What is the best supplement to increase HDL?

December 2, 2025 •

4 min read

HDL, or high-density lipoprotein, is often called the "good" cholesterol because it helps transport excess cholesterol from the bloodstream to the liver for removal. Maintaining healthy levels is a key part of cardiovascular health, and many people wonder what is the best supplement to increase HDL when diet and exercise aren't enough. The answer isn't a single magic pill, but rather a set of options with varying levels of evidence and potential side effects that should be discussed with a doctor.

Quick Summary

This article examines the most promising supplements for raising HDL cholesterol, including niacin, omega-3 fatty acids from fish oil, and policosanol. It reviews clinical findings, discusses potential side effects, and emphasizes that any supplement use should be guided by a healthcare professional.

Key Points

Niacin is potent but risky: High-dose niacin can significantly increase HDL but is associated with side effects like flushing, liver damage, and worsened blood sugar control, especially when combined with statins.
Omega-3s offer modest benefits: Fish oil supplements provide a modest increase in HDL, but their primary heart benefit is lowering triglycerides and reducing inflammation.
Lifestyle changes are paramount: The most effective and safest strategies for boosting HDL involve regular exercise, eating healthy fats (monounsaturated/polyunsaturated), maintaining a healthy weight, and not smoking.
Berberine shows promise: Studies suggest that berberine, a plant alkaloid, can modestly increase HDL while lowering other lipids, with some studies showing a more significant effect in women.
Policosanol lacks consistent evidence: While some early Cuban trials showed policosanol could increase HDL, independent research has yielded inconsistent results, making it a less reliable option.
Consult a healthcare provider: Before starting any supplement regimen, it is crucial to speak with a doctor to discuss potential benefits, risks, and interactions with other medications.

Understanding HDL: The "Good" Cholesterol

High-density lipoprotein (HDL) plays a critical role in heart health through a process called reverse cholesterol transport. In this process, HDL acts like a scavenger, picking up excess cholesterol from artery walls and carrying it to the liver for disposal. Low HDL levels are associated with an increased risk of heart disease, making it a key focus for those looking to improve their cardiovascular profile. While lifestyle changes are the most effective strategy, some supplements may offer additional support, though it's crucial to consult a healthcare provider before beginning any new regimen.

Prominent Supplements for Increasing HDL

Several supplements have been studied for their ability to influence HDL levels, with niacin historically being the most potent. However, recent research has cast doubt on the clinical benefits of artificially raising HDL without addressing other factors. Other contenders like omega-3 fatty acids and certain plant extracts also show promise, though their effects are often more modest and part of a broader lipid-lowering strategy.

Niacin (Vitamin B3)

Niacin, or nicotinic acid, has long been known for its ability to raise HDL cholesterol, with some studies showing increases of over 30%. It works by reducing the production of VLDL (a precursor to LDL) and increasing the half-life of ApoA-I, the primary protein component of HDL.

However, high-dose niacin therapy is no longer widely recommended for improving cardiovascular outcomes in patients already on statins due to mixed clinical trial results and significant side effects. Side effects can include flushing, liver toxicity, and worsened blood sugar control, especially in individuals with diabetes. Prescription-strength, slow-release formulas are designed to mitigate some of these issues, but require careful medical supervision.

Omega-3 Fatty Acids (Fish Oil)

Found in fatty fish and supplements, omega-3 fatty acids, particularly EPA and DHA, are primarily known for their ability to lower triglycerides. While their effect on HDL is generally more modest and less consistent than niacin, some research indicates they can contribute to a healthier lipid profile, especially in people with high triglycerides.

Enhances HDL Functionality: Some studies show fish oil can increase certain HDL subfractions, potentially improving its function.
Reduces Triglycerides: The most significant effect is the lowering of triglycerides, which is independently beneficial for heart health.
Anti-inflammatory Effects: Omega-3s also possess anti-inflammatory properties that support overall cardiovascular health.

Berberine

Berberine is a natural plant alkaloid that has gained attention for its lipid-modifying effects. It has been shown to lower LDL and triglycerides while providing a modest boost to HDL. A meta-analysis published in 2023 found berberine supplementation significantly increased HDL-C levels. Interestingly, some studies suggest its effects on HDL may be more pronounced in women.

Policosanol

Policosanol is a mixture of long-chain alcohols derived from plant waxes, most notably sugar cane wax. Early studies, primarily from Cuba, showed it could significantly lower LDL and raise HDL. Some long-term studies noted increases in HDL-C after several months of use. However, independent replication studies have yielded inconsistent results, and its overall efficacy for raising HDL is debated outside of initial research.

