Condition

Atherosclerosis

Atherosclerosis is a slow buildup of fatty plaque in artery walls, driven by cholesterol-carrying particles and inflammation, which narrows and stiffens the vessels. Berberine has the most research behind it, and small studies found lower C-reactive protein, a marker of inflammation; apolipoprotein A went up with niacin, and HDL cholesterol improved with L-carnitine. Still, the evidence is mostly limited, built on small trials, and naringenin's promise came largely from animal work.

Sources: PMID 22085343; PMID 19618992

Supplements studied: 14
Graded outcomes: 14
Trials: 7
People studied: 4,749

Evidence by supplement

Strong
Moderate
Limited
Very limited

14 supplements

L-Carnitine

L-Carnitine: outcomes studied for Atherosclerosis
Grade	Outcome	Effect	Size	Studies	People
	High-density lipoprotein (HDL) Small Improvement	Improves (the measure goes up)	Small effect	12 studies	18 people
Studies that measured high-density lipoprotein (hdl) Comparative study to evaluate the effect of l-carnitine plus glimepiride versus glimepiride alone on insulin resistance in type 2 diabetic patientsDiabetes Metab Syndr · PMID 30641691 Effects of simvastatin and carnitine versus simvastatin on lipoprotein(a) and apoprotein(a) in type 2 diabetes mellitusExpert Opin Pharmacother · PMID 19618992 Comparison between orlistat plus l-carnitine and orlistat alone on inflammation parameters in obese diabetic patientsFundam Clin Pharmacol · PMID 21077943 and 9 more on the L-Carnitine page
	Total cholesterol	Improves (the measure goes down)		6 studies	18 people
Studies that measured total cholesterol Effect of oral L-carnitine administration on insulin sensitivity and lipid profile in type 2 diabetes mellitus patientsAnn Nutr Metab · PMID 18714152 Effects of carnitine on glucose and lipid metabolic profiles and fertility outcomes in women with polycystic ovary syndrome: A systematic review and meta-analysis.Clin Endocrinol · PMID 36746677 Oral carnitine supplementation reduces body weight and insulin resistance in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trialClin Endocrinol · PMID 26666519 and 3 more on the L-Carnitine page
	Triglycerides	Improves (the measure goes down)		4 studies	18 people
Studies that measured triglycerides The effects of L-carnitine supplementation on cardiovascular risk factors in participants with impaired glucose tolerance and diabetes: a systematic review and dose-response meta-analysis.Diabetol Metab Syndr · PMID 39085907 Effects of combined treatment with simvastatin and L-carnitine on triglyceride levels in diabetic patients with hyperlipidaemiaClin Drug Investig · PMID 23315432 Effects of L-carnitine supplementation on lipid profiles in patients with coronary artery diseaseLipids Health Dis · PMID 27317162 and 1 more on the L-Carnitine page
	Neutrophil Count	Improves (the measure goes up)		1 study	18 people
Studies that measured neutrophil count l-Carnitine Improves Postoperative Liver Function in Hepatectomized PatientsJPEN J Parenter Enteral Nutr · PMID 31599019
	Serum Platelets	Improves (the measure goes up)		1 study	18 people
Studies that measured serum platelets Plasma Trimethylamine-N-oxide following Cessation of L-carnitine Supplementation in Healthy Aged WomenNutrients · PMID 31200429
	Low-density lipoprotein (LDL)	Improves (the measure goes down)			18 people
	Lymphocyte Count	Improves (the measure goes up)			18 people
	Monocyte Count	Improves (the measure goes up)			18 people
	TMAO	Improves (the measure goes up)			18 people
	White Blood Cell Count	Improves (the measure goes up)			18 people

Naringenin

Naringenin: outcomes studied for Atherosclerosis
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Atherosclerosis Risk A review of literature (PMID 25483717) summarizes consistent preclinical evidence that naringenin reduces LDL and triglycerides, increases HDL, suppresses macrophage inflammation, and inhibits foam cell formation. In mice, naringin reduced atherosclerotic plaque by 41% over 18 weeks (PMID 21684135). One human RCT showed reduced arterial stiffness (PMID 26016866), supporting vascular benefit.	Improves (the measure goes down)	Moderate effect	5 studies	48 people
Studies that measured atherosclerosis risk A Review on Pharmacological and Analytical Aspects of NaringeninChinese Journal of Integrative Medicine · 2018 · PMID 25501296 Flavanones protect from arterial stiffness in postmenopausal women consuming grapefruit juice for 6 mo: a randomized, controlled, crossover trialThe American Journal of Clinical Nutrition · 2015 · PMID 26016866 Naringenin and atherosclerosis: a review of literatureCurrent Pharmaceutical Biotechnology · 2015 · PMID 25483717 and 2 more on the Naringenin page

