Statins are medications prescribed by a doctor that lower your levels of LDL cholesterol. Plant sterols are compounds that help block your body from absorbing cholesterol. Read on to learn which is right for you.

There are two main types of cholesterol: high-density lipoprotein (HDL) and low-density lipoprotein (LDL).

HDL cholesterol is considered “good” cholesterol because it helps the body get rid of LDL cholesterol. According to researchers, high levels of LDL cholesterol can increase your risk of having a heart attack.

Adopting healthy lifestyle habits, as well as eating foods that increase HDL cholesterol and lower LDL cholesterol, are good for your overall health. But these steps may not be enough for you.

If your LDL cholesterol levels remain high after you improve your diet and exercise habits, there are still things you can do to reduce your risk of heart disease.

Two possible solutions are statins and plant sterols. Statins are medications prescribed by a doctor. Plant sterols are substances found in certain plant-based foods.

Let’s look at how these two options compare in lowering cholesterol levels.

Statins work by lowering levels of LDL cholesterol in your body. They do this by reducing the amount of LDL cholesterol that your liver makes. Statins also help your body reabsorb any cholesterol that’s built up in your arteries.

The American Heart Association recommends that certain people should consider statin therapy. These are people who:

  • have an LDL level of 190 mg/dL or higher
  • already have cardiovascular disease
  • have diabetes and are 40–75 years old
  • adults 40-75 years old with LDL between 70 and 189 mg/dL with a high 10 year risk of developing plaque buildup or ASCVD

Examples of statins available today include:

  • atorvastatin (Lipitor)
  • fluvastatin (Lescol)
  • lovastatin (Altoprev)
  • pitavastatin (Livalo)
  • pravastatin (Pravachol)
  • rosuvastatin (Crestor)
  • simvastatin (Zocor)

Plant sterols, or phytosterols, are compounds that help block your body from absorbing cholesterol. While plant sterols help lower LDL cholesterol, they don’t appear to affect your levels of HDL cholesterol or triglycerides.

Plant sterols are found naturally in:

  • fruits
  • vegetables
  • vegetable oils
  • wheat bran and wheat germ
  • cereals
  • legumes
  • nuts

All of these foods contain low levels of plant sterols, so eating these foods may not make a big impact on your cholesterol level.

An easier way to get enough plant sterols to lower your cholesterol level is through eating fortified foods. A 2022 study in those with mild to moderate hypercholesterolemia found that eating these fortified foods, combined with a healthy lifestyle, reduced LDL cholesterol in patients.

Plant sterols are added to certain foods, including some kinds of orange juice, yogurt, and margarine. According to researchers, you need to consume at least 1 gram of plant sterols per day for cholesterol-lowering benefits. Consuming 2 to 3 grams per day will net you the maximum cholesterol-lowering effect.

Both statins and plant sterols help lower LDL cholesterol levels. Statins are the standard for drug treatment, and sterols are thought to be one of the best natural options to combat high cholesterol.

Let’s see how else they compare.

Effectiveness

According to the American Heart Association, statins are one of the most effective medications for lowering LDL cholesterol. With this, they can help reduce the overall risk of heart attack and stroke.

Plant sterols may not reduce the risk of heart attack or stroke like statins do. However, it is proven that sterols can help reduce LDL cholesterol.

Side effects

According to the NHS, statins can cause side effects for some people. These can include:

  • headaches
  • muscle aches
  • nausea

Sterols, on the other hand, are not known to cause side effects when used short-term. Information on side effects from long-term use is not available.

Drug interactions

Plant sterols are not known to interact with other drugs. Statins, however, may interact with some drugs. According to the American Heart Association, these include:

  • antibiotics such as erythromycin
  • antifungal drugs such as ketoconazole
  • HIV medications such as protease inhibitors
  • blood pressure medications such as diltiazem and verapamil

Pregnancy

Sterols may be safer for pregnant women. However, there is confounding information about statins and birth complications.

For example, a 2021 study found that statin exposure was associated with preterm labor and low birth weight. However, there was no association between statin use for hyperlipidemia and adverse perinatal outcomes.

The study suggests that statins could be safely used during pregnancy by women with long-term use of statins beforehand.

Talk with your doctor about statin use if you are pregnant or are planning on becoming pregnant.

Cost

The more cost-effective option depends on your insurance coverage. If statins are covered by your insurance, they may be relatively inexpensive.

Consuming foods fortified with plant sterols might be more expensive, depending on the items you are buying.

However, if your insurance does not cover statins, the opposite may be true. It may be more cost effective for you to eat more foods fortified with plant sterols rather than pay out-of-pocket for statins.

Both statins and plant sterols can lower your levels of LDL cholesterol. Statins are medications. Plant sterols are compounds that occur naturally in some foods, or are added in to other foods.

The most important factor to consider when comparing statins to sterols is what your doctor prescribes for you. If your doctor prescribes a statin for you, be sure to follow their instructions.

If you would prefer a more natural option than medication, tell your doctor. Discuss what the best options may be for you and what risks you face based on your cholesterol levels.

You should also talk with your provider before making a decision on switching between statin and plant sterols.

Your doctor can also answer any questions you may have, such as:

  • Are plant sterols strong enough to lower my cholesterol to a safe level?
  • Can I try using statins and plant sterols together?
  • Am I taking any medications that might interact with a statin?
  • Can you refer me to a dietitian for guidance on a cholesterol-lowering diet?
  • When should I have my cholesterol levels retested to find out if my treatment is working?