Summary
- Do sterol/stanol and policosanol supplements lower cholesterol? Although many types of supplements are touted for lowering high cholesterol levels, those with the best evidence of efficacy are sterols/stanols, red yeast rice, and high-dose niacin. In this Review, we tested sterols/stanols. There is modest evidence of efficacy for other supplements such as policosanol (also tested in this Review), fish oil, garlic, guggulsterone, pantethine, soy protein, and Sytrinol (see Summary of Evidence table).
- What did CL's tests find in sterol/stanol cholesterol supplements? Tests by ConsumerLab revealed that one sterol product contained less of a specific sterol than claimed and a policosanol product did not contain the expected amount of a specific policosanol. Across products, the dose of sterols/stanols per serving ranged from 400 mg to 900 mg and 10 mg to 20 mg of policosanol. The cost to obtain 800 mg of sterols/stanols ranged from 16 cents to 74 cents and the cost for 20 mg of policosanol ranged from 11 cents to 59 cents. (See What CL Found)
- Top Picks for sterol/stanol and policosanol supplements Among products Approved in testing, ConsumerLab selected a Top Pick for sterols/stanols that provided an ample dose at relatively low cost and its effectiveness is backed by a positive clinical trial. The Top Pick for policosanol provided what may be the best form of policosanol and relatively low cost.
- What is the right dose of sterols/stanols and policosanol and the best time to take them? Dosage for sterols is at least 400 mg with a meal or (1,000 mg for stanols), twice daily. For policosanol, it is 10 to 20 mg daily. See the ConsumerTips™ section for more about dosage and forms.
- Cautions: Beta-sitosterol appears to be generally well-tolerated even at doses commonly found in cholesterol-lowering supplements. Rarely, however, erectile dysfunction and loss of libido have been reported. For details about this and other potential side effects (as well as side effects of saw palmetto, which is often combined with beta-sitosterol in prostate supplements) see the Concerns and Cautions section of our Prostate Supplements Review.
Sterols/stanols may also interfere with absorption of fat-soluble vitamins and, rarely, their use has been associated with elevations in liver enzymes. A range of side effects, including migraines and insomnia, have been reported with policosanol and it should be used with caution in people taking anti-platelet or anti-coagulant drugs. (For details, see Concerns and Cautions.)
