Cholesterol-lowering supplements: Lower your numbers without prescription medication

If you're worried about your cholesterol and have already started exercising and eating healthier foods, you might wonder if adding a cholesterol-lowering supplement to your diet can help reduce your numbers. Although few natural products have been proved to reduce cholesterol, some might be helpful. With your doctor's OK, consider these cholesterol-lowering supplements and products.

Cholesterol-lowering supplement	What it does	Side effects and drug interactions	Usual suggested doses
Artichoke extract	May reduce total cholesterol and LDL, or "bad," cholesterol	May cause gas or an allergic reaction	1,800 to 1,920 milligrams a day, divided into 2 to 3 doses
Barley	May reduce total cholesterol and LDL cholesterol	None	3 grams barley oil extract or 30 grams barley bran flour a day
Beta-sitosterol (found in oral supplements and some margarines, such as Promise Activ)	May reduce total cholesterol and LDL cholesterol	May cause nausea, indigestion, gas, diarrhea or constipation May be ineffective if you take ezetimibe (Zetia), a prescription cholesterol medication	800 milligrams to 6 grams a day, divided and taken before meals, or 2 tablespoons of margarine containing beta-sitosterol a day
Blond psyllium (found in seed husk and products such as Metamucil)	May reduce total cholesterol and LDL cholesterol	May cause gas, stomach pain, diarrhea, constipation or nausea	5 grams seed husk twice a day, or 1 serving a day of products such as Metamucil
Fish oil (found as a liquid oil and in oil-filled capsules)	May reduce triglycerides	May cause a fishy aftertaste, bad breath, gas, nausea, vomiting or diarrhea May interact with some blood-thinning medications, such as warfarin (Coumadin)	2 to 4 grams a day
Flaxseed, ground	May reduce total triglycerides	May cause, gas, bloating or diarrhea May interact with some blood-thinning medications, such as aspirin, clopidogrel (Plavix) and warfarin (Coumadin)	40 to 50 grams a day, stirred into cereal or yogurt, or mixed into the batter for baked goods
Garlic extract	May reduce total cholesterol, LDL cholesterol and triglycerides	May cause bad breath or body odor, heartburn, gas, nausea, vomiting or diarrhea May interact with blood-thinning medications, such as warfarin (Coumadin)	600 to 1,200 milligrams a day, divided into 3 doses
Oat bran (found in oatmeal and whole oats)	May reduce total cholesterol and LDL cholesterol	May cause gas or bloating	Up to 150 grams of whole-oat products a day
Sitostanol (found in oral supplements and some margarines, such as Benecol)	May reduce total cholesterol and LDL cholesterol	May cause diarrhea	800 milligrams to 4 grams a day, or 4 1/2 teaspoons of margarine containing sitostanol a day

Another popular cholesterol-lowering supplement is red yeast rice. There is some evidence that red yeast rice can help lower your LDL cholesterol. However, the Food and Drug Administration has warned that the following red yeast rice products could contain a naturally occurring form of the prescription medication known as lovastatin:

• Red Yeast Rice and Red Yeast Rice/Policosanol Complex sold by Swanson Health Products Inc. and manufactured by Nature's Value Inc. and Kabco Inc.
• Cholestrix sold by Sunburst Biorganics

The presence of lovastatin in the red yeast rice products in question is potentially dangerous because there's no way for you to know what level or quality of lovastatin might be in red yeast rice.
Sometimes healthy lifestyle choices, including supplements and other cholesterol-lowering products, aren't enough. If your doctor prescribes medication to reduce your cholesterol, take it as directed while you continue to focus on a healthy lifestyle. As always, if you decide to take an herbal supplement, be sure to tell your doctor. The herbal supplement you take may interact with other medications you take.