Beta-Sitosterol

Reviewed on 9/17/2019

What other names is Beta-sitosterol known by?

B-Sitosterol 3-B-D-glucoside, B-Sitosterolin, Beta Sitosterin, Bêta-sitostérine, Beta Sitosterol, Bêta-Sitostérol, Beta-Sitosterol Glucoside, Beta-Sitosterol Glycoside, Cinchol, Cupreol, Glucoside de Bêta-Sitostérol, Quebrachol, Rhamnol, Sitosterin, Sitosterol, 3-beta-stigmast-5-en-3-ol, 22-23-dihydrostigmasterol, 24-beta-ethyl-delta-5-cholesten-3beta-ol, 24-ethyl-cholesterol.

What is Beta-sitosterol?

Beta-sitosterol is a substance found in plants. Chemists call it a "plant sterol ester." It is found in fruits, vegetables, nuts, and seeds. It is used to make medicine.

Beta-sitosterol is used for heart disease and high cholesterol. It is also used for boosting the immune system and for preventing colon cancer, as well as for gallstones, the common cold, the flu (influenza), swine flu, HIV/AIDS, rheumatoid arthritis, tuberculosis, psoriasis, allergies, cervical cancer, fibromyalgia, systemic lupus erythematosus (SLE), asthma, hair loss, bronchitis, migraine headache, and chronic fatigue syndrome.

Some men use beta-sitosterol for enlarged prostate (benign prostatic hyperplasia or BPH). Some women use it for symptoms of menopause.

It is also used for enhancing sexual activity.

Marathon runners sometimes use beta-sitosterol to reduce pain and swelling after a run.

Some people apply beta-sitosterol to the skin for treating wounds and burns.

In foods, beta-sitosterol is added to some margarines (Take Control, for example) that are designed for use as part of a cholesterol-lowering diet and for preventing heart disease. The federal Food and Drug Administration (FDA) allows manufacturers to claim that foods containing plant sterol esters such as beta-sitosterol are for reducing the risk of coronary heart disease (CHD). This rule is based on the FDA's conclusion that plant sterol esters may reduce the risk of CHD by lowering blood cholesterol levels. Although there is plenty of evidence that beta-sitosterol does lower cholesterol levels, there is no proof that long-term use actually lowers the risk of developing CHD.

Don't confuse beta-sitosterol with sitostanol, a similar substance contained in the product called Benecol. Both sitostanol and beta-sitosterol are used for lowering cholesterol levels in people with high cholesterol and appear to be equally effective.

SLIDESHOW

Sex-Drive Killers: The Causes of Low Libido See Slideshow

Likely Effective for...

  • Trouble urinating because of an enlarged prostate, or "benign prostatic hyperplasia" (BPH). Taking 60-130 mg of beta-sitosterol by mouth daily helps improve symptoms of BPH, but it does not actually shrink an enlarged prostate. Taking beta-sitosterol in much lower doses does not improve symptoms.
  • High cholesterol. Taking beta-sitosterol by mouth, alone or along with soy or cholestyramine, can lower total and "bad" low-density lipoprotein (LDL) cholesterol levels, but it does not raise "good" high-density lipoprotein (HDL) cholesterol levels.

Possibly Effective for...

  • Reducing cholesterol levels in people with an inherited tendency toward high cholesterol (familial hypercholesterolemia). Taking beta-sitosterol by mouth is possibly effective for reducing total and "bad" low-density lipoprotein (LDL) cholesterol levels in children and adults with familial hypercholesterolemia who are also following a low fat and cholesterol-lowering diet. But beta-sitosterol does not appear to work as well as sitostanol or the cholesterol-lowering medication bezafibrate.

Possibly Ineffective for...

  • Tuberculosis. Taking beta-sitosterol by mouth along with conventional treatment for tuberculosis does not shorten the time it takes to cure tuberculosis.

Likely Ineffective for...

Insufficient Evidence to Rate Effectiveness for...

More evidence is needed to rate the effectiveness of beta-sitosterol for these uses.

QUESTION

Testosterone is a chemical found only in men. See Answer

How does Beta-sitosterol work?

Beta-sitosterol is a plant substance similar to cholesterol. It might help reduce cholesterol levels by limiting the amount of cholesterol that is able to enter the body. It can also help reduce swelling (inflammation) in the prostate and other tissues.

Are there safety concerns?

Beta-sitosterol is LIKELY SAFE for most people when taken by mouth. It can cause some side effects, such as nausea, indigestion, gas, diarrhea, or constipation. Beta-sitosterol has also been linked to reports of erectile dysfunction (ED), loss of interest in sex, and worsened acne.

Beta-sitosterol is POSSIBLY SAFE when applied to the skin.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Not enough is known about the use of beta-sitosterol during pregnancy and breast-feeding. Stay on the safe side and avoid use.

Sitosterolemia, a rare inherited fat storage disease: People with this condition have too much beta-sitosterol and related fats in their blood and tissues. They are prone to early heart disease. Taking beta-sitosterol makes this condition worse. Don't take beta-sitosterol if you have sitosterolemia.

Are there any interactions with medications?


Ezetimibe (Zetia)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking ezetimibe (Zetia) can reduce of amount of beta-sitosterol the body absorbs. This might decrease the effectiveness of beta-sitosterol.


Pravastatin (Pravachol)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.

Taking pravastatin (Pravachol) might decrease how much beta-sitosterol is in the body. This might decrease the effectiveness of beta-sitosterol.