Phosphorus

Vascular Calcification: improves

Phosphorus: outcomes studied for Atherosclerosis
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Vascular Calcification Mechanistic and observational studies demonstrate that excess phosphorus promotes pathological vascular calcification by inducing osteogenic differentiation of vascular smooth muscle cells. Clinical studies in CKD patients show phosphate burden accelerates arterial calcification and vascular stiffness.	Improves (the measure goes up)	Moderate effect	4 studies
Studies that measured vascular calcification Phosphate Metabolism in Health and DiseaseCalcified Tissue International · 2021 · PMID 32266417 Plant phosphates, phytate and pathological calcifications in chronic kidney diseaseNefrologia · 2017 · PMID 27697413 Phosphate-a poison for humans?Kidney International · 2016 · PMID 27282935 and 1 more on the Phosphorus page

Niacin (Vitamin B3)

Apolipoprotein A: improves
Apolipoprotein B: improves
Low-density lipoprotein (LDL): improves

Niacin (Vitamin B3): outcomes studied for Atherosclerosis
Grade	Outcome	Effect	Size	Studies	People
	Apolipoprotein A Small Increase	Improves (the measure goes up)	Small effect	1 study	3,196 people
Studies that measured apolipoprotein a Niacin in patients with low HDL cholesterol levels receiving intensive statin therapyN Engl J Med · PMID 22085343
	Apolipoprotein B	Improves (the measure goes down)		3 studies	3,196 people
Studies that measured apolipoprotein b Niacin, but not gemfibrozil, selectively increases LP-AI, a cardioprotective subfraction of HDL, in patients with low HDL cholesterolArterioscler Thromb Vasc Biol · PMID 11701466 Effect of fenofibrate and niacin on intrahepatic triglyceride content, very low-density lipoprotein kinetics, and insulin action in obese subjects with nonalcoholic fatty liver diseaseJ Clin Endocrinol Metab · PMID 20371660 Effects of niacin on apo A1 and B levels: a systematic review and meta-analysis of randomised controlled trials.Br J Nutr · PMID 38112076
	Low-density lipoprotein (LDL)	Improves (the measure goes down)		2 studies	3,196 people
Studies that measured low-density lipoprotein (ldl) Extended-release niacin raises adiponectin and leptinAtherosclerosis · PMID 16887123 Effects of nicotinic acid on insulin sensitivity and blood pressure in healthy subjectsJ Hum Hypertens · PMID 10980588
	High-density lipoprotein (HDL)	Improves (the measure goes up)		1 study	3,196 people
Studies that measured high-density lipoprotein (hdl) Nicotinic acid effects on insulin sensitivity and hepatic lipid metabolism: an in vivo to in vitro studyHorm Metab Res · PMID 24806747
	Heart Attack Risk	Changes; see studies			3,196 people
	Stroke Risk	Changes; see studies			3,196 people
	Triglycerides	Improves (the measure goes down)			3,196 people

Ginkgo Biloba

Microcirculation: improves
Oxidative Stress Biomarkers: improves

Ginkgo Biloba: outcomes studied for Atherosclerosis
Grade	Outcome	Effect	Size	Studies	People
	Microcirculation Small Improvement	Improves (the measure goes up)	Small effect	1 study	32 people
Studies that measured microcirculation A new ginkgo fresh plant extract increases microcirculation and radical scavenging activity in elderly patientsAdv Ther · PMID 22120894
	Oxidative Stress Biomarkers	Improves (the measure goes down)			32 people

Berberine

C-Reactive Protein (CRP): improves
Total cholesterol: improves
High-density lipoprotein (HDL): improves

Berberine: outcomes studied for Atherosclerosis
Grade	Outcome	Effect	Size	Studies	People
	C-Reactive Protein (CRP) Small Decrease	Improves (the measure goes down)	Small effect		120 people
	Total cholesterol	Improves (the measure goes down)		3 studies	689 people
Studies that measured total cholesterol Overall and Sex-Specific Effect of Berberine for the Treatment of Dyslipidemia in Adults: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials.Drugs · PMID 36941490 Efficacy and safety of berberine for several cardiovascular diseases: A systematic review and meta-analysis of randomized controlled trials.Phytomedicine · PMID 36805484 The Effect of Berberine on Reproduction and Metabolism in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Control Trials.Evid Based Complement Alternat Med · PMID 31915452
	High-density lipoprotein (HDL)	Improves (the measure goes up)		2 studies	589 people
Studies that measured high-density lipoprotein (hdl) Effects of berberine on lipid profile in subjects with low cardiovascular riskExpert Opin Biol Ther · 2013 · PMID 23441841 The effects of berberine supplementation on cardiovascular risk factors in adults: A systematic review and dose-response meta-analysis.Front Nutr · PMID 36313096
	Triglycerides	Improves (the measure goes down)		1 study	689 people
Studies that measured triglycerides Efficacy and Safety of Berberine Alone for Several Metabolic Disorders: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.Front Pharmacol · 2021 · PMID 33981233
	Interleukin 6	Improves (the measure goes down)			240 people
	Low-density lipoprotein (LDL)	Improves (the measure goes down)			689 people
	TNF-Alpha	Improves (the measure goes down)			240 people

