Raised LDL-C (low-density lipoprotein-cholesterol or bad cholesterol) levels constitute one of the major factors predisposing to cardiac disease. LDL-C reflects the mass of cholesterol contained within the LDL molecule.
Besides their vast gut-related health benefits, probiotics containing L. reuteri NCIMB 30242 target cardiovascular disease owing to their distinctive quality of lowering the LDL-C levels.
How does L. reuteri reduce LDL-C levels?
L reuteri NCIMB 30242 classically demonstrates bile salt hydrolase (BSH) activity, an enzyme that accelerates deconjugation (cleaves the covalent bonding) of bile acids. 
What are Bile Acids and what is Conjugation/Deconjugation of Bile Acids?
Bile acids are the products of cholesterol breakdown (catabolism) and are produced in the liver. Bile acids then conjugate (form a bond) with two amino acids, namely glycine and taurine, and are transported to the intestine. These conjugated bile acids are water-soluble and enhance the absorption of cholesterol into the bloodstream.
L. reuteri Prompts Deconjugation
On the contrary, since the BSH activity of the lactobacillus cleaves the bond of bile acids with amino acids (prompts deconjugation), it renders cholesterol less soluble and less absorbable. Additionally, the water-insoluble, deconjugated bile acids are not excreted in the urine but in feces. In an attempt to compensate for the lost deconjugated bile acids, cholesterol is used up to produce more bile acids. This eventually represents another pathway for cholesterol reduction. 
Moreover, the lactobacillus species entrap cholesterol in the intestine, impeding its outflow into the blood, which is instead flushed out via feces. 
Clinical Evidence of L. reuteri as a Cholesterol-lowering agent
The application of L. reuteri as a therapy for high cholesterol levels is gathering attention from the researchers and experts worldwide. The researchers at the Canadian Department of Biomedical Engineering reported a reduction in the LDL-C levels by 11.64% following consumption of L. reuteri capsules for nine weeks. Also noted, was a rise in the blood levels of deconjugated bile acids and substantial reduction in cholesterol-derived substances. 
Another study published in the British Journal of Nutrition showed a significant drop in LDL-C of nearly 9 % after feeding L. reuteri NCIMB 30242-yoghurt formulation to 114 individuals with increased blood cholesterol values. 
Further identified is the role of L. reuteri NCIMB 30242 in increasing the levels of vitamin D, a heart-protective vitamin.  Other than improving the high blood pressure, it appears that vitamin D may lower the LDL-C levels to some extent. 
In a nutshell, L. reuteri NCIMB 30242 lowers the blood cholesterol levels by decreasing cholesterol absorption and augmenting cholesterol’s elimination from the body. L. reuteri NCIMB 30242 is the strain of probiotic used in Microbiome Plus Probiotics.
Dr. Rasheed Huma
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- Jones ML, Martoni CJ, Prakash S. Oral supplementation with probiotic L. reuteri NCIMB 30242 increases mean circulating 25-hydroxyvitamin D: a post hoc analysis of a randomized controlled trial. The Journal of Clinical Endocrinology and Metabolism. 2013;98(7):2944-51. doi: 10.1210/jc.2012-4262.
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