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How Your Gut Microbiome Supports Healthy Cholesterol Levels
Nutrition · Gut Health
Despite its negative reputation, cholesterol is essential for life. Every cell in your body contains cholesterol, and your liver produces most of what your body needs. [2]
Emerging research shows that the gut microbiome is an important, often-overlooked partner in keeping cholesterol balanced—working alongside your liver in ways scientists are only beginning to understand.
Why Your Body Needs Cholesterol
Cholesterol serves several important functions, and about 20–25% of the body's cholesterol is found in the brain—highlighting its importance beyond heart health. [2]
What Cholesterol Does For You
- Builds and maintains healthy cell membranes. [2]
- Produces steroid hormones, including estrogen, progesterone, testosterone, cortisol, and aldosterone. [2]
- Helps your skin produce vitamin D when exposed to sunlight. [2]
- Forms bile acids that allow the body to digest and absorb fats and fat-soluble vitamins (A, D, E, and K). [2,5]
- Supports brain and nervous system function by helping form myelin, the protective coating around nerve fibers. [2]
Where Is Cholesterol Found in the Body?
Cholesterol is naturally present throughout the body—in every cell membrane, the bloodstream (where lipoproteins transport it), the liver, the brain and nervous system, muscles, the adrenal glands, reproductive organs, and the skin. [2] Two major lipoproteins carry cholesterol through the bloodstream: low-density lipoprotein (LDL), which delivers cholesterol to tissues and, at high levels, can contribute to plaque buildup in arteries, and high-density lipoprotein (HDL), which returns excess cholesterol to the liver for recycling or removal and is associated with a lower risk of cardiovascular disease. [2]
Generally considered healthy reference ranges. [2]
What Is the Gut Microbiome?
The gut microbiome is a community of trillions of bacteria, fungi, viruses, and other microorganisms that live primarily in the large intestine. These microbes help digest food, produce vitamins, support the immune system, protect against harmful bacteria, and regulate metabolism. [1] Recent research has shown that the gut microbiome also plays an important role in cholesterol regulation. [1,5]
How the Gut Microbiome Influences Cholesterol
Researchers have identified several distinct pathways by which your gut bacteria help regulate circulating cholesterol.
Recycles Bile Acids
Certain gut bacteria modify bile acids so more are excreted in stool rather than recycled. Because bile acids are made from cholesterol, the liver must use additional cholesterol to make new ones—helping lower circulating LDL. [5,8]
Produces Bile Salt Hydrolase
Beneficial bacteria, including Lactobacillus and Bifidobacterium species, produce an enzyme (BSH) that reduces bile acid reabsorption, prompting the liver to pull more cholesterol from the bloodstream. [3,4,6,7]
Produces Short-Chain Fatty Acids
Fermenting dietary fiber yields acetate, propionate, and butyrate. Propionate appears to reduce cholesterol production in the liver while improving insulin sensitivity and fat metabolism. [1]
Removes Cholesterol Directly
Several probiotic bacteria assimilate cholesterol into their own cell membranes as they grow, reducing how much is available for absorption into the bloodstream. [4,8]
Reduces Inflammation
An unhealthy microbiome (dysbiosis) increases inflammation, which contributes to abnormal cholesterol metabolism and arterial plaque. A balanced microbiome helps maintain the intestinal barrier and supports healthier regulation. [1]
Probiotic Strains Studied for Cholesterol Assimilation
- Lacticaseibacillus acidophilus (formerly Lactobacillus acidophilus)
- Lacticaseibacillus plantarum (formerly Lactobacillus plantarum)
- Bifidobacterium longum
- Bifidobacterium breve
- Bifidobacterium bifidum
- Lacticaseibacillus reuteri, which has produced modest reductions in LDL ("bad") cholesterol when consumed regularly as part of a healthy diet—one study showed an 11.64% reduction in LDL cholesterol. [4,8]
Researchers believe that cholesterol regulation, when paired with other biological processes such as bile salt hydrolase activity and bile acid metabolism, helps lower cholesterol levels.
