Policosanol is a mixture of alcohols that are derived from Cuban sugarcane wax, which contains about 60 percent octacosanol, an active ingredient in policosanol. Sugarcane-derived policosanol is not widely available in the United States, but similar supplements made from beeswax and wheat germ are.
Policosanol’s proponents say it can lower cholesterol just as well as statin drugs, but without the side effects. However, there is much debate about this claim, as nearly all of the positive studies conducted on sugarcane policosanol were done by one group in Cuba, which also owns the patent. (Arruzazabala 2002; and others) Several studies done outside of Cuba did not find the supplement to be effective at reducing cholesterol. In a double-blind, controlled study conducted in Italy, for example, sugarcane policosanol failed to lower cholesterol in patients who had diet-resistant high cholesterol. (Francini-Pesenti 2008)
Policosanol is associated with mild, short-term side effects, including indigestion, rash, insomnia, and headache. According to the positive studies, it can take up to two months before benefits are noticeable. If you choose to take policosanol, follow the package instructions.
Arruzazabala ML et al. Antiplatelet effects of policosanol (20 and 40 mg/day) in healthy volunteers and dyslipidaemic patients. Clin Exp Pharmacol Physiol 2002 Oct; 29(10): 891-97
Berthold HK et al. Effect of policosanol on lipid levels among patients with hypercholesterolemia or combined hyperlipidemia: a randomized controlled trial. JAMA 2006 May 17; 295(19): 2262-69
Francini-Pesenti F et al. Sugar cane policosanol failed to lower plasma cholesterol in primitive, diet-resistant hypercholesterolaemia: a double-blind, controlled study. Complement Ther Med 2008 Apr; 16(2): 61-65.