Life Extension Magazine®

Doctor with floating heart and heart rate symbol being supported through cholesterol lowering probiotic

A Probiotic That Lowers Cholesterol

A probiotic strain helps decrease cholesterol absorption. In a clinical trial, this probiotic reduced LDL and total cholesterol blood levels.

Scientifically reviewed by: Dr. Gary Gonzalez, MD, in August 2023. Written by: Michael Downey.

Over 35 million Americans take statin drugs to reduce their cholesterol.1

Yet some people are still unable get their cholesterol under control,2 and heart disease remains the leading killer of Americans.3

Science has found a novel way to help reduce cholesterol.

Probiotics are beneficial bacteria that can help keep the microorganisms in your gut balanced.

Clinical research has revealed that a specific probiotic strain lowers LDL ("bad") cholesterol and total cholesterol.2,4

In just nine weeks, daily intake of this probiotic:2

  • Lowered LDL cholesterol by nearly 12%,
  • Lowered total cholesterol by more than 9%, and
  • Lowered the ratio of LDL ("bad") to HDL ("good") cholesterol by more than 13%.

Using a probiotic to reduce cholesterol can be beneficial to those who are challenged to tolerate high-dose statins, as well as those who are unable to manage their cholesterol through diet and lifestyle.

Life Extension encourages most individuals to maintain LDL cholesterol levels less than 80 mg/dL and to take other actions, like lowering homocysteine and glucose, to help reduce risk of heart attack and stroke.

Individuals with preexisting conditions or at high risk for cardiovascular disease should aim for even lower levels of less than 70 mg/dL.

The Importance of Gut Bacteria

It may sound surprising that bacteria in the gut can lower cholesterol.

But in recent years, research has shown that the gut microbiome plays a key role in maintaining optimal health throughout the body.

An imbalance in the types of bacteria and other microorganisms that make up our gut flora are strongly associated with the development of a host of diseases.5,6

Research has shown that different probiotics can safely promote digestive, immune, and oral health. This field has now emerged as an important strategy for reducing the risk of cardiovascular disease.7,8

Scientists have shown that the probiotic strain Lactobacillus reuteri NCIMB 30242 has the ability to safely reduce cholesterol levels. It does so by:9,10

  • Increasing cholesterol removal from the body, into the stool, and
  • Increasing the metabolism (breakdown) of cholesterol in the liver.

Lowering Cholesterol in Human Studies

Researchers enlisted adults with high cholesterol. Some consumed regular yogurt, while others consumed yogurt with the probiotic strain L. reuteri NCIMB 30242.

After six weeks, the volunteers taking L. reuteri NCIMB 30242 had:4

  • A nearly 5% reduction in total cholesterol,
  • A nearly 9% reduction in LDL cholesterol, and
  • Significant reductions in concentration of apolipoprotein B (apoB), a marker of LDL particle numbers and a known risk factor for cardiovascular disease.11-13

In another randomized, controlled trial of adults with high cholesterol, nine weeks of taking L. reuteri NCIMB 30242 capsules resulted in:2

  • A nearly 12% reduction in LDL cholesterol,
  • A greater than 9.1% reduction in total cholesterol,
  • A greater than 8.4% reduction in apoB-100, and
  • A 13.4% reduction in the LDL-to-HDL cholesterol ratio.

Benefits Beyond Cholesterol

The nine-week study also showed that L. reuteri NCIMB 30242 intake reduced levels of C-reactive protein and fibrinogen.2

C-reactive protein is a marker of inflammation that is often used to evaluate the risk of developing coronary artery disease, the most common cause of heart attacks.14

Fibrinogen is a protein produced by the liver that promotes clotting. High levels are associated with an increased risk of harmful clots, heart disease, and strokes.15-18

The high-cholesterol volunteers who took L. reuteri NCIMB 30242 were found to have:2

  • 62% reductions (or reductions of 1.05 mg/L) in C-reactive protein (CRP), and
  • 14% reductions in fibrinogen.

In patients who began the study with average or high-risk CRP:2

  • 27.1% of those taking L. reuteri NCIMB 30242 reduced their risk by one or more categories (from high to average risk, for example, or from high to low risk), compared to just 1.7% of control subjects, and
  • 22% of the L. reuteri NCIMB 30242 group decreased their CRP risk by one category, compared to just 2% of controls.

