What’s your cholesterol supplement regimen?
- Thread starter BLaQz
- Start date
poison
Board Sponsor
Also, cheap and easy:
Psyllium lowers LDL by about 13 mg/dL across 28 randomized trials. The mechanism gets misrepresented constantly. It does not absorb cholesterol.
It does not scrub the gut. The mechanism is purely mechanical, and understanding it explains why most other "soluble fibers" do not produce the same effect.
Psyllium is the seed husk of Plantago ovata. When it hits the small intestine and hydrates, it forms a viscous gel. That gel physically traps bile acids, the cholesterol-derived molecules your liver releases through the bile duct to emulsify dietary fat. Normally about 95% of bile acids are reabsorbed in the ileum and recycled back to the liver. The pool cycles 4 to 12 times per day, losing about 5% per pass. The recycling is efficient because synthesizing new bile acids is expensive. The substrate is cholesterol.
When psyllium disrupts that recycling, the liver loses inventory. Loss of FXR-mediated feedback upregulates CYP7A1, the rate-limiting enzyme in bile acid synthesis, which depletes the hepatic cholesterol pool. SREBP-2 activates, LDL receptors get upregulated, and hepatocytes pull LDL from circulation to refill it. Serum LDL drops. This is the same mechanism used by prescription bile acid sequestrants like cholestyramine.
Jovanovski et al. (2018, American Journal of Clinical Nutrition) pooled 28 randomized controlled trials covering 1,924 participants. The median dose was about 10.2 grams of psyllium per day. LDL fell by approximately 13 mg/dL. Non-HDL fell by approximately 15 mg/dL. ApoB, a more direct measure of atherogenic particles, fell by 0.05 g/L. The apoB evidence was graded as high quality.
Two things matter. First, the mechanism is purely mechanical. Psyllium is not metabolized, does not enter circulation, does not act on a receptor. That is why it has a clean side-effect profile and does not interact with the cytochrome P450 system the way most lipid-lowering drugs do.
Second, viscosity is the active property. Inulin is also classified as a soluble fiber under FDA rules, but inulin does not form a viscous gel. It is highly fermentable instead. The label calls them both soluble fiber, but their functional profiles share almost nothing.
The honest framing on magnitude. A 13 mg/dL drop is meaningful but modest compared to even the lowest-dose statin, which typically delivers 25 to 50 mg/dL. If your numbers are borderline and you want to avoid medication, psyllium is one of the few interventions with this level of evidence. If a statin is indicated, psyllium is not a replacement.
Practical: target around 10 grams of psyllium husk daily, taken with or just before a meal with a full glass of water. That matches the Jovanovski median. Many trials dose 7 grams two or three times per day for a larger effect. Start at 5 grams and titrate up to manage GI side effects.
Jovanovski et al., Am J Clin Nutr, 2018
McRorie & McKeown, J Acad Nutr Diet, 2017
Gonzalez, Compr Physiol, 2012
Psyllium lowers LDL by about 13 mg/dL across 28 randomized trials. The mechanism gets misrepresented constantly. It does not absorb cholesterol.
It does not scrub the gut. The mechanism is purely mechanical, and understanding it explains why most other "soluble fibers" do not produce the same effect.
Psyllium is the seed husk of Plantago ovata. When it hits the small intestine and hydrates, it forms a viscous gel. That gel physically traps bile acids, the cholesterol-derived molecules your liver releases through the bile duct to emulsify dietary fat. Normally about 95% of bile acids are reabsorbed in the ileum and recycled back to the liver. The pool cycles 4 to 12 times per day, losing about 5% per pass. The recycling is efficient because synthesizing new bile acids is expensive. The substrate is cholesterol.
When psyllium disrupts that recycling, the liver loses inventory. Loss of FXR-mediated feedback upregulates CYP7A1, the rate-limiting enzyme in bile acid synthesis, which depletes the hepatic cholesterol pool. SREBP-2 activates, LDL receptors get upregulated, and hepatocytes pull LDL from circulation to refill it. Serum LDL drops. This is the same mechanism used by prescription bile acid sequestrants like cholestyramine.
Jovanovski et al. (2018, American Journal of Clinical Nutrition) pooled 28 randomized controlled trials covering 1,924 participants. The median dose was about 10.2 grams of psyllium per day. LDL fell by approximately 13 mg/dL. Non-HDL fell by approximately 15 mg/dL. ApoB, a more direct measure of atherogenic particles, fell by 0.05 g/L. The apoB evidence was graded as high quality.
Two things matter. First, the mechanism is purely mechanical. Psyllium is not metabolized, does not enter circulation, does not act on a receptor. That is why it has a clean side-effect profile and does not interact with the cytochrome P450 system the way most lipid-lowering drugs do.
Second, viscosity is the active property. Inulin is also classified as a soluble fiber under FDA rules, but inulin does not form a viscous gel. It is highly fermentable instead. The label calls them both soluble fiber, but their functional profiles share almost nothing.
The honest framing on magnitude. A 13 mg/dL drop is meaningful but modest compared to even the lowest-dose statin, which typically delivers 25 to 50 mg/dL. If your numbers are borderline and you want to avoid medication, psyllium is one of the few interventions with this level of evidence. If a statin is indicated, psyllium is not a replacement.
Practical: target around 10 grams of psyllium husk daily, taken with or just before a meal with a full glass of water. That matches the Jovanovski median. Many trials dose 7 grams two or three times per day for a larger effect. Start at 5 grams and titrate up to manage GI side effects.
Jovanovski et al., Am J Clin Nutr, 2018
McRorie & McKeown, J Acad Nutr Diet, 2017
Gonzalez, Compr Physiol, 2012
rodefeeh
Well-known member
If you can't get it down like me, I highly recommend getting a Calcium Score to see if you have plaque buildup. Thankfully mine was 0. With this and my c-reactive protein measurement being extremely low (inflammation marker), I'm holding off on a statin for now (with the blessing of my doc). I just eat super healthy, lots of veggies, less carbs, more healthy fats. I take berberine which is supposed to help with cholesterol. But I take it for its many other benefits.
Make sure you do your due diligence and truly understand the nuances of cholesterol, ie Lp(a), ApoB. There's a lot more to it than just your total cholesterol.
Good luck.
Make sure you do your due diligence and truly understand the nuances of cholesterol, ie Lp(a), ApoB. There's a lot more to it than just your total cholesterol.
Good luck.
BLaQz
Well-known member
wow, thanks for the response. thanks everyone for their responses. its a lot to take in. ive cleaned up my diet and limited processed carbs and lowered my saturated fat. I generally eat pretty well but there is also a genetic component. both parents have high cholesterol and mine has been creeping up over the years so just trying to see what I can do with diet and supplements first.
BLaQz
Well-known member
my doctor did mention getting a calcium test sometime in the future if my numbers continues to creep up especially with my family history.