Policosanol Is Safe and Natural

Policosanol May Be Good for
Your Brain as Well as Your Heart

Sugar-cane extract lowers cholesterol and
may help prevent cognitive impairment
By Dr. Edward R. Rosick

he country we live in is certainly different than the America of even one hundred years ago. Back then, it was seldom that people lived beyond their forties or fifties. Infectious diseases such as polio, smallpox, and influenza struck down most people before they became old and gray.

What a difference a century has made. People in their forties and fifties now think of themselves as early middle-aged, and it's not uncommon to see people living into their eighties and nineties. One significant reason for this change is the control of infectious diseases. Although people certainly still die of infections, it's now chronic degenerative diseases, such as heart disease, cancer, vascular dementia, and Alzheimer's disease, that are the primary cripplers and killers. In fact, heart disease is the number one cause of death today, and Alzheimer's disease, along with vascular dementia, brutally steals the minds of millions of older Americans.

Fortunately, there are ways in which even such devastating conditions as these can be successfully combated. Medical researchers are learning, in fact, that many of the contributing factors to heart disease, such as high cholesterol, might also be causing age-related dementias. For people interested in a natural way to decrease their cholesterol to help protect both their heart and their brain, policosanol, a sugar-cane extract, could be the best answer. (Policosanol does not contain any sugar and does not affect blood sugar levels.)

Statin Drugs Lower Cholesterol, but with Side Effects

In the late 1990s, there were definitive, large-scale trials of cholesterol-inhibiting medications known as statins. These studies showed that, by lowering high cholesterol levels, one could significantly decrease one's chances of dying from heart disease. The statins are now among the most widely prescribed medications in the nation, yet they are not without significant costs, from both monetary and health standpoints.

Many of the contributing factors
to heart disease, such as high
cholesterol, might also be
causing age-related dementias.

These drugs, produced by most of the major pharmaceutical corporations, are quite expensive, and until generic forms come out many years from now, they will stay expensive. They also have the potential to cause major side effects, including fatigue, muscle aches, and liver damage. Yet even with their potential side effects, the statins continue to be prescribed in ever-increasing amounts, owing to their effectiveness in lowering cholesterol.

Atherosclerosis Can Harm the Brain

It is well known that hypercholesterolemia, or high levels of cholesterol in the blood, is a significant contributor to heart disease, because it leads to the formation of cholesterol-containing deposits called plaque on the inside of blood vessels. This plaque buildup, a condition known as atherosclerosis, restricts the flow of blood, and if insufficient blood reaches important organs such as the heart or the brain, the results can be severe. The heart can be damaged, even to the point of a heart attack, and the brain can suffer the consequences of vascular dementia, defined as cognitive impairment caused by inadequate blood flow. And inadequate blood flow, of course, means inadequate oxygen, glucose, and the other nutrients the brain depends on.

Policosanol - A Safer Alternative to Statins

As already noted, cholesterol-lowering drugs, such as the statins, significantly decrease a person's chances of dying of heart disease. Policosanol, a natural derivative of sugar cane, has also been shown to decrease cholesterol levels significantly, and it does so without the significant side effects of the prescription statin drugs.

There have been multiple scientific studies examining the effectiveness of policosanol in decreasing cholesterol, along with studies looking at the effectiveness of policosanol in head-to-head comparisons with the statins. All these studies have shown that policosanol is at least as effective as the statin drugs in lowering cholesterol, and in some cases more so. Moreover, policosanol has been shown to be extremely safe and effective, with none of the more dangerous side effects of the statins, such as liver damage.1

High Cholesterol Can Lead to Dementia

Besides increasing the risk of heart disease, high cholesterol levels have been implicated in age-related cognitive decline associated with the most two common forms of dementia: Alzheimer's disease and vascular dementia. Alzheimer's disease, the most common form of dementia in people aged 65 or older, is believed to be caused by several pathological changes in the brain.

Figure 1. Degenerative changes in an Alzheimer’s-diseased brain. The senile plaques deposited between the neurons consist mainly of the protein beta-amyloid.

One of the most significant changes, and one that is generally recognized as the pathological hallmark of Alzheimer's, is the combined accumulation of harmful protein deposits known as senile plaques (these are not the same as atherosclerotic plaque) and abnormal neuronal structures known as neurofibrillary tangles (see Figure 1). It is believed that the plaques and tangles contribute to the literal degeneration of the brain seen in victims of Alzheimer's disease.

The second-most common cause of dementia in the elderly is vascular dementia. In this condition (as we have seen), the brain does not receive enough life-sustaining oxygen and other nutrients, owing to a buildup of atherosclerotic plaque in the blood vessels; it can also be caused by a series of "ministrokes" that temporarily cut off the blood supply to a region of the brain. The symptoms of vascular dementia are very much like those of Alzheimer's disease - notably memory loss and significant impairments in cognitive function.

