Supplements for three common conditions

High cholesterol, high blood pressure, and anxiety are three common conditions that are often treated with medication. But sometimes people can't tolerate those drugs or are reluctant to use them. In these instances, dietary supplements may be an option, says Dr. Donald Levy, medical director at the Osher Clinical Center for Integrative Medicine at Brigham and Women's Hospital and assistant clinical professor of medicine at Harvard Medical School.

Studies have shown that some herbs, vitamins, minerals, and other substances, alone or in combination with traditional treatments, may be effective in treating these conditions, and are largely safe to use — provided your doctor approves.

About half of all Americans routinely take dietary supplements. The most common ones are multivitamin and multimineral supplements. Making Sense of Vitamins and Minerals: Choosing the foods and nutrients you need to stay healthy explains the evidence behind the benefits and safety profiles of various vitamins and minerals. It also includes the recommended minimum and maximum amounts you should consume, as well as good food sources of each.

Statins are the most commonly prescribed class of medication to improve high cholesterol, but there are alternatives for people who can't take them.

High cholesterol

Vitamin D₃. If you cannot tolerate a statin medication and have a vitamin D deficiency (which Dr. Levy defines as a blood level below 32 nanograms per milliliter), a vitamin D₃ supplement could help, according to Dr. Levy. "It's interesting, because after taking the supplement, some people are then able to tolerate statins when they couldn't in the past," he says.

Phytosterols. Phytosterols (also called plant stanols or sterols) are derived from the cell membranes of plants and can be taken in pill form. They are also found naturally in foods such as nuts, beans, fruits, and vegetables. Studies show that phytosterol supplements can lower "bad" LDL cholesterol by up to 14% in people taking 2,000 to 3,000 milligrams (mg) a day, says Dr. Levy. When choosing a product, look for a quality seal (see "Worried about supplement safety? Here's what you should consider"), and also look for a product that contains phytosterol esters, says Dr. Levy.

Red yeast rice. Red yeast rice supplements are made from a type of yeast that is grown on white rice. Red yeast rice has long been used in Chinese medicine, and modern studies show that people taking 2,400 to 3,600 mg a day for six months were able to reduce their LDL cholesterol by 20% to 25%, says Dr. Levy. One 2008 study published in The American Journal of Cardiology found that red yeast rice was also effective in reducing deaths and recurrent heart attacks in nearly 5,000 people who took the supplement after having a heart attack. Look for a high-quality product, says Dr. Levy, because red yeast rice can contain a dangerous contaminant, citrinin, which is a toxin produced by fungus that can cause food poisoning, kidney damage, and immune system problems.

Worried about supplement safety? Here's what you should consider

While some supplements are potentially helpful (or at least harmless), a lack of regulatory oversight of these products means that others might be ineffective or dangerous, or might contain hazardous contaminants. Identifying the safe choices requires a little detective work, says Dr. Donald Levy, medical director at the Osher Clinical Center for Integrative Medicine at Brigham and Women's Hospital and assistant clinical professor of medicine at Harvard Medical School. Before taking a supplement, always talk to your doctor to make sure that it's safe for any medical conditions you may have and that it won't interact with any medications you are taking.

Although supplement makers must follow FDA rules for good manufacturing practices, the agency does not require testing the estimated 9,000 products on the market to make sure they do contain the ingredients they claim, and don't contain contaminants, such as dangerous bacteria, arsenic, cadmium, or lead. This means there is no guarantee that any particular product is effective or safe. To add a degree of protection, look for products that have voluntarily gone through quality testing, which is certified by a seal on the packaging. Some good ones to look for are those from U.S. Pharmacopeia, ConsumerLab.com, and NSF International.

High blood pressure

A few supplements have been shown to be effective in reducing high blood pressure, says Dr. Levy.

Magnesium citrate or glycinate. Some people are deficient in the mineral magnesium. But blood tests aren't good at detecting total magnesium levels inside the body, because much of your body's magnesium is stored within cells. Many people find the deficiency only after a nutritionist analyzes their diet, says Dr. Levy. In those individuals, supplements can boost magnesium levels and help reduce high blood pressure when taken along with traditional blood pressure treatments. It typically takes up to six weeks for the supplements to show an effect. However, not everyone should take magnesium, particularly those with kidney disease, says Dr. Levy, so be certain to consult with your doctor or integrative medicine specialist before taking it.

Lycopene. An antioxidant supplement that may also help reduce high blood pressure is lycopene, which gives vegetables like tomatoes their red hue. While tomato-based products, including canned sauces, contain lycopene, those foods often have a lot of sodium. So, it's better in many instances to opt for a supplement. Look for one that also contains tomato extract for an added benefit, says Dr. Levy. Typically, people need to take 15 to 25 mg of lycopene daily to see a reduction in blood pressure.

Anxiety

Problems with anxiety are common, especially around the time of menopause.

Chamomile extract. This extract, which comes from a flower, has long been used as a therapy for anxiety. Anxiety often goes hand in hand with sleeplessness, so it's no surprise that chamomile is also often recommended as a sleep aid. Many people drink chamomile tea, but taking a supplement may be more convenient (and require fewer late-night trips to the bathroom if taken before bed). Studies have found that people who took chamomile supplements saw a significant reduction in anxiety when compared with people who took a placebo, says Dr. Levy. Typically, it's best to start by taking one 220-mg capsule daily. Look for one that contains 1.2% of a substance called apigenin.

For more information on the vitamins and minerals you need for your best health, check out Making Sense of Vitamins and Minerals, a Special Health Report from Harvard Medical School.