A plant fat that gets in cholesterol’s way inside the gut. Two effects are well supported in people: blood cholesterol falls modestly, rising with dose then levelling off, and much smaller doses ease the urinary complaints of an enlarged prostate without shrinking it. Generally well tolerated; one blood test beforehand identifies the rare people who cannot clear plant fats. (Full Review)
| Marker | Target | Why |
|---|---|---|
| LDL cholesterol | < 2.6 mmol/L (100 mg/dL); < 1.8 mmol/L (70 mg/dL) with cardiovascular risk | Primary efficacy endpoint for the cholesterol indication |
| Total cholesterol | 3.6–5.2 mmol/L (140–200 mg/dL) | Confirms the direction of the lipid effect and tracks the roughly 6% fall |
| Serum sitosterol | < 1 mg/dL (< 24 µmol/L); ideally unchanged from personal baseline | Detects sterol accumulation and identifies undiagnosed sitosterolemia |
| Serum campesterol | No established functional target; unchanged from personal baseline, within the assay reference range | Second marker of cholesterol absorption efficiency; rises further than sitosterol |
| Prostate-specific antigen | < 2.5 ng/mL under age 60; < 4.0 ng/mL thereafter | Screens for malignancy before symptom treatment and tracks gland status |
| International Prostate Symptom Score | 0–7 (mild); a fall of ≥ 3 points defines meaningful change | Primary efficacy endpoint for the urinary indication |
| Post-void residual volume | < 50 mL | Objective counterpart to the symptom score |
| Plasma β-carotene | 0.4–2.5 µmol/L (about 20–130 µg/dL) | Detects the documented 10–16% carotenoid fall |
| Complete blood count with platelet indices | Platelets 150–400 × 109/L; mean platelet volume and haemoglobin within reference range | Catches stomatocytic hemolysis and macrothrombocytopenia in sterol accumulators |
Cadence: Lipid panel and symptom score at 8–12 weeks; sterol panel at 6 months; then every 6–12 months once values are stable