Policosanol supplement sugar cane extract for healthy cholesterol levels by Ray Sahelian, M.D.
Feb 18 2014

Policosanol is a mixture of very-long-chain aliphatic alcohols purified from sugar cane wax whose main component is octacosanol. Research up to now has provided mixed results with some studies showing certain benefits while other studies claiming that policosanol has no benefit in cholesterol lowering. I have included both positive and negative findings in this article. I am as confused as others regarding the role of this nutrient in health and disease, and for the time being I need to see more research to determine if it is an effective nutrient to lower cholesterol levels, and whether higher dosages, such as 40 mg daily, may be more effective. Perhaps policosanol has benefits in the human body other than lowering cholesterol, but we don't yet fully understand what these are, if any.

buy Policosanol supplement, 10 mg each pill - Source Naturals
Policosanols are a blend of compounds isolated from natural plant waxes that contain several long chain fatty alcohols, including octocossonol, hexacosanol and triacontanol. Animal and in-vitro research has shown that these compounds may support the cardiovascular system and inhibit lipid peroxidation as well as support macrophage activity.

 

 

 

 

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How much octacosanol is in the policosanol product by Source Naturals? What is the source (sugar cane, beeswax, other)?
    Since Source Naturals makes this product, it would be best to ask them since it may be different on each batch they make and they can tell you the source and the amount of octacosanol (if they test for this) in the latest batch that they have purchased and bottled.

A sugar cane extract
Doctors often prescribe drugs called statins for those with cholesterol levels above 200 mg. Many individuals are uncomfortable taking drugs to lower cholesterol and rather prefer to do so by diet and natural supplements. Although statins are effective in lowering cholesterol levels, their long-term side effects are currently not fully known, and muscle damage due to statins is probably more common than many doctors realize.
   Policosanol is a mixture of related compounds derived from the waxy portion of sugar cane. In a randomized, double-blind study done at the National Center for Scientific Research, in Havana, Cuba, investigators evaluated the cholesterol-lowering efficacy of daily intake of 20 mg of policosanol. After 24 weeks, policosanol lowered LDL-cholesterol (the bad cholesterol) by 27 percent and total cholesterol by 15 percent while HDL-cholesterol (the good cholesterol) increased by 17 percent. Policosanol also lowered triglyceride levels by 12 percent. No significant changes occurred in any lipid profile parameters in the placebo group. No unexpected adverse effects were observed. However, a 2006 German study did not find policosanol to reduce cholesterol levels.
   Eating small frequent meals, along with cold water fish, lots of vegetables, whole grains, beans, and peas, is helpful in lowering cholesterol levels. Those who are not able to reduce their cholesterol by diet and exercise alone may try policosanol at 20 mg per day along with other nutrients. Some people may respond to 40 mg of policosanol a day.
   Statin drugs should be reserved for those who fail to respond to diet and supplements. Nutrients and herbs may not be as powerful as statin drugs but still worth a try before moving on to drugs. Interactions between statin drugs and policosanol, if any, are not well understood.

Benefit of policosanol and review
Until additional trials are done, I can't say with confidence that this nutrient will consistently lower cholesterol levels. Other supplements to consider for healthy cholesterol levels include:

Psyllium half or one teaspoon in a glass of water twice daily with food. Psyllium is a fiber that reduces cholesterol levels and cardiac risk. Flax fiber is another good option.
Curcumin is a powerful antioxidant extracted from turmeric.
Fish oils work well, especially in combination with garlic or other supplements, to improve circulation.
Pectin, whether from apple or
g
rapefruit pectin, could be of benefit.
Artichoke leaf extract is a supplement to consider to lower cholesterol levels.
Red yeast rice may be helpful in lowering cholesterol
Beta glucan could be helpful, research has been done with beta glucan and cholesterol.
   For additional suggestions, see the link for cholesterol at the top of this page.