Lowering Cholesterol Levels Can Decrease Risk

Since it is known that the statin drugs decrease cholesterol levels and thus the risk of heart disease, medical researchers have been excited about the prospects of also using cholesterol-lowering agents to fight Alzheimer's disease and vascular dementia. A study recently published in the British medical journal The Lancet examined the effects of statin drugs on the risk of developing dementia.2 The study involved over 1400 patients who were either taking statin drugs to lower their cholesterol or who had high cholesterol that was untreated.

The statin drugs are quite
expensive, and until generic forms
come out many years from now,
they will stay expensive.

The researchers found that those patients who were taking statins had a significantly decreased risk of developing age-related dementia compared to those who were not. This study did not distinguish between Alzheimer's disease and vascular dementia, by the way.

Studies have shown that
policosanol is at least as
effective as the statin drugs in
lowering cholesterol, and
in some cases more so.

Other recent studies have shown further proof that having high, untreated levels of cholesterol increases one's chances of developing age-related dementia. An autopsy study done in Hawaii on over 200 patients showed that men who had high levels of cholesterol were significantly more likely to have suffered from Alzheimer's disease than those who did not.3 One theory is that high cholesterol levels may play a role in the development of Alzheimer's disease by increasing the formation of senile plaques in the brain.

Another study examined over 1400 men and women in Finland to try to correlate various heath factors with the risk of developing Alzheimer's disease or vascular dementia, or both.4 As in earlier studies, there was a strong, statistically significant correlation between high cholesterol levels and both Alzheimer's and vascular dementia. This reinforces the widely held views that high cholesterol levels: (1) impede blood flow from the heart to the brain through the formation of atherosclerotic plaque and (2) weaken and injure the blood vessels in the brain itself, which causes brain function literally to "slow down." With regard to Alzheimer's disease specifically, the authors agreed with earlier studies showing that increased levels of cholesterol could directly contribute to the formation of senile plaques.

Lower Cholesterol = Better Cognitive Function

A landmark study recently published in Archives of Neurology examined the relationship between cholesterol levels, the use of statin drugs, and cognitive function in older women.5 The study followed 1037 women for over four years, after which they were tested using standardized mental status examinations. The authors concluded that:

. . . among elderly women with coronary heart disease, higher levels of total and LDL-cholesterol [the "bad cholesterol"] were associated with worse cognitive scores and a greater likelihood of cognitive impairment. Reductions in total and LDL-cholesterol during 4 years was associated with better cognitive functioning and approximately 50% less risk of having cognitive impairment.

Interestingly, older nonstatin cholesterol-lowering agents, such as niacin (vitamin B3) and the drug cholestyramine, did not reduce the risk of developing cognitive impairment.

Policosanol Is Effective in Reducing Cholesterol

Since policosanol was not one of the cholesterol-lowering agents used in the study just cited, one wonders whether or not it would have had the same effect of decreasing the risk of developing cognitive impairment as the statin drugs did. The good news is that the answer could very well be an emphatic yes. In the study, the authors stated that the effects of the statin drugs on reducing cognitive impairment could be due to other actions of the statins, including it effects on smooth muscle function and platelet aggregation.

It seems reasonable to expect that
policosanol will be shown in
future studies to provide the
same cognition-protecting
effects as the statins.

A newly published article on the pharmacology of policosanol showed the results of numerous studies on its effectiveness in decreasing cholesterol safely and without side effects.6 The authors also looked at other effects of policosanol, including its effect on smooth muscle function and platelet aggregation - the same effects seen with the statin drugs. With these similar modes of action, it seems reasonable to expect that policosanol will be shown in future studies to provide the same cognition-protecting effects as the statins.

Although predicting the future is generally as reliable as next week's weather forecast, it is probably safe to say that the twenty-first century will be filled with scientific advances that would have been regarded as miracles a century ago. Until the time comes when heart disease and age-related dementias are put into the history box alongside smallpox and polio, it will be the wise person who uses preventive measures such as policosanol to keep both heart and brain healthy.


  1. Prat H, Roman O, Pino E. Comparative effects of policosanol and two HMG-CoA reductase inhibitors on type II hypercholesterolemia. Revista Medica de Chile 1999;127(3):286-94.
  2. Jick H, Zornberg G, Jick S, Seshadri S, Drachman D. Statins and the risk of dementia. Lancet 2000;356(9242):1627-31.
  3. Launer L, While L, Petrovich H, Ross G, Curb J. Cholesterol and neuropathologic markers of AD. Neurology 2001;57(8):1447-52.
  4. Kivipelto M, Helkala E, Hanninen T, et al. Midlife vascular risk factors and late-life mild cognitive impairment. Neurology 2001;56(12):1683-9.
  5. Yaffe K, Barrett-Conner E, Lin F, Grady D. Serum lipoprotein levels, statin use, and cognitive function in older women. Arch Neurol 2002;59(3):378-84.
  6. Gouni-Berthold I, Berthold H. Policosanol: clinical pharmacy and therapeutic significance of a new lipid-lowering agent. Am Heart J 2002;143(2):356-65.

Dr. Rosick is an attending physician and clinical assistant professor of medicine at Pennsylvania State University, where he specializes in preventive and alternative medicine. He also holds a master’s degree in healthcare administration.

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