Why People Use Policosanol

• To Lower Total and LDL Cholesterol
• To Raise HDL Cholesterol

What is the Evidence for Policosanol?

Policosanol has been touted as a dietary supplement that can lower cholesterol as well as statin drugs, without the side effects.

Studies indicate that it works by inhibiting cholesterol formation in the liver. More clinical studies below….

Dosage Information

A typical dosage of policosanol used in studies has been 5 to 10 mg two times a day. Studies generally found that it can take up to two months to notice benefits. So do not be fooled by other information floating out there. Policosanol works by itself. Nothing more is needed in this pill, just 10 mg of Policosanol.

RESEARCH SUMMARY

A mixture of higher aliphatic primary alcohols derived from sugar cane wax has become popular in such places as Cuba for its reputed cholesterol-lowering benefits, energizing effects and enhancement of sexual function. It is also the source of another increasingly popular supplement--octacosanol (the primary long-chain alcohol in policosanol).

There are a number of animal studies suggesting that policosanol can lower cholesterol, that it can inhibit experimentally induced atherosclerotic lesions of cerebral ischemia, that it can help prevent the peroxidation of lipoprotein and inhibit platelet aggregation.

Human studies have been increasing. In one recent study, patients with LDL-cholesterol greater than 160 mg/dl were randomized in double-blind fashion to receive policosanol (10 milligrams daily), lovastatin (20 milligrams daily) or simvastatin (10 milligrams daily). After eight weeks of therapy, LDL-cholesterol was reduced 24% in the policosanol groups, 22% in the lovastatin group and 15% with simvastatin. HDL-cholesterol increased significantly in the policosanol group but not in the other two groups. Policosanol was judged to be "a safe and effective cholesterol reducing agent." In another recent double-blind study of policosanol's possible effects in hypercholesterolemia, patients received 5 milligrams of policosanol or placebo daily for 12 weeks followed by 10 milligrams of policosanol or placebo for a subsequent 12 weeks. Policosanol (5 and 10 milligrams daily) appeared to significantly reduce LDL-cholesterol (18.2% and 25.6% respectively) and reduce cholesterol (13% and 17.4%). It appeared to raise HDL-cholesterol (15.5% and 28.4%). Triglycerides were unchanged in the first 12-week period but were significantly reduced (5.2%) by the end of the second 12-week period.

Side effects were few and minor. There were 11 serious (7 of these were vascular) adverse events among those taking policosanol. Policosanol appears to significantly reduce platelet aggregation in both healthy and hypercholesterolemic individuals, apparently proving as effective (at 20 milligrams daily doses) as aspirin (100 milligrams per day). The substance also appears to demonstrate beneficial effect in patients with intermittent claudicating. Long-term therapy (20 months) using 5 milligrams of policosanol twice a day resulted in significant improvement in treadmill exercise performance and exercise — ECG responses in a group of coronary heart disease patients. The addition of 125 milligrams of aspirin daily further enhanced these results. It is hoped that others will confirm these very promising, largely Cuban studies.
Policosanol's reputed efficacy in boosting energy and enhancing sexual function, particularly male sexual function, is entirely anecdotal.

PRECAUTIONS

Policosanol is not recommended for children, pregnant women and nursing mothers. Because of possible antithrombotic activity, those taking warfarin and hemophiliacs should exercise caution in the use of policosanol. Policosanol supplementation should be stopped before any surgery.

ADVERSE REACTIONS

Mild gastrointestinal side effects, skin rash, headache, insomnia and weight loss have been reported. The incidence of these adverse reactions is low. Policosanol is generally well tolerated.

Except for possible lowering of serum total cholesterol and LDL-cholesterol, policosanol does not appear to affect any other laboratory test results.

