Should you lower your cholesterol?
If your LDL cholesterol is elevated above 130 mg, will you be in better health if you lower it? But should you risk the long-range side effects of potent and expensive statin drugs? And why would you, when there’s a much safer alternative?
These and other cholesterol questions are currently being discussed in an HSI Forum thread, which I featured in last Friday’s “This Week in the HSI Forum” (9/5/03). The thread takes its title from policosanol, a compound of fatty alcohols derived primarily from sugar cane or beeswax. And while policosanol is gaining a reputation as a natural alternative to statin drugs, there is more to this supplement than meets the eye.
Fortunately, most of it is good.
The sweet source
Here’s how Jonathan V. Wright, M.D., describes policosanol in his newsletter Nutrition & Healing (1/1/02): “Policosanol is a group of eight to nine ‘long-chain alcohols’ (solid, waxy compounds). Research is accumulating to show that policosanol is more effective than the most ‘popular’ (among mainstream doctors) patent medicines for lowering total cholesterol and triglyceride levels.”
Dr. Wright also notes that policosanol may help prevent strokes by inhibiting platelet aggregation and abnormal blood clotting, and may even lower blood pressure as well.
Even though it’s drawn from the same plant that produces table sugar, policosanol doesn’t affect blood sugar levels when ingested. And several studies have shown that it can reduce cholesterol without creating the dangerous side effects associated with statin drugs.
In one trial – reported in the journal Gynecological Endocrinology – researchers tested more than 240 post-menopausal women with high cholesterol. The subjects were given 5 mg of policosanol daily for 12 weeks, then 10 mg daily for another 12 weeks. After 6 months, researchers found that the supplement was effective in significantly lowering LDL levels (25.2 percent) and total cholesterol (16.7 percent). In addition, the women experienced an overall 29.3 percent increase in HDL levels.
Walking the walk
Most discussions about cholesterol focus on the ways it endangers the heart. In fact, cholesterol performs several chores that are essential to good health. Cholesterol assists in the absorption of fatty acids, helps manufacture vitamin D, contributes to the production of sex and adrenal hormones, and maintains fatty covers around nerve fibers. As we grow older, however, our hormone levels drop, often boosting cholesterol to levels that cause concern.
One of the common age-related side effects of high cholesterol is a debilitating syndrome of cramping pain in the calves known as intermittent claudication. This is often linked to poor circulation and the presence of arterial fat deposits (atherosclerosis). Removal of those fat deposits, however, has been found to decrease claudication.
Researchers at the Medical Surgical Research Center in Havana, Cuba, tested policosanol patients who suffered from moderately severe intermittent claudication. In this two-year study, 56 patients were randomly assigned to receive either policosanol or a placebo. Results indicated that policosanol significantly relieved the effects of intermittent claudication. The 21 people taking policosanol increased their walking distance by at least 50 percent, while only five members of the placebo group showed a similar improvement.
Other research has shown that elevated cholesterol levels may play a role in the development of Alzheimer’s disease, so there’s a possibility that policosanol may offer a defense against age-related dementia. This is a controversial topic because much more research needs to be done to determine the exact relationship of cholesterol and Alzheimer’s. And yet we’ve already seen drug companies subtly (and sometimes not so subtly) promoting statins as a treatment to help prevent Alzheimer’s.
On the Q10
Studies have shown policosanol to be generally safe, but there are a few notes of caution.
Of course, a doctor or healthcare professional should be consulted before beginning any new supplement regimen. In the case of policosanol, this is especially necessary for those who are taking blood-thinning medications, or for patients who are currently taking cholesterol-lowering drugs. Also, some study subjects have experienced mild side effects from policosanol, including insomnia, headache, diarrhea, nervousness, and weight loss. These short-term side effects have been reported in less than one percent of the subjects tested. And unlike statin drugs, policosanol has not been shown to have a harmful effect on the liver – the organ that manages the production of cholesterol.
Another concern is policosanol’s effect on levels of CoQ10, the antioxidant enzyme that has been shown to promote cardiovascular health, and possibly even help prevent congestive heart failure. One of the ironies of statin drugs is that they’ve been shown to lower CoQ10 levels. So while you’re risking serious long-term side effects to reduce cholesterol, you’re also removing a powerful heart healthy antioxidant. Meanwhile, some research has indicated that policosanol may also have a negative effect on CoQ10, although Dr. Wright has stated that policosanol does not seriously interfere with the body’s ability to produce CoQ10.
In any case, a supplement of CoQ10 will be helpful for most people, and some policosanol manufacturers have even added CoQ10 to their supplement formulas.
What goes up
Policosanol can easily be found in supplement stores and through Internet sources. Typical daily doses range from 5-10mg, but some people need slightly higher doses to lower their cholesterol levels. Naturally, finding the most effective dosage requires careful monitoring of blood tests with the help of a doctor.
This initial monitoring can be problematic, however, because some patients report a rise in cholesterol and triglyceride levels within the first few weeks of policosanol use. Apparently this is not unusual, and in most cases both cholesterol and triglyceride levels can be expected to fall.
If you’ve used policosanol, please write and share your experience – either pro or con – so other members can know what to expect when using this supplement.
To Your Good Health,
Jenny Thompson
Health Sciences Institute
Sources:
“Policosanol Lowers Cholesterol” Family Nutrition, familynutrition.com
Gynecological Endocrinology, 14(3):187-95, 2000, parthpub.com/gnyend
Angiology, 52(2):115-25, 2001
“FDA- Approved Drugs Don’t Always WorkNeither Does Policosanol” Life Extension Magazine, February 2002, lef.org
