Your body knows how to heal. Think about it — if a poor diet and lifestyle can contribute to an unhealthy body, it stands to reason that a nutrient-rich diet and lifestyle can conversely contribute to a healthy body. That’s not too hard to figure out.
What is hard to figure out is what is bad for your health and what is good. Are statins good or are they bad? Should you take them? Are there alternatives? If so, what are they?
There are many conflicting stories because cholesterol metabolism is complex, making it a perpetually confusing topic. You deserve to understand your health before blindly accepting treatments.
I get a lot of questions about cholesterol, statin drugs, and how to lower cholesterol without taking statins. The good news is that certain plants and lifestyles have been scientifically proven to lower cholesterol. So, let’s break it all down. In this post, I cover:
- What is cholesterol, and why do we need it?
- Triglycerides and their relationship to cholesterol.
- How triglycerides and cholesterol interact.
- The Pareto Principle, cholesterol, and statins.
- Herbs and plants with evidence for cholesterol-lowering effects.
- Key metabolic biomarkers.
- With the proper knowledge and approach, you have the power to control your health.
What Is Cholesterol?
Cholesterol is a fatty, waxy substance found in every cell in the body. Roughly 20% comes from dietary sources, while 80% is primarily manufactured in the liver and other cells. Cholesterol metabolism studies show that this ratio can vary slightly depending on individual factors like genetics, diet, and lifestyle.
Excess sugar, particularly artificial sugars, refined carbohydrates, and genetic errors of liver metabolism, are mainly to blame for high cholesterol. Plant fibers can lower cholesterol, so a diet high in fruits and vegetables and whole grains with minimal fats helps maintain normal cholesterol levels.
• Types of cholesterol:
1. Low-density lipoprotein, LDL, is often called bad cholesterol because high levels are theorized to build plaque in the arteries.
2. High-density lipoprotein, HDL, is called the good cholesterol because it helps to remove excess cholesterol from the bloodstream and returns it to the liver for disposal.
3. Very low-density lipoprotein, VLDL, mainly carries triglycerides in the blood and is less commonly measured.
• Why do we need cholesterol? Cholesterol is present in every cell of the human body and is essential for cellular metabolism.
• Cholesterol is essential for several biological functions:1
◦Cell membrane structure — Cholesterol is a key component of cell membranes, providing stability.
◦Hormone production — The building block for steroid hormones, including sex hormones (estrogen, testosterone), cortisol, and aldosterone.
◦Vitamin D synthesis — When the skin is exposed to sunlight, the body uses cholesterol to make vitamin D.
◦Bile acid production — Cholesterol is converted into bile acids in the liver, which help digest fats.
• Cholesterol and brain health:
◦Myelin sheath formation — Cholesterol is a major component of myelin, the protective sheath around nerve fibers that speeds up electrical signaling.
◦Neurotransmitter function — It is involved in the communication between neurons, supporting the function of neurotransmitters like dopamine and serotonin.
◦Cell signaling — Cholesterol is crucial for forming “lipid rafts,” specialized areas in cell membranes that facilitate cell signaling in the brain.
◦Learning and memory — Proper cholesterol metabolism in the brain is necessary for synaptic plasticity, learning, and memory.
Triglycerides and Their Relationship to Cholesterol
Triglycerides, another type of fat (lipid) in the blood, come from foods and are synthesized in the liver. Triglycerides also come from extra calories your body does not need right away.
Excess calories are converted to triglycerides and stored as fat in the body for later use. While cholesterol is used for structural and hormonal functions, triglycerides serve primarily as an energy source:
• Energy storage — Excess calories from food are converted into triglycerides and stored in fat cells for later use.
• Transport — Triglycerides circulate in the blood within lipoproteins, especially very-low-density lipoproteins (VLDL), which also carry some cholesterol.
How Triglycerides and Cholesterol Interact
• Both are transported in the bloodstream via lipoproteins (VLDL, LDL, HDL).
• VLDL particles mainly carry triglycerides but also transport cholesterol. As triglycerides are removed from VLDL, the particles become LDL, which is richer in cholesterol.
• HDL particles help remove excess cholesterol from tissues and return it to the liver for disposal.
So while cholesterol is used for building cell walls, hormone production, and other structural and metabolic functions, triglycerides are used primarily for energy supply and storage.
In a blood test, the total cholesterol level includes LDL, HDL, triglycerides, and sometimes VLDL, and means very little as a combined total. High triglycerides are more concerning because people with high triglyceride levels have an 80% higher risk of having a heart attack compared to people with normal triglyceride levels.2
Inflammation, fibrinogen, triglycerides, homocysteine, belly fat, triglyceride to HDL ratios, and high glycemic levels are the underlying drivers of heart disease.3
“Emerging science is showing that cholesterol levels are a poor predictor of heart disease and that standard prescriptions for lowering it, such as ineffective low-fat/high-carb diets and serious, side-effect-causing statin drugs, obscure the real causes of heart disease.”
~ The Great Cholesterol Myth
The Pareto Principle and Cholesterol
The Pareto Principle states that 80% of outcomes often stem from just 20% of causes, also known as the 80/20 rule. While commonly used in business, this principle can be metaphorically applied to biology and health, especially when identifying the key drivers behind complex issues.
