Policosanol

Overview
Policosanol (or polycosanol) is the generic term for a natural extract of plant waxes. It is used as a nutritional supplement to lower (bad) LDL cholesterol and increase (good) HDL cholesterol and to help prevent atherosclerosis.

Physical properties
Policosanol is a mixture of a few fatty alcohols derived from the waxes of such plants as sugar cane and yams, as well as beeswax. The most prevalent alcohol in policosanol is octacosanol, followed by triacontanol.

There is a much lower concentration of several other fatty alcohols: behenyl alcohol, lignoceryl alcohol, ceryl alcohol, 1-heptacosanol, 1-nonacosanol, 1-dotriacontanol, and geddyl alcohol.

Studies
Policosanol is touted as a natural way to treat high cholesterol levels. Published studies have come to conflicting conclusions regarding the efficacy of policosanol in lowering LDL (i.e., "bad cholesterol") or raising HDL (i.e., "good cholesterol"). Many of the studies that have found positive effects of policosanol have come from one group in Cuba, whose research has been funded by Dalmer Laboratories (aka Laboratorios Dalmer). This company was created by the National Center for Scientific Research in Havana, Cuba specifically to market policosanol. Cuba produces sugar cane, one of the sources of policosanol. A German study failed to find evidence of cholesterol-lowering effects. In this study, 143 participants with hypercholesterolemia or combined hyperlipidemia were randomly assigned to policosanol at doses of 10, 20, 40 or 80 milligrams daily or placebo. After 12 weeks, the researchers found no statistically or clinically significant effect on LDL-C, HDL-C, total cholesterol, triglycerides, or lipoproteins. In other words they found policosanol to be of no clinical value.

As this is sometimes a Cuban product, there is controversy from the USA. (Please note that Nature's Life sells Policosanol 23 mg that is manufactured by NutraPure, Inc. in California, and states "Made with Pride in the USA".) Resistance to the acceptance of Policosanol has been driven by two factors (i) heavy investment in the marketing of competitor drugs (Lipitor and Zocor) and (ii) the US economic embargo/blockade of Cuba, which backs a general prejudice against Cuban technology. However, Policosanol is now widely marketed and used around the world. For example, it is sold in most pharmacies in Australia by Herron and Blackmores.

The above mentioned study by Berthold conflicts with more than 50 previous studies of 4596 patients over the past 20 years. Policosanol is one of the most widely studied natural supplements in the world. Many of the supportive studies were first conducted in Cuba but others in various countries including the U.S. have shown the benefits of policosanol.

For example:

Chen JT, Wesley R, Shamburek RD, Pucino F, Csako G. (2005) Meta-analysis of natural therapies for hyperlipidemia: plant sterols and stanols versus policosanol. Pharmacotherapy. 2005 Feb;25(2):171-83. [School of Pharmacy and Pharmacal Sciences, Purdue University, West Lafayette, Indiana]

Long- term effects of policosanol on older patients with Type 2 diabetes. Asia Pac J Clin Nutr. 2004;13(Suppl):S101.

Effects of policosanol and ticlopidine in patients with intermittent claudication: a double-blinded pilot comparative study. Angiology. 2004 Jul-Aug;55(4):361-71.

Concomitant use of policosanol and beta-blockers in older patients. Int J Clin Pharmacol Res. 2004;24(2-3):65-77.

Pub Med Nutr Rev. 2003 Nov;61(11):376-83. Role of policosanols in the prevention and treatment of cardiovascular disease. Varady KA, Wang Y, Jones PJ. School of Dietetics and Human Nutrition, McGill University, Ste-Anne-de-Bellevue, Quebec, Canada

Roberto Menéndez, Rosa Más, Ana MA. Amor, Rosa MA. González, Julio C. Fernández, Idania Rodeiro, Mirta Zayas & Sonia Jiménez. (2000) Effects of policosanol treatment on the susceptibility of low density lipoprotein (LDL) isolated from healthy volunteers to oxidative modification in vitro, Br J Clin Pharmacol, 50, 255-262. [Center of Natural Products, National Center for Scientific Research, PO Box 6880, Havana, Cuba]

Davalos J.M., Mederos H., Rodriguez J., et al. (1996): Effect of policosanol in hypercholesterolemia due to nephrotic syndrome. X Latinciamerican Congress of Nephrology and Hypertension, 14 September, Santiago de Chile, Chile.

Arruzazabala M. L., Carbajal D., Mas R. and Valdes S. (1997): Comparative study of policosanol, aspirin and the combination therapy policosanol-aspirin on platelet aggregation in healthy volunteers. Pharmacol Res 36(4):293-7.

Stusser R., Batista J., Padron R. et al. (1998): Long-term therapy with policosanol improves treadmill exercise-ECG testing performance of coronary heart disease patients. Int J Clin Pharmacol Ther 36(9):469-73.

Production
Policosanol (PPG)is produced, promoted and studied extensively in Cuba, where pharmaceutical research and sugar cane farms both exist in abundance. The supplement is used as a panacea by some Cubans.