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Policosanol

Policosanol is a mixture of oils from Cuban Cane Sugar; touted as a cholesterol lowering agent, it shows potency at this claim in several studies released from Cuba. Other studies undermine the quality of these, however, and it remains controversial.

Our evidence-based analysis on policosanol features 100 unique references to scientific papers.

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Summary of Policosanol

Primary information, health benefits, side effects, usage, and other important details

Policosanol is a term used to refer to a mixture of lipophilic (fat-soluble) compounds derived from the waxy coating of Cuban Cane Sugar. It has been used frequently to treat high cholesterol levels, and several studies claim that it does so with a potency rivaling statin therapy. The studies in question all appear to originate from Cuba, and when all studies are looked at collectively yet exclude Cuba the 100% success rate in Cuba declines to approximately 14% success rates in human trials. Due to this significant schism in the literature coupled with Policosanol being derived from a Cuban export, it is plausible that the scientific literature is suffering from publication bias.

The studies conducted outside of Cuba and those conducted in Cuba use similar participant pools, similar dosing, and at times have used the same sources of Cuban Cane Sugar specifically. The only difference is in the dietary protocol given, but some evidence suggests that this is a plausible explanation for the differences seen.

At this moment in time, publication bias and dietary intervention lead-in period are both plausible explanations for the observed differences. Which is disconcerting, as the latter would mean that policosanol can be as effective as statin therapy whereas the former means it is merely a placebo; a black and white issue with little grey area.

Regardless of source of the study or context, however, policosanol usage appears to be very safe; no side-effects have been reported in human interventions from Cuba or elsewhere and blatant overdoses in research animals fail to exert toxicity.

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How to Take

Medical Disclaimer

Recommended dosage, active amounts, other details

The standard supplemental dosage of policosanol is 5-10mg taken twice daily (for a daily total of 10-20mg), although due to the state of the research on this supplement it is not sure if it is bioactive in this range.

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Human Effect Matrix

The Human Effect Matrix looks at human studies (it excludes animal and in vitro studies) to tell you what effects policosanol has on your body, and how strong these effects are.
Grade Level of Evidence
Robust research conducted with repeated double-blind clinical trials
Multiple studies where at least two are double-blind and placebo controlled
Single double-blind study or multiple cohort studies
Uncontrolled or observational studies only
Level of Evidence
? The amount of high quality evidence. The more evidence, the more we can trust the results.
Outcome Magnitude of effect
? The direction and size of the supplement's impact on each outcome. Some supplements can have an increasing effect, others have a decreasing effect, and others have no effect.
Consistency of research results
? Scientific research does not always agree. HIGH or VERY HIGH means that most of the scientific research agrees.
Notes
grade-a Minor Moderate See all 12 studies
Unlikely to be potent, either small or no increases in HDL-C are likely to occur after policosanol ingestion. A good deal of the literature is based upon some highly suspicious past research from Cuba
grade-a Minor Moderate See all 13 studies
It is possible that policosanol is either effective or totally ineffective due to older Cuban studies being remarkably different than more recent replications; high probability of publicity bias
grade-a Minor Moderate See all 12 studies
There may be some limited efficacy of policosanol on cholesterol (when excluding the studies from cuba, which are highly suspicious, there is still some scattered but unreliable evidence) whereas it does not appear to be potent in any way.
grade-b - Moderate See all 5 studies
When excluding older cuban studies (which are highly suspicious) there is no evidence to support a reduction of triglycerides.
grade-c Minor - See study
Possibly a small effect in persons with high blood pressure.
grade-c Minor Moderate See 2 studies
Mixed evidence, possibly an effect but needs to be replicated
grade-c Minor - See study
Reductions in reaction time were not overly significant.
grade-c Minor Very High See 2 studies
Possible benefits to intermittent claudition, 'notable' rating is being held until it is replicated outside of Cuba
grade-c - - See study
No significant influence detected on blood flow

Studies Excluded from Consideration

  • Excluded studies due to being confounded with Berberine and Red Yeast Extract[1][2][3][4]

  • Confounded with other nutrients, such as tomato extract and grape seed extract[5]

  • Confounded with fish oil[6]

  • Combined with Red Yeast Extract[7]

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Things to Note

Primary Function:

Also Known As

Cane Sugar Extract

Do Not Confuse With

Octacosanol (major constituent)

Goes Well With

  • Aspirin (in regards to anti-platelet actions)

  • Fish Oil (complimentary benefits on lipid parameters)

Caution Notice

May Interact adversely with Warfarin, especially in the form of D-003

  • Studies may suffer from publication bias, but this is not ascertained

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