As I mentioned, about 80% of the body’s cholesterol is made in the liver, while only 20% comes directly from the diet. Statins target this liver production by blocking the enzyme HMG-CoA reductase, which seems logical on the surface. But this approach overlooks why the liver is overproducing cholesterol in the first place — it treats the symptom, not the cause.
In truth, suppressing that 80% of cholesterol production without addressing the underlying 20% of triggers of metabolic disorders, such as insulin resistance, chronic inflammation, stress, and hormonal imbalances, can be counterproductive.
Even though dietary cholesterol accounts for just 20%, certain foods (like excess sugar, refined carbs, trans fats, and high-fructose corn syrup) can prompt the liver to increase its cholesterol output. A small subset of poor dietary choices may be responsible for most of the problem — a textbook 80/20 scenario.
For many people, small, focused lifestyle changes — such as eliminating processed foods, walking regularly, or improving sleep — can lead to significant improvements in cholesterol levels. Thus, 20% of your effort may yield 80% of the results.
Herbs and Plants with Evidence for Cholesterol-Lowering Effects
Anna McIntyre writes in “The Complete Herbal Tutor”:4
• Antioxidant herbs protect arteries, inhibit the formation of atherosclerotic plaque, lower cholesterol, and help prevent cardiovascular disease.
• Useful herbs include hawthorn, cayenne, amalaki, guggulu, bilberry, elderberry, ginger, turmeric, evening primrose, Chinese Angelica, and licorice.
• Shiitake and reishi mushrooms and oats contain beta-glucans, which help lower cholesterol.
• A clove of garlic a day can substantially lower cholesterol levels.
• Red clover reduces its absorption.
• Artichoke leaves help lower cholesterol by helping the liver‘s metabolism of cholesterol.
Some of these herbs and plants studied for their potential to lower cholesterol levels are listed below in more detail. They are the most researched options, with scientific evidence and study findings cited here.5,6,7,8
• Red yeast rice (Monascus purpureus)
◦Red yeast rice contains monacolin K, a compound chemically identical to the statin drug lovastatin, with all the risks and side effects of taking a statin.9
◦Multiple randomized clinical trials and systematic reviews have shown that red yeast rice can reduce total cholesterol and LDL cholesterol by 10% to 33%.
◦It is considered one of the most effective natural products for lowering cholesterol, but quality and safety concerns exist due to variability in monacolin K content and potential contamination with citrinin, a nephrotoxin (kidney-damaging substance).
• Plant sterols and stanols
◦Found naturally in plant-based foods like fruits, vegetables, nuts, oils, seeds, and grains.
◦A 2022 network meta-analysis found that plant sterol supplementation leads to modest LDL and total cholesterol reductions.
◦They work by blocking cholesterol absorption in the small intestine.
• Bergamot (Citrus bergamia)
◦Bergamot extract and its polyphenols have shown promising lipid-lowering effects.
◦A 2022 systematic review and meta-analysis found significant decreases in total cholesterol, LDL cholesterol, and triglycerides, and an increase in HDL cholesterol. However, a small number of studies limit the evidence.
• Artichoke (Cynara scolymus)
◦Randomized trials have shown reductions in total cholesterol by up to 18.5% compared to placebo.
◦The evidence base is limited but promising, with good safety profiles reported in studies.
• Fenugreek (Trigonella foenum-graecum)
◦Several trials, mainly from India, have shown reductions in total cholesterol ranging from 15% to 33%.
◦Some studies also found reductions in LDL cholesterol, though methodological quality varies.
• Guggul (Commiphora mukul)
◦Some randomized trials have reported 10% to 27% reductions in total cholesterol.
◦Although results have been inconsistent, and quality concerns exist, it remains one of the more extensively studied herbal options.
• Garlic (Allium sativum)
◦Ancient history and a wealth of modern research support the use of garlic. More than 3,000 scientific papers cover its chemistry, pharmacology, and clinical uses.10
◦The therapeutic uses of garlic are extensive, but those specific to the cardiovascular system include reducing elevated cholesterol, preventing atherosclerosis and hypertension, treating poor circulation to the legs, and improving overall blood flow through antiplatelet actions.
• Red clover (Trifolium pratense)
◦Systematic reviews have found significant reductions in total cholesterol and increases in HDL cholesterol in postmenopausal women, but effects on LDL cholesterol are inconsistent.
• Green tea (Camellia sinensis)
◦An American Journal of Clinical Nutrition meta-analysis suggests that green tea significantly reduces total cholesterol, including LDL or “bad” cholesterol, to 2.19 mg/dL in the blood. However, green tea didn’t affect HDL, or “good” cholesterol.11
Biomarkers and Blood Work
When examining bloodwork to evaluate cardiac risk and metabolic health, cholesterol alone is insufficient. These parameters and other risk factors, such as diabetes, cardiovascular issues, and liver function, must all be considered.
