Medical Edge Newspaper Column

Lowering Cholesterol Without Medication

November 4, 2007
Dear Mayo Clinic:
My cholesterol is high, but my doctor doesn't recommend a prescription medication yet. What should I be doing to take care of it?

Answer:
You don't say how old you are or how high your cholesterol is, factors which could influence your doctor's advice. For example, if you are in your 80s, treatment might not have any significant long-term benefit, and if your cholesterol is only mildly elevated, lifestyle changes could be tried before medications.

Medication (primarily statins) can reduce low-density lipoprotein (LDL) cholesterol — the bad cholesterol — from 25 percent to 50 percent. But for a variety of reasons, statins aren't an option for everyone. Weight loss, exercise, a healthy diet and supplements are tools that can help you rein in your cholesterol levels.

Losing even five to 10 pounds of excess weight can help lower total cholesterol levels. And exercising 30 to 60 minutes a day can help lower triglyceride levels and boost high-density lipoprotein (HDL) — the good cholesterol.

In addition, experts agree that what you eat has a direct impact on your cholesterol level. Limit saturated fats and cholesterol and increase soluble fiber.

Consuming food products containing sterols or stanols, healthy substances found in certain plants, is another option. In fact, recent studies have shown that a plant sterol can work with statin medications to further reduce cholesterol levels.

Other supplements and natural products may help lower cholesterol, too. Some are more effective than others, and some have side effects.

Studies have shown niacin (vitamin B-3) can reduce LDL levels and raise HDL levels, but possible side effects include flushing, hot flashes, nausea, vomiting and diarrhea. Fish oil and ground flaxseed offer benefits by providing essential omega-3 fatty acids, and studies show that red yeast or red yeast rice actually produces a natural source of lovastatin, a prescription drug for treating high cholesterol.

With any supplement, be cautious about the purity of the product, the consistency of dosage and any possible herb-drug interactions. It's important to work closely with a doctor to monitor your regimen for safety and effectiveness.

For most people with high cholesterol, prescription medications are safe and effective. The best nonprescription therapy — a heart-healthy diet — can benefit nearly everyone.

— Brent Bauer, M.D., Complementary and Integrative Medicine Program, Mayo Clinic, Rochester, Minn.