Policosanol research, results are conflicting
Zhonghua Xin Xue Guan Bing Za Zhi. 2013. Effects of policosanol combined with simvastatin on serum lipids and sex hormones in male patients with hyperlipidemia. Simvastatin / policosanol produces greater decreases in TC, LDL-C than simvastatin / placebo without resulting more side effects and changes on sex hormones.

Zhonghua Xin Xue Guan Bing Za Zhi. 2012. Effects of policosanol on serum lipids and heme oxygenase-1 in patients with hyperlipidemia. The short-term data obtained from this small hyperlipidemia patient cohort suggest that it is a safe lipid-lowering and anti-inflammatory agent for hyperlipidemia patients.

German investigators report that policosanol may not be effective to lower LDL cholesterol. Policosanol is an extract of the waxy coating of sugar cane and other plants, and multiple trials have demonstrated that it safely lowers lipid levels. However, Dr. Heiner K. Berthold says that almost all of these studies came from one group in Cuba, whose research was funded by Dalmer Laboratories, which markets policosanol. In an attempt to confirm their findings, Berthold, from the Drug Commission of the German Medical Association in Berlin, and his team performed a "rigorously controlled" multicenter study comparing Cuban sugar cane-derived policosanol with an inactive "placebo" supplement. Their study involved 143 adults with LDL cholesterol levels of at least 150 milligrams per deciliter. Participants were randomly assigned to policosanol at doses of 10, 20, 40 or 80 milligrams daily or placebo. After 12 weeks, the researchers saw no statistically or clinically significant effect on LDL cholesterol at any dose. Similarly, the investigators report, there were no significant differences among the groups in HDL ("good") cholesterol levels, total cholesterol, very low density-cholesterol, triglycerides, or lipoprotein(a). The study was sponsored by Madaus AG, an international company specializing in plant-derived drugs, which does not manufacture or distribute any cholesterol-lowering drugs. Journal of the American Medical Association, 2006.

Lack of cholesterol-lowering efficacy of Cuban sugar cane policosanol in hypercholesterolemic persons
American Journal of Clinical Nutrition, 2006
More than 50 studies have reported substantial reductions in plasma lipid concentrations in response to 2 40 mg Cuban sugar cane policosanol mixtures per day. However, several animal and human trials conducted outside of Cuba that used non-Cuban mixtures have failed to reproduce the efficacy of policosanol observed in earlier studies. The objective was to evaluate lipid-modulating actions of the authentic Cuban sugar cane policosanol on plasma lipids in healthy hypercholesterolemic volunteers. Twenty-one volunteers consumed, under supervision, 10 mg policosanol per day or a placebo incorporated in margarine as an afternoon snack, for a period of 28 d with the use of a randomized, double-blind crossover study design. Subjects maintained their habitual diet and physical activity and were weighed daily throughout the study period. Results: Body weights did not vary significantly throughout the trial and did not affect plasma lipid values. No significant difference was observed between treatment and control groups in plasma total, LDL-, HDL-cholesterol, and triacylglycerol concentrations. Conclusion: Present results show no beneficial effects of Cuban sugar cane policosanol on lipid indicators in hypercholesterolemic persons and question the clinical usefulness of policosanol mixtures as cholesterol-lowering neutraceutical agents.
   My comments: Is 10 mg policosanol too small a dose to show a clinical response?

The results of a new study provide more evidence that rice policosanol -- a mixture of alcohols extracted from sugar-cane wax -- has favorable effects on serum lipids. In an 8-week study of 70 patients with very high cholesterol levels, 10 milligrams of rice policosanol daily significantly reduced total cholesterol concentrations in plasma and increased apolipoprotein A1 -- a protein portion of "good" HDL cholesterol that carries cholesterol in the blood. Dr. Zeljko Reiner from University Hospital Centre Zagreb in Croatia and two associates describe their study in the journal Clinical Drug Investigation. The combination of high total cholesterol and "bad" LDL cholesterol and low "good" HDL cholesterol is a major risk factor for heart disease, they note in the paper. Large studies have clearly shown that lowering elevated total and LDL cholesterol through diet, exercise, and cholesterol-lowering drug therapy is beneficial. However, concerns regarding side effects of chemically derived cholesterol-lowering drugs have fueled interest in naturally derived agents, such as rice policosanol. This compound has been shown to lower total and LDL cholesterol in animal models, healthy volunteers, and in those with very high cholesterol levels.

