Dietary supplements are widely marketed and available to health-care consumers who wish to lower their cholesterol levels. As dietary supplements are not considered drugs, there is a lack of regulation in their production and also a deficiency of appropriately designed trials demonstrating their efficacy and safety when used alone or in combination with prescription medications. However, using supplements in place of or in addition to prescribed cholesterol-lowering therapies may be more aligned with the patient’s value system or health-care philosophy. Dietary supplements, such as red yeast rice (RYR), have been shown to have the same mode of action as prescription cholesterol-lowering therapies like 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors. While others, like soluble dietary fiber (SDF), have multiple proposed modes of action. Reasonable data exist to support the use of dietary supplements—in addition to lifestyle modification—as an alternative, or add-on therapy, in those who are unable or unwilling to take conventional lipid-lowering agents.
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