The evidence splits down one clean seam. The originating lab reported that a small daily dose cut LDL by twenty to thirty per cent ^{1 2}. Then outsiders tried it. A dose-ranging trial from 10 up to 80 mg a day moved LDL by under two per cent at every dose, no different from placebo ³.

Five more independent trials across four countries found the same nothing ^{4 5 6 7}. Put head-to-head against a statin, the statin dropped LDL by about a third and policosanol matched the sugar pill ⁸. The 2019 European cholesterol guidelines, which name every nutraceutical with real support, don't mention it at all ⁹.

Cholesterol is the health problem with no symptom. A pill that does nothing costs you silently: every year your LDL stays high is a year of deposit in the artery wall, and the bill arrives whenever the artery gives way. The supplement is cheap and harmless, which is exactly why the loss is invisible ⁹.

The check is cheaper than the next bottle.

What actually moves the number, in rough order of size:

• Statins — the largest, most replicated cardiovascular drug class there is; side effects real but uncommon.
• Ezetimibe, bempedoic acid, PCSK9 inhibitors — second-line options with their own outcome trials, for people who can't take a statin.
• Soluble fibre and plant sterols — cheap, no prescription; a modest, replicated lift, smaller than a statin and larger than zero ^{9 10}.

What you get back. This week, a fact you already own: the LDL line that never moved. A few months out, the money is buying something that works. A year out, a different number on the next panel. And the low-grade dread of am I actually doing anything about this lifts, because a panel that moves answers the question the worry never could.