Policosanol

High-density lipoprotein (HDL): improves
Low-density lipoprotein (LDL): improves
Total cholesterol: improves

Policosanol: outcomes studied for Atherosclerosis
Grade	Outcome	Effect	Size	Studies	People
	High-density lipoprotein (HDL) Small Improvement	Improves (the measure goes up)	Small effect		179 people
	Low-density lipoprotein (LDL)	Improves (the measure goes down)		10 studies	179 people
Studies that measured low-density lipoprotein (ldl) Effect of sugar cane policosanol on lipid profile in primary hypercholesterolemiaPhytother Res · PMID 18167048 Efficacy and tolerability of policosanol in hypercholesterolemic postmenopausal womenInt J Clin Pharmacol Res · PMID 11708573 Lack of cholesterol-lowering efficacy of Cuban sugar cane policosanols in hypercholesterolemic personsAm J Clin Nutr · PMID 17093150 and 7 more on the Policosanol page
	Total cholesterol	Improves (the measure goes down)		3 studies	179 people
Studies that measured total cholesterol Effects of policosanol (10 mg/d) versus aspirin (100 mg/d) in patients with intermittent claudication: a 10-week, randomized, comparative studyAngiology · PMID 18388038 Policosanol for managing human immunodeficiency virus-related dyslipidemia in a medically underserved population: a randomized, controlled clinical trialAltern Ther Health Med · PMID 21717822 Effects of policosanol 20 versus 40 mg/day in the treatment of patients with type II hypercholesterolemia: a 6-month double-blind studyInt J Clin Pharmacol Res · PMID 11708574
	Triglycerides	Improves (the measure goes down)			179 people

Cyanidin

Endothelial Function: improves

Cyanidin: outcomes studied for Atherosclerosis
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Endothelial Function In apolipoprotein E-deficient mice, C3G supplementation protected against hypercholesterolemia-mediated endothelial dysfunction, attenuated atherosclerosis, and promoted endothelial repair in diabetic models. In vitro, C3G attenuated angiotensin II-induced oxidative stress in vascular endothelial cells and modulated miR-204-5p/SIRT1-mediated inflammation and apoptosis. No human cardiovascular trials with isolated C3G.	Improves (the measure goes up)	Moderate effect	6 studies
Studies that measured endothelial function Cyanidin-3-O-glucoside attenuates endothelial cell dysfunction by modulating miR-204-5p/SIRT1-mediated inflammation and apoptosis.BioFactors · 2020 · PMID 32593198 Anthocyanins and cognitive function: a review of human intervention studiesEur J Nutr · 2017 · PMID 22234894 Cyanidin-3-glucoside attenuates angiotensin II-induced oxidative stress and inflammation in vascular endothelial cells.Chemico-Biological Interactions · 2016 · PMID 27983965 and 3 more on the Cyanidin page

Chinese Hawthorn

Atherosclerosis Progression: changes; see studies

Chinese Hawthorn: outcomes studied for Atherosclerosis
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Atherosclerosis Progression Network pharmacology and animal pharmacology studies on the Danshen-Shanzha herb pair suggest protective effects against atherosclerosis. A 2026 study demonstrated synergistic promotion of fatty acid oxidation via PPARα, Plin-5, and Plin-2 activation in metabolic liver disease models.	Changes; see studies	Small effect	3 studies
Studies that measured atherosclerosis progression The active components of the Danshen-Shanzha herb-pair exert a protective effect on MASLD by synergistically promoting fatty acid oxidation via the activation of PPARα, Plin-5 and Plin-2.Journal of Ethnopharmacology · 2026 · PMID 41690426 Effects and mechanisms of Danshen-Shanzha herb-pair for atherosclerosis treatment using network pharmacology and experimental pharmacology.Journal of Ethnopharmacology · 2019 · PMID 30312741 Crataegus pinnatifida: Chemical constituents, pharmacology, and potential applicationsMolecules · 2014 · PMID 26342172

Danshen

Atherosclerosis Progression: changes; see studies

Danshen: outcomes studied for Atherosclerosis
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Atherosclerosis Progression In preclinical models, danshen compounds reduce oxidized LDL and inhibit smooth muscle cell hyperplasia after vascular injury (PMID:11367667). Magnesium lithospermate B protects human aortic endothelial cells from free radical damage in vitro (PMID:15250206). Human translation of these anti-atherogenic effects has not been established.	Changes; see studies	Small effect	2 studies
Studies that measured atherosclerosis progression Effect of magnesium lithospermate B on endothelial cells in human aorta after free radical injuryZhongguo Zhong Xi Yi Jie He Za Zhi · 2004 · PMID 15250206 Experimental study of hirudo and Salvia miltiorrhiza on smooth muscle cell hyperplasia after balloon angioplastyZhongguo Zhong Xi Yi Jie He Za Zhi · 1998 · PMID 11367667

