Do Probiotics Affect Cholesterol Levels? Unpacking the Science of Gut-Heart Health

November 10, 2025 •

4 min read

According to the World Health Organization, cardiovascular disease (CVD) is the leading cause of death globally, with high cholesterol being a major contributing factor. While medication and diet are the primary interventions, emerging research suggests that certain probiotic strains can play a complementary role in managing lipid profiles. This article explores the science behind the question: do probiotics affect cholesterol levels?

Quick Summary

This nutritional guide examines the effect of probiotics on cholesterol levels, detailing the mechanisms by which specific bacterial strains can help lower total and LDL cholesterol. It also covers the varying efficacy influenced by dosage, strain type, and duration of supplementation.

Key Points

Modest but Significant Reductions: Probiotics, especially certain strains, can lead to modest but statistically significant reductions in total and LDL cholesterol levels.
Strain-Specific Effects: The cholesterol-lowering effect is not universal across all probiotics; it is highly dependent on the specific bacterial strain used.
Multiple Mechanisms of Action: Probiotics can lower cholesterol through various biological pathways, including increasing bile acid excretion, binding directly to cholesterol, and producing short-chain fatty acids.
Importance of Dosage and Duration: Higher dosages (over $10^9$ CFU) and longer intervention periods (over 4-8 weeks) tend to yield more noticeable results.
Best for Elevated Cholesterol: Individuals with moderately elevated cholesterol tend to see a more pronounced effect from probiotic supplementation than those with normal levels.
Complementary to Lifestyle: Probiotics are best used as a supportive measure alongside a heart-healthy diet and regular exercise, not as a standalone treatment.
Not for HDL or Triglycerides: Many studies show no significant effect of probiotics on increasing HDL (good) cholesterol or lowering triglycerides. Some combination strains and synbiotics, however, may positively influence these markers.

The potential for probiotics to influence cholesterol has been a subject of significant research, with numerous studies exploring the link between gut microbiota and cardiovascular health. While the effects can vary depending on the probiotic strain, dosage, and individual health status, the overall evidence points to a beneficial, though modest, effect on lowering total and LDL (bad) cholesterol levels. The following sections delve into the specific mechanisms and key findings.

The Mechanisms Behind Probiotics' Effect on Cholesterol

Probiotics exert their cholesterol-lowering effects through several proposed biological mechanisms within the digestive tract and systemically.

Bile Salt Hydrolase (BSH) Activity

One of the most widely studied mechanisms is the activity of the enzyme bile salt hydrolase (BSH), which is produced by certain probiotic bacteria.

Disrupting Bile Acid Circulation: Bile acids are made from cholesterol in the liver and are crucial for fat digestion. They are normally reabsorbed in the intestine and recycled back to the liver through a process called enterohepatic circulation. The BSH enzyme produced by probiotics deconjugates bile salts, making them less soluble and more likely to be excreted in feces.
Increasing Demand for Cholesterol: To compensate for the loss of bile acids, the liver must pull more cholesterol from the bloodstream to produce new bile acids, thereby lowering overall serum cholesterol levels.

Cholesterol Assimilation and Binding

Some probiotics can directly interact with cholesterol in the gut, reducing the amount that gets absorbed into the body.

Assimilation: As they grow, some probiotic strains can assimilate cholesterol into their own cellular membranes. This incorporated cholesterol is then excreted from the body along with the bacteria.
Binding: Probiotics can also bind to cholesterol on their cell surfaces, effectively removing it from the intestinal tract before it can be absorbed.

Production of Short-Chain Fatty Acids (SCFAs)

When probiotics ferment non-digestible fibers in the gut, they produce beneficial compounds called short-chain fatty acids (SCFAs), such as propionate.

Inhibiting Cholesterol Synthesis: Propionate can travel to the liver and inhibit the activity of the enzyme HMG-CoA reductase, a key player in cholesterol production. This is the same enzyme targeted by statin drugs.

Comparison of Probiotic Strains for Cholesterol

Not all probiotics are created equal when it comes to cholesterol management. The effect is highly strain-specific and dependent on dosage and duration of use. Below is a table comparing some of the most-researched strains for their impact on lipid profiles.


Probiotic Strain	Primary Mechanism	Effect on TC	Effect on LDL-C	Effect on TG	Effect on HDL-C
L. plantarum CECT 7527, 7528, 7529 (e.g., AB-LIFE®)	High BSH activity	Significant reduction (13.6%)	Significant reduction (14.7%)	Reduced significantly in some studies	Increases in some studies
L. reuteri NCIMB 30242	High BSH activity	Significant reduction	Significant reduction (11.6% in 9 weeks)	No significant effect	No significant effect
L. acidophilus/B. lactis (combination)	BSH activity, assimilation	Significant reduction	Significant reduction	Variable effect	Mixed results (increases in some T2D studies)
L. plantarum ECGC 13110402	High BSH activity	Significant reduction (34.6% in 6 weeks)	Significant reduction (28.4% in 6 weeks)	Significant reduction	Increased significantly in some studies
L. acidophilus DDS-1/B. longum	Mixed mechanisms	Variable effects observed	Variable effects observed	Variable effects observed	Variable effects observed

Important Considerations for Supplementation

Several factors can influence the effectiveness of probiotics for managing cholesterol, and it's essential to consider them before starting a new regimen.

