Ask Doctor K: ‘Natural’ options not always the best treatment for high cholesterol

Tue., July 28, 2015

Anthony L. Komaroff M.D.

DEAR DOCTOR K: My cholesterol is high and my doctor wants me to go on a statin. I’d like to avoid medication. Do any supplements effectively lower cholesterol?

DEAR READER: Statin drugs lower LDL (or “bad”) cholesterol and also reduce inflammation. Together, these effects lower your risk of heart attack.

Various herbs and supplements have been touted for their ability to improve cholesterol levels. There is one general caveat you should consider. New drugs are tested by the FDA for their safety, effectiveness and purity.

However, almost the opposite is true for herbs and supplements. They are virtually free of testing and manufacturing requirements. Here’s what the research shows about some of the best-known products:

• HAWTHORNE . The leaves, berries and flowers of this plant are made into medicine that has been used to treat cardiovascular diseases. It may decrease the body’s production of cholesterol, and it may help the body excrete bile, a cholesterol-filled fluid that helps with digestion. Verdict: It may help.

• RED YEAST RICE. This Chinese medicine is marketed as a cholesterol-lowering agent. An independent analysis looked at 12 red yeast rice products that claimed to contain 600 milligrams of the active ingredient. The actual content varied between 0.10 mg and 10.9 mg. Also, some products were contaminated. Verdict: It may help, but purity remains a problem.

• FISH OIL. We know that eating fatty fish lowers heart risks for people with heart failure or a previous heart attack. But a 2013 study in the New England Journal of Medicine found that fish oil supplements don’t have the same effect. They don’t lower heart attack or stroke risk in people at high risk of heart disease. Verdict: Eat fish instead.

The truth is, “natural” treatments like herbs and supplements are not necessarily better, and there can be problems with their manufacture. Of course, conventional drugs can have adverse effects as well. But it’s rare for them to contain dangerous contaminants.