Almost none of the extract's pigments enter the bloodstream, so its action stays largely inside the gut: less cholesterol and fat taken up, starch broken down more slowly. Cholesterol and blood pressure fall modestly; several reviews combining trials find no effect. Main drawback: sharply reduced iron uptake from plant foods. Value turns on starting cholesterol, iron status and meal timing. (Full Review)
| Marker | Target | Why |
|---|---|---|
| LDL cholesterol | <100 mg/dL; <70 mg/dL if high risk | Primary efficacy target |
| Apolipoprotein B | <80 mg/dL | Counts all artery-damaging particles |
| Ferritin | 50–150 ng/mL (women); 50–200 ng/mL (men) | Detects iron blockade before anaemia |
| Haemoglobin | 13.5–15.0 g/dL (women); 14.0–16.0 g/dL (men) | Confirms no anaemia has developed |
| Alanine aminotransferase | <20 U/L (women); <25 U/L (men) | Screens for the hepatotoxicity signal |
| Glycated haemoglobin | 4.8–5.4% | Whether the glucose effect is sustained |
| Fasting glucose | 75–90 mg/dL | Baseline for the after-meal mechanism |
| Home blood pressure | <120/75 mmHg | The best-quantified vascular endpoint |
| High-sensitivity C-reactive protein | <0.5 mg/L | General inflammation; needed to interpret ferritin |
| 24-hour urinary oxalate | <40 mg/day | Only for calcium-oxalate stone formers |
| Plasma or urinary fluoride | No established target; track own baseline | Flags fluoride-rich, mature-leaf material |
Cadence: Baseline before starting; liver enzymes, blood pressure and lipids at 12 weeks; then ferritin, blood count, liver enzymes and lipids every 6–12 months.