Below you will find an overview of the different types of dietary supplements available for the promotion of healthy levels of cholesterol. Important information about the most common dietary supplements is summarized, including their main ingredient and their recommended dosage. Also provided below are links to scientific or clinical research conducted on each dietary supplement showing if they are really effective or not.

Garlic (capsules): Through the years, several studies have been conducted to determine the effect of garlic on blood cholesterol levels. In the year 2000, researchers compiled, using a statistical technique called meta-analysis, the results of 38 studies that examined the effects of garlic on total cholesterol. Of the 38 studies, only 13 studies met the criteria for inclusion in the final report and only six were considered “high-quality” studies. The results of the 13 combined studies showed that garlic lowered total cholesterol by 15.7 milligrams per deciliter (mg/dL) more than placebo, although the six studies with more rigorous research indicated that garlic did not have any noticeable effect on total cholesterol levels. The analysis concluded: “the [garlic] effect is modest, and the robustness of the effect is debatable. The implication for clinical practice, therefore, is that garlic use is not an efficient way to decrease total serum cholesterol level” and “patients… should be advised that according to current evidence, any specific effect [of garlic] is small and may not be clinically meaningful.” For more information on the studies on garlic, click here.

Robert Atkins M.D., in his book New Diet Revolution, made a relevant statement about garlic: “I like it better on a rack of lamb or scampi, but if you like [garlic] pills, consider taking 6 to 12 of them a day.” Note that if you decide to take that many pills of garlic on a daily basis, acid indigestion, bad breath, and garlic-odor perspiration may occur.

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Red yeast rice (a.k.a. âng-chau, angkak, aka-koji, beni-koji, hóng-qú, hung-chu, Xue Zhi Kang, Zhi Tai) is a food spice that has been part of the Asian people’s diet for thousands of years. Red yeast is a bright, reddish-purple fermented rice that acquires its color from being cultivated with Monascus Purpureus, a type of fungus.

In the 1990s, Japanese scientists discovered that red yeast rice inhibited the key enzyme—HMG-CoA reductase—responsible for producing cholesterol in the liver. Since then, more than 20 studies have been conducted (in China, Germany, Japan, the United States, and other countries) on the effects of red yeast rice on hundreds of individuals. Scientific and clinical studies have shown a 25 to 40 percent drop in total cholesterol levels for those individuals taking capsules containing red yeast rice powder as a dietary supplement. Red yeast rice has also shown a significant effect in promoting healthy levels of LDL and triglyceride.

One study in China was very instrumental in popularizing the effects of red yeast rice on cholesterol. In the United States at least two clinical studies have been conducted on red yeast rice. The first study was conducted by David Heber, Ph.D., M.D., at the University of California at Los Angeles (UCLA). Before completing his study, Heber anticipated that the benefits seen in his patients are clearly “beyond what would be seen with diet and exercise alone.” The second study, conducted at multiple centers throughout the United States, was directed by James Rippe, M.D., associate professor of medicine at Tufts University School of Medicine in Boston. For more information on these studies, click here.

The common manufacturer’s recommended dosage of red yeast rice is two 600 mg capsules twice a day.

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Policosanol (a.k.a. polycosanol) is a mix of a few fatty alcohols derived from some plants (mainly sugar cane), yam, and bee wax. The types of alcohol present in policosanol are octacosanol, triacontanol, and several others in lower concentrations.

Three published studies, one in Cuba, one in Germany, and one in the United States, have resulted in two divergent points of view.

The Cuban study claims that policosanol helps promote healthy levels of cholesterol, reducing LDL (“bad cholesterol”) and increasing HDL (“good cholesterol”). This first study was funded by the company Dalmer Laboratories (a.k.a. Laboratorios Dalmer), which was established by the National Center for Scientific Research in Havana specifically to patent and market policosanol on a worldwide basis. Cuba has an abundance of both “pharmaceutical research” and sugar cane farms. Policosanol is actually consumed by some Cubans as a panacea for high cholesterol.

