Policosanol is a natural supplement made from sugar cane often used to lower cholesterol levels. It may also lower blood pressure and prevent blood clotting. However, there are conflicting studies that have questioned its effectiveness. Read on to discover the potential benefits and drawbacks of policosanol, along with the optimal dosage.
What is Policosanol?
Policosanol is a term for a group of long-chain alcohols extracted from the waxy coating of sugar cane. The first policosanol supplement was isolated and produced by researchers at Dalmer Laboratories in Cuba, in the early 90s .
It is commonly used for reducing high cholesterol, including total and LDL (low-density lipoprotein) cholesterol and has become one of the fastest-growing over-the-counter supplements sold in the United States .
Most of the trials that report benefits from policosanol were conducted by a single research group in Cuba. Trials conducted by other groups have often failed to find any benefits, which is a major drawback to its use .
- May reduce blood pressure
- May improve cholesterol levels
- Protects the blood vessels
- Most benefits stem from questionable Cuban research
- There’s conflicting evidence for the effects on blood lipids
- May interact with blood thinners and statins
The components of policosanol are a mixture of high-molecular-weight alcohols, with the main ones being [3, 1]:
- Octacosanol (60 – 70%)
- Triacontanol (10 – 15%)
- Hexacosanol (4.5 – 10%)
- Dotriacontanol (3 – 8%)
Mechanisms of Action
The exact mechanisms of action of policosanol are not completely clear, however, it is thought that policosanol exerts its effects by 4]:
- Increasing the breakdown of LDL cholesterol by the liver .
- Blocking activity of HMG-CoA reductase, an enzyme involved in the production of cholesterol .
- Reducing blood clotting .
- Blocking the activity of serum cholesteryl ester transfer protein (CETP), thereby increasing HDL and lowering LDL levels .
Health Benefits of Policosanol
1) High Blood Pressure
In 589 older patients being treated for both high blood pressure and high cholesterol, one year of policosanol (5 to 10 mg/day) treatment significantly lowered their blood pressure .
Policosanol supplementation for a year reduced the blood pressure of 205 patients taking blood-pressure-lowering drugs .
While the above studies were performed in Cuba, at least one study outside of Cuba has supported these findings.
A pilot study performed by a group in South Korea found that 8 weeks of policosanol supplementation reduced blood pressure in 25 volunteers .
2) Blood Clotting
Platelets are one of the main components of blood clots, and the grouping together of platelets is one of the key steps in the clotting process (platelet aggregation).
Five studies conducted by the Cuban research team found that 5-50 mg of policosanol administered daily reduced blood clotting in both healthy volunteers and patients with high cholesterol [10, 11, 12, 13, 14].
Policosanol also prevented platelet grouping in rats .
Due to questionable outcomes of other Cuban studies, we can’t make a definite conclusion in the absence of research from other authors.
3) Intermittent Claudication
Intermittent claudication is a condition that involves cramping in the legs during exercise or walking due to clogged arteries.
Policosanol (10 mg/day) improved intermittent claudication symptoms in a 20-week study of 28 patients .
In another study, policosanol for 10 weeks improved the walking distance of 39 patients with intermittent claudication .
In a study of 21 patients given 10 mg/day of policosanol for 2 years, it significantly improved walking distance and relieved the symptoms .
These results have yet to replicate by a research group outside of Cuba.
No valid clinical evidence supports the use of policosanol for any of the conditions in this section. Below is a summary of up-to-date animal studies, cell-based research, or low-quality clinical trials which should spark further investigation. However, you shouldn’t interpret them as supportive of any health benefit.
4) Cholesterol Levels
A number of earlier studies performed by the same research team in Cuba have shown that policosanol decreases LDL and total cholesterol levels. Despite these promising results, later studies performed outside of Cuba failed to show any cholesterol-lowering effects of policosanol, which casts doubt on the validity of the previous studies.
Studies Performed in Cuba
In a study of 589 elderly patients with high cholesterol, 5 mg/day of policosanol for one year reduced LDL and total cholesterol levels .
Two studies (300 postmenopausal women with high cholesterol) found that taking 5-10 mg/day of policosanol decreased LDL by as much as 27% and total cholesterol by 19.5% [19, 20].
In another study, 75 older patients with high cholesterol were given either policosanol (10 mg/day) or a statin regularly used for treating high cholesterol (atorvastatin) for 8 weeks. Policosanol lowered both LDL and total cholesterol levels but was less effective than the statin .
In a study of 120 patients, a combination of a popular statin (simvastatin) and policosanol resulted in a greater decrease in total and LDL cholesterol levels than a combination of the statin and placebo .
In three trials of nearly 400 high-cholesterol patients, policosanol (5 to 40 mg/day) significantly reduced LDL and total cholesterol levels [23, 24, 25].
However, in a study performed out of Mount Sinai Medical Center in Miami, FL, policosanol (20 mg/day for 12 weeks) did not reduce LDL or total cholesterol levels either alone or in combination with atorvastatin in 99 patients with high cholesterol .
Also, three smaller trials conducted by American and South African researchers (95 total patients) found that policosanol did not lower LDL or total cholesterol levels [2, 27, 28].
Many additional trials by researchers outside of Cuba (over 450 total patients) also reported no effects of policosanol on LDL or total cholesterol levels [29, 30, 31, 32, 2, 33, 34].
The research group in Cuba attributed the lack of positive results to using policosanol with a different composition of alcohols than the one used in their studies. However, other researchers have shown that the original policosanol supplement has a similar purity and composition as alternative policosanol formulations derived from non-Cuban sugarcane [1, 35, 29].
