Although many of the ideas below have small effects on their own, Stanley Hazen, MD, PhD, section head of preventive cardiology at the Cleveland Clinic, says they’re great when put together. “You may get 5 or 10% here and there, but when you add them up you get something effective,” he says. Of course, you shouldn’t forgo your traditional medication for these alternatives. “I’d recommended these ideas when a patient can’t get to their goal levels with diet and a statin prescription—which sometimes happens when a person’s cholesterol is really high to begin with, or if their body doesn’t tolerate the medication well,” he says. Consult with your doctor before you make any changes to your cholesterol-lowering strategy. MORE: 7 Big Heart Mistakes You’re Making Now

  1. Onion Extract A study recently presented to the Endocrine Society found that onion extract lowered total cholesterol in diabetic rats. A handful of other studies in the past few years also found onion to be effective in reducing both LDL cholesterol (the “bad” cholesterol) and blood sugar. The catch is that all of the research was done on rats—not people—and scientists are still unsure how well onion extract would work on human cholesterol. Deepika Gopal, MD, a cardiologist at The Heart Hospital Baylor Plano, believes both onion and garlic have cholesterol-lowering properties although she, like other scientists, isn’t sure why. “In the Indian culture, we believe spices have healing properties,” she says. “And onion and garlic are both very useful in lowering cholesterol, based on what we’ve seen in Indian cooking.” Bottom line, onion could help with your cholesterol (it certainly has helped a few rats), but don’t expect miracles.
  2. Red Yeast Rice Yeast rice, which is pretty much what it sounds like—a type of yeast grown on fermented rice—contains a compound called monacolin K, which is the same compound found in a statin called lovastatin. Like the medication, monacolin K blocks the liver from creating the cholesterol your body needs to protect your cells. With a lack of naturally produced cholesterol, the liver turns on its LDL receptor that pulls bad cholesterol out of the blood. Studies have shown red yeast rice taken in pill form can reduce LDL cholesterol by 10% to 30%.  MORE: Top 10 Cholesterol-Fighting Foods
  3. Laxatives Laxatives won’t just get your bowels moving, some can also help lower cholesterol—but only if you take them the right way, Hazen says. Soluble fibers found in laxatives like Metamucil block the absorption of cholesterol into the blood. “The powder will semi-solidify like Jell-O that doesn’t set all the way,” says Hazen. As it makes its way through your stomach and intestines, that jelly-like substance picks up cholesterol, keeping it from getting absorbed. Since Metamucil grabs cholesterol from food, and not cholesterol your body produces, Hazen says it’s only effective when taken with a big meal. Besides blocking cholesterol absorption, Gopal says soluble fiber like Metamucil has secondary effects that can also lower cholesterol, like making you feel full longer so you cut down on fatty snacks.   
  4. TofuNivee Amin, MD, a cardiologist at the Perelman Heart Institute of New York-Presbyterian/Weill Cornell Medical Center Studies have found that eating tofu and other soy products in moderation reduces LDL cholesterol, and has either no effect or a positive effect on breast cancer tumors. Harvard Medical School doctors say eating about 10 ounces of tofu or 2½ cups of soymilk a day can reduce bad cholesterol by 5 to 6%. Tofu also contains phytosterols and is a low-cholesterol protein, so replacing meat with tofu at least one night a week cuts the amount of cholesterol in your diet, says .
  5. CholesterolThe plant version of cholesterol, called phytosterols, actually improves your cholesterol levels by substituting the cholesterol in your body, according to Hazen. Phytosterols act similarly to soluble fibers like Metamucil. “They bind up some of the cholesterol in the food that you eat so it’s metabolized by the body,” says Amin. Also like Metamucil, phytosterol supplements are best taken with food. Hazen recommends trying a phytosterol spread, similar to butter or margarine. You can also take phytosterols like a vitamin or add them to your diet through foods like fruits and vegetables, nuts, and whole grains like oatmeal.
