Across 4 studies, all reported beneficial small-sized effects of Lactobacillus plantarum on reducing LDL cholesterol, with 3 of 4 reaching statistical significance. The most robust evidence comes from meta-analyses and reviews, including a 2025 systematic review of 26 RCTs (n=2104) showing a significant small reduction (SMD: -0.251). Study durations and dose ranges were not consistently reported, limiting dose-specific conclusions.
Caveats: Available evidence is overwhelmingly positive — clinical literature in this area is subject to publication bias (null-result studies are less likely to be published or indexed). Evidence base is small (only 4 studies) — conclusions should be considered preliminary. Study durations and doses were not consistently reported, making it difficult to determine optimal regimen or time to effect.
While generally safe in healthy populations, rare adverse events (bacteremia, D-lactic acidosis, horizontal gene transfer) have been reported in immunocompromised or critically ill individuals, underscoring the need for individualized risk-benefit assessments and rigorous adverse-event surveillance.
from: Molecular Pathways and Clinical Applications of Probiotics as Effective Supporters of InteSubgroup analysis of trials found ... reduction of LDL-C using ... L. reuteri
L. plantarum supplementation significantly reduced LDL-C (SMD: -0.251; 95% CI: -0.477, -0.025; p = 0.029), but not HDL-C.
low-density lipoprotein cholesterol (-6.87; 95%CI: -15.03, 1.29 mg/dL; n = 3)
Meta-analyses of 30+ RCTs demonstrate that probiotic supplementation (notably L. acidophilus, L. plantarum, B. longum) lowers total and LDL cholesterol (-7 to -10 mg/dL)