Flavanols

LDL Oxidation: improves

Flavanols: outcomes studied for Atherosclerosis
Grade	Outcome	Effect	Size	Studies	People	Studies list
	LDL Oxidation In vitro studies show flavan-3-ols and procyanidins protect liposomes against lipid oxidation and bilayer disruption. Cocoa procyanidins protect LDL from oxidation regardless of polymer chain length when monomer units are controlled, suggesting monomeric flavanols are the active species.	Improves (the measure goes down)	Moderate effect	2 studies
Studies that measured ldl oxidation Flavan-3-ols and procyanidins protect liposomes against lipid oxidation and disruption of the bilayer structure.Free Radical Biology & Medicine · 2003 · PMID 12498983 Cocoa procyanidin chain length does not determine ability to protect LDL from oxidation when monomer units are controlled.The Journal of Nutritional Biochemistry · 2002 · PMID 12550061

Hederagenin

Atherosclerosis Progression: improves

Hederagenin: outcomes studied for Atherosclerosis
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Atherosclerosis Progression In a Wistar rat atherosclerosis model (high-lipid diet + vitamin D3), hederagenin improved blood rheology and endothelial function, corrected iNOS/eNOS imbalance, and inhibited IKKβ/NF-κB signaling with results comparable to atorvastatin at statistical significance (P < 0.01).	Improves (the measure goes up)	Moderate effect	1 study
Studies that measured atherosclerosis progression Experimental Study of Antiatherosclerosis Effects with Hederagenin in RatsEvidence-Based Complementary and Alternative Medicine · 2015 · PMID 26557859

Vitamin C

Adiponectin
Triglycerides: improves
Blood glucose: improves

Vitamin C: outcomes studied for Atherosclerosis
Outcome	Effect	Size	Studies	People
Adiponectin No effect		NoneNo effect		8 people
Triglycerides	Improves (the measure goes down)		5 studies	8 people
Blood glucose	Improves (the measure goes down)		3 studies	8 people
Inflammation	Improves (the measure goes down)		2 studies	8 people
Total cholesterol	Improves (the measure goes down)		2 studies	8 people
C-Reactive Protein (CRP)	Improves (the measure goes down)		1 study	8 people
High-density lipoprotein (HDL)	Improves (the measure goes up)			8 people
Insulin	Changes; see studies			8 people
LDL Oxidation	Improves (the measure goes down)			8 people
Low-density lipoprotein (LDL)	Improves (the measure goes down)			8 people

Nicotinamide Mononucleotide

Endogenous Advanced Glycation End Products
Pulse Wave Velocity: improves

Nicotinamide Mononucleotide: outcomes studied for Atherosclerosis
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Endogenous Advanced Glycation End Products No effect		NoneNo effect		36 people
	Pulse Wave Velocity	Improves (the measure goes down)		1 study	36 people

Key findings

High-density lipoprotein (HDL)L-CarnitineImproves (the measure goes up)
Atherosclerosis RiskNaringeninImproves (the measure goes down)
Vascular CalcificationPhosphorusImproves (the measure goes up)

The Atherosclerosis protocol

2 primary supplements · 4 supporting supplements

Berberine500 mg three times daily
Omega-3 Fatty Acids (EPA/DHA)2–4 g EPA/DHA daily

See the full protocol

Shop the evidence-backed picks

Support alongside medical care. These supplements are not a treatment for Atherosclerosis. If you are being treated for it, talk to your clinician before adding one: supplements can interact with medicines.

Fullscript collectionHeart and circulation: evidence-graded picksOpen on Fullscript

The collection holds the supplements we grade A or B for its theme, in third-party tested products where the catalog has them. It opens in our Fullscript store. You can look through it without signing in; Fullscript asks for a free account to order.

We earn from purchases made in our Fullscript store, and links to Fullscript, iHerb or Thorne carry our referral, so we may earn a commission at no extra cost to you. Grades come from the research and never change based on what we earn. Full disclosure

Studies cited

2 studies from PubMed

Effect of nuts on lipid profile and inflammatory biomarkers in atherosclerotic cardiovascular disease: a systematic review and meta-analysis of randomized controlled trials.Eur J Nutr · PMID 38967674
The antiatherosclerotic effect of Allium sativumAtherosclerosis · PMID 10381297

Evidence by supplement

Key findings

The Atherosclerosis protocol

Shop the evidence-backed picks

Studies cited

Related conditions

Supplement stack for Atherosclerosis