Policosanol: Nature's Cholesterol Balancer
by James South, M.A.

In spite of all the medical advances of the last 50 years, heart/artery disease still kills about half of all Americans. For many decades now, the standard medical approach to treating or preventing heart disease has been to use drugs such as Lovastatin to lower elevated blood cholesterol.

High-fiber, low-cholesterol diets have also been used to lower excessive blood cholesterol, often to little effect, since only about 1/4 of total body cholesterol comes from the diet. The other 3/4 of body cholesterol is made by the liver.

Statin drugs do often successfully lower elevated cholesterol levels, yet there are many problems associated with statin use. They aren't cheap -- they typically cost $70-100 per month. Statins also cause elevated blood levels of liver enzymes such as AST, CPK, and alkaline phosphatase,1 indicating that statin drugs are at least midly liver toxic.

Statin drugs are also known to cause male impotence. One statin drug, Bayer's Baycol, was removed from the market by the FDA several years ago after leading to many deaths due to severe muscle destruction. Statins also interfere with the liver's production of CoQ10.2

Nature's Way to Balance
Fortunately, nature has provided us with a simple, inexpensive, non-toxic way to balance cholesterol levels: the mixture of long-chain fatty alcohols, derived from sugar cane or bee's wax, called "policosanol."

An ideal cholesterol-balancing agent should; 1) lower total blood cholesterol; 2) lower LDL cholesterol (the so-called "bad" form); 3) raise HDL cholesterol (the so-called "good" form); and 4) lower blood triglycerides, fats which, when elevated, also contribute to artery damage.

This is exactly what policosanol (PCL) does. Policosanol has been the subject of many human clinical trials.3-8 Doses used have typically been 10 or 20 mg policosanol daily; occasionally 40 mg has been used. In the six studies just cited, policosanol typically lowered LDL 18-28 percent (higher does and/or longer use increased the effect), raised HDL 7-29 percent, lowered total cholesterol 14-18 percent, and lowered triglycerides 5-18 percent. Unlike statin drugs, policosanol caused no elevation of blood liver enzymes, indicating no liver toxicity. Side effects were virtually non-existent with policosanol. Ironically, the placebo groups often had worse side effects than the policosanol groups!

Policosanol vs. Statin Drugs
In three studies,3-5 Policosanol was compared with statin drugs. Policosanol typically did as well, or much better, than the statins in raising HDL and lowering total and LDL cholesterol and triglycerides.

Policosanol does more than just balance unhealthy cholesterol/triglycerides levels, however. In a group of high blood pressure patients, policosanol not only produced its typical favorable lipid profile, but also lowered systolic blood pressure 10 mm Hg after 12 months.9

Policosanol was given to 62 patients suffering intermittent claudication, a disorder of the legs involving severe pain and cramping that seriously limits walking ability. After six months' treatment with policosanol, the distance walking on a treadmill before initial claudication occurred increased from 133 to 206 meters, while the maximum walking distance increased from 230 to 365 meters. Both variables remained unchanged in the placebo group.10

Other Positive Effects of Policosanol
Policosanol also positively affects other aspects of blood vessel health. Rats were fed policosanol for four weeks, then LDL particles from their blood were examined for resistance to oxidation. It is oxidized LDL that is believed to be the chief culprit in promoting atherosclerotic damage to artery linings. Policosanol significantly increased LDL resitance to oxidation according to several measures.11 Policosanol also reduces abnormal platelet aggregation activity by favorably altering prostaglandin synthesis. Policosanol lowers blood levels of TXA2, a thromboxane that promotes blood vessel constriction and excessive platelet aggregation, while it increases blood levels of prostacyclin (PGI2), which opens blood vessels wide, and inhibits abnormal platelet aggregation.12-13

Abnormal platelet aggregation is often the trigger for a heart attack, when it occurs in a heart blood vessel already partially closed due to atherosclerotic plaque.

Policosanol has been shown to be exremely non-toxic, even with long-term use.14 In this study of 27,879 patients, the side effect incidence was only 0.31 percent, primarily weight loss, excessive urination and insomnia. However, since large amounts of cholesterol are needed during pregnancy and growth, policosanol should not be used by pregnant women or children. Policosanol is usually taken at a dose of 10 or 20 mg/day. It is best taken with the evening meal, since cholesterol biosynthesis is increased at night.

For people needing to lower their cholesterol only moderately, policosanol may be the perfect answer. However, for those needing to lower their cholesterol more dramatically, policosanol is best used in combination with other lipid control agents. Policosanol has been shown to synergize well with other cholesterol-lowering agents. Anyone using blood-thinning drugs such as warfarin, heparin, or pentoxifylline, or taking L-dopa for Parkinson's disease, should use policosanol only with their doctor's advice and consent.

  1. Crespo. N. et al. "Comparative study of the efficacy and tolerability of policosanol and lovastatin..." Int J Clin Pharm Res. 1999. 19:117-27.
  2. Folkers. K. et al. "Lovastatin decreases coenzyme Q levels in humas." Proc Nat'l Acad Sci. 1990. 87:8928-30.
  3. Crespo op. cit.
  4. Ortensi. G. et al. "Policosanol vs. simvistatin." Curr Ther Res. 1997. 58: 390-401.
  5. Castano. G. et al. "Effects of policosanol and pravastatin on lipid profile...in older hypercholesterolemic patients." Int J Clin Pharm Res. 1999. 19:105-116.
  6. Mas. R. et al. "Effects of policosanol in patients with type II hypercholeterolemia..." Int J Clin Pharm Res. 1999. 65:439-47.
  7. Castano. G. et al. "Effects of policosanol 20 vs 40 mg/day in the treatment of patients with type II hypercholeterolemia..." Int J Clin Pharm Res. 2001. 21:43-57.
  8. Castano. G. et al. "Effects of policosanol on older patients with type II hypercholeterolemia and high coronary risk." J Gerontol. 2001. 56:M186-92.
  9. Castano. G. et al. "Effects of policosanol in hypertensive patients with type II hypercholeterolemia." Curr Ther Res. 1996. 57:691-99.
  10. Castano. G. et al. "A double-blind, placebo-controlled study of the effects of policosanol in patients with intermittent claudication." Angiology. 1999. 50:123-30.
  11. "Oral administration of policosanol inhibits in vitro copper ion-induced rat lipoprotein peroxidation." Physiol Behav. 1999. 67:1-7.
  12. Arruzazabala. M. et al. "Effect of policosanol successive dose increase in platelet aggregation in healthy volunteers." Pharmacol res. 1995. 34:181-85.
  13. Valdes. S. et al. "Effect of policosanol on platelet aggregation in healthy volunteers." 1996. Inter J Clin Pharm Res. 16:67-72.
  14. Fernandez. L. et l. "Policosanol: Results of a post-marketing surveillance study of 27,879 patients." 1998. Curr Ther Res. 59:7717-22.

Copyright 2004, Vitamin Research News
Reprinted with permission
Back to Program Notes Index