Do Probiotics Reduce Cholesterol Levels? Separating Fact from Hype

December 10, 2025 •

5 min read

Cardiovascular disease is a leading global health concern, and high cholesterol is a significant risk factor. Growing evidence suggests a link between gut health and heart health, leading to questions about whether probiotics reduce cholesterol levels, offering a potential complementary approach to traditional treatments.

Quick Summary

This article explores the scientific evidence behind the use of probiotics for cholesterol reduction, detailing mechanisms, effective strains, and influential factors.

Key Points

Strain-Specific Effects: The cholesterol-lowering effects of probiotics are not universal and depend on the specific bacterial strain used, its dosage, and the duration of consumption.
Multiple Mechanisms: Probiotics may influence cholesterol through several pathways, including breaking down bile salts (BSH activity), binding to and assimilating cholesterol, and producing short-chain fatty acids.
Modest but Significant Reductions: Meta-analyses of clinical trials have shown that some probiotics can lead to modest, but statistically significant, reductions in total cholesterol (TC) and LDL cholesterol levels.
Complementary, Not Replacement: Probiotics are best viewed as a complementary strategy for supporting cardiovascular health, especially for those with mildly high cholesterol or statin intolerance; they are not a replacement for traditional statin therapy.
Requires Targeted Selection: Choosing a probiotic requires careful consideration of the specific strains, as efficacy varies significantly. Look for products with clinically studied strains and adequate, viable CFU counts.
Holistic Approach is Key: Probiotics are most effective when integrated into a comprehensive heart-healthy lifestyle, including a balanced diet and regular physical activity.

The Gut-Heart Connection: An Emerging Scientific Frontier

For decades, heart health was primarily linked to diet, exercise, and genetics. However, recent scientific advances have highlighted the profound connection between the gut microbiome and cardiovascular function, known as the 'gut-heart axis'. The trillions of microorganisms residing in the human gut play a crucial role in metabolism, inflammation, and immune regulation, all of which can indirectly influence cholesterol levels. This has sparked extensive research into the potential for specific probiotic strains—beneficial live bacteria—to help manage cholesterol.

How Probiotics May Influence Cholesterol

Research points to several potential mechanisms through which probiotics may exert a cholesterol-lowering effect. These actions primarily occur within the digestive tract, impacting the body's absorption and synthesis of cholesterol.

Bile Salt Hydrolase (BSH) Activity

One of the most widely studied mechanisms is the enzymatic deconjugation of bile acids by bile salt hydrolase (BSH), an enzyme produced by certain probiotic bacteria. In the liver, cholesterol is used to synthesize bile acids, which are then conjugated and released into the intestines to aid in fat digestion. Most bile acids are reabsorbed and recycled in a process called enterohepatic circulation. Probiotic strains with high BSH activity can deconjugate these bile salts, making them less soluble and therefore less likely to be reabsorbed. This forces the liver to pull more cholesterol from the bloodstream to produce new bile acids, resulting in a reduction of circulating cholesterol.

Cholesterol Assimilation and Binding

Some probiotic strains can directly assimilate and bind to cholesterol within the intestines, preventing it from being absorbed into the bloodstream. This cholesterol is then excreted from the body via feces. Studies conducted in laboratory settings have shown that certain strains of Lactobacillus are capable of entrapping cholesterol from their surroundings. While the exact process isn't fully understood, some evidence suggests that the cholesterol may be incorporated into the bacteria's cellular membranes during their growth.

Conversion to Coprostanol

Certain gut bacteria can convert cholesterol into a non-absorbable compound called coprostanol. This process reduces the amount of cholesterol available for absorption in the gut. While this mechanism has been recognized since the 1930s, the precise role and impact of specific probiotic strains on this conversion pathway require further investigation.

Production of Short-Chain Fatty Acids (SCFAs)

Probiotics ferment indigestible fibers in the gut to produce short-chain fatty acids (SCFAs), such as propionate. Propionate is known to inhibit HMG-CoA reductase, a key enzyme involved in the liver's synthesis of cholesterol. By suppressing this enzyme, propionate can help reduce the overall production of cholesterol in the body.

Clinical Evidence: What Do Studies Show?

Numerous human and animal studies have investigated the cholesterol-lowering effects of probiotics, with varying results. This is often due to differences in probiotic strain, dosage, study duration, and the health status of participants.

Promising Strains from Clinical Trials

Several meta-analyses and randomized controlled trials have shown modest but significant reductions in total cholesterol (TC) and low-density lipoprotein (LDL), often referred to as 'bad' cholesterol.

Lactobacillus reuteri NCIMB 30242: One of the most-researched strains, it has demonstrated an ability to significantly reduce LDL-C and TC in hypercholesterolemic adults in clinical trials. The effect is largely attributed to its potent BSH activity.
Lactiplantibacillus plantarum (formerly Lactobacillus plantarum): Several strains, such as the proprietary blend AB-LIFE® (CECT 7527, 7528, and 7529) and LPLDL, have shown efficacy in maintaining healthy cholesterol levels, particularly in individuals with mildly elevated cholesterol. The effectiveness of these strains is often linked to their BSH activity and ability to modulate cholesterol metabolism.
Bifidobacterium lactis and Bifidobacterium longum: Studies have shown that strains from this genus, often in combination with other probiotics or prebiotics (synbiotics), can significantly decrease total and LDL cholesterol. B. longum BL1, for example, has been associated with cholesterol reduction in subjects consuming probiotic yogurt.