The study performed in Germany failed to find any evidence of the cholesterol-lowering effects of policosanol. With 143 participants suffering hypercholesterolemia, the subjects were given random daily dosages (10, 20, 40, or 80 milligrams) of policosanol or placebo. After 12 weeks, researchers found no statistically or clinically significant effects on LDL, HDL, total cholesterol, triglyceride, or other lipoproteins. In summary, the German study found policosanol to be of no clinical value.

The United States study also failed to find any effects of policosanol on cholesterol. The study concluded: “Policosanol does not alter the serum lipid profile over an 8-week period in adults with mild hypercholesterolemia.”

For more information on these studies, click here.

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Niacin (nicotinic acid or vitamin B3) is best known, among individual nutrients, for lowering cholesterol. Niacin has no effect in small doses. To be effective, the dosage must be 75 to 250 times the RDA. At these huge amounts, niacin becomes a drug and must be taken only under medical supervision. Niacin, when taken in large doses, increases HDL and therefore is sometimes prescribed for patients with low HDL. Niacin is also used in the treatment of hyperlipidemia because it reduces very-low-density lipoprotein (VLDL), a precursor of LDL, and therefore it moderately inhibits cholesterol synthesis in the liver. Although it is the least expensive cholesterol-lowering dietary supplement, niacin can be unpleasant to take and sometimes has undesirable side effects, including itching and flushing. For these reasons, adherence to long-term treatment is poor. In lieu of its ability to increase levels of HDL, several pharmaceutical companies are conducting large-scale clinical trials on niacin to determine the feasibility of combining it in one pill with the “statin” drugs (see below), which have been proven effective in lowering LDL. To read a summary of a study on the effects of niacin on HDL, click here.

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Gugul (a.k.a. guggul, guggulipids, guggulu) is a gum-like substance (resin) extracted by tapping on the bark of the small, spiny Mukul Myrrh tree cultivated commercially and native to India and Pakistan. Gugul has a fragrance similar to Myrrh and therefore is commonly used in incense and perfumes; it is the same product that was known in Hebrew, ancient Greek, and Latin as bdellium. Gugul has been employed as a traditional remedy in the practice of Ayurvedic medicine, claiming benefits including relief from epilepsy, ulcers, obesity, acne, and rheumatoid arthritis. Researchers in some Asian countries believe that gugul helps in the promotion of healthy levels of cholesterol, although the precise mechanism is not yet known. Products containing guggulipids’ active ingredient (guggulsterone) are sold worldwide with the claim that they reduce cholesterol. Although several studies in the countries of origin showed a small percent decrease in total cholesterol, a more recent study conducted at the University of Pennsylvania by medical doctor Philippe O. Szapary and his colleagues concluded that “guggulipid did not appear to improve levels of serum cholesterol over the short term in this population of adults with hypercholesterolemia, and might in fact raise levels of LDL-C. Guggulipid also appeared to cause a dermatologic hypersensitivity reaction in some patients.” To read a summary of the Pennsylvania study on the effects of guggulipids on cholesterol, click here.

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Sitosterol is the most common form of phytosterol, a compound found in plant foods such as rice and soybeans. Sitosterol prevents dietary cholesterol from being absorbed in the small intestine. “Sitosterol is very effective in lowering cholesterol in the range of 10 to 15 percent,” stated the famous researcher David Kritchevsky, Ph.D., of the Wistar Institute. Sitosterol is directed toward blocking the absorption of dietary cholesterol; it does nothing to control the production of cholesterol in the liver. The dosage that is appropriate depends on how much food-cholesterol is consumed by each individual. At each meal, aim for a 2 to 1 ratio of sitosterol to cholesterol consumed. For example, if the estimated amount of cholesterol in a meal is 400 mg, you would take 800 mg of sitosterol immediately before the meal. If your diet is low in cholesterol yet your blood cholesterol level is still higher than you desire it to be, sitosterol-based dietary supplements may not be for you. Since the sitosterol won’t have anything to block, the effect on your cholesterol level will be minimal.

Source: Original research in an article published by Judith Lin and Laura Goldstein was used to complement the information provided above on this Web page.

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