DEAR DOCTOR K:
My cholesterol is high and my doctor wants me to go on a statin. I’d like to avoid medication. Do any supplements effectively lower cholesterol?
Statin drugs lower LDL (or “bad”) cholesterol and also reduce inflammation. Together, these effects lower your risk of heart attack.
Various herbs and supplements have been touted for their ability to improve cholesterol levels. There is one general caveat you should consider. New drugs are tested by the FDA for their safety, effectiveness and purity.
However, almost the opposite is true for herbs and supplements. They are virtually free of testing and manufacturing requirements. And, unfortunately, there have been occasional serious problems with contaminants getting into some supplements during their manufacture.
Here’s what the research shows — and doesn’t show — about some of the best-known products:
- HAWTHORNE. The leaves, berries and flowers of this plant are made into medicine that has been used to treat cardiovascular diseases. It may decrease the body’s production of cholesterol, and it may help the body excrete bile, a cholesterol-filled fluid that helps with digestion. Verdict: It may help.
- RED YEAST RICE. This Chinese medicine is marketed as a cholesterol-lowering agent. An independent analysis looked at 12 red yeast rice products that claimed to contain 600 milligrams (mg) of the active ingredient. The actual content varied between 0.10 mg and 10.9 mg. Also, one-third of the products were contaminated with a compound that can cause kidney failure. Verdict: It may help, but purity remains a problem.
- GARLIC. Some early studies suggested that garlic might slightly lower cholesterol levels. A study funded by the National Center on Complementary and Alternative Medicine looked at the effectiveness of fresh garlic, dried powdered garlic tablets and aged garlic extract tablets. It found garlic had no effect on cholesterol levels. Verdict: For lowering cholesterol, save your money. For cooking, follow the judgment of your nose and palate.
- FISH OIL. We know that eating fatty fish lowers heart risks for people with heart failure or a previous heart attack. But a 2013 study in The New England Journal of Medicine found that fish oil supplements don’t have the same effect. They don’t lower heart attack or stroke risk in people at high risk of heart disease. Verdict: Eat fish instead.
The truth is, “natural” treatments like herbs and supplements are not necessarily better, and there can be problems with their manufacture. Of course, conventional drugs can have adverse effects as well. But it’s rare for them to contain dangerous contaminants.
It wouldn’t surprise me if some readers think I emphasize conventional pharmaceuticals too much. As a doctor, I actually tend to prescribe fewer conventional drugs than many of my colleagues. And I surely don’t believe that the first treatment for a problem should always be a drug.
But I believe that research has led to the development of some drugs that can achieve results that just are not possible with natural remedies. Statins to lower cholesterol are one such example.