If you have high cholesterol, don’t fret. While this condition is partly hereditary, there are things you can do to help lower your cholesterol level. But how long does it take to lower cholesterol? I will answer this question, give actionable tips and resources, and much more in this article.
Want to save this article for later? Click here to get a free PDF delivered straight to your inbox!
Table of Contents
What is Cholesterol?
Cholesterol is a waxy substance that is naturally present in our bodies. Our liver produces all the cholesterol our body needs. And cholesterol plays many important roles within our bodies to keep us healthy.
That’s right, cholesterol itself is not bad. It serves a purpose.
Cholesterol is carried through our bloodstream on lipoproteins. We have different types of lipoproteins. In this article, I will primarily talk about targeting low-density lipoprotein (LDL) and non-HDL cholesterol, but I will fill you in on a few other ones as well.
When there is an imbalance in the amount of cholesterol or lipoproteins in our blood, this is called dyslipidemia (1).
Is High Cholesterol Genetic?
The only way to know what your cholesterol level is to get it tested. High cholesterol has NO symptoms.
For some people, high cholesterol or dyslipidemia is very much genetic. In fact, there is a condition called familial hypercholesterolemia, which involves a genetic mutation that causes high levels of LDL cholesterol (1,2). This condition affects one in every 200 adults (2).
For individuals with familial hypercholesterolemia, diet and lifestyle change alone is not enough to manage lipid (fat) levels.
For others who do not have familial hypercholesterolemia, unhealthy lifestyle factors, and diet choices are primary factors in their elevated lipid levels.
Cholesterol takes years to build up in your arteries. Build-up begins during childhood and may become worse and more rapid during our adult years (3). Some pediatricians will recommend your child get their first cholesterol test done between the age of 9 and 11 years of age. Otherwise, the American Heart Association recommends most adults get checked around the age of 20 years and every 4 to 6 years moving forward.
Related article: How To Lower Your Calcium Score Naturally
Cholesterol and Impact on Heart Health
As mentioned, cholesterol only becomes an issue when there is an imbalance. This could be levels that are too high or too low. That is the difference between dyslipidemia and hyperlipidemia.
Dyslipidemia is when lipid levels are either too high or too low, while hyperlipidemia refers to elevated LDL cholesterol or triglycerides.
According to the National Lipid Association, the three most common dyslipidemias in adults are:
- low-density lipoprotein cholesterol (LDL-C) elevation
- triglyceride (TG) elevation,
- combined dyslipidemia, with elevations in both LDL-C and TG levels.
If you have high levels of LDL cholesterol circulating in your blood, plaque build-up can accumulate on the walls of your blood vessels (AKA atherosclerosis). This plaque formation can lead to blocked arteries (AKA atherosclerotic cardiovascular disease or ASCVD). This significantly increases your chances of having a heart attack, stroke, or other health issues.
Consistently high triglycerides can lead to the same results, though it can also lead to inflammation within your pancreas, called pancreatitis (4).
If you don’t have any symptoms of heart disease but have several risk factors, you may want to do a test, called a coronary artery calcium score test, to determine the degree of build-up you currently have. Or if you are already showing symptoms of cardiovascular disease, you may be ready for other tests or procedures, including a stress test or heart catheterization, for example.
Related article: Can You Eat Before a Stress Test?
Types of Cholesterol Explained
There are several different types of cholesterol. If you have ever had your lipid levels checked, you’re probably aware of this. Or maybe you’ve heard the terms “good” cholesterol and “bad” cholesterol?
Let me give you a breakdown of the different types of lipids and lipoproteins you may see when getting a routine lipid panel test.
This refers to the total amount of cholesterol that is circulating in your blood. Your total cholesterol number is the sum of your HDL, LDL, and a portion of your triglycerides.
High-density lipoprotein (HDL) cholesterol refers to the “good” cholesterol that helps remove excess cholesterol from your bloodstream. You want this HDL number to be higher. To help you remember that HDL is good cholesterol, think of “h” for happy. 😄
Low-density lipoprotein (LDL) cholesterol is the “bad” cholesterol that promotes dangerous plaque build-up in your arteries. You need some LDL, however too much leads to atherosclerotic heart disease and other issues. To help you remember that LDL is bad cholesterol, think of “l” for lousy. 😟
Triglycerides are a type of fat that your body uses for energy. However, when you have a combination of low HDL, high LDL, and high triglycerides, you’re putting yourself at a higher risk of having a heart attack and other health issues. In addition, high triglycerides on their own are linked to heart disease and early death.