Dosing considerations for Beta-sitosterol.

The following doses have been studied in scientific research:

ADULTS

BY MOUTH:

  • For benign prostatic hyperplasia (BPH): 60-130 mg of beta-sitosterol divided into 2-3 doses daily has been used.
  • For high cholesterol: 0.65-1.5 grams of beta-sitosterol has been taken twice daily. Beta-sitosterol is usually taken along with a low-fat diet. A combination product containing 2.5 grams of beta-sitosterol and 8 grams of cholestyramine has also been taken daily for 12 weeks. Another combination product containing 8 grams of soy protein and 2 grams of beta-sitosterol has been used daily for 40 days.
  • For reducing cholesterol levels in adults with an inherited tendency toward high cholesterol (familial hypercholesterolemia): 2.5-21.1 grams of beta-sitosterol has been taken daily in divided doses, usually before meals. Some research suggests that beta-sitosterol is most effective when taken at a dose of 6 grams daily. Higher doses don't seem to work better.
CHILDREN

BY MOUTH:

  • For reducing cholesterol levels in children with an inherited tendency toward high cholesterol (familial hypercholesterolemia): 2-4 grams of beta-sitosterol taken 3 times daily for 3 months has been used in children and teenagers. Also 1 gram of beta-sitosterol has been taken 3 times daily in combination with the medication bezafibrate for 24 months.
Beta-sitosterol is usually taken along with a low-fat diet.

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Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

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Reviewed on 9/17/2019
References

Aceves, M., Grimalt, J. O., Sunyer, J., Anto, J. M., and Reed, C. E. Identification of soybean dust as an epidemic asthma agent in urban areas by molecular marker and RAST analysis of aerosols. J Allergy Clin.Immunol. 1991;88(1):124-134. View abstract.

Amundsen, A. L., Ntanios, F., Put, N., and Ose, L. Long-term compliance and changes in plasma lipids, plant sterols and carotenoids in children and parents with FH consuming plant sterol ester-enriched spread. Eur.J Clin.Nutr. 2004;58(12):1612-1620. View abstract.

Andrikopoulos, N. K., Kaliora, A. C., Assimopoulou, A. N., and Papageorgiou, V. P. Inhibitory activity of minor polyphenolic and nonpolyphenolic constituents of olive oil against in vitro low-density lipoprotein oxidation. J Med.Food 2002;5(1):1-7. View abstract.

Awad, A. B., Gan, Y., and Fink, C. S. Effect of beta-sitosterol, a plant sterol, on growth, protein phosphatase 2A, and phospholipase D in LNCaP cells. Nutr.Cancer 2000;36(1):74-78. View abstract.

Awad, A. B., Roy, R., and Fink, C. S. Beta-sitosterol, a plant sterol, induces apoptosis and activates key caspases in MDA-MB-231 human breast cancer cells. Oncol.Rep. 2003;10(2):497-500. View abstract.

Ayesh, R., Weststrate, J. A., Drewitt, P. N., and Hepburn, P. A. Safety evaluation of phytosterol esters. Part 5. Faecal short-chain fatty acid and microflora content, faecal bacterial enzyme activity and serum female sex hormones in healthy normolipidaemic volunteers consuming a controlled diet either with or without a phytosterol ester-enriched margarine. Food Chem Toxicol. 1999;37(12):1127-1138. View abstract.

Baker, W. L., Baker, E. L., and Coleman, C. I. The effect of plant sterols or stanols on lipid parameters in patients with type 2 diabetes: a meta-analysis. Diabetes Res Clin Pract. 2009;84(2):e33-e37. View abstract.

Begemann, F., Bandomer, G., and Herget, H. J. The influence of beta-sitosterol on biliary cholesterol saturation and bile acid kinetics in man. Scand.J Gastroenterol. 1978;13(1):57-63. View abstract.

Bhattacharyya, A. K., Connor, W. E., and Lin, D. S. The origin of plant sterols in the skin surface lipids in humans: from diet to plasma to skin. J.Invest Dermatol. 1983;80(4):294-296. View abstract.

Bialluch, W. [Beta-sitosterin in the conservative therapy of prostatic adenoma. Experiences in urologic practice]. ZFA.(Stuttgart.) 9-20-1980;56(26):1684-1687. View abstract.

Bouic, P. J., Clark, A., Brittle, W., Lamprecht, J. H., Freestone, M., and Liebenberg, R. W. Plant sterol/sterolin supplement use in a cohort of South African HIV-infected patients--effects on immunological and virological surrogate markers. S.Afr.Med.J 2001;91(10):848-850. View abstract.

Canzler, H. [Drug therapy of hypercholesterinemias (author's transl)]. MMW.Munch.Med.Wochenschr. 3-28-1980;122(13):464-470. View abstract.

Carayanni, V. J., Tsati, E. G., Spyropoulou, G. C., Antonopoulou, F. N., and Ioannovich, J. D. Comparing oil based ointment versus standard practice for the treatment of moderate burns in Greece: a trial based cost effectiveness evaluation. BMC.Complement Altern.Med. 2011;11:122. View abstract.

Charest, A., Desroches, S., Vanstone, C. A., Jones, P. J., and Lamarche, B. Unesterified plant sterols and stanols do not affect LDL electrophoretic characteristics in hypercholesterolemic subjects. J.Nutr. 2004;134(3):592-595. View abstract.