The current findings from Reiner and colleagues support rice policosanol's favorable effects on serum lipids. Compared with placebo, policosanol for 8 weeks significantly lowered plasma total cholesterol from 7.3 to 7 mmol/L and increased Apo A1 from 1.49 to 1.58 mmol/L, Reiner and colleagues report. In this brief study, however, the researchers could not prove a significant reduction in triglycerides or LDL cholesterol or increase in HDL cholesterol with policosanol, as has been shown in other studies. It may be that the dose of policosanol used (10 milligrams daily) was too low and the duration of the study was too short, the authors offer. There were no side effects from policosanol therapy. Reiner and colleagues conclude that further study of rice policosanol as a potentially natural cholesterol-lowering aid is warranted. Clinical Drug Investigation, 2005.

Long-term effects of policosanol on obese patients with Type II Hypercholesterolemia.
Asia Pac J Clin Nutr. 2004.
This randomised, double-blinded, placebo-controlled study was undertaken to investigate the long-term efficacy and safety of policosanol in obese patients (BMI>or =30) with Type II hypercholesterolemia. After 5 weeks on step one cholesterol-lowering diet, 129 patients were randomised to policosanol 5 mg or placebo tablets taken once daily with the evening meal for 3 years. After one year on treatment, policosanol significantly lowered serum LDL-C, the primary efficacy variable (24 %) and total cholesterol (TC) (15 %), whereas increased high-density lipoprotein-cholesterol (HDL-C). Changes of lipid variables in placebo were not significant. Treatment effects were persistent, even slightly enhanced, during the trial. At study completion, policosanol had lowered LDL-C (31 %) and TC (20 %), while markedly raised HDL-C (24 %). Thirty patients (18 placebo, 12 policosanol) discontinued the study: 15 (11 placebo, 4 policosanol) due to AE and 12 (9 placebo, 3 policosanol) due to serious adverse events (SAE), most vascular. Policosanol was safe and well tolerated, not impairing significantly any safety indicator. Average body weight was slightly reduced over the study, indicating a general acceptable compliance with dietary recommendations, but policosanol did not show any drug effect on body weight. Overall, 28 placebo and 26 policosanol patients reported some mild or moderate AE during the study. It is concluded that policosanol was effective for lowering cholesterol in obese patients with type II hypercholesterolemia, being also safe and well tolerated.

Effects of concurrent therapy with policosanol and omega-3 fatty acids on lipid profile and platelet aggregation in rabbits.
Drugs R D. 2005.
Center of Natural Products, National Center of Scientific Research, Havana City, Cuba.
Policosanol is a mixture of high-molecular-weight aliphatic primary alcohols isolated from sugarcane wax with cholesterol-lowering and antiplatelet effects. Omega-3 fatty acids from fish oil can protect against coronary disease. An antiarrhythmic mechanism is emerging as the most convincing explanation for omega-3 FA cardiovascular protection, but triglyceride (TG)-lowering effects and inhibition of platelet function could play a role. In view of the effects of policosanol and omega-3 FA on lipid profile and platelet function, potential benefits of combined therapy were expected. OBJECTIVE: To investigate whether combined therapy with policosanol and omega-3 FA would offer some benefit, compared with policosanol or omega-3 FA alone, on serum lipid profile and platelet aggregation in rabbits.  Concurrent therapy with policosanol 5 m/kg and omega-3 FA 250 mg/kg lowered LDL-C, TC and TG and increased HDL-C. All treatments inhibited platelet aggregation, but better effects were observed with policosanol + omega-3 FA compared with either treatment alone. Combined therapy was well tolerated. These results suggest that treatment with policosanol + omega-3 FA could be useful for regulating lipid profile and inhibiting platelet aggregation, but conclusive demonstration of such effects requires further experimental and clinical studies.

