High cholesterol and natural remedies
High cholesterol is one of the most common cardiovascular risk factors worldwide, and it is estimated that 2.6 million deaths each year are attributable to it. Whilst statins represent the first-line pharmacological treatment, many people are turning to natural alternatives, either because they cannot tolerate the side effects of statins — particularly muscle pain — or because they wish to support their diet with preventative supplements before medication becomes necessary.
In this article, we review the natural supplements most extensively studied in the peer-reviewed scientific literature for lowering ‘bad’ cholesterol (LDL) and improving the overall lipid profile, along with the actual percentages documented in clinical trials.
The most effective natural supplements — ranked by strength of evidence
1. Berberine — the most potent of the natural supplements
Berberine is a natural alkaloid extracted from several plants, most notably Berberis. It works by activating the AMPK pathway, which inhibits cholesterol synthesis in the liver and increases the density of LDL receptors on the surface of liver cells — a mechanism that is essentially similar to that of statins.
A meta-analysis concluded that berberine reduced LDL by −0.46 mmol/l, total cholesterol by −0.48 mmol/l, and triglycerides by −0.34 mmol/l, whilst increasing HDL by 0.06 mmol/l — over treatment periods ranging from 4 to 24 weeks. Another analysis confirmed these findings in 12 randomised controlled clinical trials involving 889 participants.
2. Phytosterols and plant stanols — the most effective in supporting heart health
Phytosterols are compounds with a structure similar to that of cholesterol; they compete with it for absorption in the gut, thereby reducing the amount of cholesterol that enters the bloodstream. According to a 2026 review that examined randomised clinical trials and meta-analyses up to April 2026. A review published in PMC documented that phytosterols reduce LDL by between 7% and 10% when 2 grams are consumed daily, and that they are included in the recommendations of the European and American Heart Associations as a dietary supplement option.
3. Omega-3 (EPA and DHA) — The most potent effect on triglycerides
Omega-3 fatty acids are renowned for their distinctive effect on lowering triglycerides by inhibiting their synthesis in the liver and promoting their oxidation in the mitochondria. The US National Centre for Health has noted that omega-3 is one of the most extensively studied natural supplements in the context of lipid management, with a limited effect on LDL but a significant effect on triglycerides. A PMC review (2025) has shown that combining omega-3s, phytosterols and fibre within a healthy diet may achieve a further reduction in total cholesterol that exceeds the results achieved by any of these components alone.
5. Viscous fibre — beta-glucan and psyllium
Viscous fibres, such as beta-glucan found in oats and psyllium, work by binding to bile acids in the gut and excreting them in the stools, thereby forcing the liver to use cholesterol to produce more bile acids — thus lowering the level of free cholesterol in the blood. An IFM Synergy review (2026) classified viscous fibre under the category ‘Strength of evidence: Strong’, and it is included in the recommendations of the US and European dietary guidelines.
6. Spirulina — an algal polyphenol for lipid profile
A review in PMC (2025) noted that spirulina is among the polyphenols that have shown supportive results in improving the lipid profile, particularly in reducing triglycerides and LDL and improving HDL in multiple studies.nii
| Medication | Primary Target | Expected LDL Reduction | Main Mechanism |
| Berberine | LDL + triglycerides | 10–15% | Activates AMPK + increases LDL receptors |
| Fenofibrate | LDL | 7–10% | Reduces intestinal cholesterol absorption |
| Omega-3 | Triglycerides | Up to 30% for triglycerides | Inhibits hepatic fat synthesis |
| Garlic extract | LDL | 5–10% | Inhibits the HMG-CoA enzyme |
| Bile acid sequestrants | LDL | 5–10% | Binds bile acids and promotes their excretion |
| Spirulina | LDL + triglycerides | 5–10% | Antioxidant effects + regulation of fat metabolism |
Can these supplements be taken together?
Yes, and combining them usually produces an additive rather than an antagonistic effect, as each acts via a different biological pathway. A PMC review (2025) demonstrated that combining phytosterols, omega-3s, fibre and polyphenols within a healthy diet yields better results than any single supplement. However, the IFM Synergy review (2026) pointed out that some combinations — such as the combination of phytosterols with bergamot and artichoke — did not demonstrate an additional effect on LDL in a randomised clinical trial in 2025 compared with the individual components, suggesting that combination does not always produce an additive effect.
Marnys® supports heart health
Marnys® offers the OmegaCod product, which combines omega-3 from fish oil rich in EPA and DHA with cod liver oil rich in vitamins D and A. This formula supports cardiovascular health by lowering triglycerides and improving vascular elasticity. Circulmar oil also supports blood lipid levels through its natural allicin compounds.
Frequently Asked Questions
Does berberine work in the same way as statins? Berberine, like statins, inhibits the HMG-CoA pathway, but does so indirectly via AMPK. Its effect is weaker than that of statins, but it does not cause their well-known muscular side effects.
How long does it take for garlic extract to lower cholesterol? Studies suggest that a noticeable effect begins after 8–12 weeks of regular use.
Are phytosterols safe for long-term use? Yes, at the recommended doses (2 g per day); they have been included in fortified food products in Europe and North America for two decades.
Do I need to change my diet whilst taking these supplements? Absolutely; supplements complement a healthy diet, they do not replace it. Reducing saturated and trans fats and increasing fibre intake doubles the effectiveness of any supplement.
Is it possible to lower cholesterol entirely without medication? In cases of mild to moderate hypercholesterolaemia with no cardiovascular risk factors, supplements and diet may achieve sufficient results. However, severe hypercholesterolaemia or a history of heart disease inevitably requires drug treatment.
With omega-3 from fish oil rich in EPA and DHA, and cod liver oil rich in vitamins D and A. This combination supports cardiovascular health by lowering triglycerides and improving the elasticity of blood vessels. Circulmar oil also supports blood lipid levels through natural allicin compounds.
Summary
Scientifically studied natural supplements — such as berberine, phytosterols, omega-3, garlic and fibre — offer effective tools to support cholesterol management as part of a holistic health approach. Their true value lies in the cumulative effects of these supplements through integrated biological pathways, rather than in relying on a single supplement. However, medical follow-up and monitoring of lipid profiles remain essential and cannot be replaced by any supplement, regardless of its scientific evidence.
