Best Natural Treatments for High Cholesterol

Flaxseed and Flaxseed Oil

Flaxseed is high in fiber, omega-3 fatty acids and phytochemicals called lignans. Flaxseed can help reduce total blood cholesterol and LDL ("bad") cholesterol levels. This fiber is probably mainly responsible for the cholesterol-lowering effects of flaxseed.

In recent 2008 double-blind, randomized, controlled clinical trial of subjects taking 40 g/day of ground flaxseed in baked goods, LDL was lowered but the effect was modest and short lived. However, flaxseed was associated with lower HDL ("good") cholesterol.

Scientific evidence of Flaxseed and Flaxseed Oil effectiveness

• 1. Bloedon LT, Balikai S, Chittams J, et al. Flaxseed and cardiovascular risk factors: results from a double blind, randomized, controlled clinical trial. Journal of the American College of Nutrition. 2008;27:65-74 .
• 2. Cunnane SC, Hamadeh MJ, Liede AC, et al. Nutritional attributes of traditional flaxseed in healthy young adults. Am J Clin Nutr. 1995;61:62-68.
• 3. Lemay A, Dodin S, Kadri N, et al. Flaxseed dietary supplement versus hormone replacement therapy in hypercholesterolemic menopausal women. Obstet Gynecol. 2002;100:495-504.

Garlic

The relationship between garlic and cholesterol lowering remains unproven. Garlic is known to act as a blood thinner and may reduce other risk factors for heart disease. For these reasons, some doctors recommend eating garlic as food, taking 900 mg of garlic powder from capsules, or using a tincture of 2 to 4 ml, taken three times daily.

The older studies on garlic looked pretty positive. Results of 3 studies demonstrated a lowering of cholesterol in the range of 6.1% to 11.5%, primarily due to the lowering of low-density lipoproteins. More recently, however, several double-blind trials have found garlic to have minimal success in lowering cholesterol. A recent well-designed study of about 192 adults which looked at the use of garlic — raw garlic, an extract which was a powdered form and then another extract of garlic which was a standardized preparation and a placebo — four different groups in that study. And really what that study showed was no benefit on cholesterol from garlic.

Scientific evidence of Garlic effectiveness

• 1. Jain A, Vargas R, Gotzkowsky S, McMahon F. Can garlic reduce the levels of serum lipids? A controlled clinical study. Am J Med. 1993;94:632-635.
• 2. Steiner M, Khan AH, Holbert D. Lin R. A double-blind crossover study in moderately hypercholesterolemic men that compared the effect of aged garlic extract and placebo administration on blood lipids. Am J Clin Nutr. 1996;64:866-870.
• 3. Adler AJ, Holub BJ. Effect of garlic and fish oil supplementation on serum lipid and lipoprotein concentrations in hypercholesterolemic men. Am J Clin Nutr.1997;65:445-450.
• 4. Byrne Dj, Neil HA, Vallance DT, et al. A pilot study of garlic consumption shows no significant effect on markers of oxidation or sub-fraction composition of low-density lipoprotein including lipoprotein(a) after allowance for non-compliance and the placebo effect. Clin Chim Acta. 1999;285:21-33
• 5. Gardner CD, Lawson LD, Block E, Chatterjee LM, Kiazand A, Balise RR, Kraemer HC. Free Full Text Effect of raw garlic vs commercial garlic supplements on plasma lipid concentrations in adults with moderate hypercholesterolemia: a randomized clinical trial. Arch Intern Med. 2007 Feb 26;167(4):346-53

Grape Seed Extract

The medicinal and nutritional value of grapes has been heralded for thousands of years. Researchers are now discovering that many of the health properties of grapes may actually come from the seeds. Although grape seed has been suggested for many conditions, the best evidence supports its use for its antioxidant effects, and for improving cardiovascular health.

The study, published in the December 2000 issue of the Journal of Medicine, found that grape seed extract and chromium taken together significantly decreased total and LDL cholesterol levels, and seemed to reduce the oxidized form of LDL cholesterol. LDL and particularly oxidized LDL are known risk factors in heart disease.