CLINCIAL STUDIES

Hypercholesterolemia The majority of policosanol research is on patients with type II hypercholesterolemia. Fifteen randomized, placebo-controlled, double-blind studies have shown positive results. (15-29) Significant decreases in total cholesterol (TC) (8-23%), LDL (11.3-27.5%), LDL/HDL (15.3-38.3%), and TC/HDL (9.1-30.5%) were observed in all trials. Of the 13 trials measuring HDL, seven showed significant increases and in six HDL was unchanged. Doses ranged from 2-40 mg/day, with decreases in TC, LDL, LDL/HDL, and TC/HDL and increases in HDL being dose-dependent up to 20 mg/day, with no further benefit at 40 mg/day. However, 40 mg/day significantly decreased triglycerides (TG), which was not seen with lower doses. (28)

Policosanol was effective in three studies on patients with type 2 diabetes mellitus and hypercholesterolemia. (30-32) All three trials used 5 mg twice daily for 12 weeks. Total cholesterol was reduced by 14-29 percent, LDL was reduced by 20-44 percent, LDL/ HDL ratio was reduced by 24-52 percent, and HDL was increased by 8-24 percent. No adverse effect on glycemic control was noted in any of the studies. In trials comparing policosanol with lovastatin (20 mg/ day), policosanol performed significantly better at raising HDL and lowering the LDL/HDL ratio. (32,33)

Two studies with a total of 300 patients indicate policosanol is effective in postmenopausal women with hyperlipidemia. (34,35) Both studies started with 5 mg daily, which was later increased (at week 8 in one study. (34) and week 12 in the other (33)) to 10 mg daily for a period of eight or 12 more weeks. At the end of the 5-mg portion, TC, LDL, LDL/HDL, and TC/HDL decreased by 13-20 percent, 17-18 percent, 17.0-17.2 percent, and 16.3-16.7 percent, respectively, whereas HDL was unchanged in one trial and increased by 16.5 percent in the other. At the end of the 10-mg/day period policosanol supplementation resulted in decreased TC, LDL, LDL/HDL, and TC/ HDL by 17-20 percent, 25-28 percent, 27-30 percent, and 21-27 percent, respectively, and increased HDL 7-29 percent. Significantly more side effects were seen in the placebo group in each trial.

In comparative trials policosanol generated lipid profiles similar to simvastatin, (36,37) pravastatin, (10,38) lovastatin, (32,35,39) probucol, (40) acipimox, (41) and atorvastatin. (42) First, two trials on patients with type II hypercholesterolemia, comparing low dose simvastatin (5 or 10 mg/day) and moderate dose policosanol (5 or 10 mg/day), demonstrated that both substances greatly improved lipid profiles with no significant differences in results or side effects between the groups. (36,37) Second, policosanol (10 mg/day) compared favorably to low-dose pravastatin (10 mg/day) in patients with type II hypercholesterolemia in two studies. (10,38) In one trial. Policosanol-treated patients had significantly greater decreases in LDL, LDL/HDL, TC/HDL, and increases in HDL, (38) while in another trial policosanol-treated patients had significantly greater increases in HDL. (10) The pravastatin group had more side effects in both studies. A study comparing policosanol to lovastatin in patients with type 2 diabetes and hypercholesterolemia (type II) found policosanol (10 mg/ day) is more effective at lowering LDL/HDL and increasing HDL than 10 mg/day lovastatin, with significantly fewer side effects. (32) In addition, in patients with type II hypercholesterolemia and concomitant coronary risk factors, policosanol (10 mg/day) decreased LDL/HDL and increased HDL more effectively than 20 mg/day lovastatin, with fewer side effects. (39) Policosanol (5 mg twice daily) also compared favorably to probucol (500 mg twice daily) at reducing TC, LDL, and TG in patients with type II hypercholesterolemia. (40) Again, policosanol (10 mg/day) compared favorably to acipimox (750 mg/day), a niacin derivative, in regard to TC, LDL, LDL/HDL, TC/HDL, and HDL, with fewer side effects. (41) Lastly, policosanol was significantly less effective than atorvastatin (Lipitor) in reducing both LDL and TC, although it was similar in reducing both atherogenic ratios and TG. Atorvastatin, however, significantly increased (p < 0.05) creatine phosphokinase (CPK) and creatinine, whereas policosanol significantly reduced alanine aminotransferase (AST), glucose (p < 0.01), and CPK (p < 0.05) levels. (42) These studies suggest a therapeutic benefit to policosanol in type II hypercholesterolemia, while presenting no adverse effects on the liver.