Having high cholesterol puts you at risk for a heart attack or stroke. That’s why it’s important to have your levels checked regularly, and to develop a treatment plan with your doctor. While there are several cholesterol-lowering drugs on the market, there are also natural alternatives out there. If you would like to try lowering your cholesterol without medication, talk with your doctor about dietary changes and natural supplements.

What Are Statins?

Statins are one of the most commonly prescribed categories of medication for high cholesterol in the United States. Research has shown that the drugs are effective in preventing heart disease. They work by blocking your body from using a substance in your liver to make cholesterol. Some statins are also able to help reduce the cholesterol that’s already started to form in blood vessels.

Read More: The Pros and Cons of Statins »

Your body needs some cholesterol, but too much low-density lipoprotein cholesterol (LDL) or “bad cholesterol” in your blood will cause blockages in your blood vessels, which can lead to a heart attack or stroke. If you’re unable to lower your cholesterol with diet and exercise, your doctor may prescribe statins.

Statins come in pill form and are available by prescription only. Your doctor will typically prescribe a statin if your LDL cholesterol levels are above 100 mg/dL and aren’t getting lower with lifestyle changes, if you have a higher risk of developing heart disease, or if you’ve already had a heart attack or stroke.

There are seven statin-category drugs available in the United States:

The Natural Options

Natural statins are dietary supplements that are considered helpful in lowering your cholesterol. There is some evidence that the following are effective when it comes to reducing cholesterol levels.

1. Red Yeast Rice

Red yeast rice is a product of the yeast that grows on rice. In parts of Asia, it’s a common component of people’s diets. As a supplement, it’s used to treat a variety of medical conditions, including high cholesterol, diarrhea, and heartburn.

The active ingredient in red yeast rice is a compound called monacolins, which blocks the production of cholesterol. This is also an ingredient found in the statins lovastatin and mevinolin. According to Mayo Clinic, using red yeast rice may reduce LDL cholesterol by 10 to 33 percent.

2. Psyllium

Psyllium is an herb that’s often used to treat constipation because it contains large amounts of fiber. For example, it’s found in products like Metamucil.

The seed and husk are the parts of the plant used for medical purposes. Sold in powder form, it can be added to foods or mixed with water. Daily doses of 10 to 12 grams are recommended for lowering LDL cholesterol. There is also some evidence that taking blond psyllium by mouth is effective for lowering cholesterol in people with high cholesterol.

Read More: The Many Health Benefits of Psyllium »

3. Fenugreek

Fenugreek is a plant that grows in parts of Europe and western Asia. Its small brown seeds have a long history of being used to help different medical conditions, including high cholesterol.

You can buy fenugreek as a spice in whole or powdered form. Seeds for cooking are usually found in Indian spice stores or in the international food section of your grocery store. You can also get concentrated pill or liquid supplements of fenugreek, along with fenugreek teas and skin creams. Supplements, teas, and creams can be purchased at a health food store or online.

There is some clinical evidence that dietary fenugreek may help to lower cholesterol.

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4. Fish Oil

Fish like salmon, tuna, sardines, and anchovies are all rich in omega-3 fatty acids. These can help lower your triglyceride levels and provide protection against heart disease. If you don’t get enough fish in your diet, you can take daily fish oil supplements.

Healthy Lifestyle Changes

Even if you’re taking a medication, you should still practice healthy habits. Making the right dietary changes and getting enough regular exercise are effective at helping you reduce cholesterol levels.

On the exercise front, physical activity helps you lose weight and boosts your good cholesterol (HDL) levels, which protect you from heart disease. Aim for 30 to 60 minutes a day of moderate cardio activities, like brisk walking, bike riding, playing sports, and swimming.

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When it comes to eating, try to get more fiber and focus on complex carbohydrates rather than simple ones — replace white breads and pastas with whole grains. Also focus on healthy fats: Olive oil, avocado, and nuts all have fats that won’t raise your LDL levels. Finally, reduce the amount of cholesterol you take in through your diet (all of the cholesterol you need is produced by your body!). Reduce the amount of high-cholesterol foods like cheese, whole milk, and eggs that you consume.