Scientific evidence of Grape Seed Extract effectiveness

• 1. Preuss HG, Wallerstedt D, Talpur N, Tutuncuoglu SO, Echard B, Myers A, Bui M, Bagchi D. Abstract Effects of niacin-bound chromium and grape seed proanthocyanidin extract on the lipid profile of hypercholesterolemic subjects: a pilot study. J Med. 2000;31(5-6):227-46 PubMed
• 2. Vigna GB, Costantini F, Aldini G, Carini M, Catapano A, Schena F, Tangerini A, Zanca R, Bombardelli E, Morazzoni P, Mezzetti A, Fellin R, Maffei Facino R. t Effect of a standardized grape seed extract on low-density lipoprotein susceptibility to oxidation in heavy smokers. Metabolism. 2003 Oct;52(10):1250-7. PubMed
• 3. Sano A, Uchida R, Saito M, Shioya N, Komori Y, Tho Y, Hashizume N. Abstract Beneficial effects of grape seed extract on malondialdehyde-modified LDL. J Nutr Sci Vitaminol (Tokyo). 2007 Apr;53(2):174-82.

Green Tea

Green tea lowers total cholesterol and LDL cholesterol levels and improves the ratio of HDL cholesterol to LDL cholesterol. Studies have shown that people who drink green tea as a daily part of their diet have lower cholesterol levels than those who do not drink any green tea.

Researchers believe that one of the underlying mechanisms by which green tea lowers blood cholesterol levels is by reducing lipids absorption in the digestive tract and promoting their excretion from the body.

Much of the research documenting the health benefits of green tea is based on the amount of green tea typically drunk in Asian countries - about three cups per day, providing 240 to 320 mg of polyphenols.

An extract of green tea, enriched with a compound present in black tea (theaflavins), has been found to lower serum cholesterol in a double-blind study of people with moderately high cholesterol levels. The average reduction in total serum cholesterol during the 12-week study was 11.3%, and the average reduction in LDL cholesterol was 16.4%. The extract used in this study provided daily 75 mg of theaflavins, 150 mg of green tea catechins, and 150 mg of other tea polyphenols.

Scientific evidence of Green Tea effectiveness

• 1. Kono S, Shinchi K, Wakabayashi K, Honjo S, Todoroki I, Sakurai Y, Imanishi K, Nishikawa H, Ogawa S, Katsurada M. Relation of green tea consumption to serum lipids and lipoproteins in Japanese men. J Epidemiol. 1996 Sep;6(3):128-33. PubMed
• 2. Erba D, Riso P, Bordoni A, Foti P, Biagi PL, Testolin G. Effectiveness of moderate green tea consumption on antioxidative status and plasma lipid profile in humans. J Nutr Biochem. 2005 Mar;16(3):144-9. PubMed
• 3. Koo SI, Noh SK. Green tea as inhibitor of the intestinal absorption of lipids: potential mechanism for its lipid-lowering effect. J Nutr Biochem. 2007 Mar;18(3):179-83. PubMed
• 4. Maron DJ, Lu GP, Cai NS, et al. Cholesterol-lowering effect of a theaflavin-enriched green tea extract: a randomized controlled trial. Archives of Internal Medicine 2003;163:1448-1453.

Soy

In 1995, an analysis of many trials proved that soy reduces both total and LDL cholesterol.

Soy is available in foods such as tofu, miso, and tempeh and as a supplemental protein powder. Soy contains isoflavones, naturally occurring plant components that are believed to be soy's main cholesterol-lowering ingredients. A controlled trial showed that soy preparations containing high amounts of isoflavones effectively lowered total cholesterol and LDL cholesterol, whereas low-isoflavone preparations (less than 27 mg per day) did not. However, supplementation with either soy or non-soy isoflavones (from red clover) in pill form failed to reduce cholesterol levels in a group of healthy volunteers, suggesting that isoflavone may not be responsible for the cholesterol-lowering effects of soy.

The Nutrition Committee of the American Heart Association has assessed 22 randomized trials conducted since 1999 and found that isolated soy protein with isoflavones (ISF) slightly decreased LDL cholesterol but had no effect on HDL cholesterol, triglycerides, lipoprotein(a), or blood pressure. (Sacks FM, Lichtenstein A, Van Horn L, Harris W, Kris-Etherton P, Winston M; American Heart Association Nutrition Committee. Free Full Text Soy protein, isoflavones, and cardiovascular health: an American Heart Association Science Advisory for professionals from the Nutrition Committee. Circulation. 2006 Feb 21;113(7):1034-44. Epub 2006 Jan 17)

