Protocol · Cardiovascular
High Cholesterol (Hypercholesterolemia) Protocol
Plant Sterols/Stanols and Soluble Fiber (Beta-glucan/Psyllium) are the core of this stack, with 4 supporting supplements. Each row gives the amount the protocol lists and the grade our evidence database holds for that supplement in High Cholesterol (Hypercholesterolemia).
We are re-verifying the studies cited on protocol pages; only confirmed citations are shown.
The stack
6 supplements · 3 graded · 1 graded A · 1 confirmed study
| Grade | Supplement | Amount listed | Why it’s in the stack | Evidence on file | Shop |
|---|---|---|---|---|---|
| Primary stackThe core of this protocol | |||||
| Plant Sterols/Stanols | Amount listed: 2–3 g daily with meals | Structurally similar to cholesterol, they compete for intestinal absorption, reducing dietary and biliary cholesterol uptake | Not graded yet | ||
| Soluble Fiber (Beta-glucan/Psyllium) | Amount listed: 3 g beta-glucan or 10 g psyllium daily | Binds bile acids, increasing hepatic LDL receptor expression to clear more cholesterol from blood
| Grade A for Blood glucose3 studies · 603 people | ||
Confirmed studies for Soluble Fiber (Beta-glucan/Psyllium) (titles as PubMed lists them) | |||||
| Supporting stackListed as additions to the core | |||||
| Red Yeast Rice | Amount listed: 1,200–2,400 mg daily (standardized to 3–10 mg monacolin K) | Contains monacolin K (natural lovastatin) that inhibits HMG-CoA reductase, reducing cholesterol synthesis | Not graded yet | ||
| Berberine | Amount listed: 500 mg 2–3× daily with meals | Inhibits PCSK9 to increase LDL receptor expression and activates AMPK to reduce cholesterol synthesis
| Grade C for Blood glucose116 people | ||
| Omega-3 Fatty Acids | Amount listed: 2–4 g EPA/DHA daily (for triglycerides) | Primarily lowers triglycerides; modest effect on raising HDL; little direct LDL-lowering effect
| Grade D for Adiponectin147 people | ||
| Niacin (Vitamin B3) | Amount listed: 1–2 g extended-release daily (with physician monitoring) | Raises HDL cholesterol significantly while lowering LDL and triglycerides
| Not graded yet | ||
Shop the evidence-backed picks
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.
Or shop one supplement
The supplement in this protocol graded A or B. Each opens third-party tested products, matched to the dose above where we can.
- Grade A
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How this protocol works
In plain language
High cholesterol, particularly elevated LDL ('bad cholesterol'), is a major risk factor for heart disease and stroke. Cholesterol comes from two sources: dietary intake and liver production. This protocol addresses both pathways while also supporting HDL ('good cholesterol').
- Plant Sterols/Stanols are one of the most effective natural cholesterol-lowering supplements. These plant compounds are structurally similar to cholesterol, so they compete with cholesterol for absorption in your intestines. Taking 2-3g daily can reduce LDL by 6-15%. They're often found fortified in margarine spreads, yogurt drinks, and standalone supplements.
- Soluble Fiber (Beta-glucan/Psyllium) works by binding bile acids in your intestine. Your liver then has to use more cholesterol to make new bile acids, reducing the cholesterol circulating in your blood. The FDA allows health claims for oat beta-glucan—just 3g daily (about 1.5 cups of oatmeal) can lower LDL by 5-10%. Psyllium works similarly.
- Red Yeast Rice contains monacolin K, which is chemically identical to the prescription statin lovastatin. It can lower LDL by 15-25%. However, because it works like a statin, it has similar precautions—potential for muscle problems and liver effects. Quality varies greatly between products, and some may contain contaminants.
- Berberine is a remarkable compound that lowers LDL by 20-25%—comparable to a low-dose statin—but through a different mechanism. It inhibits PCSK9, which increases the number of LDL receptors on liver cells, helping clear more cholesterol from your blood. It also lowers triglycerides and blood sugar.
- Omega-3 Fatty Acids primarily lower triglycerides (by 15-30%) rather than LDL. However, they're important for overall cardiovascular health and can raise HDL modestly. Higher doses (2-4g) are needed for significant lipid effects.
- Niacin (Vitamin B3) is the most effective supplement for raising HDL—increases of 15-35% are common. It also lowers LDL and triglycerides. However, it causes uncomfortable flushing in most people, and extended-release forms are better tolerated.
Expected timeline: LDL reductions from fiber and plant sterols appear within 4-6 weeks. Berberine and red yeast rice effects visible in 4-8 weeks. Retest your lipid panel after 8-12 weeks of supplementation.