By Mark Hyman, M.D.

Q My cholesterol is elevated and my doctor recommends that I take statins, but I’m not eager to go on drugs. Are there natural options?

A Yes—but I’m not surprised you haven’t learned about them from your doctor. In medicine, as in life, perception is everything. If all you have is a hammer, everything looks like a nail. The current class of cholesterol-lowering drugs we have—statins—are effective at reducing LDL, or low-density-lipoprotein cholesterol, so that’s what doctors prescribe. Yet in a recent study published in the Journal of the American Medical Association, a diet that includes soy foods, fiber, almonds, and plant sterols was found to be just as effective as a common statin. It also helped reduce two leading causes of heart disease—inflammation and homocysteine, an amino acid that is elevated when people don’t get enough folic acid. In spite of research like this, the message from the medical establishment is that taking a drug is the only way to avoid dying prematurely.

Medication should be the last resort. Though statins can be very effective, they can frequently cause muscle pain and, occasionally, serious muscle damage. They also can sap levels of coenzyme Q10, an important part of our cellular energy metabolism.

Swallowing a pill is a lot easier than making lifestyle shifts. But exercising and eating right are the kind of fundamental changes that can promote good health for the rest of your life, and by lowering your risk of stroke, heart disease, dementia, cancer, diabetes, and nearly all age-related diseases.

Many of my patients get remarkable results from this approach. In fact, after one woman I know lowered her cholesterol by 100 points, her doctor assumed she had started taking statins. Your response may not be as dramatic, but you’ll certainly see a difference.

Here’s the program I recommend to my patients. I suggest they take policosanol, derived from sugar cane wax (10 mg, twice a day), which lowers cholesterol and other risk factors, such as platelet clumping.

The diet I favor is one very low in trans fatty acids, high-fructose corn syrup, and animal fats—all of which can raise cholesterol—and high in soy foods, fiber, and nuts. The more vigorously you exercise, the more your cholesterol will drop. Start with half an hour of aerobic activity, like running, biking, or walking, four to five times a week. Lowering stress also lowers cholesterol, so try yoga, meditation, or watching a sunset—whatever helps you relax.