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Policosanol is a nutritional supplement derived from sugar cane wax and may be useful to decrease platelet aggregation and claudication. Policosanol taken alone does not appear to be as useful as when it is used in combination with other nutrients such as berberine and red yeast rice extract.

Cholesterol Myths

Research from Germany published by the Journal of the American Medical Association in 2006 looked at the supplementation of policosanol in people with hypercholesterolemia or combined hyperlipidemia. There were a total of 143 people in the study. The policosanol was given as a dietary supplement at dosages ranging from 10 mg/day up to 80 mg/day. After several months, there did not appear to be a benefit on lipid levels from supplementation at any level.

Another study from a research group in Italy gave policosanol in combination with berberine and red yeast rice extract. This study was published by the Mediterranean Journal of Nutrition and Metabolism in 2011. This study followed over 1700 patients with dyslipidemia. Just over half took the nutritional supplement in combination with a healthy diet. They were compared with patients treating their dyslipidemia with diet alone. The proprietary combination supplement appeared to benefit multiple lipid parameters, including lowering the LDL, raising the HDL, and lowering the triglycerides.

Yet another study from Italy looked at 80 patients with dyslipidemia. The results were published in Advances in Therapy in 2011. This study was a randomized, blinded, prospective study that compared a combination supplement with placebo. This supplement contained policosanol (10 mg), red yeast rice (200 mg), berberine (500 mg), folic acid, coenzyme Q10, and astaxanthin. All of the patients previously had been found to be statin intolerant and unable to take pharmaceutical statin medications for treatment. This study found that the combination supplement was effective in lowering total and LDL cholesterol levels.

These studies suggest policosanol in combination with red yeast rice and berberine may be useful in the treatment of dyslipidemia. These combination supplements may be better tolerated than statin pharmacotherapy for many people.

Risks and Safety

Like any other medication, consuming policosanol-containing supplements can result in an allergic reaction in some people, have interaction effects, and cause transient nausea if taken on an empty stomach. It also appears to decrease platelet aggregation which should be monitored. For some, this may be a desirable side effect, like taking an aspirin a day. Nevertheless, it is recommended to only take policosanol under the supervision of a doctor to monitor for side effects. Routine blood tests can be particularly helpful and typically include a lipid panel, liver panel, and perhaps platelet and clotting studies as well.

High Cholesterol Foods

Policosanol at low dosages appears to be safe and well tolerated by the large majority of people. In combination with red yeast rice and berberine, it has been shown to improve cholesterol levels and may be better tolerated than pharmaceutical therapy with statins. It is recommended to work with a doctor when taking policosanol in order to monitor its effects. 

Reviewed by Dr. Jennifer Monti, MD, MPH

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