The general sentiment among doctors is that supplements are not a reliable substitute for guideline-recommended, scientifically proven lipid-lowering therapies.
Aman reiterated that no dietary supplement has yet demonstrated significant LDL-C-lowering effects.
“The SPORT trial randomized adults at intermediate with heart disease risk to low-dose rosuvastatin (5 mg), one of six supplements (fish oil, cinnamon, garlic, turmeric, plant sterols, or red yeast rice), or placebo. Rosuvastatin reduced LDL-C by 37.9%, while none of the supplements significantly lowered LDL-C compared with placebo,” he said.
Buttar said that, compared with prescription fish oil, over-the-counter fish oil supplements have variable contents and generally inconsistent LDL-cholesterol-lowering effects.
“Prescription fish oil, Icosapent ethyl, a purified EPA product, was shown to reduce cardiovascular events in specific high risk groups in trials, but it does not substantially lower LDL in the way statins do,” Buttar said.
On the topic of red yeast rice supplements, Buttar said, “It contains monacolin K, which is chemically similar to statin therapy, lovastatin, and can lower LDL.”
She said the main concern with such supplements was product purity and potency.
“Contamination or inconsistent dosing are concerns. Because it essentially delivers a statin-like compound without regulation, clinicians generally advise caution. It is not a reliable or recommended substitute for prescribed therapy,” she added.