Cicero, A. F., Fiorito, A., Panourgia, M. P., Sangiorgi, Z., and Gaddi, A. Effects of a new soy/beta-sitosterol supplement on plasma lipids in moderately hypercholesterolemic subjects. J Am.Diet.Assoc. 2002;102(12):1807-1811. View abstract.

Cicero, A. F., Minardi, M., Mirembe, S., Pedro, E., and Gaddi, A. Effects of a new low dose soy protein/beta-sitosterol association on plasma lipid levels and oxidation. Eur.J Nutr. 2004;43(5):319-322. View abstract.

Clifton, P. M., Noakes, M., Sullivan, D., Erichsen, N., Ross, D., Annison, G., Fassoulakis, A., Cehun, M., and Nestel, P. Cholesterol-lowering effects of plant sterol esters differ in milk, yoghurt, bread and cereal. Eur.J Clin.Nutr. 2004;58(3):503-509. View abstract.

Cobb, M. M., Salen, G., and Tint, G. S. Comparative effect of dietary sitosterol on plasma sterols and cholesterol and bile acid synthesis in a sitosterolemic homozygote and heterozygote subject. J Am Coll.Nutr. 1997;16(6):605-613. View abstract.

Davidson, M. H., Maki, K. C., Umporowicz, D. M., Ingram, K. A., Dicklin, M. R., Schaefer, E., Lane, R. W., McNamara, J. R., Ribaya-Mercado, J. D., Perrone, G., Robins, S. J., and Franke, W. C. Safety and tolerability of esterified phytosterols administered in reduced-fat spread and salad dressing to healthy adult men and women. J Am Coll.Nutr. 2001;20(4):307-319. View abstract.

De Stefani, E., Boffetta, P., Ronco, A. L., Brennan, P., Deneo-Pellegrini, H., Carzoglio, J. C., and Mendilaharsu, M. Plant sterols and risk of stomach cancer: a case-control study in Uruguay. Nutr.Cancer 2000;37(2):140-144. View abstract.

Demonty, I., Chan, Y. M., Pelled, D., and Jones, P. J. Fish-oil esters of plant sterols improve the lipid profile of dyslipidemic subjects more than do fish-oil or sunflower oil esters of plant sterols. Am J Clin Nutr 2006;84(6):1534-1542. View abstract.

Denke, M. A. Lack of efficacy of low-dose sitostanol therapy as an adjunct to a cholesterol-lowering diet in men with moderate hypercholesterolemia. Am J Clin.Nutr. 1995;61(2):392-396. View abstract.

Devaraj, S., Jialal, I., and Vega-Lopez, S. Plant sterol-fortified orange juice effectively lowers cholesterol levels in mildly hypercholesterolemic healthy individuals. Arterioscler.Thromb.Vasc.Biol. 2004;24(3):e25-e28. View abstract.

Dreikorn, K. The role of phytotherapy in treating lower urinary tract symptoms and benign prostatic hyperplasia. World J Urol. 2002;19(6):426-435. View abstract.

Drexel, H., Breier, C., Lisch, H. J., and Sailer, S. Lowering plasma cholesterol with beta-sitosterol and diet. Lancet 5-23-1981;1(8230):1157. View abstract.

Etminan, K., Gau, H. P., Kanokvichitra, S. C., and Eickenbusch, W. [Beta sitosterin in hypercholesterinemia]. ZFA.(Stuttgart.) 9-30-1979;55(27):1503-1506. View abstract.

Fernandez, C., Suarez, Y., Ferruelo, A. J., Gomez-Coronado, D., and Lasuncion, M. A. Inhibition of cholesterol biosynthesis by Delta22-unsaturated phytosterols via competitive inhibition of sterol Delta24-reductase in mammalian cells. Biochem.J 8-15-2002;366(Pt 1):109-119. View abstract.

Fuentes, F., Lopez-Miranda, J., Garcia, A., Perez-Martinez, P., Moreno, J., Cofan, M., Caballero, J., Paniagua, J. A., Ros, E., and Perez-Jimenez, F. Basal plasma concentrations of plant sterols can predict LDL-C response to sitosterol in patients with familial hypercholesterolemia. Eur J Clin Nutr 2008;62(4):495-501. View abstract.

Gerber, G. S. Phytotherapy for benign prostatic hyperplasia. Curr Urol.Rep. 2002;3(4):285-291. View abstract.

Grundy, S. M., Ahrens, E. H., Jr., and Salen, G. Dietary beta-sitosterol as an internal standard to correct for cholesterol losses in sterol balance studies. J Lipid Res 1968;9(3):374-387. View abstract.

Heinemann, T., Leiss, O., and von Bergmann, K. Effect of low-dose sitostanol on serum cholesterol in patients with hypercholesterolemia. Atherosclerosis 1986;61(3):219-223. View abstract.

Hendriks, H. F., Brink, E. J., Meijer, G. W., Princen, H. M., and Ntanios, F. Y. Safety of long-term consumption of plant sterol esters-enriched spread. Eur.J Clin.Nutr. 2003;57(5):681-692. View abstract.

Hernandez-Mijares, A., Banuls, C., Jover, A., Sola, E., Bellod, L., Martinez-Triguero, M. L., Lagarda, M. J., Victor, V. M., and Rocha, M. Low intestinal cholesterol absorption is associated with a reduced efficacy of phytosterol esters as hypolipemic agents in patients with metabolic syndrome. Clin Nutr 2011;30(5):604-609. View abstract.