  6. Alcohol A daily glass of red wine isn’t going to do anything for your LDL. However, it has been found to increase levels of HDL cholesterol (the “good” kind). “You can compare HDL to Liquid Draino,” says Gopal. “It actually cleans out your arteries. So the higher your HDL, the better your total cholesterol.” But this doesn’t mean you can grab a bottle of wine and go to town. Drinking alcohol in excess is still bad for you, and “excess” might be less than you think. The Mayo Clinic recommends no more than one drink a day for women and for men older than 65. Men under 65 can have two drinks a day. But if you don’t drink, there’s certainly no reason to start now. “I would always caution people about alcohol because it has side effects,” says Amin. “In some people it can worsen heart failure; in others it can worsen liver disease.” But if you already drink every day, she recommends you follow the guidelines and talk to your doctor.   MORE: This Is Your Body On Alcohol (Infographic)
  7. Pectin The bitter white rind on oranges contains pectin, a fiber that can also lower LDL cholesterol by 7% to 10%, according to a study from doctors in the Netherlands. It works like phytosterols and Metamucil to bind up cholesterol in your diet before it gets absorbed. Luckily for us, pectin can also be found in apples—which are way tastier than orange pulp. Both apple and citrus pectin are also available as a supplement at most drugstores.
  8. Sleep A study from the Nihon University School of Medicine in Japan found that for women not getting enough sleep (less than five hours) and getting too much sleep (more than eight hours) both correlated to higher levels of bad and lower levels of good cholesterol. “Our cholesterol metabolism occurs at night,” says Amin. “And so that’s why a lot of times the medications we take for cholesterol are prescribed to be taken at bedtime.” Losing sleep or getting too much sleep both disrupt your body’s processing of the fats and sugars you ate throughout the day. But Amin says getting enough sleep also has a secondary effect on cholesterol. “If you’re sleeping enough you have the energy to do the sort of things that allow you to maintain a healthy lifestyle, like choosing healthy foods and exercising regularly.” MORE: 6 Simple Ways To Lower Your Stroke Risk (And Why You Need To Worry About It Now)
  9. Indian Gooseberry This Indian fruit has as much vitamin C as two oranges, which Gopal says gives it its cholesterol-fighting power. “It’s a very potent antioxidant that helps your cardiovascular system,” she says. Here’s how: LDL cholesterol is oxidized in your bloodstream and transforms into plaque that gums up your arteries. Antioxidants like vitamin C stop the oxidation and therefore reduce the amount of plaque deposited in your arteries. Indian Gooseberries can be found both fresh or frozen in Indian markets. Can’t locate them near you? You can also take it in vitamin form, which is called “Amla.”
  10. Licorice Root The licorice candy you’re used to isn’t actually licorice at all—much of what’s sold in candy stores won’t do anything to get rid of cholesterol (sorry). It’s licorice root that you want, which can be taken in pill form. A handful of small studies have found licorice root both reduces LDL cholesterol and fat buildup, but more research is needed to determine why and how well it works. Licorice root can interact dangerously with other medications like insulin, laxatives, and contraceptives, so talk to your doctor before you try it out. MORE: Is Your Statin Alternative A Waste Of Money?
  11. Bergamot A bergamot is like a cross between an orange and a lemon, and though it just recently hit the cholesterol-lowering market as a supplement, you’ve likely encountered it in other forms: Essential oil from Bergamot rinds gives Earl Grey tea its distinctive taste and is also used in many perfumes. But instead of pectin being this fruit’s cholesterol-fighting superpower, researchers believe a high concentration of five flavonoids makes it an effective treatment. Two of the flavonoids (also in grapefruit) have been found to inhibit LDL cholesterol from depositing plaque in the arteries. And two others, called melitidine and brutieridine, exhibit statin-like properties. Research is just preliminary, but so far bergamot has proven to reduce LDL cholesterol by about 27% and also raise HDL cholesterol.