7 Best Natural Alternatives to Statins 2024

By Dr Frank Yap, MD - March 28, 2024

Heart disease is the No. 1 cause of death in the U.S., killing one person every 33 seconds (CDC 2023). Your diet plays a prominent role in your heart health, but the role of individual micronutrients continues to be debated.

Oxidized blood lipids refer to fats in the bloodstream that have undergone oxidation, a process in which molecules lose electrons. Low-density lipoprotein (LDL) cholesterol, commonly known as “bad” cholesterol, can become oxidized due to various factors, including smoking, high blood pressure, diabetes, and high levels of other reactive substances in the body.

When LDL cholesterol is oxidized, it can contribute to plaque formation in the arteries. This plaque can narrow the arteries and restrict blood flow, leading to atherosclerosis, which is the thickening or hardening of the arteries and can increase the risk of heart disease and stroke.

While nutraceuticals—products obtained from foods with beneficial health effects—may help lower biomarkers for heart disease, they don’t address the root lifestyle causes that lead to cardiovascular issues in the first place.

True reversal of heart disease requires more comprehensive changes. Eating a wholesome diet and avoiding inflammatory foods is essential. Regular exercise, adequate sleep, sun exposure, and minimizing environmental toxins also contribute to optimal heart health in the long term.

Micronutrients Benefit Cardiometabolic Health

Brown University researchers conducted a study (2022) to determine which micronutrients are best for your heart.

They unveiled an up-to-date evidence-based map that quantifies the impact of micronutrients on cardiovascular outcomes. Out of 27 micronutrients, three — omega-3 fats, folate and coenzyme Q10 (CoQ10) — came out on top.

Conventionally, statins have been the go-to treatment for preventing heart disease .But they may not be the cure-all they’ve been made out to be.

These cholesterol-lowering drugs fail to address one of what experts say is the actual root causes of cardiovascular issues: inflammation from oxidized blood lipids.

Micronutrients are vitamins and minerals that your body needs to function optimally. Deficiencies in micronutrients can lead to a range of acute and chronic conditions. In terms of heart health, Brown University researchers conducted a systematic review and meta-analysis involving 884 trials. The study, published in the Journal of the American College of Cardiology, evaluated 27 types of micronutrients used by 883,627 participants.3

"For the first time, we developed a comprehensive, evidence-based integrative map to characterize and quantify micronutrient supplements' potential effects on cardiometabolic outcomes," study author Dr. Simin Liu, professor of epidemiology and medicine at Brown University, said in a news release. “Our study highlights the importance of micronutrient diversity and the balance of health benefits and risks.”4

Most, but not all, of the micronutrients showed “moderate- to high-quality evidence” of reducing risk factors for cardiovascular disease. Those that were beneficial included:5

Folic acid (folate)
Vitamin D
Magnesium
Zinc
Alpha-lipoic acid
Coenzyme Q10
Melatonin
Catechin
Curcumin
Flavanol
Genistein
Quercetin

The study was unique in that it took a comprehensive look at micronutrient supplementation, including phytochemicals and antioxidants. Liu explained:6

“Research on micronutrient supplementation has mainly focused on the health effects of a single or a few vitamins and minerals. We decided to take a comprehensive and systematic approach to evaluate all the publicly available and accessible studies reporting all micronutrients, including phytochemicals and antioxidant supplements and their effects on cardiovascular risk factors as well as multiple cardiovascular diseases."

While beta carotene supplementation increased all-cause mortality, omega-3 fats, folate and CoQ10 were highly protective.

Best Natural Alternatives to Statins

Here are more details and evidence about how these important nutrients affect your heart health.

1. Omega-3s

The study found omega-3 fats decreased mortality from cardiovascular disease, while also reducing heart attacks and coronary heart disease events (7). This mirrors previous studies, which have also found beneficial effects of omega-3s on heart health. Omega-3 fats derived from krill oil, for instance, have been found to reduce triglyceride levels and help reduce cardiovascular risk. (8)

Further, people with Type 2 diabetes who used omega-3 supplements had a lower incidence of hospitalization with heart failure — a form of heart disease in which the heart experiences ventricular dysfunction — in another study.9

An omega-3 index test is one of the most important annual health screens that everyone needs, and it’s a more important predictor of your heart disease risk than your cholesterol levels. Even research supported by the National Institutes of Health suggests an omega-3 test is a good predictor of overall health and all-cause mortality.10,11

That study measured the omega-3 index in 2,500 participants and found those with the highest omega-3 index had lower risks of heart problems and lower total mortality. The omega-3 index measures of the amount of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the membranes of your red blood cells (RBC). Your index is expressed as a percent of your total RBC fatty acids.

