Grade “A” means the supplement has “strong positive scientific evidence” of benefit. B-vitamins such as niacin and folate are among the top (Grade A) cholesterol-lowering vitamins and supplements, but there’s more:

2. Fiber Supplements, Especially 3 Soluble Fibers: Beta-glucan, Glucomannan, and Psyllium. For lowering cholesterol, soluble fiber supplements are key. A soluble fiber is one that has a high water-holding capacity and forms a gel when dissolved in water. Soluble fibers interfere with the transport of cholesterol and bile acids to help lower blood cholesterol levels. Natural Standard includes the following three specific soluble fibers in their list of top cholesterol-lowering vitamins and supplements: 

• Beta-glucan is a type of soluble fiber that is especially abundant in oats and barley. Three grams oat or barley beta glucans daily, an amount which can be obtained through supplements or foods enriched with oat bran, significantly reduces total and LDL cholesterol and triglycerides in clinical studies according to a recent meta-analysis published in the journal Nutrition.[1] You might find smaller amounts of beta glucan included in some multi-ingredient cholesterol-lowering vitamins and supplements, but the dose is generally too low to have a therapeutic effect in these products.
• Glucomannan is a soluble fiber derived from the root of Amorphophallus konjac. It is known for its high molecular weight and viscosity compared to other fibers. According to a meta-analysis of 14 trials, glucomannan supplementation significantly reduces total cholesterol by an average of 19 mg/dl, LDL cholesterol by 16 mg/dL, and triglycerides by 11 mg/dL. It also significantly reduces body weight and blood sugar levels.[2] Dosages used in studies have varied widely, but 3.6 grams per day in divided doses has been found effective for cholesterol-lowering.
• Psyllium is a soluble fiber derived from the husks of the seeds of Plantago ovate and is the chief ingredient in many commonly used bulk laxatives, such as Metamucil®. Psyllium is well studied as a cholesterol-lowering agent, with clinically and statistically significant reductions seen in total and LDL cholesterol after 6-8 weeks of regular consumption of 12 grams three times daily before meals.[3]

3. Plant Sterols, Especially Beta-Sitosterol: Plant sterols also make Natural Standards’ grade A list of cholesterol-lowering vitamins and supplements. One of the most prized plant sterols (phytosterols) is beta-sitosterol. Beta sitosterol and other sterols are synthesized exclusively by plants and are present naturally in grains, nuts, seeds, fruits and vegetable oils. A meta-analysis of 20 different high- quality studies, published in 2009, concluded that plant sterol supplements including beta-sitosterol significantly lower total and LDL cholesterol as well as triglycerides.[4] You can’t get enough beta-sitosterol or other plant sterols through your diet to exert this action, so you can either take a supplement or eat  foods fortified with them. Take 1.6 to 3.2 grams daily; once-daily dosing has been found to lower LDL levels just as effectively as three times daily.[5]

Additional Grade “A” cholesterol-lowering supplements:

In addition to the above Grade A cholesterol-lowering vitamins and supplements, there are many effective, science-based alternatives to statins for lowering cholesterol. You’ll find information on these and more evidence-based, cholesterol-lowering vitamins and other therapies in our comprehensive guide, Lowering Cholesterol Naturally. This is a thorough and complete resource on how to get your cholesterol levels in proper balance using natural health strategies recommended by leading integrative physicians and research study groups. You’ll learn about not only supplements but other natural therapies for achieving optimal cholesterol and reducing your chance of suffering a heart attack or stroke.

[1] Nutrition. 2011 Oct;27(10):1008-16.

[2] Am J Clin Nutr. 2008 Oct;88(4):1167-75.

[3] Br J Nutr. 2011 Jan;105(1):90-100.

[4] Asia Pac J Clin Nutr. 2009;18(2):179-86.

[5] Curr Opin Lipidol. 2000 Dec;11(6):571-6.