What's It Take to Lower Cholesterol? I have very high cholesterol that is obviously hereditary, since I'm a vegetarian and eat no animal products. I have a very low fat intake, and also take vitamin E. I don't want to take any medication. Is there anything I can take in the way of herbs or natural products to lower my cholesterol? And yes, I do exercise regularly. I'm assuming from your question that you've done all of the standard lifestyle interventions to try to manipulate cholesterol. The primary step, of course, is to reduce saturated fat in your diet as much as possible, meaning mostly fats of animal origin -- but also palm and coconut oils. Plus, don't forget that your body makes its own cholesterol. Peanut butter, vegetable oils, shortenings, and margarines can cause your body to make too much. Also cut out coffee, black tea, and cola. On the positive side, Japanese green tea and foods like onions, garlic, chili peppers and shiitake mushrooms all have some cholesterol lowering effects. Also, as you know, make sure you exercise (I always recommend 30 minutes, at least five days a week.) Most people find that changing their eating and exercise habits brings their cholesterol profile down to normal. But everyone's biochemical balance is unique, of course, so these interventions may not have worked for you. If so, then I think it may be time to try niacin, or vitamin B-3. There have been some ineffective forms of niacin on the market. But there's a new form that definitely works, a wax-impregnated, time-release niacin. Carlson Laboratories, based in Arlington Heights, Ill., is one of the companies that makes it, in a product called Niacin.Time. I would start with a dose of one 500 mg tablet twice a day with meals. I will caution you, though, to take niacin with great care and with medical supervision. Time-release niacin is strikingly effective at lowering cholesterol, but it can also disturb liver function. In rare cases, it can cause a fulminant toxic hepatitis. That's a real medical catastrophe, and frequently fatal. You must monitor liver function when starting time-release niacin. Have liver function checked at the start of therapy, then test it again after two weeks on niacin. You can get a liver test at any clinical laboratory, but a doctor has to phone in an order for it. As long as your liver enzymes are normal you can stay on the niacin indefinitely, increasing the dose until cholesterol comes down to the level you want. You may want to go up to 1,500 mg a day or even higher, but I'll emphasize again that this can only be done with liver monitoring. Keep the dose as low as possible to maintain improvement. You should also know the early signs of liver dysfunction: They are unexplained loss of appetite, nausea, a feeling of abdominal fullness, abdominal pain, and any other unusual digestive symptoms. Don't take niacin if you are pregnant or have ulcers, gout, diabetes, gallbladder disease, liver disease, or have had a recent heart attack. Niacin seems to both lower the bad LDL cholesterol, which damages artery walls, and maybe raise HDL, the good cholesterol that protects arteries. Your total cholesterol should be under 180. If you can get your total cholesterol under 150, your chance of a heart attack is negligible.