Ask what's needed to improve your cholesterol levels, and most health experts will put a healthy diet and plenty of exercise at the top of their list. However, certain supplements may also help raise the good type of cholesterol and possibly lower the bad.
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The Lowdown on Cholesterol
High-density lipoprotein cholesterol, or HDL, is considered "good" cholesterol because it helps your body get rid of some of the bad type: called low-density lipoprotein (LDL), according to the Centers for Disease Control and Prevention.
It "picks up extra cholesterol particles from tissues and blood vessels and brings them back to the liver, where it is broken down and passed from the body," explains Rajsree Nambudripad, MD, an integrative medicine specialist with St. Jude Medical Center in Fullerton, California. "The higher your HDL, the better."
A desirable level of HDL for men and women is 60 milligrams of cholesterol per deciliter of blood (mg/dL) or above, according to the Mayo Clinic.
However, HDL only carriers away about a third to a fourth of your bad LDL cholesterol, the American Heart Association (AHA) says. And it's LDL that gives cholesterol its bad rap. Too much LDL cholesterol in your blood can cause a buildup of plaque in artery walls, restricting or blocking blood flow and possibly leading to heart problems, according to AHA.
What to Do
Cardiovascular exercise is a good way to raise your HDL, Dr. Nambudripad says. "This can include brisk walking, running, hiking, biking, swimming or dancing — so, find an exercise you enjoy," he suggests.
What about supplements? AHA says that vitamin or mineral supplements aren't a substitute for a balanced, nutritious diet — one that keeps extra calories, saturated fat, trans fat, sodium and cholesterol to a minimum. However, some supplements like fish oil, which contain omega-3s, may help increase your good cholesterol.
Omega-3 fatty acids may raise HDL, the Cleveland Clinic says. Naturally, omega-3 fatty acids are found in fatty fish.
"Omega-3s seem to have a more beneficial effect when absorbed from foods, so I recommend a couple of servings a week of rich sources such as salmon or tuna," says Kristian Morey, RD, LDN, a clinical dietitian at The Center for Endocrinology at Mercy Medical Center in Baltimore. AHA recommends consuming two servings of fish — particularly fatty fish like salmon, mackerel, sardines or albacore tuna — a week.
Omega-3s are also in fish oil pills or capsules. Look for fish oil supplements with EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), the Cleveland Clinic says. These are both omega-3 fatty acids.
AHA says patients with heart disease should consume about 1 gram of EPA and DHA per day and that this should ideally come from your diet. However, AHA notes that this level can be difficult to reach by diet alone, so a supplement could be needed. You should discuss taking supplements with your doctor first.
Supplement Suggestions Have Changed
In the past, niacin and red yeast rice have been recommended to lower total cholesterol, but neither is now.
Niacin is not recommended as a supplement to lower total cholesterol because the doses would have to be quite high to make a difference, and that high level could increase your risk of developing diabetes, worsen gout or result in liver damage, Morey says.
Niacin is available as a prescription and in dietary supplement form. However, the supplement version shouldn't be used in place of prescription niacin because of possible serious side effects and because the niacin amount in supplements may vary widely, according to AHA.
Red yeast rice contains a compound called monacolin K, which may reduce cholesterol, according to the Mayo Clinic. However, the U.S. Food and Drug Administration required this compound to be removed from all products sold in the United States, Morey says. Even if you were to find red yeast rice with monacolin K, the quality and quantity is not guaranteed in the same way a prescribed medication is, Morey says.
The best way to get the vitamins and minerals you need to maintain healthy cholesterol levels is through diet, Morey says. If you're interested in supplements, it's best to consult with your doctor to find the best plan for you.
- Centers for Disease Control and Prevention: “LDL and HDL Cholesterol: Bad and Good Cholesterol”
- American Heart Association: “HDL, LDL Cholesterol and Triglycerides”
- Rajsree Nambudripad, MD, integrative medicine specialist, St. Jude Medical Center, Fullerton, California
- Mayo Clinic: “HDL Cholesterol: How to Boost Your ‘Good’ Cholesterol”
- Cleveland Clinic: “From Fiber to Fish Oil: Natural Ways to Lower Your Cholesterol”
- Cleveland Clinic: “Omega-3 Fatty Acids”
- AHA: "Vitamin Supplements: Hype of Help for Healthy Eating"
- Kristian Morey, RD, LDN, clinical dietitian, The Center for Endocrinology, Mercy Medical Center, Baltimore
- AHA: "Cholesterol Medications"
- Mayo Clinic: "Red Yeast Rice"