Wheat germ policosanol failed to lower plasma cholesterol in subjects with normal to mildly elevated cholesterol concentrations.
Metabolism. 2004.
We investigated the effect of wheat germ policosanol (WGP) on plasma lipid profiles in 58 adults (30 men and 28 women, aged 49 +/- 11 years) with normal to mildly elevated plasma cholesterol concentrations in a double-blind, randomized, parallel placebo-controlled study. Subjects consumed chocolate pellets with or without 20 mg/d wheat germ policosanol for 4 weeks. Plasma lipid concentrations, routine blood chemistry and hematology were determined at the start and the end of the study. The initial plasma total, LDL-cholesterol, high-density lipoprotein (HDL)-cholesterol, and triacylglycerol concentrations in the wheat germ policosanol and the control groups were identical. Over the 4 weeks, neither the wheat germ policosanol nor the control treatment significantly changed plasma total cholesterol, LDL- and HDL-cholesterol, or triacylglycerol concentrations when compared to baseline values. In addition, there was no significant difference in plasma lipid profiles between the wheat germ policosanol and the control groups at the end of the study. Wheat germ policosanol did not result in any adverse effects as indicated by plasma activities of L-gamma-glutamyltransferase (gamma-GT), ALT, AST, bilirubin concentrations, and blood cell profiles. Chemical analysis showed that wheat germ policosanol consists of 8% hexacosanol, 67% octacosanol, 12% triacosanol, and 13% other long-chain alcohols, which is similar to the composition of sugar cane policosanol. In conclusion, wheat germ policosanol at 20 mg/d had no beneficial effects on blood lipid profiles. It therefore seems unlikely that the long chain (C24-34) alcohols have any cholesterol-lowering activity.

Long- term effects of policosanol on older patients with Type 2 diabetes.
Asia Pac J Clin Nutr. 2004.
 Previous short-term studies have shown the efficacy and tolerability of policosanol at 10 mg/day on patients with Type 2 diabetes, but no previous study on the effects of long-term treatment or lower doses has been reported. This study was undertaken to investigate the long-term efficacy, safety and tolerability of policosanol on patients with Type 2 diabetes. After 5 weeks on a step one cholesterol lowering diet, 239 patients with Type 2 diabetes were randomized to policosanol 5 mg/day or placebo for 2 years. Analysis was by Intention-to-treat. Baseline characteristics were well matched in both groups. After one year, policosanol reduced significantly low-density lipoprotein-cholesterol (LDL-C) (21 %), total cholesterol (TC) (17 %) and triglycerides (TG) (16 %), whereas increased high-density lipoprotein-cholesterol (HDL-C) levels (10 %). No significant changes on lipid profile variables of placebo group occurred during the study. Of 239 randomized patients, 63 (26 %) discontinued the study, 43/120 placebo (35 %) and 20/119 policosanol patients (16 %). Of them, 35 patients (28 placebo, 7 policosanol) withdrew from the study due to some adverse effect. The frequency of serious adverse events, most vascular, in policosanol patients was lower than in respective placebo. Five patients, all placebo, died during the study, four of them due to myocardial infarction. No drug-related impairment of safety indicators, particularly on glycemic control, was observed. Nevertheless, a reduction of systolic and diastolic blood pressure was observed in policosanol patients compared with placebo. The overall frequency of policosanol patients reporting mild and/or moderate was similar than in placebo. It is concluded that policosanol was long-term effective, safe and well tolerated on patients with dyslipidemia due to Type 2 diabetes.