Comparison of HDL-Boosting Supplements


Feature	Niacin (High Dose)	Omega-3s (Fish Oil)	Berberine	Policosanol
Primary Lipid Effect	Raises HDL, Lowers LDL & Triglycerides	Lowers Triglycerides	Lowers LDL & Triglycerides	Lowers LDL & Raises HDL
HDL Effect	Potent increase (~25-30%)	Modest increase, variable	Modest increase	Inconsistent results outside early Cuban trials
Clinical Outcome Evidence	Not shown to improve outcomes with statins	Reduces heart disease risk factors	Emerging evidence, more research needed	Lacks consistent, independent evidence
Main Side Effects	Flushing, liver issues, worsened blood sugar	GI upset, bad breath	GI upset (diarrhea, constipation)	GI issues, drug interaction potential
Medical Supervision	Required due to potency and side effects	Advised, especially with blood thinners	Advised due to drug interactions	Recommended due to interaction risk

The Importance of Lifestyle Changes

While supplements offer potential, they are not a replacement for a healthy lifestyle. Lifestyle interventions have the most robust evidence for improving overall cardiovascular health, and their effects on HDL are often more consistent and safer than high-dose supplements.

Exercise Regularly: Aim for at least 30-60 minutes of moderate-intensity aerobic exercise several times per week. Regular physical activity is one of the most effective ways to boost HDL.
Quit Smoking: Smoking can significantly lower HDL levels. Quitting is a crucial step for improving cardiovascular health.
Eat Healthful Fats: Incorporate monounsaturated and polyunsaturated fats found in foods like olive oil, nuts, and avocados. Avoid trans fats, which lower HDL.
Manage Weight: Losing excess weight, especially abdominal fat, can increase HDL levels.
Limit Alcohol: Moderate alcohol consumption has been linked with higher HDL, but excessive intake is harmful. If you don't drink, don't start.

Conclusion

There is no single "best" supplement to increase HDL that works for everyone without risks. Niacin can raise HDL most significantly, but its use is complicated by potential side effects and recent findings questioning its effectiveness for preventing cardiovascular events in conjunction with statins. Omega-3 fatty acids offer a more modest, but safer, boost, primarily by lowering triglycerides and supporting overall heart health. Berberine and policosanol show some promise, but need more conclusive, independent research. Ultimately, the most reliable and safest path to improving HDL is through proven lifestyle changes like regular exercise, a heart-healthy diet, and quitting smoking. Any decision to use supplements should be made in consultation with a healthcare professional to ensure safety and appropriateness for your specific health needs.

An excellent resource for learning more about heart-healthy strategies is the American Heart Association.

Frequently Asked Questions

Niacin (vitamin B3) can significantly increase HDL levels, with some studies showing increases of 25-30%. However, high-dose niacin comes with risks, including severe side effects like flushing, liver damage, and worsened blood sugar control. It should only be taken under medical supervision, as recent clinical trials have shown it does not provide additional cardiovascular benefits for patients on statins.

The impact of fish oil on HDL is generally modest and can be inconsistent. Its most notable benefit for heart health is its ability to lower triglyceride levels. While it may slightly raise HDL, it is not considered the primary solution for low HDL.

Policosanol's ability to raise HDL is unreliable. Initial studies from Cuba showed promising results, but independent, replicated trials have shown little to no effect. It is not a recommended first-line option for managing cholesterol.

Yes, lifestyle changes are the most effective and safest way to increase HDL. Regular aerobic exercise, quitting smoking, maintaining a healthy weight, and eating a diet rich in monounsaturated fats can all significantly and sustainably improve HDL levels.

Berberine has been shown in some studies to modestly increase HDL while also lowering LDL and triglycerides. A meta-analysis from 2023 supports its beneficial effect on lipids, though more large-scale trials are needed to confirm its long-term impact on cardiovascular health.

Yes, many foods naturally contain compounds that support heart health and can contribute to higher HDL. These include fatty fish (omega-3s), olive oil, avocados, nuts (almonds, walnuts), and high-fiber foods like oats, beans, and fruits.

Combining multiple supplements without professional guidance is not recommended. Interactions between different supplements and medications can occur, leading to adverse effects or reduced effectiveness. It is essential to consult a healthcare provider to ensure a safe and appropriate treatment plan.