The same contradictory results seen with policosanol and LDL and total cholesterol changes are also seen with regard to HDL changes.
Several clinical studies (1,123 total patients) conducted by the same Cuban research team found that in addition to lowering LDL and total cholesterol levels, policosanol increases HDL levels [8, 23, 20, 19, 36].
However, studies performed outside of Cuba (253 total patients) by other research teams showed no change in HDL cholesterol levels [2, 33, 31].
5) Triglyceride Levels
Similar contradictory results have also been seen with regard to triglyceride levels.
A study from Cuba found that policosanol had similar effectiveness as the popular statin atorvastatin in decreasing serum triglycerides in a study of 75 older patients .
A study conducted by the same research team in Cuba showed that triglyceride levels were decreased by 11.9% in 589 elderly patients with high cholesterol after 6 weeks of taking 5-10 mg/day of policosanol for one year .
However, other studies performed outside of Cuba (459 total patients) reported no change in triglyceride levels, even in studies where LDL and total cholesterol were lowered [33, 31, 37].
6) Fat Loss
A significant decrease in visceral fat was reported in a study of 25 volunteers taking 10 mg of policosanol daily for 8 weeks. Further research is warranted .
Animal and Cellular Research (Lacking Evidence)
No clinical evidence supports the use of policosanol for any of the conditions listed in this section. Below is a summary of the existing animal and cell-based studies; they should guide further investigational efforts but should not be interpreted as supportive of any health benefit.
Blood Vessel Health
Policosanol helped prevent injury to damaged blood vessels in rabbits .
Policosanol led to faster cell renewal and improved tissue recovery in zebrafish .
Blood Sugar Levels
Policosanol decreased blood sugar levels in zebrafish .
Policosanol in Combination with Other Supplements
A combination of policosanol and red yeast rice, berberine, folic acid, coenzyme Q10, and astaxanthin in addition to low-dose statins reduced LDL-c and total cholesterol levels greater than low-dose statins alone in 100 heart disease patients .
In another study, 40 children with high cholesterol disorders were given 200 mg of red rice extract and 20 mg of policosanol or placebo for 4 weeks. Total cholesterol and LDL cholesterol and were significantly reduced compared to the placebo group .
In a study of 90 patients with high cholesterol, a combination of policosanol and omega-3 fatty acids reduced LDL cholesterol and total cholesterol, and increased HDL cholesterol levels after 8 weeks .
A combination of policosanol and omega-3 fatty acids improved mood and reaction time of 10 male athletes compared to placebo .
In one pilot study, 50 patients who suffered a stroke and were given 20 mg/day of policosanol, along with aspirin and vitamins C, E, and folic acid, and showed improved neurological outcomes .
Limitations and Caveats
Most of the studies conducted in Cuba reported benefits from policosanol on cholesterol levels, but these were not supported by most of the studies conducted outside of Cuba.
This could be due to the Cuban researchers only publishing studies that show positive results, and leaving out any studies that showed a lack of benefit (publication bias).
Another plausible explanation is diet. Many of the trials performed by the Cuban research team often had participants who were on special diets designed to lower cholesterol levels before they began supplementing with policosanol [43, 8, 46, 23, 47, 21, 36].
All three studies outside of Cuba that found benefits with policosanol used cholesterol-lowering diets before starting policosanol supplementation [48, 49].
Policosanol Side Effects & Precautions
This list does not cover all possible side effects. Contact your doctor or pharmacist if you notice any other side effects. In the US, you may report side effects to the FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch. In Canada, you may report side effects to Health Canada at 1-866-234-2345.
Large long-term studies, some lasting up to 3 years, have shown policosanol to be likely safe [50, 51, 26, 33, 52].
Studies in rats, rabbits, and monkeys showed no toxic or cancer-related effects associated with policosanol [53, 54, 55, 56, 57].
Side effects are generally mild but may include [24, 14]:
- Skin rash
- A headache
- Nose and gum bleeding
Due to the lack of safety data, pregnant women and children should avoid policosanol.
Supplement-drug interactions can be dangerous and, in rare cases, even life-threatening. Always consult your doctor before supplementing and let them know about all drugs and supplements you are using or considering.
Taken with aspirin, policosanol was also shown to reduce blood clotting, and the combined effect was greater than either one alone (45 heart disease patients and 43 healthy volunteers) [14, 58].
Policosanol may also enhance the cholesterol-lowering effects of statins and the effects of blood pressure-lowering drugs [22, 8].
The below doses may not apply to you personally. If your doctor suggests using policosanol, work with them to find the optimal dosage according to your health condition and other factors.
Policosanol is usually sold in 5 mg or 10 mg tablets and one tablet can be taken twice daily, up to a total of 10 mg or 20 mg per day .
The dosages effective in clinical trials range from 5-40 mg/day [8, 9, 16, 17].
User Reviews & Experiences
The opinions expressed in this section are solely from the users who may or may not have a medical background. SelfDecode does not endorse any specific product, service, or treatment. Do not consider user experiences as medical advice. Never delay or disregard seeking professional medical advice because of something you have read on SelfDecode.
Reviews on the web are generally positive, with the vast majority of users reporting a reduction in total and LDL cholesterol levels. Users often report using the supplement red yeast rice in combination with policosanol, as red yeast rice has been shown to decrease cholesterol levels .
Most users do not experience any side effects, however some report minor side effects, including:
- Headaches and migraines
- Dizziness throughout the day
- Tingling in the head, hands, feet, and tongue
- One user noted very darkly, tarry stools
Another user experienced foot pain similar to foot pain associated with taking statins.