Homma, Y., Ikeda, I., Ishikawa, T., Tateno, M., Sugano, M., and Nakamura, H. Decrease in plasma low-density lipoprotein cholesterol, apolipoprotein B, cholesteryl ester transfer protein, and oxidized low-density lipoprotein by plant stanol ester-containing spread: a randomized, placebo-controlled trial. Nutrition 2003;19(4):369-374. View abstract.

Jones, P. J. Cholesterol-lowering action of plant sterols. Curr.Atheroscler.Rep. 1999;1(3):230-235. View abstract.

Jones, P. J., Howell, T., MacDougall, D. E., Feng, J. Y., and Parsons, W. Short-term administration of tall oil phytosterols improves plasma lipid profiles in subjects with different cholesterol levels. Metabolism 1998;47(6):751-756. View abstract.

Jourdain, C., Tenca, G., Deguercy, A., Troplin, P., and Poelman, D. In-vitro effects of polyphenols from cocoa and beta-sitosterol on the growth of human prostate cancer and normal cells. Eur J Cancer Prev. 2006;15(4):353-361. View abstract.

Ju, Y. H., Clausen, L. M., Allred, K. F., Almada, A. L., and Helferich, W. G. beta-Sitosterol, beta-Sitosterol Glucoside, and a Mixture of beta-Sitosterol and beta-Sitosterol Glucoside Modulate the Growth of Estrogen-Responsive Breast Cancer Cells In Vitro and in Ovariectomized Athymic Mice. J Nutr. 2004;134(5):1145-1151. View abstract.

Kadow, C. and Abrams, P. H. A double-blind trial of the effect of beta-sitosteryl glucoside (WA184) in the treatment of benign prostatic hyperplasia. Eur.Urol. 1986;12(3):187-189. View abstract.

Kaffarnik, H., Muhlfellner, G., Muhlfellner, O., Schneider, J., Hausmann, L., Zofel, P., Schubotz, R., and Fuchs, F. [Beta-sitosterin in the treatment of essential type II hyperlipoproteinemias]. Fortschr.Med. 12-8-1977;95(46):2785-2787. View abstract.

Kandziora, J. [Lowering of the serum cholesterol level with beta-sitosterin. Experiences from the medical practice]. Med.Welt. 1980;31(8):302-303. View abstract.

Karlaganis, G., Bremmelgaard, A., Karlaganis, V., and Sjovall, J. Precursor of 27-nor-5 beta-cholestane-3 alpha, 7 alpha, 12 alpha, 24,25-pentol in man. J Steroid Biochem. 1983;18(6):725-729. View abstract.

Kassen, A. [Effect of beta-sitosterin on the growth of the prostate]. Krankenpfl.J 1999;37(7-8):286. View abstract.

Katan, M. B., Grundy, S. M., Jones, P., Law, M., Miettinen, T., and Paoletti, R. Efficacy and safety of plant stanols and sterols in the management of blood cholesterol levels. Mayo Clin.Proc. 2003;78(8):965-978. View abstract.

Kennedy, A. R. The evidence for soybean products as cancer preventive agents. J Nutr 1995;125(3 Suppl):733S-743S. View abstract.

Klingeberg, J. [Measurement of urinary flow in general practice. Efficacy of beta-sitosterine]. ZFA.(Stuttgart.) 10-10-1981;57(28):1634-1637. View abstract.

Kobayashi, Y., Sugaya, Y., and Tokue, A. [Clinical effects of beta-sitosterol (phytosterol) on benign prostatic hyperplasia: preliminary study]. Hinyokika Kiyo 1998;44(12):865-868. View abstract.

Koletzko, B., Filler, R. M., and Heim, T. Immaturity alters plasma lipoprotein composition of intravenously alimented newborn infants. Eur.J Med.Res 2-21-1998;3(1-2):89-94. View abstract.

Lee, S., Kim, K. S., Shim, S. H., Park, Y. M., and Kim, B. K. Constituents from the non-polar fraction of Artemisia apiacea. Arch.Pharm.Res 2003;26(11):902-905. View abstract.

Louw, I. and et al. A pilot study of the clinical effects of a mixture of Beta-Sitosterol and Beta-Sitosterol glucoside in active rheumatoid arthritis (RA). Abstract NutritionWeek Congress 2002;

Mabrouk, A., Boughdadi, N. S., Helal, H. A., Zaki, B. M., and Maher, A. Moist occlusive dressing (Aquacel((R)) Ag) versus moist open dressing (MEBO((R))) in the management of partial-thickness facial burns: a comparative study in Ain Shams University. Burns 2012;38(3):396-403. View abstract.

Maguire, L., Konoplyannikov, M., Ford, A., Maguire, A. R., and O'Brien, N. M. Comparison of the cytotoxic effects of beta-sitosterol oxides and a cholesterol oxide, 7beta-hydroxycholesterol, in cultured mammalian cells. Br.J Nutr. 2003;90(4):767-775. View abstract.

Mattson, F. H., Grundy, S. M., and Crouse, J. R. Optimizing the effect of plant sterols on cholesterol absorption in man. Am.J.Clin.Nutr. 1982;35(4):697-700. View abstract.

Meguro, S., Higashi, K., Hase, T., Honda, Y., Otsuka, A., Tokimitsu, I., and Itakura, H. Solubilization of phytosterols in diacylglycerol versus triacylglycerol improves the serum cholesterol-lowering effect. Eur.J Clin.Nutr. 2001;55(7):513-517. View abstract.