It is also interesting to know that triglycerides are a better predictor of coronary risk in women versus men.
Cholesterol to HDL Ratio
The total cholesterol to HDL ratio is configured by taking your total cholesterol and dividing it by your HDL cholesterol number.
Thankfully, you don’t have to calculate these numbers. The lab will do this for you.
Additionally, since the total cholesterol number includes triglycerides (which remember, is a better predictor of risk in women versus men), this makes the cholesterol to HDL ratio a better predictor of coronary disease risk in women. However, another circumstance where this ratio is helpful is when your triglyceride level is greater than 300 mg/dL.
Essentially, the higher your cholesterol to HDL ratio, the higher your risk of heart disease.
Other Types of Lipids
There are other lipoproteins present in our blood that are good indicators of heart health. Most of these are not part of a routine lipid panel test. They include:
- Non-HDL-cholesterol: This includes all of your artery-clogging lipids minus your HDL number. Researchers believe this number may be a better indicator of heart health risk than LDL alone.
- Apolipoprotein B: Also called ApoB or ApoB-100, this lipoprotein carries particles such as LDL cholesterol and chylomicrons, from the liver to your cells. Measuring your ApoB may be beneficial to those with type 2 diabetes or metabolic syndrome. High levels are associated with atherosclerotic heart disease and may be a good indicator of how many atherogenic particles you have circulating in your system.
- Lipoprotein(a): Also called Lp(a), this lipoprotein is a main component of LDL cholesterol particles, and includes apolipoprotein B-100 and apolipoprotein(a). High levels of Lp(a) are highly genetic and associated with a high risk of irregular heart rhythms, coronary artery disease, ischemic stroke, and aortic valve stenosis (5,6). Lp(a) is also a causal risk factor for ASCVD (7).
Now, let’s talk about what an acceptable range is for your lipid levels.
Normal Cholesterol Levels
So-called “normal” cholesterol ranges will vary depending on your age and if you have other cardiovascular risk factors.
For example, if you have hyperlipidemia and diabetes, the American Diabetes Association recently updated its 2023 American Diabetes Association Standards of Care. Their recent updates include lower thresholds for both LDL cholesterol and blood pressure.
For example, if you have diabetes, are between 40-75 years of age, and are at high risk of heart disease, your target LDL level should be less than 70 mg/dL (it was previously 100 mg/dL).
And if you have diabetes, are between 40-75 years of age, and are currently being treated for heart disease with statins, your LDL cholesterol goal should be 55 mg/dL (it was previously 75 mg/dL).
However, if the above does not apply to you, for the sake of this article, I will provide a list of ranges for total cholesterol, LDL, HDL, and triglyceride levels according to the National Cholesterol Education Program:
- Total Cholesterol Level:
- Desirable: less than 200 mg/dL
- Borderline high: 200-239 mg/dL
- High: greater than 240 mg/dL
- LDL Cholesterol Level:
- Optimal: less than 100 mg/ dL
- Near optimal/above optimal:100 to 129 mg/dL
- Borderline high: 130 to 159 mg/dL
- High: 160 to 189 mg/dL
- Very high: greater than 190 mg/dL
- HDL Cholesterol Level:
- Low: less than 40
- High: greater than or equal to 60
- Fasting Triglyceride Level:
- Normal: less than 150 mg/dL
- Mild hypertriglyceridemia: 150 to 499 mg/dL
- Moderate hypertriglyceridemia: 500 to 886 mg/dL
- Very high or severe hypertriglyceridemia: greater than 886 mg/dL
How Long Does It Take To Lower Cholesterol?
Many factors affect how long it takes to lower cholesterol. These include pre-existing health factors, dietary habits, exercise routine (if any), and any supplements or medications you may be taking.
My positive message for you here is that you can take an active role in speeding up the process. You need to take all of the above factors into account and make improvements to any areas that you feel you’re falling short.
A timeline for seeing results is based on your approach and commitment to managing your cholesterol levels. And generally speaking, if you are trying to reduce your levels through diet and lifestyle, you should see improvements in your cholesterol levels within 3-6 months!