Scientific evidence of Soy effectiveness

• 1. Crouse JR 3rd, Morgan T, Terry JG, et al. A randomized trial comparing the effect of casein with that of soy protein containing varying amounts of isoflavones on plasma concentrations of lipids and lipoproteins. Archives of Internal Medicine 1999 Sep 27;159(17):2070-6.
• 2. Nestel PJ, Yamashita T, Sasahara T, et al. Soy isoflavones improve systemic arterial compliance but not plasma lipids in menopausal and perimenopausal women. Arteriosclerosis, Thrombosis, and Vascular Biology 1997;17:3392-3398.
• 3. Samman S, Lyons, Wall PM, et al. The effect of supplementation with isoflavones on plasma lipids and oxidisability of low density lipoprotein in premenopausal women. Atherosclerosis. 1999 Dec;147(2):277-83.
• 4. Sacks FM, Lichtenstein A, Van Horn L, Harris W, Kris-Etherton P, Winston M; American Heart Association Nutrition Committee. Soy protein, isoflavones, and cardiovascular health: an American Heart Association Science Advisory for professionals from the Nutrition Committee. Circulation. 2006 Feb 21;113(7):1034-44.

Artichoke leaf extract

In the 1940s, Japanese scientists noted that artichoke juice "enhanced well-being" while stimulating production of bile and lowering cholesterol. Studies done during that time by scientists in both Switzerland and Texas showed that blood cholesterol levels dropped significantly after eating artichokes.

Recently, researchers at the University of Reading have found that an over-the-counter Artichoke Leaf Extract (ALE) from the globe artichoke plant can lower cholesterol in otherwise healthy individuals with moderately raised levels.

There is some evidence that the cholesterol-lowering effect of artichokes is due to cynarin, a compound that boosts production of bile in the liver and the flow of bile from the gallbladder. These actions may help the body excrete cholesterol.

Scientific evidence of Artichoke effectiveness

• 1. Fintelmann V. Antidyspeptic and lipid-lowering effect of artichoke leaf extract. Journal of Pharmacology And Experimental Therapeutics 2004 Sep;310(3):926-32.
• 2. Bundy R, Walker AF, Middleton RW, Wallis C, Simpson HC. Abstract Artichoke leaf extract (Cynara scolymus) reduces plasma cholesterol in otherwise healthy hypercholesterolemic adults: a randomized, double blind placebo controlled trial. Phytomedicine. 2008 Sep;15(9):668-75.
• 3. Englisch W, Beckers C, Unkauf M, Ruepp M, Zinserling V. Abstract Efficacy of Artichoke dry extract in patients with hyperlipoproteinemia. Arzneimittelforschung. 2000 Mar;50(3):260-5.

Barley

The addition of barley to a healthy diet may be effective in lowering total and LDL cholesterol in both men and women. In December, 2005 FDA allowed whole grain barley and barley-containing products to claim reduction in risk of coronary heart disease.

Scientific evidence of Barley effectiveness

• 1. Smith KN, Queenan KM, Thomas W, Fulcher RG, Slavin JL. Abstract Physiological effects of concentrated barley beta-glucan in mildly hypercholesterolemic adults. J Am Coll Nutr. 2008 Jun;27(3):434-40.
• 2. Shimizu C, Kihara M, Aoe S, Araki S, Ito K, Hayashi K, Watari J, Sakata Y, Ikegami S. Abstract Effect of high beta-glucan barley on serum cholesterol concentrations and visceral fat area in Japanese men--a randomized, double-blinded, placebo-controlled trial. Plant Foods Hum Nutr. 2008 Mar;63(1):21-5. Epub 2007 Dec 12.
• 3. Keenan JM, Goulson M, Shamliyan T, Knutson N, Kolberg L, Curry L. Abstract The effects of concentrated barley beta-glucan on blood lipids in a population of hypercholesterolaemic men and women. Br J Nutr. 2007 Jun;97(6):1162-8. Epub 2007 Apr 20. Erratum in: Br J Nutr. 2007 Aug;98(2):445. PubMed

Oats

There's plenty of evidence that eating oatmeal and oat bran lowers total cholesterol and LDL cholesterol levels. It's such a well-accepted belief that the FDA gave it the status of a "health claim" in 1997. The most of oats cholesterol-lowering power comes from the soluble fiber beta-glucan. In fact, oats have a greater proportion of soluble fiber than any other grain. Recent research suggests that other components of oats - such as the protein and natural antioxidants-may also contribute to heart health.