Mensink, R. P., Ebbing, S., Lindhout, M., Plat, J., and van Heugten, M. M. Effects of plant stanol esters supplied in low-fat yoghurt on serum lipids and lipoproteins, non-cholesterol sterols and fat soluble antioxidant concentrations. Atherosclerosis 2002;160(1):205-213. View abstract.

Michel, M. C., Bressel, H. U., Mehlburger, L., and Goepel, M. Tamsulosin: real life clinical experience in 19,365 patients. Eur.Urol. 1998;34 Suppl 2:37-45. View abstract.

Miehle, W. Arthrosis or osteoarthritis: do these terms imply therapy with pure analgesics or non-steroidal antirheumatic agents? Scand.J Rheumatol.Suppl 1987;65:123-130. View abstract.

Miettinen, T. A. and Gylling, H. Regulation of cholesterol metabolism by dietary plant sterols. Curr.Opin.Lipidol. 1999;10(1):9-14. View abstract.

Miettinen, T. A., Farkkila, M., Vuoristo, M., Karvonen, A. L., Leino, R., Lehtola, J., Friman, C., Seppala, K., and Tuominen, J. Serum cholestanol, cholesterol precursors, and plant sterols during placebo-controlled treatment of primary biliary cirrhosis with ursodeoxycholic acid or colchicine. Hepatology 1995;21(5):1261-1268. View abstract.

Monograph. Plant sterols and sterolins. Altern.Med.Rev. 2001;6(2):203-206. View abstract.

Muhlfellner, G., Muhlfellner, O., and Kaffarnik, H. [Beta-sitosterin in unsuccessfully pretreated patients with hypercholesteremia. Simultaneously, a contribution to dose dependence]. Med.Klin. 4-30-1976;71(18):775-778. View abstract.

Muti, P., Awad, A. B., Schunemann, H., Fink, C. S., Hovey, K., Freudenheim, J. L., Wu, Y. W., Bellati, C., Pala, V., and Berrino, F. A plant food-based diet modifies the serum beta-sitosterol concentration in hyperandrogenic postmenopausal women. J Nutr. 2003;133(12):4252-4255. View abstract.

Nagaoka, S., Futamura, Y., Miwa, K., Awano, T., Yamauchi, K., Kanamaru, Y., Tadashi, K., and Kuwata, T. Identification of novel hypocholesterolemic peptides derived from bovine milk beta-lactoglobulin. Biochem.Biophys Res Commun. 2-16-2001;281(1):11-17. View abstract.

Nigon, F., Serfaty-Lacrosniere, C., Beucler, I., Chauvois, D., Neveu, C., Giral, P., Chapman, M. J., and Bruckert, E. Plant sterol-enriched margarine lowers plasma LDL in hyperlipidemic subjects with low cholesterol intake: effect of fibrate treatment. Clin.Chem Lab Med. 2001;39(7):634-640. View abstract.

Noakes, M., Clifton, P., Ntanios, F., Shrapnel, W., Record, I., and McInerney, J. An increase in dietary carotenoids when consuming plant sterols or stanols is effective in maintaining plasma carotenoid concentrations. Am.J.Clin.Nutr. 2002;75(1):79-86. View abstract.

Normen, A. L., Brants, H. A., Voorrips, L. E., Andersson, H. A., van den Brandt, P. A., and Goldbohm, R. A. Plant sterol intakes and colorectal cancer risk in the Netherlands Cohort Study on Diet and Cancer. Am J Clin.Nutr. 2001;74(1):141-148. View abstract.

Patch, C. S., Tapsell, L. C., and Williams, P. G. Plant sterol/stanol prescription is an effective treatment strategy for managing hypercholesterolemia in outpatient clinical practice. J Am Diet.Assoc. 2005;105(1):46-52. View abstract.

Plat, J. and Mensink, R. P. Effects of plant sterols and stanols on lipid metabolism and cardiovascular risk. Nutr.Metab Cardiovasc.Dis. 2001;11(1):31-40. View abstract.

Plat, J., Kerckhoffs, D. A., and Mensink, R. P. Therapeutic potential of plant sterols and stanols. Curr.Opin.Lipidol. 2000;11(6):571-576. View abstract.

Pont, F., Duvillard, L., Maugeais, C., Athias, A., Persegol, L., Gambert, P., and Verges, B. Isotope ratio mass spectrometry, compared with conventional mass spectrometry in kinetic studies at low and high enrichment levels: application to lipoprotein kinetics. Anal.Biochem. 6-1-1997;248(2):277-287. View abstract.

Puato, M., Faggin, E., Rattazzi, M., Zambon, A., Cipollone, F., Grego, F., Ganassin, L., Plebani, M., Mezzetti, A., and Pauletto, P. Atorvastatin reduces macrophage accumulation in atherosclerotic plaques: a comparison of a nonstatin-based regimen in patients undergoing carotid endarterectomy. Stroke 2010;41(6):1163-1168. View abstract.

Relas, H., Gylling, H., and Miettinen, T. A. Fate of intravenously administered squalene and plant sterols in human subjects. J.Lipid Res. 2001;42(6):988-994. View abstract.

Saludes, J. P., Garson, M. J., Franzblau, S. G., and Aguinaldo, A. M. Antitubercular constituents from the hexane fraction of Morinda citrifolia Linn. (Rubiaceae). Phytother Res 2002;16(7):683-685. View abstract.

Schwandt, P. and Richter, W. O. [Drug therapy of hypercholesterolemia]. Wien.Klin.Wochenschr. 1995;107(18):544-548. View abstract.