The omega-3 index has been validated as a stable, long-term marker of your omega-3 status, and it reflects your tissue levels of EPA and DHA. An omega-3 index over 8% is associated with the lowest risk of death from heart disease, while an index below 4% places you at the highest risk of heart disease-related mortality.

The ideal sources for EPA and DHA include cold-water fatty fish, like wild-caught Alaskan salmon, sardines, herring and anchovies. If you do not eat these fish on a regular basis, consider taking a krill oil supplement.

In addition, be aware that your omega-6 to omega-3 ratio should be about 1-to-1 or possibly up to 4-to-1, but most Americans consume far too many omega-6 fats and not enough omega-3. For optimal heart health, in addition to increasing your omega-3, it’s important to cut down on industrially processed seeds oils, often referred to as “vegetable oils,” found in most processed foods.

2. Folate

The Journal of the American College of Cardiology study revealed that folic acid reduced stroke risk (12). Folic acid is the synthetic version of folate, or vitamin B9, and it’s the most important dietary determinant of homocysteine. Elevated levels of homocysteine (Hcy) are a risk factor for coronary artery disease and are found in most patients with vascular disease.13 According to a literature review published in Advances in Therapy (14):

“Several mechanisms have been proposed for Hcy’s pathogenesis related to vascular disease. Hcy can cause endothelial injury, dysfunction of DNA, proliferation of smooth muscle cells, oxidative stress, decreased function of glutathione peroxidase, impaired nitric oxide synthase, and inflammation.”

Evidence suggests that daily folic acid supplementation lowers homocysteine levels. “In fact, it has been shown that folic acid supplementation of 0.5 to 5.0 mg can lower Hcy levels by 25% and, thus, may decrease the risk of cardiovascular disease … Given that folic acid is cheap and effective, this should be a viable option for patients with high-risk for cardiovascular adverse events,” the researchers explained.15

In an animal study, folic acid was also found to prevent age-related structure changes and dysfunction of the heart that may lead to heart failure.16 It reduced cellular senescence, a hallmark of aging. The best way to increase your levels of this important micronutrient is to eat foods rich in natural folate, such as asparagus, avocados, Brussels sprouts, broccoli and spinach.

3. CoQ10

CoQ10 decreased all-cause mortality events, according to the Journal of the American College of Cardiology study. (17) Ubiquinol — the reduced, electron-rich form of CoQ10 that your body produces naturally — plays an important role in the electron transport chain of your mitochondria, where it facilitates the conversion of energy substrates and oxygen into the biological energy (adenosine triphosphate, or ATP) needed by your cells for life, repair and regeneration.

It’s a fat-soluble antioxidant, meaning it works in the fat portions of your body, such as your cell membranes, where it mops up potentially harmful byproducts of metabolism known as reactive oxygen species (ROS). As such, ubiquinol and CoQ10 supplements help protect your mitochondrial membranes from oxidative damage.

Many conditions, including heart disease, appear to be rooted in mitochondrial dysfunction.18 CoQ10 is used by every cell in your body, but especially your heart cells. Cardiac muscle cells have about 5,000 mitochondria per cell.19 For further comparison, mitochondria make up about 35% of the volume of cardiac tissue and only 3% to 8% of the volume of skeletal muscle tissue.20

In other research, CoQ10 has been found to help improve atrial fibrillation (AFib).21 AFib is an abnormal, often rapid, heart rhythm that occurs when the atria, your heart's upper chambers, beat out of sync with the ventricles, the heart's lower chambers. It's a common symptom in those with heart failure or heart disease. In addition, CoQ10 influences several other aspects of heart health, including:

