Statins are prescription medications commonly used to improve cholesterol levels. But since these medications are expensive and have side effects, many people seek alternative therapies. Policosanol (pol-e-KO-se-nol) is a natural substance derived from sugar cane wax that is sold in more than 40 countries and marketed as an alternative way of reducing low-density lipoprotein (LDL, or “bad”) cholesterol. More than 80 clinical trials have suggested that Cuban sugar cane policosanol has cholesterol-lowering effects comparable with statins. But since a single research group in Cuba conducted most of these studies, the results need to be verified by other research groups.

A new study performed in Germany and published in the May 17, 2006 issue of the Journal of the American Medical Association found that policosanol was no more effective than a placebo in improving unhealthy cholesterol levels.

About the Study

Researchers randomly assigned 143 people to receive 10, 20, 40, or 80 milligrams of Cuban sugar cane policosanol or a placebo pill daily. The participants had LDL cholesterol levels of 150 milligrams per deciliter (mg/dL [3.9 mmol/L]) or higher when the study began. The researchers measured the participants’ cholesterol levels before the study began and after six and 12 weeks.

There was no significant difference between any dose of policosanol and the placebo in reducing LDL cholesterol levels. When compared with the placebo, policosanol was also not associated with any improvement in high-density lipoprotein (HDL, or “good”) cholesterol, very low-density lipoprotein (VLDL) cholesterol, total cholesterol, triglycerides, or lipoprotein(a). The policosanol was well-tolerated and no serious adverse events occurred.

How Does This Affect You?

These findings indicate that policosanol may not have the cholesterol-lowering effects seen in previous studies. Earlier trials consistently reported that policosanol was associated with about a 25% reduction in LDL-cholesterol levels, but the current study showed no effect. It is possible that the benefits seen in previous studies could have been due to bias, since most of these studies were conducted by a single research group and supported by a manufacturer of Cuban sugar cane policosanol.

If you have cholesterol problems, it seems that policosanol may not be the effective statin alternative it is marketed to be. For people who need medications to treat their cholesterol and cannot tolerate statins, your physician can recommend several other types of effective cholesterol-lowering medications.