Senge, T., Windeler, J., Berges, R. R., and Trampisch, H. J. [The effectiveness of beta-sitosterol in treatment of benign prostatic hyperplasia]. Urologe A 1995;34(2):130-131. View abstract.

Sudhop, T., Lutjohann, D., Agna, M., von Ameln, C., Prange, W., and von Bergmann, K. Comparison of the effects of sitostanol, sitostanol acetate, and sitostanol oleate on the inhibition of cholesterol absorption in normolipemic healthy male volunteers. A placebo controlled randomized cross-over study. Arzneimittelforschung. 2003;53(10):708-713. View abstract.

Vanstone, C. A., Raeini-Sarjaz, M., Parsons, W. E., and Jones, P. J. Unesterified plant sterols and stanols lower LDL-cholesterol concentrations equivalently in hypercholesterolemic persons. Am.J.Clin.Nutr. 2002;76(6):1272-1278. View abstract.

Varady, K. A., Ebine, N., Vanstone, C. A., Parsons, W. E., and Jones, P. J. Plant sterols and endurance training combine to favorably alter plasma lipid profiles in previously sedentary hypercholesterolemic adults after 8 wk. Am.J.Clin.Nutr. 2004;80(5):1159-1166. View abstract.

Weisweiler, P., Heinemann, V., and Schwandt, P. Serum lipoproteins and lecithin: cholesterol acyltransferase (LCAT) activity in hypercholesterolemic subjects given beta-sitosterol. Int.J Clin.Pharmacol Ther.Toxicol. 1984;22(4):204-206. View abstract.

Weizel, A. and Richter, W. O. Drug therapy of severe hypercholesterolemia. Eur.J Med.Res 6-16-1997;2(6):265-269. View abstract.

Weststrate, J. A., Ayesh, R., Bauer-Plank, C., and Drewitt, P. N. Safety evaluation of phytosterol esters. Part 4. Faecal concentrations of bile acids and neutral sterols in healthy normolipidaemic volunteers consuming a controlled diet either with or without a phytosterol ester-enriched margarine. Food Chem Toxicol. 1999;37(11):1063-1071. View abstract.

Wilt, T., Ishani, A., MacDonald, R., Stark, G., Mulrow, C., and Lau, J. Beta-sitosterols for benign prostatic hyperplasia. Cochrane.Database.Syst.Rev 2000;(2):CD001043. View abstract.

Yeshurun, D. and Gotto, A. M., Jr. Drug treatment of hyperlipidemia. Am J Med. 1976;60(3):379-396. View abstract.

Zak, A., Hatle, K., Mares, P., Vrana, A., Zeman, M., Sindelkova, E., Skorepa, J., and Hrabak, P. Effects of dietary n-3 fatty acids on the composition of cholesteryl esters and triglycerides in plasma and liver perfusate of the rat. J Nutr.Biochem. 1990;1(9):472-477. View abstract.

Ang ES, Lee ST, Gan CS, et al. Evaluating the role of alternative therapy in burn wound management: randomized trial comparing moist exposed burn ointment with conventional methods in the management of patients with second-degree burns. MedGenMed 2001;3:3. View abstract.

Anon. FDA authorizes new coronary heart disease health claim for plant sterol and plant stanol esters. FDA. 2000. Available at: http://www3.scienceblog.com/community/older/archives/M/1/fda0642.htm. (Accessed 26 May 2016).

Anon. W&B Associates Inc. website. URL http://www.wandb.com/cholesterol.6.htm (Accessed 30 March 2000).

Anon. Cholesterol-lowering Margarines. Med Lett Drugs Ther 1999;41:56-8.

Awad AB, Chen YC, Fink CS, Hennessey T. Beta-sitosterol inhibits HT-29 human colon cancer cell growth and alters membrane lipids. Anticancer Res 1996;16:2797-804. View abstract.

Awad AB, von Holtz RL, Cone JP, et al. Beta-sitosterol inhibits growth of HT-29 human colon cancer cells by activating the sphingomyelin cycle. Anticancer Res 1998;18:471-3. View abstract.

Becker M, Staab D, Von Bergman K. Long-term treatment of severe familial hypercholesterolemia in children: effect of sitosterol and bezafibrate. Pediatrics 1992;89:138-42. View abstract.

Becker M, Staab D, Von Bergmann K. Treatment of severe familial hypercholesterolemia in childhood with sitosterol and sitostanol. J Pediatr 1993;122:292-6. View abstract.

Becker M, Staab D, Von Bergmann K. Treatment of severe familial hypercholesterolemia in childhood with sitosterol and sitostanol. J Pediatr 1993;122:292-6. View abstract.

Berges RR, Kassen A, Senge T. Treatment of symptomatic benign prostatic hyperplasia with beta-sitosterol: an 18-month follow-up. BJU Int 2000;85:842-6. View abstract.

Berges RR, Windeler J, Trampisch HJ, et al. Randomised, placebo-controlled, double-blind clinical trial of beta-sitosterol in patients with benign prostatic hyperplasia. Beta-sitosterol Study Group. Lancet 1995;345:1529-32. View abstract.

Berges RR, Windeler J, Trampisch HJ, et al. Randomized, placebo-controlled, double-blind clinical trial of beta-sitosterol in patients with benign prostatic hyperplasia. Lancet 1995;345:1529-32. View abstract.