Effects of policosanol and ticlopidine in patients with intermittent claudication: a double-blinded pilot comparative study.
Angiology. 2004.
The present study was undertaken to compare the effects of policosanol and ticlopidine in patients with moderately severe intermittent claudication (IC). The study had a 4-week baseline step, followed by a 20-week double-blinded, randomized treatment period. Twenty-eight eligible patients were randomized to policosanol 10 mg or ticlopidine 250 mg tablets twice daily (bid). Walking distances in a treadmill (constant speed 3.2 km/hr, slope 10 degrees, temperature 25 degrees C) were assessed before and after 20 weeks of treatment. Both groups were similar at baseline. Compared with baseline, policosanol significantly increased (p < 0.01) mean values of initial (ICD) and absolute (ACD) claudication distances from 162 to 273 m and from 255 to 401 m, respectively. Ticlopidine also raised significantly ICD (166 to 266 m) and ACD (252 to 386 m). Comparisons between groups did not show significant differences. Policosanol, but not ticlopidine, significantly, but modestly, increased the ankle/arm pressure ratio. After 10 weeks, policosanol significantly lowered low-density lipoprotein-cholesterol (LDL-C), total cholesterol (TC), and TC/HDL-C and raised (p < 0.05) high-density lipoprotein-cholesterol (HDL-C). At study completion, policosanol lowered LDL-C (30%), TC (17%), and TC/HDL-C (33%), increased HDL-C (+31%), and left triglycerides unchanged. Ticlopidine did not affect the lipid profile variable. Policosanol induced modest, but significant, reductions of fibrinogen levels compared with baseline and ticlopidine. Treatments were well tolerated and did not impair safety indicators. Three ticlopidine patients (21%) withdrew from the trial, only 1 owing to a serious adverse experience (AE) (unstable angina). Three other ticlopidine patients experienced mild AE (headache, diarrhea, and acidity). It is concluded that policosanol (10 mg bid) can be as effective as ticlopidine (250 mg bid) for improving walking distances of claudicant patients, and it could be advantageous for the global risk of these individuals owing to its cholesterol-lowering effects. This study is, however, just a pilot comparison, so that further studies in larger sample sizes are needed for definitive conclusions of the comparative effects of both drugs on patients with IC.

Meta-analysis of natural therapies for hyperlipidemia: plant sterols and stanols versus policosanol.
Pharmacotherapy. 2005.
To compare the efficacy and safety of plant sterols and stanols as well as policosanol in the treatment of coronary heart disease, as measured by a reduction in low-density lipoprotein cholesterol (LDL) levels. Systematic review and meta-analysis of randomized controlled trials. A total of 4596 patients from 52 eligible studies. We searched MEDLINE, EMBASE, the Web of Science, and the Cochrane Library from January 1967-June 2003 to identify pertinent studies. Reduction of LDL levels was the primary end point; effects on other lipid parameters and withdrawal of study patients due to adverse effects were the secondary end points. Weighted estimates of percent change in LDL were -11.0% for plant sterol and stanol esters 3.4 g/day (range 2-9 g/day [893 patients]) versus -2.3% for placebo (769 patients) in 23 eligible studies, compared with -23.7% for policosanol 12 mg/day (range 5-40 mg/day) versus -0.11% for placebo in 29 eligible studies. Cumulative p values were significantly different from placebo for both. The net LDL reduction in the treatment groups minus that in the placebo groups was greater with policosanol than plant sterols and stanols (-24% versus -10%). Policosanol also affected total cholesterol, high-density lipoprotein cholesterol (HDL), and triglyceride levels more favorably than plant sterols and stanols. Policosanol caused a clinically significant decrease in the LDL:HDL ratio. Plant sterols and stanols and policosanol are well tolerated and safe; however, policosanol is more effective than plant sterols and stanols for LDL level reduction and more favorably alters the lipid profile, approaching antilipemic drug efficacy.

