β-sitosterol: benefits, dosage, contraindications
Family or group:
Phytosubstances
Indications
Scoring methodology
EFSA approval.
Hypercholesterolemia ✪✪✪✪✪
Oral intake of beta-sitosterol significantly reduces total cholesterol and low-density lipoprotein (LDL) cholesterol levels, but has little or no effect on high-density lipoprotein (HDL) cholesterol levels. Some preliminary clinical research shows that taking a combination of 8 g of soy protein and 2 g of beta-sitosterol per day for 40 days slightly reduces LDL cholesterol by 17 to 20 mg/dL from baseline in patients with moderately elevated cholesterol; however, this combination does not affect triglyceride levels or HDL cholesterol.
Posologie
Oral
1500 - 3500 mg
Atorvastatin reduces macrophage accumulation in atherosclerotic plaques: a comparison of a nonstatin-based regimen in patients undergoing carotid endarterectomy
Scientific Opinion on the substantiation of health claims related to plant sterols and plant stanols and maintenance of normal blood cholesterol concentrations (ID 549, 550, 567, 713, 1234, 1235, 1466, 1634, 1984, 2909, 3140), and maintenance of normal prostate size and normal urination
Effects of a new low dose soy protein/beta-sitosterol association on plasma lipid levels and oxidation
AHA Science Advisory. Stanol/sterol ester-containing foods and blood cholesterol levels. A statement for healthcare professionals from the Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association
Benign prostatic hyperplasia ✪✪✪✪✪
Oral intake of beta-sitosterol at 60 to 130 mg given orally in 2 or 3 divided doses per day improves urinary symptoms, increases maximum urinary flow rate, and decreases post-void residual urine volume, but does not affect prostate size. nnThe optimal dose is 60 mg twice daily. This dose can be reduced to 30 mg twice daily when symptoms improve.nn
Posologie
Oral
60 - 130 mg
Treatment of symptomatic benign prostatic hyperplasia with beta-sitosterol: an 18-month follow-up
Effects of Difaprost® on voiding dysfunction, histology and inflammation markers in patients with benign prostatic hyperplasia who are candidates for surgical treatment
AHA Science Advisory. Stanol/sterol ester-containing foods and blood cholesterol levels. A statement for healthcare professionals from the Nutrition Committee of the Council on Nutrition, Physical Activity, and Metabolism of the American Heart Association
A double-blind trial of the effect of beta-sitosteryl glucoside (WA184) in the treatment of benign prostatic hyperplasia
Beta-sitosterols for benign prostatic hyperplasia
A multicentric, placebo-controlled, double-blind clinical trial of beta-sitosterol (phytosterol) for the treatment of benign prostatic hyperplasia. German BPH-Phyto Study group
Randomised, placebo-controlled, double-blind clinical trial of beta-sitosterol in patients with benign prostatic hyperplasia. Beta-sitosterol Study Group
Hair loss ✪✪✪✪✪
Preliminary clinical research shows that a combination of 50 mg beta-sitosterol and 200 mg saw palmetto extract (dwarf palm) taken twice daily improves hair quantity and quality in men with androgenetic alopecia. nn
Posologie
Oral
100 mg
Synergies
Burns ✪✪✪✪✪
Preliminary clinical research shows that applying an ointment containing sesame oil, beta-sitosterol, berberine, and other plant-derived ingredients to thermal burns every 4 hours is as effective as applying a silver sulfadiazine dressing twice a day. Moreover, this ointment appears to be more effective than povidone-iodine and bepanthenol cream at reducing pain in patients with partial-thickness thermal burns.
Posologie
Topically
0.25%
ointment
Comparing oil based ointment versus standard practice for the treatment of moderate burns in Greece: a trial based cost effectiveness evaluation
Moist Exposed Burn Ointment (MEBO) in partial thickness burns - a randomized, comparative open mono-center study on the efficacy of dermaheal (MEBO) ointment on thermal 2nd degree burns compared to conventional therapy
Moist occlusive dressing (Aquacel(®) Ag) versus moist open dressing (MEBO(®)) in the management of partial-thickness facial burns: a comparative study in Ain Shams University
Properties
Hypolipidemic
Beta-sitosterol inhibits intestinal cholesterol absorption by a competitive effect within the limited space of mixed micelles, which reduces cholesterol absorption by about 50%. However, because the body has less cholesterol available, compensatory mechanisms come into play by increasing cholesterol synthesis in the liver.