Strain Specificity: As the table above demonstrates, different strains yield different results. A product containing Lactobacillus acidophilus might show a modest effect, while a specific, clinically tested strain like L. reuteri NCIMB 30242 has demonstrated more significant LDL-lowering potential. Always look for specific strains rather than generic species names.
Dosage and Duration: Studies indicate that both a sufficient dosage and longer treatment duration are key for a more pronounced effect. Meta-analyses have shown that interventions lasting longer than four to eight weeks, with doses exceeding $10^9$ CFU (Colony-Forming Units) per day, generally produce more notable results.
Individual Health Status: The effectiveness of probiotics appears to be more significant in individuals with moderately elevated cholesterol levels (hypercholesterolemia) compared to those with normal levels. Certain conditions, like type 2 diabetes, can also influence how probiotics affect lipid profiles.
Delivery Method: Probiotics can be delivered via fermented foods like yogurt or as encapsulated supplements. While some studies favor capsules for their controlled dosage, fermented dairy products containing probiotics have also shown positive results.
Lifestyle and Diet: Probiotics are not a replacement for a heart-healthy diet and regular exercise. They function best as a complementary tool alongside proven lifestyle interventions. A diet rich in fiber, for example, can enhance the production of beneficial SCFAs that further support cholesterol reduction.

Potential for Adjunct Therapy

With potential side effects and inconsistent adherence to traditional drug therapies like statins, interest in natural alternatives is growing. Probiotics, especially specific, highly-researched strains, offer a promising adjunct therapy for individuals seeking to manage their cholesterol levels without relying solely on pharmaceuticals. Some studies even show successful combinations of probiotics with other natural cholesterol-lowering agents like red yeast rice. However, it is crucial to consult a healthcare professional before making any significant changes to your cholesterol management plan.

Conclusion: A Promising Complement, Not a Cure-All

In conclusion, the answer to "do probiotics affect cholesterol levels?" is a qualified yes, but with important caveats. Scientific studies and meta-analyses suggest that specific, high-dose, and long-term probiotic interventions can modestly yet significantly reduce total and LDL cholesterol, particularly in hypercholesterolemic individuals. This effect is driven by multiple mechanisms, including the deconjugation of bile acids, direct cholesterol binding, and the production of beneficial short-chain fatty acids. However, the efficacy is highly dependent on the strain of probiotic used, with some showing more consistent and potent effects than others. While not a replacement for medical treatment or healthy lifestyle choices, probiotics represent a promising and safe supplementary strategy for those looking to improve their heart health and lipid profiles.

Frequently Asked Questions

Strains with documented effectiveness include Lactobacillus plantarum CECT 7527, 7528, and 7529, and Lactobacillus reuteri NCIMB 30242. These strains have demonstrated cholesterol-lowering properties in clinical studies, primarily by reducing total and LDL cholesterol.

The effects can take time to become noticeable. Studies have shown significant reductions in cholesterol levels after supplementation periods of 6 to 12 weeks. Longer interventions, typically over 8 weeks, are generally more effective.

Yes, several meta-analyses and studies confirm that specific probiotic strains can lead to modest, but significant, reductions in LDL cholesterol, especially in individuals with high baseline levels.

The effect of probiotics on triglycerides and HDL cholesterol is less consistent and less pronounced than the effect on LDL cholesterol. Most studies show no significant change, though a few have noted improvements, particularly with multi-strain or synbiotic products.

Probiotics lower cholesterol through several mechanisms. They produce the enzyme bile salt hydrolase (BSH), which disrupts bile acid recycling and forces the body to use more cholesterol to make new bile. Some strains also bind to and assimilate cholesterol in the gut, preventing its absorption.

No, probiotics are not a replacement for prescribed cholesterol-lowering medication like statins. They should be considered a complementary therapy to be used alongside a healthy lifestyle, and you should always consult a healthcare professional before stopping or altering any prescribed medication.

Look for a product that specifies the exact strains shown to be effective, such as Lactobacillus plantarum CECT 7527, 7528, 7529 or Lactobacillus reuteri NCIMB 30242. Ensure it provides a high enough CFU count (at least $10^9$) and plan for a long-term, consistent intervention to see potential benefits.