Concomitant use of policosanol and beta-blockers in older patients.
Int J Clin Pharmacol Res. 2004.
Policosanol therapy added to hypercholesterolemic elderly individuals taking beta-blockers could provide additional benefits in lowering blood pressure; SAE were not more frequent in the policosanol group than in the placebo group and there was no increase in AE.

Effects of policosanol and lovastatin on lipid profile and lipid peroxidation in patients with dyslipidemia associated with type 2 diabetes mellitus.
Int J Clin Pharmacol Res. 2002.
In this pilot, randomized, double-blind study, we compared the effects of policosanol and lovastatin on lipid profile and lipid peroxidation in patients with dyslipidemia and type 2 diabetes mellitus. After 4 weeks on a cholesterol-lowering diet, 36 patients were randomized to policosanol (10 mg/day) or lovastatin (20 mg/day) tablets o.i.d. for 8 weeks. Policosanol significantly lowered serum low-density lipoprotein-cholesterol (LDL-C) (29%), total cholesterol (21.1%), triglycerides (13.6%) and the LDL-C/high-density lipoprotein-cholesterol (HDL-C) (36%) and total cholesterol/HDL-C (28.9%) ratios and significantly increased HDL-C (12.5%). Lovastatin significantly (p < 0.001) lowered LDL-C (25%), total cholesterol (18%), triglycerides (10.9%) and the LDL-C/HDL-C (30.4%) and total cholesterol/HDL-C ratios (23.9%) and significantly (p < 0.01) raised HDL-C (8.3%). Policosanol was more effective than lovastatin in reducing both ratios and in increasing HDL-C. Policosanol, but not lovastatin, significantly raised the lag time (20%) of Cu+2-induced LDL peroxidation and total plasma antioxidant activity (24%). Both policosanol and lovastatin significantly decreased the propagation rate, maximal diene production (8% and 5%) and plasma levels of thiobarbituric acid reactive substances (9.7% and 11.5%). Both treatments were well tolerated. Only one patient in the lovastatin group withdrew from the trial due to adverse events. In conclusion, policosanol and lovastatin administered short term to patients with dyslipidemia secondary to type 2 diabetes were effective in lowering cholesterol and in inhibiting the extent of lipid peroxidation. Policosanol (10 mg/day) was slightly more effective than lovastatin (20 mg/day) in reducing the LDL-C/HDL-C and total cholesterol/HDL-C ratios, in increasing HDL-C levels and in preventing LDL oxidation. Nevertheless, since this was a pilot study, further clinical studies performed in larger sample sizes of diabetic patients are needed for definitive conclusions.

Cholesterol-lowering action of policosanol compares well to that of pravastatin and lovastatin. Cardiovasc J S Afr. 2003.

A 6-Month Study on the Toxicity of High Doses of Policosanol Orally Administered to Sprague-Dawley Rats.
J Med Food. 2001.
Policosanol is a cholesterol-lowering drug purified from sugar cane. Previous toxicological studies have not demonstrated any policosanol-related toxicity, even with long-term oral administration at 500 mg/kg, a dose 1,724 times larger than the maximal therapeutic dose (20 mg/day) recommended to date. The present study was undertaken to investigate the oral toxicity of policosanol administered for 6 months in doses up to 5,000 mg/kg to Sprague-Dawley rats. Animals were randomly distributed in five groups (15 animals per dose per sex): a control and four groups given oral policosanol (50, 500, 2,500, or 5,000 mg/kg). Eight treated rats (6 males, 2 females) died during the study, five of them (4 males, 1 female) from among those receiving the highest dose (5,000 mg/kg). According to necropsy, all deaths were related to gavage manipulation of higher doses. Although the differences were not significant, body weight gain and food consumption in the groups receiving 2,500 or 5,000 mg/kg tended to be lower than in the control group. Nevertheless, no drug-related toxicity symptoms were detected. Analysis of blood biochemistry, hematology, organ weight ratios, and histopathological findings did not show significant differences compared with controls, nor any tendency with the dose. Therefore, the present study did not show any new evidence of oral toxicity of policosanol, and the findings observed were a consequence of long-term administration by gastric gavage of the highly concentrated suspensions needed to reach the higher doses. It is concluded that policosanol chronically administered by the oral route is safe and that no drug-related toxicity was demonstrated.

