phytosterols

Phytosterols collectively refer to plant sterols and stanols, substances that are structurally related to cholesterol. Phytosterols have the same functions in plants that cholesterol has in animals and humans. People take phytosterols as supplements to reduce cholesterol levels and to improve urinary symptoms associated with prostate enlargement (benign prostate hyperplasia/BPH). Phytosterols occur in many foods including whole grains, legumes, nuts, seeds, unrefined vegetable oils, and some fruits and vegetables.

Phytosterols lower blood cholesterol levels by competing with and inhibiting the absorption of cholesterol in the intestines. Phytosterols also facilitate the excretion of dietary and biliary cholesterol in the stools. Studies show that daily intake of phytosterols significantly lowers the level of low-density lipoprotein (LDL) cholesterol in the blood. Preliminary studies indicate phytosterols may relieve urinary symptoms and improve urinary flow in patients with BPH, however, further research is required to confirm these findings.

Warnings

Do not take phytosterols if you have phytosterolemia (sitosterolemia), a rare inherited condition in which phytosterols accumulate in the blood and tissues, causing the growth of nodules (xanthomas) on tendons and pressure areas such as elbows, knees and heels. Sitosterolemia may also promote the deposit of cholesterol and plaque formation (atherosclerosis) in the coronary arteries and increase the risk for cardiovascular diseases.

Common side effects of phytosterols include:

• Nausea
• Indigestion
• Diarrhea
• Constipation
• Gas (flatulence)

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

• Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
• Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
• Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

There are no established standard dosages for phytosterols, check manufacturer’s labels. Suggested dosing:

Adults:

Hypercholesterolemia

• 1200 mg/day oral capsules
• 1-2 tablespoons 1-3 times daily as functional foods (margarine, salad dressing)

Bayer Heart Health Advantage

• 12 years or older: 400 mg orally twice daily with meals

Benign Prostatic Hyperplasia

• 60 -130 mg/day oral beta-sitosterol divided two or three times daily

Overdose

Phytosterols are poorly absorbed in the gastrointestinal tract and oral intake is unlikely to result in overdose. The effect of long-term use of phytosterols is not known.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Phytosterols have no known severe, serious or moderate interactions with other drugs.
• Mild interactions of phytosterols may include:
  • statins
  • ezetimibe
  • fat-soluble vitamins
  • carotenoids

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

There are no studies on the safety of taking phytosterols during pregnancy or lactation. Avoid taking phytosterol supplements if you are pregnant or breastfeeding. There is no evidence of harm from dietary intake of phytosterol containing foods by pregnant or breastfeeding women.

Do not take any herbal product, including phytosterols, without first checking with your healthcare provider, if you are pregnant or breastfeeding.

• Phytosterols are likely safe if consumed in quantities that are normally part of the dietary intake. Phytosterol products are possibly safe for most adults taken in recommended dosages for up to 18 months. There is no information on the safety of prolonged use of phytosterol supplements.
• Take phytosterol supplements exactly as per label instructions. Natural products are not necessarily safe always and following suggested dosing is important.
• Check with your healthcare provider before taking any herbal product, including phytosterols, particularly if you have any health conditions or if you are on any regular medication.
• Dietary supplements often contain many ingredients. Check labels for the components in the phytosterols product you choose.
• Phytosterols is marketed as a dietary supplement and is not regulated by the FDA. Products may differ in formulations and strengths, and labels may not always match contents. Exercise caution in choosing your product.
• Store phytosterol products safely out of reach of children.
• In case of overdose, seek medical help or contact Poison Control.