Bouic PJ, Clark A, Lamprecht J, et al. The effects of B-sitosterol (BSS) and B-sitosterol glucoside (BSSG) mixture on selected immune parameters of marathon runners: inhibition of post marathon immune suppression and inflammation. Int J Sports Med 1999;20:258-62. View abstract.

Bouic PJ, Etsebeth S, Liebenberg RW, et al. Beta-sitosterol and beta-sitosterol glucoside stimulate human peripheral blood lymphocyte proliferation: implications for their use as an immunomodulatory vitamin combination. Int J Immunopharmacol 1996;18:693-700. View abstract.

Bouic PJ, Lamprecht JH, Plant sterols and sterolins: a review of their immune-modulating properties. Altern Med Rev 1999;4:170-7. View abstract.

Cabeza M, Bratoeff E, Heuze I, et al. Effect of beta-sitosterol as inhibitor of 5 alpha-reductase in hamster prostate. Proc West Pharmacol Soc 2003;46:153-5.

Donald PR, Lamprecht JH, Freestone M, et al. A randomised placebo-controlled trial of the efficacy of beta-sitosterol and its glucoside as adjuvants in the treatment of pulmonary tuberculosis. Int J Tubercul Lung Dis 1997;1:518-22. View abstract.

Gerolami A, Sarles H. Letter: Beta-sitosterol and chenodeoxycholic acid in the treatment of cholesterol gallstones. Lancet 1975;2:721.

Gylling H, Radhakrishnan R, Miettinen TA. Reduction of serum cholesterol in postmenopausal women with previous myocardial infarction and cholesterol malabsorption induced by dietary sitostanol ester margarine: women and dietary sitostanol. Circulation 1997;96:4226-31. View abstract.

Gylling H, Siimes MA, Miettinen TA. Sitostanol ester margarine in dietary treatment of children with familial hypercholesterolemia. J Lipid Res 1995;36:1807-12. View abstract.

Hallikainen MA, Sarkkinen ES, Gylling H, et al. Comparison of the effects of plant sterol ester and plant stanol ester-enriched margarines in lowering serum cholesterol concentrations in hypercholesterolaemic subjects on a low-fat diet. Eur J Clin Nutr 2000;54:715-25. View abstract.

Hallikainen MA, Sarkkinen ES, Uusitupa MI. Effects of low-fat stanol ester enriched margarines on concentrations of serum carotenoids in subjects with elevated serum cholesterol concentrations. Eur J Clin Nutr 1999;53:966-9. View abstract.

Hallikainen MA, Uusitupa MI. Effects of 2 low-fat stanol ester-containing margarines on serum cholesterol concentrations as part of a low-fat diet in hypercholesterolemic subjects. Am J Clin Nutr 1999;69:403-10. View abstract.

Heinemann T, Kullak-Ublick GA, Pietruck B, von Bergmann K. Mechanisms of action of plant sterols on inhibition of cholesterol absorption. Comparison of sitosterol and sitostanol. Eur J Clin Pharmacol 1991;40 Suppl 1:S59-63. View abstract.

Hidaka H, Kojima H, Kawabata T, et al. Effects of an HMG-CoA reductase inhibitor, pravastatin, and bile sequestering resin, cholestyramine, on plasma plant sterol levels in hypercholesterolemic subjects. J Atheroscler Thromb 1995;2:60-5. View abstract.

Jones PJ, Ntanios FY, Raeini-Sarjaz M, et al. Cholesterol-lowering efficacy of a sitostanol-containing phytosterol mixture with a prudent diet in hyperlipidemic men. Am J Clin Nutr 1999;69:1144-50. View abstract.

Jones PJ, Raeini-Sarjaz M, Ntanios FY, et al. Modulation of plasma lipid levels and cholesterol kinetics by phytosterol versus phytostanol esters. J Lipid Res 2000;41:697-705. View abstract.

Kassen A, Berges R, Senge T, et al. Effect of beta-sitosterol on transforming growth factor-beta-1 expression and translocation protein kinase C alpha in human prostate stromal cells in vitro. Eur Urol 2000;37:735-41. . View abstract.

Klippel KF, Hiltl DM, Schipp B. A multicentric, placebo-controlled, double-blind clinical trial of beta-sitosterol (phytosterol) for the treatment of benign prostatic hyperplasia. Br J Urol 1997;80:427-32. View abstract.

Korpela R, Tuomilehto J, Högström P, Seppo L, Piironen V, Salo-Väänänen P, Toivo J, Lamberg-Allardt C, Kärkkäinen M, Outila T, Sundvall J, Vilkkilä S, Tikkanen MJ. Safety aspects and cholesterol-lowering efficacy of low fat dairy products containing plant sterols. Eur J Clin Nutr. 2006 May;60(5):633-42. View abstract.

Law M. Plant sterol and stanol margarines and health. BMJ 2000;320:861-4. View abstract.

Lichtenstein AH, Deckelbaum RJ. Stanol/sterol ester-containing foods and blood cholesterol levels: a statement for healthcare professionals from Nutrition Committee, Council on Nutrition, Physical Activity, Metabolism of American Heart Association. Circulation 2001;103:1177-9. View abstract.

Lowe FC, Ku JC. Phytotherapy in treatment of benign prostatic hyperplasia: a critical review. Urol 1996;48:12-20. View abstract.

Matvienko OA, Lewis DS, Swanson M, et al. A single daily dose of soybean phytosterols in ground beef decreases serum total cholesterol and LDL cholesterol in young, mildly hypercholesterolemic men. Am J Clin Nutr 2002;76:57-64. View abstract.