Emails
Q. I wonder if Sytrinol can be combined with other supplements such as policosanol? Are there any contraindications with supplements or medications that the consumer should be aware of?
   A. it is very difficult to predict what will happen when both are combined. There is hardly any research on the individual supplements, let alone the combination. Add to this factor the individual variation in response, additional medicines a person may be taking, the quality of the supplements, timing of intake, diet of the person, etc, and this all makes it so difficult to predict. A good option is to try one supplement, such as policosanol, for a few weeks to see how it works, and then add a second one for a few weeks to see if there are additional benefits.

Q. Are their benefits or cautions in combining guggulsterones with policosanol? I noticed that you note a study on use of policosanol for elderly people on beta-blockers; would use use guggulsterones in conjunction make a positive or negative difference to this?
   A. First, there still is no evidence that policosanol is effective by itself for lowering cholesterol. Second, we are not familiar with research combining policosanol and guggul.

Q. Thanks for all the information on policosanol. However, I'm confused: when replying to an email regarding the effects of combining policosanol with guggul, you say, "First, there still is no evidence that policosanol is effective by itself for lowering cholesterol. Second, we are not familiar with research combining policosanol and guggul." This comes after you publish a series of studies (most not Cuban) that seem to show that policosanol is in fact extremely effective, with the exception of the German study, which was much smaller that most of the others.
   A. There have been some positive studies from Cuba, but some negative studies from other countries, so we are not sure at this point if policosanol is helpful. We are awaiting the results of further studies before speaking with more confidence.

Q. I have high cholesterol and tried policosanol for two months. Results indicate policosanol was not helpful to lower cholesterol.
   A. Most policosanol studies have not been promising as we note on our website.

In 2002, on the advice of a medical doctor, and after a lack of success with policosanol at the regular, 20mg per day dosage, the dosage was doubled to 40mg per day. No policosanol side effects were observed, and my cholesterol levels were significantly affected over a four-month period, without a significant change to my diet. Total cholesterol went from 8.0 mmol/L to 6.0 mmol/L; LDL went from 6.4 mmol/L to 4.4 mmol/L, and HDL went from 1.2 mmol/L to 1.0 mmol/L. Triglycerides went from 2.35 mmol/L to 1.4 mmol/L I noticed that none of the studies in your list for policosanol cited dosages above 20mg per day.
   This is interesting. Perhaps policosanol does work but higher amounts need to be taken. We are not certain if any policosanol side effects would occur on higher dosages when tested in a large group of people.

My policosanol shipment has arrived from the US. Even my doctor here in the UK had not heard of it! I have been on statins since April 2004. I was prescribed Lipitor initially, but this was later replaced by simvastatin Tablets with a 40mg strength. My blood pressure is currently 106/62, blood sugar level is 6.3 and cholestoral level within the normal range. Would you be kind enough to advise me what potency level of policosanol I should now take to replace the statins I have been on?
   We can't give such individual advice on how much to take or for how long. We suggest your doctor read the page on cholesterol on our website.

I am wondering if there may be some personal factors involved in the effectiveness of Policosanol. I use only 10 mg/day and find that does an amazing job of adjusting my blood lipids in the right direction. Maybe this is diet sensitive, or some other factor is at play. In my case I follow a healthy diet -- low fat / good fat diet, low carb, etc. I think someone needs to isolate what synergistic factors are at work for some people. It had little or no effect on my wife's blood lipids. In my case it is extremely effective in raising HDL. My ratio is about 2.1 as a result.
   Sometimes it is difficult to know why some meds or natural pills work in some people but not others.