Supporting a Healthy Gut for Better Cholesterol
Although genetics influences cholesterol levels, lifestyle choices also significantly impact both the microbiome and cardiovascular health. [1,2] Fiber-rich foods feed the same beneficial bacteria discussed above, and a targeted probiotic—like the Bergamot, artichoke, and Lactobacillus plantarum blend in TWC's Cholesterol Support—can complement these habits rather than replace them.
Habits That Support Gut & Cholesterol Health
- Eat a variety of fiber-rich fruits, vegetables, legumes, and whole grains—fiber is the food probiotics need to produce healthy metabolites. [1]
- Include fermented foods such as yogurt, kefir, kimchi, or sauerkraut if appropriate for your diet. [4]
- Choose healthy fats, including those from nuts, seeds, olive oil, and fatty fish. [2]
- Stay physically active. [2]
- Limit highly processed foods and excessive saturated fat. [2]
- Use antibiotics only when medically necessary, as they can temporarily disrupt beneficial gut bacteria.
- Reduce stress; chronically high cortisol levels signal the liver to produce more LDL ("bad") cholesterol. [1]
- Get good quality sleep—at least 7 hours. Lack of sleep raises cortisol levels and inflammation. [3]
Takeaway
Cholesterol is not the enemy—it is an essential molecule your body depends on for normal function. [2] The key is maintaining healthy cholesterol balance. Beneficial bacteria help regulate cholesterol by modifying bile acids, producing beneficial metabolites, converting cholesterol into less absorbable compounds, and reducing inflammation. [1,4,5] As scientists continue to study the gut-heart connection, one message is becoming increasingly clear: caring for your gut microbiome may also be one of the best ways to support long-term heart health.
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References
- Brown, J. M., & Hazen, S. L. (2018). Microbial modulation of cardiovascular disease. Nature Reviews Microbiology, 16(3), 171–181.
- Grundy, S. M., Stone, N. J., Bailey, A. L., et al. (2019). 2018 AHA/ACC Guideline on the Management of Blood Cholesterol. Circulation, 139(25), e1082–e1143.
- Bernstein, S. (2025, July 27). How does sleep affect your cholesterol levels? WebMD.
- Jones, M. L., Martoni, C. J., & Prakash, S. (2012). Cholesterol lowering and inhibition of sterol absorption by Lacticaseibacillus reuteri NCIMB 30242. European Journal of Clinical Nutrition, 66(11), 1234–1241.
- Le Roy, T., Lécuyer, E., Chassaing, B., Rhimi, M., Lhomme, M., Boudebbouze, S., et al. (2019). The intestinal microbiota regulates host cholesterol homeostasis. BMC Biology, 17, 94.
- Wahlström, A., Sayin, S. I., Marschall, H. U., & Bäckhed, F. (2016). Intestinal crosstalk between bile acids and microbiota and its impact on host metabolism. Cell Metabolism, 24(1), 41–50.
- Ridlon, J. M., Kang, D. J., & Hylemon, P. B. (2006). Bile salt biotransformations by human intestinal bacteria. Journal of Lipid Research, 47(2), 241–259.
- Lye, H. S., Rahmat-Ali, G. R., & Liong, M. T. (2010). Mechanisms of cholesterol removal by lactobacilli under conditions that mimic the human gastrointestinal tract. International Dairy Journal, 20(3), 169–175.
- Pereira, D. I. A., & Gibson, G. R. (2002). Effects of consumption of probiotics and prebiotics on serum lipid levels in humans. Critical Reviews in Biochemistry and Molecular Biology, 37(4), 259–281.
- Jones, M. L., Martoni, C. J., Parent, M., & Prakash, S. (2012). Cholesterol-lowering efficacy of a microencapsulated bile salt hydrolase-active Lacticaseibacillus reuteri NCIMB 30242 yogurt formulation in hypercholesterolemic adults. Applied and Environmental Microbiology, 78(19), 6914–6922.
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