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Which are more effective in cutting cholesterol—statins or supplements?

MDlinx Jan 13, 2023

As people shy away from using traditional medications such as statins to reduce their cholesterol, they are turning to supplements as natural remedies. But are supplements as effective as statins?

Research indicates supplements are not, prompting clinicians to discuss the health benefits and potential side effects of statins with patients who question their efficacy and safety.

 

Statins vs. supplements

A study conducted by the Cleveland Clinic found that statins are more effective at reducing cholesterol than supplements, according to an NPR report.

Aubrey A. Statins vs. supplements: New study finds one is ‘vastly superior’ to cut cholesterol. NPR. November 6, 2022.

 

As published in the Journal of the American College of Cardiology, the study included 190 adults between the ages of 40–75.

Laffin LJ, Bruemmer D, Garcia M, et al. Comparative effects of low-dose rosuvastatin, placebo and dietary supplements on lipids and inflammatory biomarkers. J Am Coll Cardiol. 2023;81(1):1–12.

 

For 28 days, some of the participants were given supplements such as cinnamon, garlic, turmeric, red yeast rice, and fish oil, as well as plant sterols. The other participants were given 5 mg of rosuvastatin (Crestor).

What we found was that rosuvastatin lowered LDL cholesterol by almost 38%, and that was vastly superior to placebo and any of the six supplements studied in the trial.

These results indicated that statins are effective in reducing LDL, the type of cholesterol that builds up in arteries and could possibly lead to heart disease and stroke. Supplements, however, showed no difference in reducing LDL or promoting heart health.

In addition to supplements having little to no effect on reducing cholesterol, they are also reportedly more expensive than statins. Because supplements are typically bought over the counter, people will end up paying more for them compared with statins, which are mostly covered by insurance.

 

 

Side effects studied

A major reason people hesitate to take statins is that they worry about their associated side effects.

To help address this concern, a study published in the New England Journal of Medicine compared the possible side effects of statins vs. those of placebos.

Wood FA, Howard JP, Finegold JA, et al. N-of-1 trial of a statin, placebo, or no treatment to assess side effects. N Engl J Med. 2020;383(22):2182–2184.

 

This was a double-blind, three-group study of patients who had previously been on statins but then stopped taking them after the onset of side effects within 2 weeks of starting the medications.

Each participant was to cycle randomly through a 4-month period in one of three treatment groups: 20 mg of atorvastatin, a placebo, or no medication at all. They rate their daily symptoms on a scale of 0 to 100, with 0 meaning no symptoms while 100 indicated terrible symptoms.

The conclusions drawn from this study were based on 49 adults who had completed the 1-year trial within these treatment groups. The study found that about 90% of the symptoms recorded from statins were also associated with the placebo group, and about 50% of the participants began taking statins again after the study had ended.

These results indicate that statins are superior to supplements at reducing LDL, as well as promoting heart health and lowering the risk of stroke and heart disease.

As research shows, there are minimal side effects associated with statins, so physicians may want to discuss them with patients to help allay their concerns about this type of medication.

What this means for you

Clinicians should check their patients’ risk factors for heart disease. Based on those risk factors, you can discuss the appropriateness of starting statins and clarify their minimal side effects.

 

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