Neil HA, Meijer GW, Roe LS. Randomised controlled trial of use by hypercholesterolaemic patients of a vegetable oil sterol-enriched fat spread. Atherosclerosis 2001;156:329-37.. View abstract.

Nguyen LB, Shefer S, Salen G, et al. Competitive inhibition of hepatic sterol 27-hydroxylase by sitosterol: decreased activity in sitosterolemia. Proc Assoc Am Physicians 1998;110:32-9. View abstract.

Nguyen TT, Dale LC, von Bergmann K, Croghan IT. Cholesterol-lowering effect of stanol ester in a US population of mildly hypercholesterolemic men and women: a randomized controlled trial. Mayo Clin Proc 1999;74:1198-206. View abstract.

Normen L, Dutta P, Lia A, et al. Soy sterol esters and B-sitostanol ester as inhibitors of cholesterol absorption in human small bowel. Am J Clin Nutr 2000;71:908-13. View abstract.

Ntanios FY, Jones PJ, Frohlich JJ. Effect of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor on sterol absorption in hypercholesterolemic subjects. Metabolism 1999;48:68-73. View abstract.

Oster P, Schlierf G, Heuck CC, et al. [Sitosterol in familial hyperlipoproteinemia type II. A randomized, double-blind, cross-over study]. Dtsch Med Wochenschr 1976;101:1308-11. View abstract.

Ostlund RE Jr, Spilburg CA, Stenson WF. Sitostanol administered in lecithin micelles potently reduces cholesterol absorption in humans. Am J Clin Nutr 1999;70:826-31. View abstract.

Patel SB, Honda A, Salen G. Sitosterolemia: exclusion of genes involved in reduced cholesterol biosynthesis. J Lipid Res 1998;39:1055-61. View abstract.

Prager N, Bickett K, French N, Marcovici G. A randomized, double-blind, placebo-controlled trial to determine the effectiveness of botanically derived inhibitors of 5-alpha-reductase in the treatment of androgenetic alopecia. J Altern Complement Med 2002;8:143-52. View abstract.

Preuss HG, Marcusen C, Regan J, et al. Randomized trial of a combination of natural products (cernitin, saw palmetto, B-sitosterol, vitamin E) on symptoms of benign prostatic hyperplasia (BPH). Int Urol Nephrol 2001; 33: 217-25. View abstract.

Richelle M, Enslen M, Hager C, et al. Both free and esterified plant sterols reduce cholesterol absorption and the bioavailability of beta-carotene and alpha-tocopherol in normocholesterolemic humans. Am J Clin Nutr 2004;80:171-7. View abstract.

Rubnov S, Kashman Y, Rabinowitz R, et al. Suppressors of cancer cell proliferation from fig (Ficus carica) resin: isolation and structure elucidation. J Nat Prod 2001;64:993-6. View abstract.

Salen G, Shefer S, Nguyen L, et al. Sisterolemia. J Lipid Res 1992;33:945-55. View abstract.

Salen G, Shore V, Tint GS, et al. Increased sitosterol absorption, decreased removal, and expanded body pools compensate for reduced cholesterol synthesis in sitosterolemia with xanthomatosis. J Lipid Res 1989;30:1319-30. View abstract.

Salen G, von Bergmann K, Lutjohann D, et al. Ezetimibe effectively reduces plasma plant sterols in patients with sitosterolemia. Circulation 2004;109:966-71. View abstract.

Schlierf G, Oster P, Heuck CC, et al. Sitosterol in juvenile type II hyperlipoproteinemia. Atherosclerosis 1978;30:245-8. View abstract.

Schwartzkopff W, Jantke HJ. [Dose-effect of beta-sitosterin in type IIa and IIb hypercholesterolemias]. MMW Munch Med Wochenschr 1978;120:1575-8. View abstract.

Stalenhoef AF, Hectors M, Demacker PN. Effect of plant sterol-enriched margarine on plasma lipids and sterols in subjects heterozygous for phytosterolaemia. J Intern Med 2001;249:163-6.. View abstract.

Stalenhoef AF. Images in clinical medicine. Phytosterolemia and xanthomatosis. N Engl J Med 2003;349:51.. View abstract.

Sudhop T, Lutjohann D, Kodal A, et al. Inhibition of intestinal cholesterol absorption by ezetimibe in humans. Circulation 2002;106:1943-8. View abstract.

Tammi A, Ronnemaa T, Gylling H, et al. Plant stanol ester margarine lowers serum total and low-density lipoprotein cholesterol concentrations of healthy children: the STRIP project. Spec Turku Coronary Risk Factors Intervention Project. J Pediatr 2000;136:503-10. View abstract.

Tangedahl TN, Thistle JL, Hofmann AF, et al. Effect of beta-sitosterol alone or in combination with chenic acid on cholesterol saturation of bile and cholesterol absorption in gallstone patients. Gastroenterol 1979;76:1341-6.

Weststrate JA, Meijer GW. Plant sterol-enriched margarines and reduction of plasma total- and LDL-cholesterol concentrations in normocholesterolaemic and mildly hypercholesterolaemic subjects. Eur J Clin Nutr 1998;52:334-43. View abstract.

Wilt TJ, MacDonald R, Ishani A. beta-sitosterol for the treatment of benign prostatic hyperplasia: a systematic review. BJU Int 1999;83:976-83. View abstract.