THREE DIETARY SUPPLEMENTS AND HERBS FOR CHOLESTEROL LOWERING - ONE POTENTIALLY GOOD, ONE UNDOCUMENTED, ONE PROBABLY NO GOOD
(July 2004)

We have multiple prescription medicines that will lower blood cholesterol levels, often markedly. There are also nutritional, herbal, and dietary supplement approaches to cholesterol lowering. Soluble fiber, soy and soy products, garlic, and nuts in the diet can reduce cholesterol levels to a modest extent.

One dietary supplement that is probably effective is a fermented product of rice on which a red yeast has grown. That product is under legal dispute because the active component is identical to the active component of prescription statin drugs. Then, there are three others.

First, the potentially good one - policonasol, used particularly in Cuba, where some of the best research has taken place. Policonasol is a long chain alcohol that is found in sugar cane, beeswax, and yams. Several well-conducted studies indicate that policonasol, 5 to 10 milligrams a day, can lower total cholesterol levels and its dangerous component, low-density lipoprotein cholesterol (LDL - bad cholesterol) to almost as great an extent as powerful statin drugs. Policonasol will also increase levels of high-density lipoprotein cholesterol (HDL - good cholesterol).

The drug is also said to increase energy and sexual performance, but those claims are unproved.

The second substance is octaconasol. This is one of the major components of policonasol. It is sold in health food stores under several brand names, but it is not at all clear that policonasol’s cholesterol-lowering effect is due to octaconasol. At present, there are just no persuasive data that would support the use of octaconasol as a cholesterol-lowering drug.

The third agent is guggul. This is a herbal extract of resin of the mukul myrrh tree. For centuries, it has been used as treatment for a variety of illnesses and conditions. It is a recognized dietary supplement in the United States for cholesterol lowering; this is based almost exclusively on studies published in the Indian literature. The first controlled study in the United States is reported in the August 13, 2003 issue of the Journal of the American Medical Association. A standardized guggul extract (guggulipid) in a standard dose or a high dose or an inactive placebo were given to a total of 103 adults with elevated cholesterol levels. After eight weeks of treatment, there was no improvement in total cholesterol levels among the guggul-treated. Furthermore, the levels of the dangerous component of cholesterol, low-density lipoprotein cholesterol (LDL - bad cholesterol), actually rose significantly and the levels of protective high-density lipoprotein, cholesterol (HDL - good cholesterol) fell. Only one in five subjects showed a good response to guggul with a lowering of LDL levels. Overall, the herbal extract was a failure. Furthermore, some participants developed a rash from guggul use. The authors conclude that their results do not support use of guggul for treatment of high cholesterol levels.

In sum: policonasol looks very hopeful as a cholesterol-lowering agent. Octaconasol is undocumented, and guggul cannot be recommended.

Szapary, P.O., et al. Guggulipid for the treatment of hypercholesterolemia. Journal of the American Medical Association. Vol 290 (August 13) Pgs 765-772. 2003.

One of our Scientific Advisory Board members argues that we need a lot more careful studies on policonasol before being able to recommend it.

See policonasol update, February 7, 2007 "Policonasol for cholesterol lowering: A sobering report".