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A person can also take other dietary supplements, such as berberine and fish oil, to help lower cholesterol. However, people should only use these products after speaking with a doctor. Cholesterol is a waxy substance that circulates in the blood. There are two main types of cholesterol: low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Sometimes, people call LDL “bad” cholesterol and HDL “good” cholesterol. LDL takes cholesterol and fats, such as triglycerides, to the cells that need them. HDL takes excess cholesterol and fats to the liver, which removes them from the body. When there is more LDL cholesterol than the HDL cholesterol can remove, it stays in the blood. When this happens, fatty deposits called plaque can build up in the arteries. Plaque consists of cholesterol, cellular waste products, calcium, fibrin, and fatty substances. This plaque build-up can increase the risk of cardiovascular diseases (CVDs) such as heart attacks and strokes. Vitamins are substances, usually present in food, that the body needs to develop and function. Niacin is a vitamin that can help lower LDL cholesterol levels. However, people should not start taking it without speaking with a doctor first. This article will examine how niacin helps lower a person’s cholesterol. It also looks at other supplements a person may take, safety precautions, and alternatives to cholesterol. Learn more about HDL and LDL cholesterol here. Niacin and cholesterol Share on PinterestJW LTD/Getty ImagesNiacin, or nicotinic acid, is a B vitamin that can help to lower cholesterol. Although niacin is naturally present in certain foods, there are two types of dietary niacin supplements. These are nicotinic acid and nicotinamide. A doctor may prescribe prescription-strength nicotinic acid to treat high cholesterol. The American Heart Association (AHA) states that nicotinic acid limits the production of fats in the liver. This lowers the levels of triglycerides and, as a result, lowers LDL cholesterol. However, the Office of Dietary Supplements (ODS) notes that although niacin can reduce LDL cholesterol, it does not significantly affect a person’s risk of developing a cardiovascular event. Prescription-strength nicotinic acid is over 100 times the recommended daily allowance, and as a result, people should only take niacin under the approval and supervision of a doctor. Learn what causes high cholesterol here. Dose People should take the medication at bedtime after eating a low fat snack. A doctor typically prescribes 500 milligrams (mg) for 1–4 weeks to reduce the chance and severity of the side effects. They may then increase the dose to 1,000–2,000 mg daily, depending on the individual’s needs. Learn more about niacin here. Safety and precautions The AHA notes that the Food and Drug Administration (FDA) does not regulate niacin in the form of dietary supplements. These products may contain higher or lower doses of niacin than stated on the label. Always consult a doctor before taking niacin. A person should never take the dietary supplement version of niacin to replace prescription niacin. This is because it can lead to serious side effects. The ODS states that if a person takes daily dietary supplements that contain 30 mg or more of nicotinic acid, they can develop the following:flushed skin on the arms, face, neck, and chestburningitchingheadachedizzinessrashes Those who take 1,000 mg or more of nicotinic acid daily as a medication can experience:low blood pressurehigh blood sugar levelsnauseaheartburnstomach painimpaired or blurred visiona build up of fluid in the eyesliver problems, such as liver failure and hepatitis As niacin can raise a person’s blood sugar levels, it may not suit those with diabetes. High doses of niacin may also not be suitable for those who take statins. Learn more about diabetes in our dedicated hub here. Supplements to lower cholesterol Other dietary supplements that may help to lower cholesterol include: Omega-3 polyunsaturated fatty acids PUFA Omega-3 PUFAs, also known as omega-3 fish oils or omega-3 fatty acids, can help reduce the levels of triglycerides fats in the blood. Omega-3 PUFAs are present in foods such as oily fish, seeds, and nuts. Supplements are also available. The AHA recommends people only use these supplements under their doctor’s care. Large doses can cause serious side effects, including:bleedingstroke In people with diabetes, omega-3 PUFA supplements can make it more difficult to control their blood sugar levels. People with fish or shellfish allergies may have an allergic reaction to omega-3 PUFAs. Learn more about polyunsaturated fats (PUFAs here. Berberine Berberine comes from plants such as goldenseal, barberry, Oregon grape, and tree turmeric. Some studies have shown that it may be able to reduce levels of LDL and triglycerides in the blood when combined with a healthy lifestyle. However, researchers are not yet sure if this will work for everyone. The possible side effects of berberine include:diarrheaconstipationnauseavomiting Learn more about triglycerides and cholesterol levels here. Flaxseed Flaxseed contains α-linolenic acid, lignans, and phenolic compounds, which can lower LDL and triglycerides in the blood. The dietary supplement form of flaxseed is usually an oil. Learn more about the best supplements for lowering cholesterol. Alternatives Other ways to lower cholesterol include: Eating a balanced diet The best way for a person to help lower their cholesterol level is to limit the amount of total and saturated fat they eat. Saturated fat raises LDL levels more than any other food. Red meat, dairy, chocolate, deep-fried and processed foods all contain high levels of saturated fat. Learn about how much saturated fat to eat daily. Exercising more Exercise can increase the levels of HDL cholesterol in the blood. The AHA recommends that adults get at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous aerobic activity each week. Learn more about how exercise helps cholesterol levels here. Taking prescription medicines There are lots of prescription medications for people with high cholesterol. They include:statinscholesterol absorption inhibitorsbile acid sequestrantsPCSK9 inhibitorsadenosine triphosphate-citrate lyase (ACL) inhibitors The right treatment approach will depend on the individual. That is why it is important for people to speak with their doctor if they are concerned about their cholesterol. Learn more about cholesterol-lowering medications and other remedies here. Summary The body needs a balance of LDL and HDL cholesterol. However, eating foods high in saturated fats can upset this balance, adding to CVD risks. Niacin is a vitamin that can help lower LDL cholesterol. However, people should only take niacin under the supervision of a doctor because it can lead to severe side effects. Last medically reviewed on July 22, 2022CholesterolSupplements 14 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.American Heart Association recommendations for physical activity in adults and kids. (2018).https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adultsCholesterol medications. 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(2021).https://ods.od.nih.gov/factsheets/Niacin-HealthProfessional/Niaspan – niacin tablet, film coated, extended release. (2010).https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ccc64ee7-f581-493b-b8c2-6147a0db197ePizzini, A., et al. (2017). The role of omega-3 fatty acids in reverse cholesterol transport: A review.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5691715/Tabeshpour, J, et al. (2017). A review of the effects of Berberis vulgaris and its major component, berberine, in metabolic syndrome.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478784/What is atherosclerosis? (2020).https://www.heart.org/en/health-topics/cholesterol/about-cholesterol/atherosclerosisWhat is cholesterol? (2020).https://www.heart.org/en/health-topics/cholesterol/about-cholesterolYe, Y, et al. (2021). Efficacy and safety of berberine alone for several metabolic disorders: A systematic review and meta-analysis of randomized clinical trials.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107691/FEEDBACK:Medically reviewed by Sade Meeks, MS, RD, Nutrition — By Amanda Barrell on July 22, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageVitamin D and cholesterol: What to knowMedically reviewed by Alana Biggers, M.D., MPH The connection between vitamin D and cholesterol is inconclusive. 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