to a comfortable level.

  • Fish Oil for Heart Health: Journal of the American Medical Association. (2020). “Effect of High-Dose Omega-3 Fatty Acids vs Corn Oil on Major Adverse Cardiovascular Events in Patients at High Cardiovascular Risk: The STRENGTH Randomized Clinical Trial.” jamanetwork.com/journals/jama/article-abstract/2773120
  • Red Yeast Rice Extract: European Journal of Preventive Cardiology. (2017). “Variability in strength of red yeast rice supplements purchased from mainstream retailers.” pubmed.ncbi.nlm.nih.gov/28641460/
  • Garlic and Cholesterol: Archive of Internal Medicine. (2007). “Effect of Raw Garlic vs Commercial Garlic Supplements on Plasma Lipid Concentrations in Adults With Moderate Hypercholesterolemia: A Randomized Clinical Trial.” jamanetwork.com/journals/jamainternalmedicine/fullarticle/411743
Patty Onderko
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Patty Onderko

Patty Onderko is a writer and editor who has covered health, parenting, psychology, travel, and more for more than 20 years. She lives in Brooklyn, NY with her wife and two sons.