Cholesterol/LipidsCoenzyme Q10Policosanol

How policosanol lowers cholesterol and implications for your safety

In a previous post I reviewed policosanol, which can lower LDL (bad) cholesterol levels by 20% to 30%.

The source of policosanol seems to influence its activity, with Cuban sugar cane-based policosanol being most effective. It’s available on the Internet and in stores. In fact, One-A-Day Cholesterol Plus contains sugar cane-based policosanol.

Now, a study conducted at the University of Kentucky College of Pharmacy shows how it works.

The active component of policosanol that reduces cholesterol synthesis is triacontanol, not octacosanol as was speculated in the past.

There’s no direct inhibition of HMG-CoA reductase, which means the mechanism of action is different from statins. There is however, a three-fold increase in AMPkinase phosphorylation, which subsequently suppresses HMG-CoA reductase, and ultimately, lowers LDL cholesterol blood levels. So, policosanol has an indirect effect on HMG-CoA reductase.

Caution advised.

The ability to inhibit HMG-CoA reductase leads to a reduction in mevalonic acid, which plays an important role in cholesterol synthesis and in the production of coenzyme Q 10. In muscle cells coenzyme Q 10 is involved with energy production. Therefore, inhibition of HMG-CoA reductase directly (by statins) can lead to interference with energy levels in muscle cells, and this might be the mechanism of muscle injury (or rarely, rhabdomyolysis) with these drugs.

Still to be determined is whether policosanol, which suppresses HMG-CoA reductase indirectly, also increases the risk of muscle injury.

If you decide to try policosanol, report promptly any unexplained muscle pain, tenderness, or weakness to your doctor or pharmacist, especially if you are already taking a statin such as simvastatin (Zocor), lovastatin (Mevacor) and pravastatin (Pravachol), fluvastatin (Lescol), atorvastatin (Lipitor), or rosuvastatin (Crestor).

8/24/06 22:03 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.