How to Lower Cholesterol Naturally with Chinese Medicine

By Dr (TCM) Attilio D'Alberto | Traditional Chinese Medicine Practitioner, Wokingham

High cholesterol (hypercholesterolaemia) is one of the most common cardiovascular risk factors in the UK, affecting approximately 40% of adults. Whilst statins remain the cornerstone of conventional treatment, a significant proportion of patients either cannot tolerate them or prefer to manage their cholesterol through diet, lifestyle and natural approaches. Acupuncture and Chinese herbal medicine have a strong evidence base for reducing total cholesterol, LDL cholesterol and triglycerides, and for raising HDL cholesterol, through mechanisms that directly address the metabolic root of the problem.

Understanding cholesterol

Cholesterol is a fatty substance produced by the liver and obtained from food. It is essential for cell membrane structure, hormone synthesis (including sex hormones and cortisol) and bile acid production. The key markers are total cholesterol, LDL (“bad” cholesterol, which deposits in arterial walls), HDL (“good” cholesterol, which removes LDL from circulation), and triglycerides (stored fats associated with metabolic syndrome, insulin resistance and cardiovascular risk). Elevated LDL and triglycerides with low HDL is the most dangerous pattern. UK guidelines recommend total cholesterol below 5 mmol/L and LDL below 3 mmol/L for most adults.

High cholesterol in TCM

In traditional Chinese medicine, elevated cholesterol corresponds to an accumulation of Phlegm-Damp in the blood and vessels — a turbidity of the blood produced when the Spleen fails to transform and transport fluids and nutrients effectively. The Spleen in TCM is the organ of digestion and transformation; when it is weakened by poor diet, excessive sitting, damp environments or constitutional deficiency, it generates Phlegm-Damp that accumulates in the blood, thickens it and deposits in the vessel walls — precisely what elevated LDL and triglycerides represent in biomedical terms. The specific patterns are:

1. Spleen Qi deficiency with Phlegm-Damp accumulation — the most common pattern; fatigue, heavy sensation, bloating after eating, loose stools, overweight, craving sweet or fatty foods; the Spleen cannot metabolise dietary fats and generates Phlegm that accumulates in the blood; treatment strengthens the Spleen and transforms Phlegm using Liu Jun Zi Tang modifications with lipid-lowering herbs
2. Liver Qi stagnation with Phlegm and Blood stasis — when chronic stress and emotional tension impair the Liver’s function of regulating metabolism, Qi stagnates and generates Heat that condenses Body Fluids into Phlegm; combined with Blood stasis from the obstructed channels, this produces elevated LDL with cardiovascular risk; treatment moves Liver Qi, transforms Phlegm and activates Blood using Xue Fu Zhu Yu Tang modifications
3. Kidney Yang deficiency with Phlegm-Cold — insufficient Kidney Yang fails to warm and support the Spleen’s transforming function; elevated cholesterol and triglycerides in a patient who is cold, fatigued, tends to weight gain and has a slow metabolism; treatment warms Kidney Yang and strengthens the Spleen’s transformation
4. Liver and Kidney Yin deficiency with Empty Fire — more common in post-menopausal women; elevated cholesterol accompanies hot flushes, night sweats and dryness; treatment nourishes Liver and Kidney Yin

Chinese herbs for lowering cholesterol

Several Chinese herbs have substantial clinical evidence for lipid-lowering activity through mechanisms distinct from statins, making them useful as complementary agents:

1. Shan Zha (Hawthorn — Crataegus pinnatifida) — the most important herb for cholesterol in Chinese medicine; reduces LDL cholesterol and triglycerides by inhibiting fatty acid synthesis in the liver, promoting bile acid excretion and improving lipid metabolism; also improves coronary blood flow and reduces atherosclerotic plaque formation; multiple RCTs confirm significant lipid-lowering effects; included in virtually all TCM formulae for high cholesterol
2. Dan Shen (Salvia miltiorrhiza) — activates Blood, reduces Blood stasis and has documented anti-atherosclerotic properties; inhibits LDL oxidation and reduces platelet aggregation; particularly indicated in patterns involving Blood stasis and cardiovascular risk
3. Ze Xie (Alisma orientalis) — resolves Damp and drains turbidity from the blood; reduces total cholesterol, LDL and triglycerides in clinical trials; included in Liu Wei Di Huang Wan and commonly added to cholesterol formulae
4. Jue Ming Zi (Cassia seed) — clears Liver Heat and brightens the eyes; one of the most widely studied herbs for hyperlipidaemia; reduces total cholesterol, LDL and triglycerides and raises HDL; commonly used as a daily tea as well as in formulae
5. He Shou Wu (Polygonum multiflorum) — tonifies Liver and Kidney Yin and Jing; reduces LDL and total cholesterol; particularly useful in patients with Kidney-Liver deficiency pattern; note: raw He Shou Wu carries hepatotoxic risk — only processed (Zhi) He Shou Wu should be used at appropriate doses under professional supervision

Acupuncture for cholesterol

Acupuncture improves lipid profiles through its effects on the hypothalamic-pituitary-adrenal axis, insulin sensitivity and hepatic lipid metabolism. A 2019 systematic review of 22 RCTs found acupuncture significantly reduced total cholesterol, LDL cholesterol and triglycerides compared to control groups. Electroacupuncture in particular has demonstrated measurable effects on lipid metabolism. Key points include ST36 (Zusanli) and SP6 (Sanyinjiao) to strengthen the Spleen and improve metabolic transformation, ST40 (Fenglong) — the principal point for Phlegm — and LV3 (Taichong) to regulate Liver function.

Diet and lifestyle in TCM

From a TCM perspective, the most important dietary factors in managing cholesterol are: reducing cold, raw and greasy foods that burden the Spleen; eating warm, cooked foods that support digestive transformation; moderating alcohol (which generates Damp-Heat); avoiding excessive sitting (which impairs Spleen Qi circulation); and including cholesterol-lowering foods such as oats, garlic, green tea, hawthorn berries and oily fish. Regular moderate exercise warms Yang and moves Qi and Blood, directly improving the Spleen’s metabolic function.

See also: High blood pressure treatment | Fatty liver treatment | Cortisol and stress

To discuss cholesterol management at my clinic in Wokingham, contact me or book a consultation.

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