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Are there any over-the-counter treatments for high cholesterol?

High cholesterol - also called hypercholesterolemia - is a condition in which the level of cholesterol in the blood is higher than normal, increasing your risk of heart disease and stroke. When changes in diet and exercise don’t work to bring blood cholesterol levels into a healthy range, doctors most commonly recommend niacin or prescription medication next.

When used properly, niacin works very well to lower total cholesterol and LDL-cholesterol, also known as "bad cholesterol." Niacin can also increase HDL-cholesterol, or "good cholesterol." Also called vitamin B3, niacin products are available in both regular and slow-release forms. Slow-release niacin may cause less flushing and upset stomach than regular niacin. Unfortunately, slow-release niacin has been found to cause liver damage more often than regular niacin. For this reason, only people who experience bothersome side effects while taking regular niacin should use slow-release niacin.

Niacin should be used to lower cholesterol only under the direction of a doctor.

A recent review of scientific research showed that taking 10 grams of psyllium powder (such as >Metamucil or >Perdiem) every day in addition to a low fat diet can lower total and LDL cholesterol an additional 4 to 7 percent respectively.

Sources:
The Merck Manual of Medical Information: Home Edition. Merck & Co., 1997.
The National Cholesterol Education Program Web Site, National Institutes of Health http://rover.nhlbi.nih.gov/chd/. Last accessed 8/10/01.
Micromedex Healthcare Series. Micromedex Inc., 2001.
Anderson, J.W., et al "Cholesterol-Lowering Effects of Psyllium Intake Adjunctive to Diet Therapy in Men and Women with Hypercholesterolemia: Meta-Analysis of 8 Controlled Studies," American Journal of Clinical Nutrition 71 (2000).

This answer prepared 8/10/01.