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Total Cholesterol

Total Cholesterol is a phrase used to refer to all circulating cholesterol molecules, and is totalled by adding LDL-C, HDL-C and vLDL-C together. It is distinct from Triglycerides.

Research analysis led by Kamal Patel.
All content reviewed by the Examine.com Team. Published: Feb 6, 2013
Last Updated:

Human Effect Matrix

The Human Effect Matrix looks at human studies (it excludes animal and in vitro studies) to tell you what supplements affect total cholesterol
Grade Level of Evidence
Robust research conducted with repeated double-blind clinical trials
Multiple studies where at least two are double-blind and placebo controlled
Single double-blind study or multiple cohort studies
Uncontrolled or observational studies only
Level of Evidence
? The amount of high quality evidence. The more evidence, the more we can trust the results.
Outcome Magnitude of effect
? The direction and size of the supplement's impact on each outcome. Some supplements can have an increasing effect, others have a decreasing effect, and others have no effect.
Consistency of research results
? Scientific research does not always agree. HIGH or VERY HIGH means that most of the scientific research agrees.
Notes
grade-a Notable Very High See all 17 studies
Garlic supplementation or the raw garlic bulb appears to reduce cholesterol (total cholesterol, mostly due to LDL reductions) reliably and in the range of 10-15%
grade-a Minor Moderate See all 12 studies
There may be some limited efficacy of policosanol on cholesterol (when excluding the studies from cuba, which are highly suspicious, there is still some scattered but unreliable evidence) whereas it does not appear to be potent in any way.
grade-a - Very High See all 18 studies
Similar to its actions on LDL and HDL individually, chromium does not appear to have a significant role in improving total cholesterol levels in type II diabetic subjects.
grade-a - Very High See all 14 studies
Although LDL-C may be decreased mildly, alterations in total cholesterol did not appear to occur; this may be due to unreliable but mild increases in HDL-C balancing out the numbers.
grade-a - Very High See all 18 studies
Although some decreases have been noted, overall there does not appear to be a significant clinical reduction in total cholesterol like there is with triglycerides
grade-a - Very High See all 14 studies
The majority of evidence does not support a role for reducing total cholesterol with supplementation of red clover extract, except perhaps a minor (less than 10%) reduction in overweight postmenopausal women.
grade-b Notable Very High See all 4 studies
Total cholesterol appears to be decreased by around −0.58mmol/L (95% CI −1.02 to −0.14), which is not overly potent. The reduction in notable as if this mechanism is via PCSK9 inhibition then it would work very well with statin drugs.
grade-b Minor Low See all 3 studies
May decrease total cholesterol to an unremarkable degree when taken either at high (600mg) doses or in high risk populations; reductions in cholesterol are definitely not reliable
grade-b Minor Moderate See all 8 studies
Decreases have been sporadically noted in persons with high cholesterol initially, the cholesterol reductions are mild at best and do not affect persons with normal cholesterol.
grade-b Minor Moderate See all 4 studies
There appears to be somewhat of a decrease in total cholesterol (mostly due to LDL) with olive leaf consumption; it is not overly reliable
grade-b Minor Very High See all 4 studies
Not unique to psyllium, but has the standard slight reduction of cholesterol that affects persons with high cholesterol. Not strong enough for monotherapy, can be a nice addition to more potent supplements or drugs
grade-b Minor Very High See 2 studies
A decrease in total cholesterol is noted in the range of 10% associated with 50-100mg of Royal Jelly daily; the evidence this conclusion was drawn from (via a meta-analysis) is a bit lacklustre
grade-b Minor Very High See all 6 studies
Reductions in cholesterol seen are positive, but not overly remarkable
grade-b Minor High See all 3 studies
One study noted a stasis in total cholesterol when placebo decreased (a relative increase). Reasons for this unknown and the data needs to be replicated.
grade-b - - See all 4 studies
grade-b - High See all 4 studies
No effect on overall cholesterol levels in otherwise healthy males.
grade-b - Very High See all 22 studies
More robust evidence suggests no significant influence of curcumin on total cholesterol, although there may be a potential role in people with elevated lipids.