Beyond these heart-health benefits, L. reuteri NCIMB 30242 has been shown to:

  • Increase circulating bile acid levels, which may help prevent various chronic diseases,2,19
  • Boost vitamin D levels by more than 25%, potentially further reducing the risk of cardio-vascular and other diseases,20 and
  • Significantly improve diarrhea symptoms and scores in gastrointestinal health surveys.21

What you need to know

Protect the Heart with a Probiotic

  • Cardiovascular disease is the leading cause of death for adults in America, partially driven by high levels of LDL ("bad") cholesterol and total cholesterol.
  • Statins lower LDL cholesterol, but they produce some side effects that that may cause some people to stop taking the drugs.
  • Human studies show that the probiotic strain L. reuteri NCIMB 30242 has the ability to lower total cholesterol by more than 9%, reduce LDL cholesterol by nearly 12%, and significantly improve other cardiovascular risk factors.
  • Shown to be safe and effective, L. reuteri NCIMB 30242 helps lower high or even normal cholesterol levels.
  • Blood tests should be used to measure cardiovascular risk factors like LDL to ensure optimal levels (under 80 mg/dL) are being achieved.

How L. Reuteri NCIMB 30242 Works

One of the main functions of the gallbladder is to release a fluid called bile. Bile breaks down fats and oils in the intestinal tract, making cholesterol available for digestion.

This is important, because cholesterol is needed by the body to form cell membranes, create hormones, and perform other functions.

But cholesterol levels can become too high due to excess dietary intake, excess cholesterol release from the liver, or genetic predisposition. Higher blood levels of cholesterol raise the risk of cardiovascular disease.13,22

The probiotic strain L. reuteri NCIMB 30242 can produce an enzyme called bile salt hydrolase. This enzyme breaks certain chemical bonds of cholesterol and bile acids. This makes cholesterol less water-soluble and less absorbable.23

As a result, instead of entering the bloodstream (and then the walls of arteries), excess cholesterol becomes trapped in the gut. It is eventually excreted from the body in feces, reducing cholesterol levels in the blood.23

L. reuteri NCIMB 30242 may provide a second mechanism for cholesterol reduction.

When the enzyme released by this probiotic strain helps breaks down cholesterol, the resulting bile acids act as potent signaling molecules. These molecules regulate cholesterol metabolism, accelerating the breakdown and excretion of cholesterol.24-27

The end result is that L. reuteri NCIMB 30342 reduces total and LDL cholesterol levels.

Proven Safety

Many bacteria of the Lactobacillus family are classed as GRAS, or "generally recognized as safe," by the U.S. Food and Drug Administration.

Lactobacillus reuteri NCIMB 30242, in particular, has undergone extensive laboratory characterization and safety testing.

L. reuteri NCIMB 30242 has demonstrated no adverse effects associated with its consumption.28,29

It is a safe and effective way to reduce cholesterol and lower risk of heart disease.

Summary

With advancing age, virtually every American is at risk for atherosclerotic disorders.

Clinical evidence shows that the probiotic strain L. reuteri NCIMB 30242 has the ability to lower total cholesterol by more than 9% and high-risk LDL cholesterol by almost 12%, while improving other cardiovascular risk factors like elevated C-reactive protein.

If you have any questions on the scientific content of this article, please call a Life Extension Wellness Specialist at 1-866-864-3027.