Expert Tips for Lowering Cholesterol
In my profession, I educate heart patients daily regarding how to improve lipid levels through dietary approaches. I also sprinkle in some other recommendations based on scientific evidence, like lifestyle changes, supplements, and medication management with the help of one’s doctor.
Let me elaborate on how you can use these methods to improve YOUR lipid levels too!
When it comes to your diet, there are several things you should keep in mind if your goal is to lower your cholesterol. With the help of the National Lipid Association’s very recently updated (June 2, 2023) guidelines for nutrition interventions for adults with dyslipidemia, you should be covered. Here are a few of the diet-related highlights.
Reduce Saturated and Trans Fats
Cholesterol in the foods we eat used to be deemed the devil when it came to elevated LDL cholesterol and heart disease risk. However, the overall consensus of the Science Advisory from the American Heart Association in 2020, states that what really matters in terms of lowering your LDL is consuming a higher ratio of unsaturated fats versus saturated fats.
Polyunsaturated fats are shown to have more of a cholesterol-lowering effect than monounsaturated fats (8).
Still, some individuals are more sensitive to dietary cholesterol than others, so of course, work with your personal registered dietitian to find the appropriate dietary pattern for you!
Be sure to avoid foods with trans fatty acids and keep saturated fat intake to less than 50% of the total amount of fat. For, example:
If you have a bag of chicharrones (AKA fried pork rinds) that are 5 gm of total fat per serving and 2.5 gm of saturated fat per serving, this means that half or 50% of the total amount of fat is from saturated fat!
All-in-all, a healthy dietary pattern should be low in saturated fats and contain less than 300 mg of total cholesterol for the day.
And finally, another important point regarding fat intake is that not all fats are created equal. Specific forms of saturated fats actually show more of a negative effect on lipid levels than others (8). These saturated fats come in the form of:
- butter and full-fat dairy products
- processed and high-fat meats
- tropical oils (i.e., coconut, palm, and palm kernel oils)
Vary Your Protein Sources
To help lower your LDL cholesterol and non-HDL cholesterol levels more significantly, try eating more plant-based sources of protein.
One study, the OMNIHEART feeding study, investigated three different forms of the DASH diet. What was revealed is that consuming a slightly higher amount of protein (25%), a lower amount of carbohydrates, (48%), and heart-healthy fats (27%), resulted in lower blood pressure and lipid levels over 6 weeks.
To accomplish similar results for yourself, you would need to replace some of your carbohydrates with “mixed-source proteins”, meaning ~50% from plant sources. This could include beans, legumes, tofu, or tempeh to name just a few.
Related article: The Best Alternatives to Deli Meat (Plus 13 Yummy Recipes)
Get Adequate Viscous Fiber
All types of fiber, soluble or insoluble, are great to add to a healthy diet. However, viscous fibers such as pectins, gums, mucilages, and some hemicelluloses, are known to reduce LDL, non-HDL, and Apo B levels. This is because they form a gel in your gastrointestinal tract and prevent bad cholesterol from being absorbed.
Another special type of viscous fiber that helps lower LDL cholesterol is β-glucan (beta-glucan). It is commonly found in oats.
One review of studies shows that consuming 3.5 grams of oat β-glucan per day for 6 weeks was associated with a moderate reduction in LDL cholesterol and non-HDL-cholesterol.
And yet more randomized controlled trials show that eating between 5-10 grams of viscous fiber per day can potentially lower your LDL cholesterol level by 5.5 to 11.0 mg/dL! Hmm, might have to add some more oatmeal to your daily routine, am I right?
One and a half cups of cooked oatmeal contain around 3 grams of beta-glucan (9).
The FDA also backs up the claim for beta-glucan from oats with an official heart health claim dating back to 1997. This states that consuming beta-glucan soluble fiber from whole oats, oat bran, and whole oat flour may reduce the risk of coronary heart disease.
Other foods containing viscous fibers that are known to reduce LDL cholesterol include:
- Legumes (e.g., lentils, lima beans, kidney beans)
- Chia seeds
- Fruits, including apples, peaches, and pears
- Vegetables, including asparagus, Brussels sprouts, and sweet potatoes
Follow a Cholesterol Friendly Diet
As a whole, fruits, vegetables, and whole grains are excellent and obvious additions to a low-cholesterol diet. These foods do not contain any cholesterol and are packed with antioxidants, phytonutrients, phytosterols, and fiber that can prevent lipid levels from rising and even improve them.