High LDL cholesterol was once thought to contribute to plaque buildup in the arteries, which could lead to the plaque becoming dislodged at some point, leading to a heart attack or stroke. Newer schools of thought don’t point to LDL as causing plaque buildup in the arteries but rather to chronic inflammation as being the cause.12
The newer cardiovascular assessment blood tests measure a specific protein called Apolipoprotein B (ApoB) within the LDL, which directly counts the number of atherogenic (plaque-producing) particles in the blood.
If ApoB is not measured, C-reactive protein (CRP) may be measured. CRP measures overall inflammation in the body and screens for cardiovascular risk. That’s important because many chronic diseases result from chronic inflammation. Metabolic biomarkers are key indicators of overall cellular health and disease risk.
The specific thresholds depend on your risk factors, and each lab has its parameters, but for reference, these are the normal ranges from LabCorp:
• LDL
◦Optimal — <100 mg/dL
◦Near-optimal — 100–129 mg/dL
◦Borderline high — 130–159 mg/dL
◦High — 160–189 mg/dL
◦Very high — ≥190 mg/dL
• HDL Cholesterol
◦Optimal — >39 mg/dL
• VLDL Cholesterol Cal
◦Optimal — 5–40 mg/dL
• Triglycerides
◦Optimal — 0–149 mg/dL
• Apolipoprotein B (ApoB)
◦Optimal — <130 mg/dL.
• C-reactive protein (CRP)
◦< 1.0 mg/dL or 10.0 mg/L
Relationship of Total Cholesterol to HDL
“Neither type of cholesterol is inherently bad or good. Both are necessary for good health. They need to be balanced in the body. Divide your total cholesterol by your HDL cholesterol. If the resulting number is 4 or less, you are at low risk, regardless what your total cholesterol number is. The ratio of total cholesterol to HDL is a much better predictor of risk than simply your total cholesterol number.13”
~ Christiane Northrup, M.D., The Wisdom of Menopause
Key Metabolic Biomarkers
In her book “Good Energy,” Casey Means, M.D., writes about the five specific biomarkers to evaluate for overall metabolic health.14 Research shows that exercise improves all five of the following basic biomarkers of metabolism:
• Glucose levels above 100 mg/dL — Twelve-week exercise programs of either high-intensity running (40 minutes per week) or low-intensity running (150 minutes per week) both brought participants’ blood sugar from the prediabetic range (100 mg/dL or greater) to the nondiabetic range.
• HDL cholesterol less than 40 mg/dL — A 2019 review of the literature showed that exercise increased HDL cholesterol, “with exercise volume, rather than intensity, having a greater influence.” Meanwhile, “raising HDL levels pharmacologically has not shown convincing clinical benefits.”
• Triglycerides above 150 mg/dL — Numerous studies have demonstrated that physical activity effectively lowers triglyceride levels. In a 2019 study, an eight-week moderate aerobic exercise program significantly reduced triglyceride levels in participants. Furthermore, even a single session of intense aerobic exercise has been found to decrease triglyceride levels the following day.
This positive effect could be due to the increased activity of hepatic lipase in the liver, an enzyme that facilitates the absorption of triglyceride from the bloodstream.
• Blood pressure of 130/85 mm Hg or higher — Research has shown the effects of exercise among populations with high blood pressure were similar to the effects of commonly used medications.
(Note: blood pressure parameters considered high used to be above 140/90 mm Hg. This study15 changed that. The top number (systolic) measures artery pressure during a heartbeat; the bottom (diastolic) measures it between beats. Both are important but know systolic pressure can spike with stress. Blood pressure should be measured in both arms over time — not based on a single reading — especially before starting medication.)
• A waistline of more than 35 inches for women and 40 inches for men — Not surprisingly, regular exercise can help decrease obesity by increasing energy expenditure and promoting weight loss.
Research shows a clear inverse relationship between the amount of movement people do each week and the size of their waistline: more movement, smaller waist circumference. What’s more, lower activity (fewer than 5,100 steps per day) yields a 2.5 times higher risk of central obesity than higher activity (more than 8,985 steps per day).
Key Takeaways
With the proper knowledge and approach, you have the power to control your health.
• Reduce sugar, HFCS, refined carbohydrates, and other highly processed foods.
• Eat a diet high in vegetables, whole grains, especially oats, beans, legumes, pulses (such as beans, lentils, chickpeas), good fats, and oily fish.
• Take regular aerobic exercise and daily walking.
• There is no “one size fits all” diet for heart health. Eat whole foods without preservatives and additives, and concentrate on plant foods.
One important caveat:
• Statins lower LDL cholesterol quickly by blocking an enzyme (HMG-CoA reductase) the liver uses to make cholesterol. Results are often seen in 4 to 6 weeks.
• Diet and lifestyle can be highly effective, but changes may take 3 to 6 months or more. The degree of improvement depends on adherence, genetics, and overall health.
Live life well.
About Author
Mary Ann Rollano is a writer, registered nurse, and award-winning tea specialist with 40 years of experience in health and wellness. Passionate about the four pillars of health — physical, emotional, spiritual, and social harmony — she blends her expertise in tea, herbs, and nutrition to inspire meaningful connections and happier, healthier lives. Connect with her through her Steeped Stories newsletter.
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