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Introduction into 24-alpha-ethylcholestanol
Scientific Name: Stanol
Other Names: 24-alpha-ethylcholestanol, 3-beta,5-alpha-stigmastan-3-ol, Beta-sitostanol, Dihydro-beta-sitosterol, Fucostanol, Phytostanol, Plant Stanol, Plant Stanol Esters, Stigmastanol
Who is this for?
Stanol is taken by mouth to help prevent heart disease. It works by lowering total cholesterol and LDL cholesterol, the "bad" types of cholesterol that contribute to heart disease. Even though the exact ways it works are not yet understood, it is known that stanol molecules are similar in shape to cholesterol molecules. Therefore, stanol attaches to some of the places in the intestines where cholesterol is usually absorbed. Unlike cholesterol, however, very little stanol is absorbed by the body. Because it blocks cholesterol absorption, stanol forces more cholesterol to be eliminated from the body and less cholesterol enters the blood. Lower levels of cholesterol in the blood help to prevent hardening of the arteries and the formation of plaques in blood vessels. Plaques are accumulations of fat and other substances that stick in blood vessels. Eventually, plaques may lead to blood clots, heart attacks, or strokes.
When should I be careful taking it?
Because no studies were done in pregnant or breast-feeding women, little is known about how stanol might affect a developing fetus or an infant. Therefore, the use of stanol is not recommended during pregnancy or breast-feeding.
What side effects should I watch for?
No clinically significant side effects have been reported from clinical studies or from general use in Finland, where foods containing stanol have been available since 1995. However, some participants in clinical studies of stanol experienced diarrhea.
What interactions should I watch for?
Interactions have not been identified between stanol and prescription drugs, non-prescription drugs, other herbal products, or foods. However, stanol may have side effects that are not yet known. If you experience unexplained side effects while taking stanol, you should stop taking it and call your doctor or pharmacist.
Taking stanol with cholesterol-lowering drugs such as lovastatin, pravastatin or Zocor or with dietary supplements, such as garlic, niacin, or oat bran that also lower cholesterol, may result in a lower cholesterol level than would be achieved with either alone.
Some interactions between herbal products and medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals.
Should I take it?
Although plants do not contain cholesterol, they produce plant sterols, which have a structure very similar to cholesterol. Stanol is a plant sterol that is found in pine trees and in some vegetable oils. When a modified form of stanol is taken by mouth, it blocks some of the spaces that cholesterol usually occupies in cells. As a result, stanol interferes with the body's use of cholesterol, whether the cholesterol is produced by the body or eaten in foods. More cholesterol leaves the body and less stays in the blood.
Dosage and Administration
Usually included in "functional foods" such as butter substitutes, salad dressings, or other fat-based foods, stanol has been available in Finland and other Scandinavian countries for several years. Functional foods have added health benefits in addition to their nutritive value. Introduced in the United States in the last few years, stanol-fortified products may be used alone, but more commonly they are part of a low-fat diet. Frequently, they are also used at the same time as cholesterol-lowering drugs such as HMG-CoA Reductase Inhibitors, which are also called statins.
In addition to being included in foods, stanol is also available as capsules. In clinical studies, participants with normal or high cholesterol including children less than 2 years of age took stanol doses ranging from 800 mg to 4000 mg daily. The results from the higher doses, however, were no better than doses of about 2000 mg per day for adults or about 1500 mg per day for children. Clinical study results appear to show that either stanol-fortified foods or stanol capsules have the same general effectiveness for lowering cholesterol.
Neither the time of day that doses are taken nor the number of doses per day seems to have any significant bearing on stanol's effects. In studies, individuals who took one large dose per day were equally as likely to show beneficial changes in cholesterol levels as those who took smaller amounts of stanol two or three times a day. About 8 out of 10 study participants showed a response to stanol, with an average 10% to 15% reduction in cholesterol from stanol alone. By comparison, diet changes typically lower cholesterol levels by about 10%; statin-type drugs generally lower LDL cholesterol by 20% to 45%.
Stanol takes 2 to 3 weeks of daily use to reach its peak effectiveness. Although taking stanol reduced cholesterol levels for adults with normal cholesterol, no significant benefits were seen for children with normal cholesterol levels. Because clinical trials lasted one year with adults and 3 months with children, the use of stanol products is not recommend for longer than these periods of time.
Stanol is used to lower "bad" total and LDL cholesterol levels and to prevent heart disease.
Pregnant women and women who are breast-feeding should avoid using stanol because little is known about stanol's effects on developing babies or nursing infants. Children should not use stanol for longer than 3 months unless a doctor supervises such use.
Diarrhea may be caused by stanol.
No negative interactions have been attributed to the use of stanol. It may, however, increase the effectiveness of a low-cholesterol diet and cholesterol-lowering medications.
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(Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.)