Alternatives to Statins and How to Avoid One

Michelle Routhenstein, MS, RD, CDE


June 14, 2024

Statins are a class of medications primarily used to lower cholesterol levels in the blood. By reducing cholesterol, statins are intended to help prevent cardiovascular disease, heart attacks, and strokes.

Statins can be life-saving drugs, but they’re not always the best long-term option for everyone. Plus, some people may be statin-intolerant or otherwise hesitant to use them. While I don’t recommend ignoring your doctor’s care plan, there are some alternatives to statins you may want to discuss with them. 

A Statin Success Story

A 45-year-old gentleman came to see me because he had just had a couple of stents placed and wanted to prevent future complications. ​​​​​​​​

​​​​​​He joined my individualized VIP program for 4 months, and we worked together to optimize his cardiovascular function and to keep his stent patent. He had borderline blood pressure values (128/80mmHg), high LDL (129mg/dL), and a strong family history of heart disease that could have accelerated his arterial plaque formation.​​​​​​​​

Within 3 weeks of implementing science-based nutrition, his blood pressure normalized and he gained energy. His doctor reduced his statins soon after and discontinued them completely after the program (when his LDL reached 19mg/dL). ​​​He was eventually able to stop his beta blocker too.

Statin Drugs Pros and Cons

Statins can be a necessary intervention, but they don’t cure existing cardiovascular disease or risk factors. Daily lifestyle habits like good nutrition are critical, which we’ll cover later.

As with other medications, statins have potential side effects, like: 

  • Muscle pain and damage
  • Increased blood sugar or risk of developing type 2 diabetes
  • Liver damage
  • Neurological side effects

You may be at a higher risk of side effects if you’re female, have a smaller body frame, have existing liver or kidney disease, drink excessively, are 80 or older, or have conditions like hypothyroidism or neuromuscular disorders.

Additionally, if you’re taking multiple medications, there’s always a risk for drug interactions. Your healthcare team needs to be aware of everything you’re using. 

Alternatives to Statins

If your goal is to prevent the need for statins or be able to get off of them, it’s important to focus on doing things that help bring apoB and LDL cholesterol into normal ranges. (Apolipoprotein B is considered a more accurate measure of cardiovascular risk.) 

The approach to do this needs to be personalized and monitored closely by your healthcare team to ensure your cardiovascular risk is reduced. 

Lifestyle Changes

Science based nutrition provides your body with the nutrients and compounds it needs to fight inflammation, damage, and disease. By creating a healthy, nourishing environment for your body, it has a better opportunity to heal itself. 

Focus on minimally processed foods including fruits, vegetables, nuts, seeds, whole grains, legumes, and other lean proteins, in the right balanced, timing and in therapeutic doses for you to achieve your goals. These foods provide vitamins, minerals, fiber, antioxidants, and omega-3s that your body needs to thrive.

At the same time, avoid ultra-processed foods like pastries, sugar-sweetened beverages like soda, processed and red meats, and fast food, which have the opposite effect on health.

In addition to a healthier diet, incorporate daily movement in the form of activities you enjoy. For instance, a mix of jogging, playing sports, swimming, weightlifting, yoga, and biking. Aim for a minimum of 150 minutes per week. Resistance training can help reduce high LDL and reduce cardiovascular mortality by 40%.

Diet and exercise can also help you achieve and maintain a healthy weight and address abdominal weight, which is important as overweight and obesity are risk factors for cardiovascular disease.

If you need support on implementing a heart healthy diet, consider working with a Registered Dietitian who specializes in heart disease management and prevention

Nutritional Supplements

I always emphasize nutrition first, as you can’t supplement your way out of an unhealthy diet. However, there may be some instances in which a supplement in addition to healthier eating may be beneficial. 

Examples include: 

  • Phytosterols and phytostanols: These compounds are structurally similar to cholesterol but are found in small amounts in many fruits, vegetables, nuts, and grains. They reduce cholesterol by interfering with its absorption in the digestive system. It is important before adding in phytosterols that you understand if you are a hyper absorber of cholesterol to ensure it does not do potential harm.
  • Soluble fiber: Effective bowel movements are important for heart health and reducing high cholesterol naturally. If you’re not getting enough fiber from your diet (only found in plant foods), your healthcare team may have you consider a soluble fiber supplement. This type of fiber binds to cholesterol and helps get rid of the excess. If you’re familiar with the Bristol Stool Chart, I tell my clients to aim for type 4 stool to help eliminate cholesterol.

Herbal Remedies

While herbal remedies are popular recommendations for lowering cholesterol naturally, I don’t often recommend them. 

Two of the common ones clients ask me about are:

Red yeast rice

This is a fermented rice that has been associated with reduced cholesterol. It often contains a compound called monacolin K that was previously found in statins. However, this ingredient caused liver damage and anything containing more than trace amounts has been removed from the market. 

The problem is that red yeast rice is a supplement and therefore less heavily regulated than pharmaceuticals. Because of this, there’s no way of knowing how much monacolin K is present in most red yeast rice products, and thus taking them poses a potential risk. Plus, since monacolin K is the ingredient said to provide cholesterol-lowering benefits, red yeast rice without it is unlikely to be effective. 


The key active component in garlic, allicin, is believed to inhibit cholesterol synthesis in the liver, lowering total and LDL cholesterol. Additionally, garlic has antioxidant properties that can help protect against oxidative damage. However, garlic isn’t a good choice for those using aspirin or blood-thinning medications. Garlic contains compounds that inhibit platelet aggregation, similar to how aspirin works to prevent blood clots by inhibiting the enzyme cyclooxygenase. When taken together, the combined anticoagulant effect can increase the risk of excessive bleeding.

How Long Does it Take to Lower Cholesterol?

The time it takes to lower cholesterol can vary between people. However, it typically takes 4-6 weeks for statins to significantly lower cholesterol levels, depending on the type and dose of the statin and whether other lifestyle interventions are happening. 

As you saw with my client above, we were able to lower his LDL significantly within 6 weeks by adding science-based nutrition to his statin regimen (which he ultimately was able to stop). 

How to Avoid a Statin: Final Thoughts

Statins can’t always be avoided, but they also don’t necessarily have to be a long-term intervention. If you have high cholesterol, there are alternatives to statins that can help improve overall cardiovascular health and potentially reduce your cholesterol naturally. 

Start by knowing your risk factors for cardiovascular disease. If you don’t identify and address underlying inflammation, blood vessel health, insulin resistance, and other root causes, you are still at risk. Your arteries can still become inflamed, blocked, and clogged, even on a statin. 

Overall, just because you’re on a statin does not mean you won’t have a heart attack. Again, any medication is not a quick fix for a health problem that has many underlying lifestyle factors.

Optimizing your heart health, with or without the use of medications like statins, takes an integrative team approach. It’s important to work closely with your healthcare team and cardiovascular dietitian, weigh the pros and cons of statins, and determine additional ways to monitor and improve your heart health.

Finally, it’s empowering to know that you have control over many aspects of your health. If you feel overwhelmed, choose 1-2 things to start focusing on before adding others. 

I can help you with personalized support including science-based nutrition recommendations. Click here to learn about my 1:1 counseling services or click here for more information about my 6 week heart optimization group program.


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