High blood pressure — CoQ10 acts directly on your endothelium, dilating your blood vessels and lowering blood pressure.22,23 CoQ10 also decreases aldosterone, a hormone that makes you retain salt and water.24,25 When aldosterone goes down, excess salt and water are excreted through your kidneys, often causing your blood pressure to go down.
Systemic inflammation — Supplementing with 60 milligrams (mg) to 500 mg of CoQ10 for eight to 12 weeks can significantly reduce tumor necrosis factor alpha (TNF-α), IL-6 and C-reactive protein (CRP);26,27 three measures of widespread inflammation.
Stroke — Systemic inflammation, oxidative stress and nerve cell damage play a role in the development of stroke. Research suggests supplementing with CoQ10 can reduce ischemic lesions and improve outcomes in patients who have been treated with a statin drug after having a stroke (statins reduce CoQ10 levels in your body).28

Your body can naturally make CoQ10, but genetic alterations in metabolism, poor diet, oxidative stress, chronic conditions and aging can all interfere with CoQ10 production and lead to CoQ10 deficiency. Statin drugs can also deplete CoQ10.

Ubiquinol production ramps up from early childhood until your mid- to late 20s. By the time you hit 30, it begins to decline.29 Young people are able to use CoQ10 supplements quite well, but older people do better with ubiquinol, as it's more readily absorbed.

4. Berberine

Berberine, a compound found in Chinese goldthread and barberry plants, has been used in traditional Chinese medicine (TCM) for thousands of years. It boasts health benefits ranging from improved cognitive function and immune system by reducing inflammation to controlled blood glucose levels.

A 2023 meta-analysis of 44 studies found berberine improved blood lipids, inflammation, and atherosclerosis with minimal risks. It also outperformed statins in reducing factors like stroke risk and artery plaque buildup.

One-third of people with Type 2 diabetes also have cardiovascular disease, according to a review published in Cardiovascular Diabetology. The two metabolic diseases are often interconnected. People with diabetes have a doubled risk of developing heart disease or experiencing a stroke in comparison to those without diabetes.

Emerging research also highlights berberine’s anti-diabetic potential. Studies show it may lower blood glucose, triglycerides, and insulin. One 2009 paper called it the “ideal medicine” for treating Type 2 diabetes, while a 2023 report found that berberine outperformed metformin, a drug that lowers blood glucose levels, in treating obesity and controlling blood lipids.

That said, high doses may cause cramping or loose stools. Therefore, working with a holistic doctor can prevent side effects.

5. Natto (Nattokinase)

Natto is a traditional fermented soybean dish widely consumed throughout Japan for thousands of years. Nattokinase, an enzyme from the fermented soy food natto, has been researched for its potential cardiovascular benefits.

“Nattokinase is an enzyme that breaks down unwanted blood clots in the blood circulation,” Gitte Jensen, research director at NIS Labs, a contract research laboratory, told The Epoch Times. Nattokinase can break down problematic blood clots by “digesting” fibrin, a protein that plays a central role in blood clotting.

“Fibrin is a molecule that is only wanted when we have a wound and we need to repair the wound,” Ms. Jensen said. However, when the body is inflamed, clumps of fibrin can form, contributing to atherosclerosis, she added.

Studies since the 1980s have explored whether nattokinase supplements could help prevent cardiovascular events and strokes.

While some studies found nattokinase did not provide meaningful cardiovascular protection, more recent research found higher-dose nattokinase improved biomarkers in people with atherosclerosis and high blood lipids.

One 2022 study published in Frontiers in Cardiovascular Medicine found that supplementing nattokinase for a year effectively managed atherosclerosis and high lipid levels. Another study showed nattokinase reduced plaque buildup by 36.6 percent compared to 11.5 percent for statins.

Nattokinase prevents plaque buildup, a leading cause of heart attacks and strokes, according to Dr. David Brownstein, a board-certified family physician. Statins are often ineffective for this, he added.

6. Magnesium

According to Dr Julian Whitaker:

If I had to choose just one supplement to use on a regular basis, it would likely be magnesium. This mineral is one of the most potent, versatile, and safe therapies available. Yet it is woefully underused in American medicine. The following stories and studies illustrate the healing power of miraculous magnesium.

Low levels of magnesium are a culprit in the development of inflammation and may play a role in hardening of your arteries as they inhibit the deposit of lipids on your arterialswalls and plaque formation.

Use of the mineral also has significantly positive effects when administered intravenously (IV) as soon as possible after a heart attack.