grade-b - Very High See all 6 studies
While there may be a slight decrease which only applies to those with very elevated cholesterol at baseline, in normal persons or those with mild to moderately high cholesterol there is no significant influence.
grade-b - Very High See all 4 studies
For the most part, there does not appear to be a significant influence of carnitine on total cholesterol levels
grade-b - - See all 3 studies
grade-b - Very High See all 13 studies
No significant influence on total cholesterol seems apparent with vitamin C supplementation
grade-b - Very High See all 10 studies
There does not appear to be a significant influence of vitamin E supplementation on cholesterol levels whether used by a healthy person or one with elevated cholesterol.
grade-c Notable High See all 4 studies
There is a decrease in total cholesterol of around 10% when ashwagandha (water extract of the roots) is ingested. It is notable, however, since this appears to occur in all persons regardless of whether they have high cholesterol or not
grade-c Notable - See study
A decrease in total cholesterol, mostly due to LDL-C, has been noted to the magnitude of 40.66-42.00% which is astounding; requires replication.
grade-c Minor Moderate See all 4 studies
Despite its traditional usage, the decreases in cholesterol are not remarkable and are quite small in magnitude.
grade-c Minor - See study
Reductions in total cholesterol not overly remarkable relative to placebo and confounded with weight loss which occurred with cissus
grade-c Minor Moderate See 2 studies
There may be a reduction in total cholesterol in those with high cholesterol, but it has a large degree of variability.
grade-c Minor Moderate See all 3 studies
There may be a decrease in cholesterol seen with DHEA in hypercholesterolemics, but it is not overly reliable
grade-c Minor Very High See 2 studies
A possible reduction in total cholesterol concentrations
grade-c Minor - See study
Possible cholesterol reducing effects associated with ginger consumption
grade-c Minor - See study
A decrease in total cholesterol has been noted, this is confounded with weight loss (also occurred)
grade-c Minor - See study
A decrease in cholesterol is noted with green tea catechins, but to a small degree
grade-c Minor Moderate See 2 studies
Possible decrease in total cholesterol, but this is unreliable (and paired with a possible increase in LDL-C, this is likely to be not desirable)
grade-c Minor - See 2 studies
One underpowered study noted an increase in total cholesterol while another suggested no significant effect. The exact effect of HMB on total cholesterol is not currently known and required replication
grade-c Minor Very High See all 4 studies
A small decrease in total cholesterol has been noted with supplementation of inositol in women with PCOS
grade-c Minor Very High See 2 studies
A decrease in total cholesterol has been noted, but is confounded with weight loss
grade-c Minor Very High See 2 studies
A decrease in total cholesterol has been noted with krill oil, to a fairly normal degree (reduction is lessened from the remarkable increase in HDL)
grade-c Minor Very High See 2 studies
May be able to reduce total cholesterol by a moderate to low degree (8-10%), but requires more robust evidence
grade-c Minor Moderate See 2 studies
Possible cholesterol reducing effect, but appears unreliable
grade-c Minor - See study
An increase in total cholesterol, attributable to LDL, has been seen in hypercholesterolemic adults given pterostilbene.
grade-c Minor - See study
A reduction in total cholesterol has been noted once in response to a high fat hypercaloric diet; practical relevance unknown
grade-c Minor Moderate See 2 studies
May decrease total cholesterol to a small degree in unhealthy persons
grade-c Minor Moderate See all 4 studies
A decrease in total cholesterol has been noted to a mild degree in obese persons, although a study in rheumatic patients without any abnormalities in cholesterol metabolism failed to find such an effect.
grade-c Minor Very High See all 3 studies
Possible reductions in total cholesterol with supplementation of TTA
grade-c Minor Moderate See all 3 studies
Total cholesterol is decreased with pharmacological doses of niacin owing to decreases of LDL and vLDL cholesterol, although the overall reduction is lesser due to a concomitant increase in HDL cholesterol.
grade-c Minor Moderate See 2 studies
A decrease in cholesterol, due to LDL-C being reduced, seems to occur following oral supplementation of zinc in persons who are obese and likely zinc deficient
grade-c - - See 2 studies
grade-c - - See study
No significant changes in total cholesterol
grade-c - - See study
grade-c - Very High See 2 studies
No significant influence on total cholesterol concentrations in the blood.