Usages associés
Antiandrogenic
Inhibition of 5-alpha-reductase, which prevents the conversion of testosterone to dihydrotestosterone (DHT), may contribute to beta-sitosterol's activity in androgenetic alopecia. The reduction in cholesterol bioavailability by beta-sitosterol may also reduce the biosynthesis of testosterone and DHT. As a reminder, it is suggested that androgenetic alopecia involves increased hair follicle sensitivity to DHT, shortening their growth phase and reducing their size. For prostate hyperplasia, animal research suggests that beta-sitosterol may inhibit 5-alpha-reductase activity, although finasteride appears more potent. Laboratory studies suggest beta-sitosterol may have antiproliferative effects on the prostate, possibly by inhibiting growth factors. In animals, beta-sitosterol shrinks the prostate, but this has not been demonstrated in humans.
Usages associés
Anticancer
There is preliminary evidence that beta-sitosterol may have anticancer effects. Beta-sitosterol can inhibit the growth of human colon cancer cells in vitro. The mechanism of action involves membrane signaling, caspases, and inflammatory mediators.
Usages associés
Immunomodulatory
Beta-sitosterol may have immunostimulatory effects. Mixtures of beta-sitosterol and its glycoside, sitosterolin, also appear to enhance T-cell proliferative responses in vitro. Beta-sitosterol may also moderate the immune suppression and inflammation observed in marathon runners after a race.
Hypoglycemic
A study showed that oral treatment with beta-sitosterol decreases fasting blood glucose and improves glucose tolerance by increasing fasting plasma insulin levels in hyperglycemic rats. The mechanisms of this increase are not yet well understood and require further studies.
Wound healing
Beta-sitosterol has an angiogenic effect. Indeed, beta-sitosterol improves the formation of new blood vessels in a dose-dependent manner and promotes the expression of several proteins related to angiogenesis, including von Willebrand factors, VEGF (Vascular Endothelial Growth Factor) and the VEGF receptor.
Usages associés
Neurological
An in vivo study conducted in mice showed that administration of beta-sitosterol reduces anxiety without the side effects of anxiolytic drugs and without impairment of locomotion. Other research has shown that the combination of beta-sitosterol and fluoxetine (an antidepressant drug) has a synergistic effect.
Βeta-sitosterol enhances motor coordination, attenuates memory loss and demyelination in a vanadium-induced model of experimental neurotoxicity
Bioactivity-guided isolation of beta-sitosterol and some fatty acids as active compounds in the anxiolytic and sedative effects of Tilia americana var. mexicana
Safe dosage
Adults aged 18 years and older: 60 mg - 4000 mg
Beta-sitosterol is most commonly used at doses of 60 to 130 mg per day for up to 18 months, or at higher doses of 3 to 4 grams per day for 1 to 3 months.
Interactions
Médicaments
Ezetimibe: moderate interaction
Ezetimibe inhibits intestinal absorption of beta-sitosterol and reduces plasma concentrations in people with or without sitosterolemia. In people with mild to moderate hypercholesterolemia, ezetimibe reduces beta-sitosterol levels by 41%.
Pravastatin: weak interaction
There is evidence that pravastatin can lower blood levels of beta-sitosterol. Theoretically, this could occur with other HMG-CoA reductase inhibitors ("statins").
Precautions
Pregnant women: avoid use
Avoid use due to lack of reliable and sufficient information. nn
Lactating woman: avoid
Avoid use due to lack of reliable and sufficient information. nn
Contraindications
Sitosterolemia: contraindicated
Taking beta-sitosterol may exacerbate sitosterolemia, a rare hereditary lipid storage disorder. People with this condition have increased absorption of cholesterol and beta-sitosterol from the diet, and decreased clearance of beta-sitosterol. Total body stores of beta-sitosterol increase substantially. High hepatic beta-sitosterol levels competitively inhibit cholesterol catabolism, thereby contributing to hypercholesterolemia. nnBeta-sitosterol and its glycoside, sitosterolin, are contraindicated in patients with sitosterolemia. nn
