Heart and circulation

Advised

• Vitamin D

  A vitamin the body makes when skin is in sunlight. Oily fish, eggs and fortified foods have some; supplements come as D3 or D2.

  • NHS: Everyone should consider 10 micrograms a day in autumn and winter.

  Also covered by BHF (Vitamins and supplements to avoid with heart medicines; Do I need supplements for better heart health?).

  What vitamin D is, and the forms it comes in

Limited evidence

• Garlic

  Garlic made into capsules, powder or extract, often from aged or black garlic.

  • BHF: Evidence for garlic supplements is too limited and inconsistent.

  Also covered by BHF (7 natural alternatives to statins that claim to lower cholesterol; Vitamins and supplements to avoid with heart medicines).

• Omega-3 and fish oil

  Fats found in oily fish, and in some plant oils, nuts and seeds; supplements come from fish, krill or algae.

  • NICE: No evidence that omega-3 compounds lower cardiovascular disease risk, except one prescription medicine.

  Also covered by BHF (Omega-3 foods and your heart; Vitamins and supplements to avoid with heart medicines; 7 natural alternatives to statins that claim to lower cholesterol) and HEART UK.

• Vitamin K2

  One form of vitamin K, a group of vitamins found in green leafy vegetables, vegetable oils and cereal grains, with small amounts in meat and dairy.

  • NHS: Do not take vitamin K supplements while taking warfarin.

  Also covered by BHF and NHS.

No good evidence

• CoQ10

  A vitamin-like substance found in every cell of the body, which the body makes; small amounts are in meat, fish and nuts.

  • BHF: No good evidence for CoQ10 for muscle pain blamed on statins; NICE advises against it.
  • BHF: Not in UK heart failure guidelines and not prescribed by UK doctors; more research needed.

  Also covered by NICE and BHF.

Advised against

• Plant sterol and stanol supplements

  Plant compounds similar in structure to cholesterol, found in small amounts in nuts, seeds, grains and vegetable oils, and sold as capsules or added to some foods.

  • NICE: Do not advise taking plant stanols or sterols to lower cardiovascular disease risk.
  • HEART UK: Not recommended as supplements for high cholesterol; not to be confused with fortified foods.

  Also covered by BHF.

• Red yeast rice

  Rice fermented with a type of yeast. It contains monacolin K, an ingredient also found in the statin lovastatin.

  • BHF: Not recommended: little research on long-term safety, and the active amount varies.
  • NHS SPS: It can cause liver toxicity and muscle damage.

• Magnesium

  A mineral found in a wide variety of foods, including spinach, nuts and wholemeal bread.

  • NICE: Do not offer magnesium supplements as a way of lowering blood pressure.

  Also covered by NHS.

• Potassium

  A mineral found in most foods, including fruit, vegetables, beans, nuts, fish and meat.

  • NICE: Do not offer potassium supplements as a way of lowering blood pressure.
  • BHF: Generally not recommended unless prescribed, especially for older people, kidney disease or heart failure.

  Also covered by NHS.

Things to check

• BHF: Vitamin K, omega-3 and St John's wort all interact with the blood-thinning drug warfarin.
• BHF: Garlic supplements can interact with blood thinners such as warfarin; check with your GP first.
• BHF: With blood pressure medicines, garlic supplements could lower blood pressure more than intended.
• BHF: CoQ10 supplements may interact with blood pressure medicines and with warfarin.
• NICE: Some foods, such as grapefruit juice, and some supplements may interfere with statins; ask a pharmacist first.
• BHF: Avoid multivitamins that mix antioxidant vitamins such as A, E and beta-carotene; research links them to a raised risk of death.
• HEART UK: Do not choose fish liver oils: they contain less omega-3 than fish oils and too much vitamin A.
• NHS: Do not take more than 100 micrograms (4,000 IU) of vitamin D a day.

If you take medication, are pregnant, or have a health condition, check with a pharmacist or GP first.