Scientific evidence of Oats effectiveness

• 1. Queenan KM, Stewart ML, Smith KN, Thomas W, Fulcher RG, Slavin JL. Free in PMC Concentrated oat beta-glucan, a fermentable fiber, lowers serum cholesterol in hypercholesterolemic adults in a randomized controlled trial. Nutrition Journal. 2007 Mar 26;6:6. PubMed
• 2. Berg A, Ko"nig D, Deibert P, Grathwohl D, Berg A, Baumstark MW, Franz IW. Abstract Effect of an oat bran enriched diet on the atherogenic lipid profile in patients with an increased coronary heart disease risk. A controlled randomized lifestyle intervention study. Ann Nutr Metab. 2003;47(6):306-11.
• 3. Maki KC, Shinnick F, Seeley MA, Veith PE, Quinn LC, Hallissey PJ, Temer A, Davidson MH. Free Full Text Food products containing free tall oil-based phytosterols and oat beta-glucan lower serum total and LDL cholesterol in hypercholesterolemic adults. Journal of Nutrition. 2003 Mar;133(3):808-13.

Fenugreek

Fenugreek seeds contain compounds known as steroidal saponins that inhibit both cholesterol absorption in the intestines and cholesterol production by the liver. Dietary fiber may also contribute to fenugreek's activity. Several human trials (some double-blind) have found that fenugreek may help lower total cholesterol in people with moderate atherosclerosis or those having insulin-dependent or non-insulin-dependent diabetes.

One double-blind study has also shown that defatted fenugreek seeds may raise levels of beneficial HDL cholesterol.

Germination of the fenugreek seeds may improve the soluble fiber content of the seeds, thus improving their effect on cholesterol.

Fenugreek powder is generally taken in amounts of 10 to 30 grams three times per day with meals.

Scientific evidence of Fenugreek effectiveness

• 1. Sauvaire Y, Ribes G, Baccou JC, Loubatieres-Mariani MM. Implication of steroid saponins and sapogenins in the hypocholesterolemic effect of fenugreek. Lipids. 1991 Mar;26(3):191-7.
• 2. Bordia A, Verma SK, Srivastava KC. Effect of ginger (Zingiber officinale Rosc.) and fenugreek (Trigonella foenumgraecum L.) on blood lipids, blood sugar and platelet aggregation in patients with coronary artery disease. Prostaglandins Leukot Essent Fatty Acids. 1997 May;56(5):379-84. PubMed
• 3. Sharma RD, Raghuram TC, Rao NS. t Effect of fenugreek seeds on blood glucose and serum lipids in type I diabetes. Eur J Clin Nutr. 1990 Apr;44(4):301-6.
• 4. Boban PT, Nambisan B, Sudhakaran PR. Hypolipidaemic effect of chemically different mucilages in rats: a comparative study. Br J Nutr. 2006 Dec;96(6):1021-9.

Royal jelly

Royal jelly is a honey bee secretion that is used in the nutrition of the larvae. Royal jelly equals pollen in its salutary effects.

Royal jelly has prevented the cholesterol-elevating effect of nicotine and has lowered serum cholesterol in animal studies. Preliminary human trials have also found that royal jelly may lower cholesterol levels. An analysis of cholesterol-lowering trials shows that 50 to 100 mg per day is the typical amount used in such research.

Scientific evidence of Royal jelly effectiveness

• 1. Guo H, Saiga A, Sato M, Miyazawa I, Shibata M, Takahata Y, Morimatsu F. Free Full Text Royal jelly supplementation improves lipoprotein metabolism in humans. J Nutr Sci Vitaminol (Tokyo). 2007 Aug;53(4):345-8.
• 2. Vittek J. Abstract Effect of royal jelly on serum lipids in experimental animals and humans with atherosclerosis. Experientia. 1995 Sep 29;51(9-10):927-35. Review.

Psyllium

The psyllium is a fiber that comes from the husks of the seeds of the psyllium plant. Psyllium is used in the treatment of constipation. It is also used to lower cholesterol and high blood pressure.

Use of psyllium as a way to reduce cholesterol levels has been extensively studied. An analysis of all double-blind trials in 1997 concluded that a daily amount of 10 grams psyllium lowered cholesterol levels by 5% and LDL cholesterol by 9%. Since then, a large controlled trial found that use of 5.1 grams of psyllium two times per day significantly reduced serum cholesterol as well as LDL-cholesterol.

