context: There are many alternative treatments proposed for lowering cholesterol. But before you add any supplements or alternative therapies to your diet, talk to your health care provider. Few natural products have been proven in scientific studies to reduce cholesterol, but some might be helpful. But also, some supplements may interact with other medication you're taking or have the potential for dangerous side effects. Some of the herbal and nutritional supplements that may help lower cholesterol include: Garlic: According to some studies, garlic may decrease blood levels of total cholesterol by a few percentage points, but only in the short term. Other studies, however, suggest that it may not be as beneficial as once thought. Garlic may prolong bleeding and blood clotting time, so garlic and garlic supplements should not be taken prior to surgery or with blood-thinning drugs such as Coumadin. Fiber: Taking a fiber supplement to help meet your daily fiber intake can help lower your overall cholesterol level and your LDL (bad) cholesterol. Examples include psyllium, methylcellulose, wheat dextrin, and calcium polycarbophil. If you take a fiber supplement, increase the amount you take slowly. This can help prevent gas and cramping. It’s also important to drink enough liquids when you increase your fiber intake. Guggulipid: Guggulipid is the gum resin of the mukul myrrh tree. It has been used in traditional Ayurvedic medicine, which originated in India more than 2,000 years ago. In clinical studies done in India, guggulipid significantly reduced blood levels of total cholesterol and LDL cholesterol. But most of these studies do not meet the criteria for scientific validity. In addition, the enthusiasm for using guggulipid as a cholesterol-lowering herbal agent diminished after the publication of negative results from a clinical trial in the U. S. Further research is necessary to determine the safety and effectiveness of this herb. Red yeast rice: Red yeast rice has been found to lower cholesterol in studies and was previously found in the over-the-counter supplement Cholestin. However, in 2001, FDA took Cholestin off the shelf because it contained lovastatin, a compound found in the cholesterol prescription medication Mevacor. Reformulated " Cholestin" no longer contains red yeast rice. Other red yeast rice-containing supplements currently available in the U. S. can only contain very small levels of lovastatin. The FDA does not allow promotion of red yeast rice for lowering cholesterol. Policosanol: Produced from sugar cane, policosanol was found to be effective in lowering LDL cholesterol in several studies. Most policosanol supplements found in the U. S., including the reformulated Cholestin, contain policosanol extracted from beeswax and not the sugar cane policosanol. There is no evidence that policosanol extracted from beeswax can lower cholesterol. Additional studies on sugar cane policosanol are needed to determine its effectiveness and safety in lowering cholesterol. Other herbal products: The results of several studies suggest fenugreek seeds and leaves, artichoke leaf extract, yarrow, and holy basil all may help lower cholesterol. These and other commonly used herbs and spices -- including ginger, turmeric, and rosemary -- are being investigated for their potential beneficial effects relating to coronary disease prevention. Increased consumption of dietary fiber, soy foods, omega-3 fatty acids, and plant compounds similar to cholesterol (plant stanols and sterols) can significantly reduce LDL cholesterol, or bad cholesterol. Fiber: Only plant foods (vegetables, fruits, legumes, unrefined grains) contain dietary fiber. The soluble fiber found in foods such as oat bran, barley, psyllium seeds, flax seed meal, apples, citrus fruits, lentils and beans are particularly effective in lowering total and LDL cholesterol. Nuts: Many nuts such as almonds, walnuts, pecans, and pistachios can reduce cholesterol. According to the FDA, eating a handful (1.5 ounces ) of walnuts daily can reduce the risk of heart disease. You can replace foods high in saturated fats with nuts and they are a good source of fiber. Soybeans: Substituting soybeans or soy protein for other proteins have been shown to prevent coronary heart disease by lowering LDL cholesterol and triglycerides. Soy protein is present in tofu, tempeh, soy milk, soy yogurt, edamame, soy nuts, and many other food products made from soybeans. Phytosterols: Phytosterols (plant sterol and stanol esters) are compounds found in small amounts in foods such as whole grains as well as in many vegetables, fruits, and vegetable oils. They decrease LDL cholesterol, mostly by interfering with the intestinal absorption of cholesterol. Phytosterols can be found in spreads (like the cholesterol-lowering margarines Benecol, Promise, Smart Balance, and Take Control), dressings for salads, and dietary supplements. Additional phytosterol-fortified foods include Minute Maid Heart Wise orange juice, Nature Valley Healthy Heart chewy granola bars, Coco Via chocolates, Rice Dream Heartwise rice drink, and Lifetime low-fat cheese. Omega-3 fatty acids: Eating foods rich in omega-3 fatty acids may also help reduce heart disease and lower triglycerides. Omega-3 fatty acids decrease the rate at which the liver produces triglycerides. Omega-3 fatty acids also have an anti-inflammatory effect in the body, decrease the growth of plaque in the arteries, and aid in thinning blood. Aim for at least two servings of fatty fish like salmon, mackerel, herring, tuna, and sardines per week. Other dietary sources of omega-3 fatty acids include flax seed and walnuts. Supplement sources include fish oil capsules, flaxseed and flaxseed oil. If you are considering taking omega-3 fatty acids, first discuss with your health care provider if omega-3 fatty acid supplements are right for you, especially if you are currently taking blood-thinning medication. Dietary fiber, nuts, soybeans, and phytosterols decrease cholesterol levels by different mechanisms. Therefore, it is not surprising that the combined dietary intake of these foods and other plant substances along with a low intake of saturated fats is more effective at reducing cholesterol levels than each individual substance alone. Avoid Trans Fats Avoid partially hydrogenated and hydrogenated vegetable oils. These man-made oils are sources of trans fatty acids known to increase LDL cholesterol. They lower heart-protecting HDL (good) cholesterol and increase the inflammatory response in the body. You can now find trans fats listed on the Nutrition Facts panel of packaged foods. Minimize consumption of trans fatty acid-containing food. If diet and regular exercise isn't effective at reducing your cholesterol levels, talk to your doctor about taking cholesterol-lowering medications.