Lowering cholesterol with natural supplements - What is safe?

Ezetimide has been in the news recently. When I started rosuvastatin three years ago the benefits were minimal. After my doctor added ezetimibe as a "booster to make the statin more effective before we increase the statins" my ldl and total cholesterol (100) dropped immediately. 3 years later I learned my calcified plaque score is off the charts, however, the blessing is the calcification rather than obstruction. I fought statins for 20 years and now believe they saved my life. Ezetemibe kept my statin dosage low and I've had zero side effects.
https://www.indiatoday.in/health/story/combining-two-cholesterol-lowering-drugs-statins-ezetimibe-could-reduce-heart-attack-stroke-cases-2700425-2025-03-28

You may want to read this - https://files.nccih.nih.gov/s3fs-public/Red_Yeast_Rice_11-30-2015.pdf

I believe some statins are from RYR, but not all.

Thanks for the link to this study. I've been on a statin for more than 25 years and ezetemibe added about 15 years ago. The combination lowered my total cholesterol from 423 to about 178 and LDL from 250 to around 100. Great decrease but family genes said not good enough, so last year Repatha was added to the mix. Total cholesterol down to 87 and LDL at 17 now.

For me, it’s really clear I tested it over 40 years: eat more fatty fishes - if you can like salmon, sardines, tuna, yellowtail and the white meats. Introduce more fruits and vegetables and whole grains. Don’t eat fat, skin, dark meat, red meat That took down my stubborncholesterol within a couple months.
And for the triglycerides: get rid of all refined carbohydrates and replace with whole grains, legumes, and complex carbohydrates. This skin mean replacing your white rice with red or brown rice as an example. Replacing white potatoes with sweet potatoes or rose potatoes. Replacing pasta with brown rice pasta and introducing all kinds of beans and legumes into your diet. Make sure you at least do some light exercising even if it’s walking for 20 or 30 minutes at least four times a week. Then you can cheat once in a while with a couple cookies or a little dark chocolate. But if you still good habits into your week, the little treats will not affect you. I had had model triglycerides for 40 years and then I got IBS which changed my eating habits and when I introduced the refined carbohydrates into my diet, my triglycerides shot up 75%. So now I’m working on bringing them back down I expect great improvement when I test next in three months!

yes I went from 40 mg to 20 mg of rosuvastatin after adding ezetimibe and my lipid levels remained in the low range.

This may sound silly but statins and red yeast affect liver numbers. I switched my week day breakfast to oatmeal with blueberries, strawberries, black berries and bananas topped with cinnamon. My cholesterol has stayed steady for years. I started in the high 260+ and now the numbers are around 169 . Needless to say I lost a bit of weight along the way too. I do like to walk so I try to make it a habit and try to eat well, but like everyone I have a few foods and snacks I can say no to.

If you are getting muscle and joint pain from statins, tell your doctor immediately. You may not be able to tolerate that particular statin or possibly, any statin. And without a cardio's advice, I wouldn't take both the statin AND the red yeast rice as that combination may complicate the issue of your tolerance to statins.

Your heart is a muscle and if statins are adversely affecting your muscles, you need to discuss with your cardio ASAP.

I wasn't able to tolerate statins or red yeast rice and am now on the self injecting Repatha which is amazing in the degree of cholesterol control.

Good luck.

Everyone's body is somewhat different. I had slightly elevated total and LDL cholesterol a few years ago and my doctor told me to cut out or at least reduce red meat (which I did) and my next checkup the numbers were worse. I did my own research and limited the refined carbs which helped much more.

In the process of biochemistry, we are similar as humans. The problem is that genetically we might have mutations that make us different from others. Yes, focusing on one or the other triglyceride versus LDL is not good anymore. Now there is information that all the lipid panels must be done to ascertain what is going on. When your triglycerides are lowered, then your LDL is lowered along with your HDL being increased. The old-fashioned doctors and information are focusing on the LDL and the HDL. The old doctors before that just focused on the cholesterol panel in total. We are now in a new world where triglycerides are recognized trigger and additional lipid panels are required like Lpa (which discovered my familial heart, disease, mutation) and APOEa and APOEB, which are lipids that cross the bloodstream barrier and enter to surround the heart. No longer can a GP doctor or a primary care, doctor discuss serious heart problems, and prevention with you. I would suggest that if you have numbers that need to be seriously controlled and you have a family history of heart disease that you see a cardiologist.
I was given a cardiologist consultation a year ago and it was decided I was in pretty good shape at 66 and they did a gazillion tests. And then they abandoned me because I wasn’t in bad enough shape. That is not how I want to be treated as this year. My numbers went in the wrong direction. So I had to bug my doctor to get a regular cardiologist. The problem is that with familial coronary artery disease I am not gonna stay in good condition without having continued testing along the way. The point is my dad had the best numbers in the world and it didn’t stop him from having three heart bypasses along the way after having a Widowmaker heart attack. All the low cholesterol and statins did not stop plaque from accumulating in his arteries on the way to his heart. It takes more than that if you have familial, coronary artery disease.