Scientific evidence of Psyllium effectiveness

• 1. Ganji V, Kuo J. Free in PMC Serum lipid responses to psyllium fiber: differences between pre- and post-menopausal, hypercholesterolemic women. Nutr J. 2008 Aug 26;7:22.
• 2. Olson BH, Anderson SM, Becker MP, Anderson JW, Hunninghake DB, Jenkins DJ, LaRosa JC, Rippe JM, Roberts DC, Stoy DB, Summerbell CD, Truswell AS, Wolever TM, Morris DH, Fulgoni VL 3rd. Psyllium-enriched cereals lower blood total cholesterol and LDL cholesterol, but not HDL cholesterol, in hypercholesterolemic adults: results of a meta-analysis. Journal of Nutrition 1997 Oct;127(10):1973-80.
• 3. Anderson JW, Davidson MH, Blonde L, Brown WV, Howard WJ, Ginsberg H, Allgood LD, Weingand KW. Long-term cholesterol-lowering effects of psyllium as an adjunct to diet therapy in the treatment of hypercholesterolemia. Am J Clin Nutr. 2000 Jun;71(6):1433-8.

Guggul

Guggulipid is an ancient Ayurvedic herb that comes from the gummy resin of the mukul myrrh tree (Commiphora mukul). It is a thorny tree that grows in Northern India.

Researchers established that guggul-lipid blocks the activity of a receptor in the liver's cell, called farnesoid X receptor (FXR). This receptor binds bile acids, which maintain normal cholesterol levels.

Before 2003, most scientific evidence suggested that guggulipid produces significant reductions in serum total cholesterol, low-density lipoprotein, and triglycerides, as well as elevations in high-density lipoprotein. However, most published studies were small and methodologically flawed. In August 2003, a well-designed trial reported small significant increases in serum LDL levels associated with the use of guggul compared to placebo.

Guggul may cause stomach discomfort or allergic rash. It should be avoided in pregnant or breast-feeding women and in children.

Scientific evidence of Guggul effectiveness

• 1. Kotiyal JP, Bisht DB, Singh DS. Double blind cross-over trial of gum guggulu (Commiphora mukul) Fraction A in hypercholesterolemia. J Res Indian Med Yoga Hom 1979;14(2):11-6
• 2. Gaur SP, Garg RK, Kar AM, et al. Gugulipid, a new hypolipidaemic agent, in patients of acute ischaemic stroke: effect on clinical outcome, platelet function and serum lipids. Asia Pacif J Pharm 1997;12:65-9
• 3. Szapary PO, Wolfe ML, Bloedon LT, Cucchiara AJ, DerMarderosian AH, Cirigliano MD, Rader DJ. Free Full Text Guggulipid for the treatment of hypercholesterolemia: a randomized controlled trial. JAMA. 2003 Aug 13;290(6):765-72.

Vitamin B3 (Niacin)

Niacin is a B vitamin that has been proven to lower LDL cholesterol and triglycerides, and increase HDL cholesterol. Niacin is available in prescription form and as a dietary supplement.

Well-designed studies have found that niacin lowers LDL cholesterol by approximately 10%, lowers triglycerides by 25%, and raises HDL cholesterol by 15% to 30%. Niacin also appears to significantly lower levels for another risk factor for atherosclerosis, lipoprotein A.

Scientific evidence of Vitamin B3 effectiveness

• 1. Illingworth DR, Stein EA, Mitchel YB, et al. Comparative effects of lovastatin and niacin in primary hypercholesterolemia. A prospective trial. Arch Intern Med. 154 (1994): 1586-1595.
• 2. Karas RH, Kashyap ML, Knopp RH, Keller LH, Bajorunas DR, Davidson MH. Abstract Long-term safety and efficacy of a combination of niacin extended release and simvastatin in patients with dyslipidemia: the OCEANS study. Am J Cardiovasc Drugs. 2008;8(2):69-81.
• 3. Li XP, Duan J, Zhao SP, Tan MY, Xu ZM, Zhang DQ. Abstract [Efficacy and safety of extended-release niacin alone or with atorvastatin for lipid profile modification] Zhonghua Yi Xue Za Zhi. 2006 Sep 12;86(34):2399-403. Chinese.
• 4. Goldberg AC. Abstract A meta-analysis of randomized controlled studies on the effects of extended-release niacin in women. Am J Cardiol. 2004 Jul 1;94(1):121-4.