grade-c - - See study
No significant influence on total cholesterol concentrations
grade-c - Very High See 2 studies
No significant or consistent effects on total cholesterol levels noted with CoQ10
grade-c - - See study
grade-c - - See study
No significant influence on total cholesterol levels
grade-c - - See study
In resistance trained males, no significant influence of ecdysterone supplementation on cholesterol
grade-c - - See study
No significant influences yet known for total cholesterol
grade-c - Very High See 2 studies
No significant alterations seen in total cholesterol levels with supplementation
grade-c - - See study
No significant alterations in total cholesterol observed with reishi ingestion
grade-c - - See study
No significant alterations seen in total cholesterol levels
grade-c - - See study
No significant alterations in total cholesterol seen with green coffee extract
grade-c - Very High See all 3 studies
No significant changes in total cholesterol noted
grade-c - - See study
No significant alterations in cholesterol seen with Japanese Knotweed ingestion
grade-c - - See study
grade-c - - See study
No significant influence on total cholesterol is observed following licorice ingestion
grade-c - Very High See 2 studies
No significant influence on total cholesterol levels seen with magnesium supplementation
grade-c - - See study
No significant influence on total cholesterol levels
grade-c - - See study
No significant influence on total cholesterol seen with supplementation
grade-c - - See study
grade-c - - See study
No significant influence with PS supplementation on total cholesterol
grade-c - - See study
No significant influence on total cholesterol levels
grade-c - - See study
No significant effect on total cholesterol levels
grade-c - Very High See 2 studies
No significant influence on total cholesterol levels after inclusion of chia seeds into the diet
grade-c - - See study
Total cholesterol does not appear to be affected with supplementation of sea buckthorn in otherwise healthy persons.
grade-c - - See study
No significant effect on total cholesterol levels have been detected with stevia consumption
grade-c - - See study
No significant influence on total cholesterol levels with theaflavins supplementation
grade-c - - See all 3 studies
A decrease in cholesterol levels has been noted with tribulus supplementation in some studies. However, the largest study found no significant decrease, and none of the studies have made cholesterol their primary endpoint.
grade-c - Very High See 2 studies
No significant alterations in the levels of total cholesterol per se, but a decrease has been noted to be secondary to attenuating diabetic symptoms
grade-c - - See study
No significant interactions with total cholesterol concentrations in persons given vitamin K supplementation
grade-c - Very High See 2 studies
No significant influence on circulating cholesterol has been demonstrated with whey protein
grade-c - - See study
No significant influence on total cholesterol has been noted despite changes in LDL and accompanying weight loss.
grade-d Minor Very High See 2 studies
Requires more studies before conclusions can be made, appears to simply be exerting anti-oxidant effects.
grade-d Minor - See study
An increase in cholesterol has been noted in one study which attributed most of the increase to HDL
grade-d Minor - See study
A mild decrease in total cholesterol has been noted with supplementation of colostrum in type II diabetics.
grade-d Minor - See study
A decrease in total cholesterol has been noted with supplementation of eclipta alba
grade-d Minor - See study
A decrease in cholesterol has been noted and appears to affect both healthy controls as well as diabetics
grade-d Minor - See study
A decrease in total cholesterol (both the LDL and HDL portions) has been noted with purified MCTs to a minor degree, relative to longer chain fatty acids.
grade-d Minor Moderate See 2 studies
Possible cholesterol lowering effects of small magnitude, but these are not wholly reliable
grade-d Minor - See study
An increase in total cholesterol has been noted, but mostly attributed to HDL
grade-d Minor - See study
A decrease in total cholesterol (9.4%) has been noted in diabetic persons alongside an increase in HDL-C. Requires replication.
grade-d Minor - See study
A decrease in total cholesterol in serum has been noted secondary to treating cholestasis
grade-d Minor - See study
A decrease of total cholesterol has been noted with Mate consumption
grade-d - - See study
grade-d - - See study
No significant influence have been detected on total cholesterol
grade-d - - See study
Currently the only study is in otherwise healthy men with no cholesterol problems, and there was no influence of berry consumption.
grade-d - - See study
No change noted in people with high blood sugar