References

  1. Medicine JH. Statins starve cancer cells to death. ScienceDaily. 2020.
  2. Jones ML, Martoni CJ, Prakash S. Cholesterol lowering and inhibition of sterol absorption by Lactobacillus reuteri NCIMB 30242: a randomized controlled trial. Eur J Clin Nutr. 2012 Nov;66(11):1234-41.
  3. Available at: https://www.cdc.gov/heartdisease/facts.htm. Accessed October 26, 2021.
  4. Jones ML, Martoni CJ, Parent M, et al. Cholesterol-lowering efficacy of a microencapsulated bile salt hydrolase-active Lactobacillus reuteri NCIMB 30242 yoghurt formulation in hypercholesterolaemic adults. Br J Nutr. 2012 May;107(10):1505-13.
  5. Kovatcheva-Datchary P, Arora T. Nutrition, the gut microbiome and the metabolic syndrome. Best Pract Res Clin Gastroenterol. 2013 Feb;27(1):59-72.
  6. DiRienzo DB. Effect of probiotics on biomarkers of cardiovascular disease: implications for heart-healthy diets. Nutr Rev. 2014 Jan;72(1):18-29.
  7. Vindigni SM, Broussard EK, Surawicz CM. Alteration of the intestinal microbiome: fecal microbiota transplant and probiotics for Clostridium difficile and beyond. Expert Rev Gastroenterol Hepatol. 2013 Sep;7(7):615-28.
  8. Ebel B, Lemetais G, Beney L, et al. Impact of probiotics on risk factors for cardiovascular diseases. A review. Crit Rev Food Sci Nutr. 2014;54(2):175-89.
  9. Tuohy KM, Fava F, Viola R. ‘The way to a man’s heart is through his gut microbiota’--dietary pro- and prebiotics for the management of cardiovascular risk. Proc Nutr Soc. 2014 May;73(2):172-85.
  10. Jones ML, Tomaro-Duchesneau C, Martoni CJ, et al. Cholesterol lowering with bile salt hydrolase-active probiotic bacteria, mechanism of action, clinical evidence, and future direction for heart health applications. Expert Opin Biol Ther. 2013 May;13(5):631-42.
  11. Davidson MH, Ballantyne CM, Jacobson TA, et al. Clinical utility of inflammatory markers and advanced lipoprotein testing: advice from an expert panel of lipid specialists. J Clin Lipidol. 2011 Sep-Oct;5(5):338-67.
  12. AMPLION. biomarker: Apo B. biomarkerbase by amplion. 2018.
  13. Imes CC, Austin MA. Low-density lipoprotein cholesterol, apolipoprotein B, and risk of coronary heart disease: from familial hyperlipidemia to genomics. Biol Res Nurs. 2013 Jul;15(3):292-308.
  14. Jialal I, Devaraj S. Inflammation and atherosclerosis: the value of the high-sensitivity C-reactive protein assay as a risk marker. Am J Clin Pathol. 2001 Dec;116 Suppl:S108-15.
  15. Fibrinogen Studies C, Danesh J, Lewington S, et al. Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis. JAMA. 2005 Oct 12;294(14):1799-809.
  16. Scarabin PY, Aillaud MF, Amouyel P, et al. Associations of fibrinogen, factor VII and PAI-1 with baseline findings among 10,500 male participants in a prospective study of myocardial infarction--the PRIME Study. Prospective Epidemiological Study of Myocardial Infarction. Thromb Haemost. 1998 Nov;80(5):749-56.
  17. Wilhelmsen L, Svardsudd K, Korsan-Bengtsen K, et al. Fibrinogen as a risk factor for stroke and myocardial infarction. N Engl J Med. 1984 Aug 23;311(8):501-5.
  18. Available at: https://www.iosrjournals.org/iosr-jpbs/papers/Vol10-issue3/Version-2/O010329198.pdf. Accessed October 25, 2021.
  19. Martoni CJ, Labbe A, Ganopolsky JG, et al. Changes in bile acids, FGF-19 and sterol absorption in response to bile salt hydrolase active L. reuteri NCIMB 30242. Gut Microbes. 2015;6(1):57-65.
  20. Jones ML, Martoni CJ, Prakash S. Oral supplementation with probiotic L. reuteri NCIMB 30242 increases mean circulating 25-hydroxyvitamin D: a post hoc analysis of a randomized controlled trial. J Clin Endocrinol Metab. 2013 Jul;98(7):2944-51.
  21. Jones ML, Martoni CJ, Ganopolsky JG, et al. Improvement of gastrointestinal health status in subjects consuming Lactobacillus reuteri NCIMB 30242 capsules: a post-hoc analysis of a randomized controlled trial. Expert Opin Biol Ther. 2013 Dec;13(12):1643-51.
  22. Yu XH, Qian K, Jiang N, et al. ABCG5/ABCG8 in cholesterol excretion and atherosclerosis. Clin Chim Acta. 2014 Jan 20;428:82-8.
  23. Ramasamy K, Abdullah N, Wong MC, et al. Bile salt deconjugation and cholesterol removal from media by Lactobacillus strains used as probiotics in chickens. J Sci Food Agric. 2010 Jan 15;90(1):65-9.
  24. Sayin SI, Wahlstrom A, Felin J, et al. Gut microbiota regulates bile acid metabolism by reducing the levels of tauro-beta-muricholic acid, a naturally occurring FXR antagonist. Cell Metab. 2013 Feb 5;17(2):225-35.
  25. Zhou H, Hylemon PB. Bile acids are nutrient signaling hormones. Steroids. 2014 Aug;86:62-8.
  26. Qi Y, Jiang C, Cheng J, et al. Bile acid signaling in lipid metabolism: metabolomic and lipidomic analysis of lipid and bile acid markers linked to anti-obesity and anti-diabetes in mice. Biochim Biophys Acta. 2015 Jan;1851(1):19-29.
  27. Li T, Chiang JY. Regulation of bile acid and cholesterol metabolism by PPARs. PPAR Res. 2009 2009/07/14;2009:501739.
  28. Jones ML, Martoni CJ, Tamber S, et al. Evaluation of safety and tolerance of microencapsulated Lactobacillus reuteri NCIMB 30242 in a yogurt formulation: a randomized, placebo-controlled, double-blind study. Food Chem Toxicol. 2012 Jun;50(6):2216-23.
  29. Jones ML, Martoni CJ, Di Pietro E, et al. Evaluation of clinical safety and tolerance of a Lactobacillus reuteri NCIMB 30242 supplement capsule: a randomized control trial. Regul Toxicol Pharmacol. 2012 Jul;63(2):313-20.