Living a healthy lifestyle is also a great way to facilitate the lowering of your cholesterol. This means:
- Living an active lifestyle
- Obtaining a healthy weight
- Quitting smoking or never starting to smoke
- Avoiding alcohol intake or drinking in moderation
- Managing stress levels
I want to add that a person of heavier weight will not necessarily have high cholesterol.
However, studies do show a correlation between weight gain and increases in lipid levels. Additionally, studies also confirm that when heavier individuals lose weight, their lipid levels also decrease.
For more on some of these lifestyle changes, check out the article, “5 Things You Can Do to Support Heart Health NOW“.
Depending on your lipid levels, your doctor may want you to try some approaches in addition to diet and lifestyle. These could include dietary supplements. There are two supplements I’d like to review with you to help reduce your cholesterol. These are:
- Plant sterols and plant stanols
- Red yeast rice
FYI, if you’d like to try either of these supplements, I suggest talking to your doctor before adding them to your normal regimen, as they may cause interactions with other medications you’re taking.
Plant Sterols and Stanols
Plant sterols and plant stanols are also known as phytosterols. These substances are naturally found in vegetable oils, nuts, seeds, and grain products. They lower LDL cholesterol by reducing how much is being absorbed in your intestines.
Phytosterol supplements may be useful for those that are at low to moderate risk for cardiovascular disease and that do not qualify for statin therapy.
Red Yeast Rice
Red yeast rice is a dietary supplement made from fermenting yeast on rice. During the fermentation process, a compound called monacolin K is produced. What’s super interesting is that monacolin K is structurally identical to lovastatin!
Some of you reading this may already be aware that lovastatin is a medication (a statin to be exact) made to help lower cholesterol.
Unfortunately, when purchasing red yeast rice supplements, labels do not list the amount of monacolin K on the label. However, studies on red yeast rice show that an intake of 1200 to 2400 grams per day show reductions in LDL cholesterol level (12, 13).
Future insight on the use of red yeast rice should be interesting. But for now, it should be used with caution, as it isn’t yet FDA-approved as a drug and there’s no way to know how much of the active component you’re getting.
Depending on the results of your lipid panel, your doctor may consider prescribing lipid-lowering medication for you. The most common type of medication given to lower cholesterol is statins.
There are also other medications that are commonly given to reduce lipid levels. They may include:
- Bile acid sequestrants
- Niacin or nicotinic acid
- PCSK9 inhibitors
- Omega-3 Fatty Acid Ethyl Esters
According to the Cleveland Clinic, statins can actually dissolve cholesterol build-up in your arteries. And if you’re wondering how long it takes statins to lower cholesterol, the answer is 6 to 8 weeks, though improvements can also be seen within 2 weeks.
For more on statins, you can read this brief article about controlling cholesterol with statins. Or for more information on the rest of these medications, visit this article on cholesterol medications from the AHA.
How long does it take to lower cholesterol? It’s dependent on many factors, including what type of dyslipidemia you have and what plan of treatment you and your doctor decide upon. Dietary approaches to lower your cholesterol can take 3 to 6 months and lifestyle factors should also be considered to help lower it quickly.
Following a proper cholesterol-lowering diet such as the DASH diet or Mediterranean diet may be beneficial. As is reducing overall saturated fat intake and consuming a larger ratio of unsaturated fats and soluble fiber.
Lifestyle recommendations to lower cholesterol include staying physically active, avoiding or limiting alcohol, maintaining a healthy weight, avoiding smoking, and reducing stress levels.
For some, diet and lifestyle changes may not be enough to lower cholesterol naturally. You may need extra help in the form of nutritional supplements or medication management prescribed by your doctor.
Download this Cholesterol Guide from the AHA to learn more about how you can improve lipid levels and protect yourself from heart disease.
Kiran Campbell is a registered dietitian and entrepreneur with 13 years of experience. She has a degree in psychology as well as dietetics. She is also a proud member of the Academy of Nutrition and Dietetics’ and its Cardiovascular Health and Well-being Dietetics Practice Group among others. Kiran proudly presents and promotes the most up-to-date, science-based nutrition information on all things heart-related. She aims to serve not only individuals with heart disease, but also those wanting to protect against it. Learn more about Kiran by visiting her About Page.