Dear Dr. Roach: Please look into citrus bergamot. It is a beneficial supplement that lowers cholesterol very efficiently and effectively. It lowered my cholesterol by 70 points. — R.M.

Answer: You are right. The early data suggest that bergamot may be effective at improving cholesterol results. This was found in people who are resistant to statins and in people with the common metabolic dysfunction-associated steatotic liver disease.

The results you saw are certainly dramatic. However, I have seen many promising treatments for cholesterol fail in large trials. Not only does the product need to be proven to lower cholesterol, it needs to be proven to do so with a high degree of safety. Most importantly, it needs to have a real benefit to the person taking it, meaning it reduces their risk of heart attacks, strokes, or death well enough that it makes taking the product worthwhile.

A 2023 study compared a statin (low-dose rosuvastatin) to a placebo, fish oil, cinnamon, garlic, turmeric, plant sterols, and red yeast rice. None of these supplements lowered cholesterol compared to the placebo. Sadly, bergamot was not included.

It may be that in larger trials, bergamot will prove to be a safe and effective means of lowering cholesterol and preventing heart disease. I’m waiting until then to prescribe or recommend it, and with my high-risk patients, I will continue to discuss the risks and benefits of statins.