Total Cholesterol

When high

Supplements:

• Omega-3 (EPA/DHA) -- 2-3g/day (with fat-containing meals)
• Citrus Bergamot -- 500mg 2x/day
• Berberine -- 500mg 2-3x/day (before meals)
• Dihydroberberine -- 100-200mg 2x/day, an alternative to berberine rather than an addition. It absorbs far better: 100mg reached roughly nine times the peak plasma berberine of a 500mg berberine dose (Moon et al., 2021). Two honest caveats. That trial ran five participants over a single day, and it measured no significant difference in glucose or insulin between any condition, so the absorption advantage is established while the glycaemic benefit is not. Better tolerability is the reason dihydroberberine was developed rather than something that trial tested

Lifestyle:

• Regular cardio exercise 3-5x/week (most effective intervention)
• Increase dietary fibre (oats, vegetables)
• Reduce saturated fats and processed foods

Pharmacological options (when supplements are insufficient):

• Rosuvastatin -- 5-20mg/day; first-line for ApoB-driven elevation; preferred over atorvastatin/simvastatin in AAS users due to lower CK elevation risk; monitor liver enzymes and CK
• Ezetimibe -- 10mg/day; cholesterol absorption inhibitor; ~20% LDL reduction; minimal side effects; additive to statin or stand-alone for statin-intolerant athletes
• Bempedoic acid -- 180mg/day; ATP-citrate lyase inhibitor; not taken up by muscle (zero CK elevation); preferred for statin-intolerant athletes
• PCSK9 inhibitors (alirocumab, evolocumab) -- 75-150mg subQ every 2 weeks; reserved for severe familial elevation or resistant cases; expensive but ~60% LDL drop
• All require physician oversight and baseline liver/CK panel

Every cholesterol supplement ranked by clinical effect size, with exact doses: Best cholesterol supplements on cycle, ranked by evidence.