Policosanol for Cholesterol

Policosanol is a dietary supplement that some people take to lower cholesterol. The compound is mainly derived from sugar cane but can also be obtained from beeswax, cereal grains, fruits, nuts, and seeds.

This article describes the potential health benefits of policosanol, including how it is taken and what possible side effects may occur. It also takes an unbiased look at whether policosanol can help lower cholesterol as some people claim.

Health Benefits

Policosanol has been touted as a dietary supplement that can help lower cholesterol. Policosanol is claimed to offer numerous health benefits, including:

• Lowering "bad" low-density lipoprotein (LDL) cholesterol
• Increasing "good" high-density lipoprotein (HDL) cholesterol
• Reducing blood glucose (sugar)
• Inhibiting the formation of blood clots
• Reducing the risk of atherosclerosis ("hardening of the arteries") and coronary artery disease (CAD)
• Treating hypertension (high blood pressure)

How policosanol does so remains a bit unclear. Some contend that it directly blocks the formation of cholesterol in the liver in the same way as statin drugs commonly prescribed to treat hypercholesterolemia (high cholesterol).

Animal studies involving rats have suggested that policosanol interferes with the activity of 3-hydroxy-3-methylglutaryl-coenzyme reductase (HMG-CoA), an enzyme essential to the production of cholesterol. HMG-CoA is the same enzyme targeted by statin drugs.

Whether this effect translates to lower cholesterol in humans is under debate.

A 2018 review of studies in Molecular Nutrition and Food Research concluded that, based on 22 studies involving 1,886 participants, policosanol from sugar cane can improve LDL and HDL levels. Even so, the researchers found inconsistency in the findings and advised that additional human trials are needed.

The concerns are heightened by an earlier review of studies focusing on three human trials (out of 16) that met strict inclusion criteria for participants. This group of researchers could find no evidence that policosanol altered either LDL or total cholesterol levels in any way.

The same conclusions were drawn from a 2006 study in the Journal of the American Medical Association. The multi-center, double-blind, placebo-controlled trial (one of the few such trials conducted in policosanol research) could find no changes in LDL, HDL, or total cholesterol after 12 weeks of treatment and different doses of the supplement.

Possible Side Effects

Most studies suggest that policosanol derived from sugar cane is well tolerated with minimal side effects. Among the most common are:

• Indigestion
• Skin rash
• Headache
• Insomnia
• Weight loss

Policosanol is thought by some to have significant anticoagulant (blood-thinning) effects. As such, it should be used with caution if you are taking any of the following blood thinners:

• Aspirin
• Warfarin
• Heparin
• Plavix (clopidogrel)
• Ticlid (ticlopidine)
• Trental (pentoxifylline)
• Arixtra (fondaparinux)
• Brilinta (ticagrelor)
• Eliquis (apixiban)
• High-dose vitamin E
• Garlic
• Ginkgo biloba

Policosanol may also increase the side effects of levodopa, a medication used for Parkinson's disease.

Dosage and Preparation

Policosanol is typically sold in capsule or tablet form at drugstores, nutritional supplement stores, health food shops, and online.

There is no standard recommended dose of policosanol. Many manufacturers recommend taking 10 milligrams (mg) once daily. Studies have reported that doses of up to 10 mg twice daily are safe.

What to Look For

Most of the studies examining the benefits of the supplement used policosanol derived from sugar cane. Because there is far less research on the effectiveness and safety of other forms of policosanol, check the product label to ensure the supplement is derived from sugar cane.

In the United States, supplements are not strictly regulated. As such, the quality can vary from one brand to the next.

To better ensure purity and safety, only buy supplements that have been voluntarily submitted for evaluation by an independent certifying body like U.S. Pharmacopeia (USP), ConsumerLab, or NSF International. '

Certification does not mean that the supplement works but only that it contains the ingredients listed on the product label in correct amounts and with no impurities.

Summary

Policosanol is a supplement mainly derived from sugar cane. It is thought to lower cholesterol and have other health benefits as well. Although some studies support the claims, the findings are not consistent. Further quality research is needed.

A Word From Verywell

Due to a lack of supporting evidence, it's too soon to recommend policosanol for the treatment of high cholesterol. If you're considering using it, talk with your healthcare provider first. Self-treating a condition and avoiding or delaying standard care may have serious consequences.