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Policosanol is a compound derived from sugar cane and barley sprouts that has been studied for its potential health benefits, particularly in relation to lowering cholesterol levels, blood pressure, and blood sugar management.
Emerging research suggests that policosanol may help lower cholesterol by decreasing cholesterol production in the liver, increasing the breakdown of "bad" LDL (low-density lipoprotein) cholesterol, and improving the function of "good" HDL (high-density lipoprotein) cholesterol[1]. This article will examine the evidence in more detail and see what the science says about this nutritional supplement.
Elevated total cholesterol levels are believed to be a leading risk factor for coronary artery disease and strokes, which contribute to premature death. Finding ways to help reduce cholesterol is thought to be beneficial in preventing premature death from cholesterol-related conditions. It has been estimated that up to 3 million deaths occur each year due to the effects of high cholesterol[2].
Cholesterol tests ordered by a physician include several reported results. These include total cholesterol levels, LDL cholesterol, and HDL cholesterol. LDL cholesterol is also called bad cholesterol, and elevated levels are a risk factor for cardiovascular events. Here is also HDL cholesterol, often considered "good cholesterol'. The higher this number is, the better. It is commonly believed that elevated HDL cholesterol levels protect the heart.
The possible benefit of policosanol and cholesterol goes back to 1994 in studies[3] where rabbits were given the policosanol, and researchers saw a reduction in LDL cholesterol. A 2002 researcher[4] even stated that its benefits were similar to the prescription drugs lovastatin and simvastatin. t has also been compared to atorvastatin[5].
While some studies, particularly those conducted in Cuba, have shown positive effects of Policosanol on cholesterol levels, it's important to note that research findings outside of Cuba have been more mixed, with some studies finding no significant impact on cholesterol[6,7]. Therefore, the effectiveness of Policosanol for lowering cholesterol may vary based on the source of the research.
A study[8] published in 2001 found that Policosanol at doses of 20 and 40 mg/day significantly lowered the bad LDL-cholesterol (21% to 29%), total cholesterol (17% to 21%), and the LDL-cholesterol/HDL-cholesterol ratio while increasing the so-called, good HDL-cholesterol levels by 8% to 15%.
In addition, a 2018 study[9] reviewed 22 studies and showed beneficial cholesterol-lowering effects, including 1886 individuals. Policosanol did not show any benefit in lowering triglycerides.
A 2019 study[10] also showed beneficial findings in cholesterol reduction. The study's authors concluded, "…that policosanol supplementation induces anti-hypercholesterolemia by inhibiting cholesterol biosynthesis, LDL cholesterol uptake, and cholesterol excretion.
However, a 2022 study[11] found no benefit of Policosanol and cholesterol-lowering. However, the dose used in the studies is unknown.
High blood pressure, also known as hypertension, is a common condition that requires the heart to pump harder than desired due to increased pressure and stiffness in the arteries. Affecting hundreds of millions of people worldwide — one in every four adults — this condition often causes no symptoms, leaving many with high blood pressure undiagnosed. For this reason, hypertension has been called "the silent killer." high blood pressure is known to increase the risk of heart attack, stroke, heart failure, and kidney disease, especially if left untreated.
Blood pressure consists of two numbers, traditionally measured in millimeters of mercury (mmHg). The first number is the systolic blood pressure, and the second is the diastolic pressure. Blood pressure is expressed as 120/80 (systolic/diastolic).
Those with high blood pressure need to be under the care of their personal physician.
In addition to its potential effects on cholesterol and blood pressure, Policosanol has been investigated for its impact on other health conditions. For example, it may have benefits for individuals with metabolic syndrome, and early research suggests it could be useful for reducing heart disease-related events in people with clogged arteries[1]. However, it's essential to interpret these findings with caution, as more research is needed to fully understand the range of health benefits associated with Policosanol.
Some research also suggests that Policosanol may help lower blood pressure, with a systematic review and meta-analysis of randomized controlled trials indicating a significant decrease in both systolic and diastolic blood pressure.[12]
A 2018 animal study[13] showed that eight weeks of policosanol consumption significantly lowered blood pressure and aldosterone levels.
In addition, a 2018 double-blind placebo-controlled trial of 52 women also showed a significant reduction in blood pressure in those who took the supplement. The group of women who were given Policosanol saw a 10% and 14% reduction in the systolic and diastolic blood pressure, respectively.
Lastly, a 2019 study[14] of healthy Korean adults also saw a significant reduction in blood pressure by almost 8%.
Worldwide, more than 422 million people have diabetes. The vast majority—90 to 95 percent— have type 2 diabetes, a condition primarily due to lifestyle factors, like consumption of excess sugar, starchy carbohydrates, processed foods, and limited physical activity. Type 1 diabetes is not preventable and occurs when the immune system attacks the pancreas, preventing its ability to secrete insulin.
Chronically elevated blood sugar levels can cause damage to the brain, nerves, tissues, eyes, heart, and kidneys. When blood sugar is poorly controlled, the walls of the arteries become damaged (endothelial dysfunction), leading to artery blockage, stroke, or heart attack. Elevated cholesterol levels may worsen this. Diabetes also increases the risk of various cancers and Alzheimer's disease, and it's believed that elevated levels of insulin are a leading reason this occurs. Fasting and consuming a low carbohydrate diet, or keto diet, may be beneficial.
Policosanol may have an impact on blood sugar levels. Research[15] suggests that it might reduce blood sugar levels after a meal, a common need for those with diabetes.
Additionally, a study reported that Policosanol caused a 5% increase in insulin secretion at basal glucose levels and a 14% increase at high blood glucose levels[16]. Therefore, individuals with diabetes or those taking medications to manage blood sugar should monitor their blood sugar levels closely while using Policosanol and consult a healthcare professional to determine if any adjustments to their diabetes medication are necessary[17].
Fatty liver affects 1 in 3 people in most developed countries around the world. Excess sugar, processed foods, and alcohol intake are the primary reasons. Those who consume a diet high in processed foods, including refined carbohydrates, also have an increased risk for a fatty liver. Fatty liver is a risk factor for liver cirrhosis and liver cancer[18]. In my own private practice, I have had several patients who developed end-stage liver disease simply because they ate poorly.
Since we know that Policosanol has favorable effects on one's metabolic parameters, as discussed above, it would follow that it also has a benefit on fatty liver. However, most of the studies out there regarding this are based primarily on animal studies. According to this 2022 study[19], Policosanol had a beneficial effect on a fibrotic liver using a rat model. This was consistent with a similar study[20] in 2003 conducted in Cuba.
Lastly, Policosanol also appears to help reverse fatty liver, according to a 2016 study[21].
However, the data on Policosanol and the prevention and or reversal of fatty liver is sparse, so more studies need to be conducted before more conclusive evidence is presented.
There are currently animal research studies[22,23] on the benefits of Policosanol for use in the treatment of memory loss and/or Alzheimer's disease. Preliminary findings are encouraging, but more research needs to be undertaken in human populations. In addition, Policosanol may also be beneficial for those with mitochondrial dysfunction, according to a 2022 study[24].
In summary, some studies have shown promising results regarding the potential health benefits of Policosanol in those with metabolic syndrome, particularly in relation to cholesterol, blood pressure, and blood sugar. It's important for individuals considering the use of Policosanol to consult with a healthcare professional and to make informed decisions based on the available evidence.
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By Dr. Eric Madrid, M.D.