Mixed Results and Influencing Factors

Despite the positive findings, some studies report no significant effect on lipid profiles with probiotic supplementation. These inconsistencies highlight the complexity of the gut microbiome and the need for more targeted research. Factors contributing to the variable outcomes include:

Strain Specificity: The effect is highly dependent on the specific bacterial strain. A positive result from one strain of Lactobacillus acidophilus does not mean all strains of that species will have the same effect.
Individual Variability: The efficacy can vary based on a person's unique gut microbiota composition, genetics, and baseline cholesterol levels.
Dosage and Duration: The amount of viable bacteria (CFU) and the length of the intervention play critical roles. Effective dosages appear to be strain-dependent and can vary significantly.
Delivery Matrix: Probiotics delivered in fermented foods like yogurt may have different effects compared to those in capsules or powders.

Probiotic vs. Statin Treatment


Feature	Probiotic Supplementation	Statin Therapy
Mechanism	Modulates gut microbiota, impacts bile acid metabolism, and cholesterol absorption.	Directly inhibits HMG-CoA reductase, the key enzyme in cholesterol synthesis.
Effect Size	Modest reductions in TC and LDL-C, often more pronounced in those with mildly elevated cholesterol.	Substantial, clinically significant reductions in LDL-C and TC.
Side Effects	Generally well-tolerated with a low risk of side effects, though individual intolerance can occur.	Potential for side effects such as myalgia, liver dysfunction, and cognitive impairment.
Primary Use	Complementary approach for supporting heart health and maintaining cholesterol levels already in a healthy range.	First-line pharmacological treatment for significantly high cholesterol levels and cardiovascular disease prevention.
Regimen	Varies by strain; typically consumed daily as capsules, powder, or in fermented foods.	Daily oral medication, with specific dosage tailored to individual risk factors.

How to Choose a Probiotic for Cholesterol Support

To maximize the potential benefits, it is crucial to choose a probiotic product carefully. A smart approach involves a combination of targeted microbes alongside a heart-healthy diet and lifestyle.

Look for Clinically Studied Strains: Choose products that specify the exact strain and have clinical research supporting its efficacy for cholesterol management, such as L. reuteri NCIMB 30242 or L. plantarum LPLDL.
Consider Symbiotics: The combination of probiotics and prebiotics (synbiotics) can have a synergistic effect, as prebiotics can enhance the growth and activity of the beneficial bacteria.
Check Dosage and Viability: Ensure the product contains a clinically relevant dose, typically in the billions of Colony-Forming Units (CFUs), and has a delivery system that ensures viability through the digestive tract.
Assess Delivery Method: Fermented foods like kefir and yogurt can be great sources, but for targeted effects, capsules or sachets with specific strains may be more reliable.

Conclusion: The Role of Probiotics in Cholesterol Management

Scientific evidence indicates that certain probiotic strains can play a complementary role in supporting healthy cholesterol levels, especially in individuals with mildly elevated cholesterol. The mechanisms primarily involve altering bile acid metabolism and cholesterol absorption in the gut. However, the effects are highly strain-specific and influenced by many factors, including dosage, duration, and individual physiology. Probiotics should be considered a supportive measure within a holistic approach to cardiovascular health, which includes a balanced diet rich in fiber and polyphenols, regular exercise, and consultation with a healthcare provider. They are not a replacement for statin therapy in cases of high-risk hypercholesterolemia. As research continues, the understanding of the gut-heart axis will undoubtedly refine the role of probiotics in managing cholesterol and overall cardiovascular wellness.

Frequently Asked Questions

Strains with the strongest evidence include Lactobacillus reuteri NCIMB 30242, certain Lactobacillus plantarum strains (e.g., CECT 7527, 7528, 7529), and some Bifidobacterium strains, often in combination.

Clinical trials show varying timeframes, with positive effects often observed after several weeks or months of consistent daily intake. For example, some studies showed results after 6 to 12 weeks.

Yogurt and other fermented foods can be good sources, but they often contain different strains and dosages than those used in specific clinical trials. For targeted effects, a supplement with a proven strain may be more reliable.

Probiotics are not a replacement for statin therapy, especially for high-risk hypercholesterolemia. They should be considered a complementary supplement to support a heart-healthy lifestyle.

Some studies have shown that effective probiotic strains can lead to reductions in total cholesterol and LDL cholesterol, while effects on HDL cholesterol can be mixed and depend on the specific strain and patient characteristics.

Generally, probiotics are well-tolerated and can be taken alongside most medications, including statins. However, it is essential to consult a healthcare provider before starting any new supplement regimen, particularly if you have underlying health conditions or take other medications.

The effectiveness can be influenced by the specific probiotic strain, the dosage, the duration of use, the individual's baseline cholesterol levels, genetics, and the overall diet.

The gut microbiome influences cholesterol metabolism via several mechanisms, including the recycling of bile acids and the production of metabolites like short-chain fatty acids that can affect cholesterol synthesis.