In a double-blind, placebo controlled trial, IV magnesium or normal saline was administered to 2,000 patients within 24 hours of their heart attack. Those who received the magnesium experienced 24% fewer deaths and within the following five years, the death rate was also 21% lower than those not treated with magnesium. IV magnesium has been used to treat patients with congestive heart failure and arrhythmias.

Low levels have been found to be an important predictor of suddencardiac death and IV magnesium has been used to treat the onset of atrial fibrillation. The use of magnesium during an immediate cardiac event demonstrates the significant health benefits of the mineral. However, ensuring an adequate level of magnesium on a daily basis may help to prevent these cardiac events as the mineral is also closely associated with reducing the inflammatory response.

A study in the European Journal of Clinical Nutrition determined there was an inverse relationship between levels of magnesium in the body of participants and the level of creactive proteins. The researchers concluded the beneficial effect of magnesium intake on chronic diseases could potentially be explained by the effect the mineral has on inhibiting inflammation.

Following the release of another study demonstrating the role inflammation plays in chronic disease, Dr. Carolyn Dean, magnesium expert and author of "The Magnesium Miracle," stated:

"Cholesterol is not the cause of heart disease and the decades-long attempt to treat this condition with statin drugs has failed, because the true cause is inflammation."

Dean went on to comment on another study that demonstrated magnesium deficiency contributes to an exaggerated response to oxidative stress and inflammation, saying:

"This study shows that at the cellular level, magnesium reduces inflammation. In the animal model used, magnesium deficiency is created when an inflammatory condition is produced. Increasing magnesium intake decreases the inflammation. With magnesium being actively required by 600 to 700 enzyme systems in the human body, internal functions that reduce inflammation with the help of magnesium are being newly discovered every year. For example, magnesium has been found to be a natural calcium channel blocker, which is crucial because calcium in excess is one of the most pro-inflammatory substances in the body."

Our preference for magnesium supplementation is magnesium threonate as it appears to more efficiently penetrate cell membranes, including your mitochondria. It penetrates your blood-brain barrier and may help improve memory and it may be a good alternative to reduce migraine headaches.

7. Nitric Oxide Supplements

Hypertension is a key risk factor for cardiovascular disease because it damages arteries by making them less elastic, reducing blood and oxygen flow to the heart and leading to heart disease. Additionally, lowering high blood pressure lowers the risk of cardiovascular events.

Nitric Oxide is a vasodilator, which means it relaxes the inner muscles of your blood vessels, widening them. Nitric oxide enhances blood flow and decreases blood pressure in this way.

A study showed that nitric oxide supplementation appears to lower blood pressure in patients with prehypertension and might be beneficial as a routine supplementation for cardiovascular protection.

Erectile dysfunction is the inability to achieve and maintain an erection suitable for sexual intercourse.

Nitric oxide activates relaxation of corporal cavernosal smooth muscle tissue allowing more blood to flow into the penis, resulting in an erection. Several supplements, including L-citrulline, L-arginine and French maritime pine bark extract, have been proven to enhance nitric oxide levels in men with erectile dysfunction.

In one study was determine the effects of a single dose of citrulline malate (CM) on the performance of flat barbell bench presses as an anaerobic exercise and in terms of decreasing muscle soreness after exercise.

Those given citrulline malate had 40% less muscle soreness 24 and 48 hours after the exercise than those given a placebo.

In persons with type 2 diabetes, nitric oxide production is reduced. This results in poor blood vessel health, which can eventually lead to high blood pressure, kidney illness, and heart disease.

As a result, nitric oxide-increasing supplements may have important implications for diabetes therapy and disease prevention.

A Personalized Approach Is Best

There’s no one-size-fits-all approach when it comes to supporting your heart health. Indeed, the featured study researchers noted that “an optimal nutritional strategy to promote cardiometabolic health will likely involve personalized combinations of these nutrients.”30

However, healthy diet, exercise, stress reduction and heart-based connections — i.e., strong and positive relationships — are key to heart and overall health. As mentioned, I also believe an omega-3 index test is one of the most important annual health screenings you can receive.

GrassrootsHealth makes testing easy through its D*Action+Omega-3 consumer-sponsored research project.31 You can find the GrassrootsHealth omega-3 index test kit on the GrassrootsHealth website.32

Sources and References

Related: Lumbrokinase for heart health

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