Pterostilbene for Health & Longevity - Quick Reference Sheet

Pterostilbene for Health & Longevity

Created on 06/30/2026 – Quick Reference based on Evidence Review created using AI4L / Opus 4.8 Audit

A blueberry-derived relative of resveratrol, absorbed far more efficiently. Lab and animal work shows broad promise for heart, metabolism, brain, and anti-cancer effects, and it reliably strengthens antioxidant defenses. Human evidence is thin and mixed: it lowered blood pressure but unexpectedly raised "bad" cholesterol when taken on its own. Mechanistically interesting but clinically unproven. (Full Review)

Protocol

Standard Dose
50–250 mg/day
250 mg/day is the highest dose shown generally safe; many longevity users take 50–150 mg/day.
Formulation
Isolated or combined
Isolated pterostilbene, paired with nicotinamide riboside for NAD+ support, or with grape extract to offset the LDL effect.
Timing & Frequency
With a meal
Commonly taken with a morning meal containing some fat; twice-daily dosing was used in trials, once-daily is common in practice.
Time to effect
Blood Pressure
6–8 weeks
Cardiometabolic effects emerged over 6–8 weeks in the human trial; no acute, perceptible effect.
NAD+ Elevation
4 weeks
Combined with nicotinamide riboside, blood NAD+ rose by 4 weeks; a biomarker change, not a health outcome.
Liver Enzyme Markers
6 months
In the 6-month combination trial in fatty liver disease, ALT and GGT fell; standalone role unclear.

Benefits

Contraindications
  • Pregnancy or breastfeeding
  • High or poorly controlled LDL cholesterol, or established cardiovascular disease (recent heart attack within 90 days, NYHA Class III–IV heart failure)
  • Significant liver impairment (Child-Pugh Class C)
Key Interactions
  • Antihypertensive drugs (ACE inhibitors, ARBs, calcium channel blockers, diuretics)
  • Lipid-lowering drugs (statins, ezetimibe)
  • Blood-pressure-lowering supplements (beetroot/nitrate, magnesium, garlic extract, omega-3 fish oil, CoQ10)
  • Other polyphenol supplements (resveratrol, grape extract)
  • Drugs with narrow therapeutic windows metabolized by glucuronidation/CYP (CYP3A4 substrates such as certain statins, immunosuppressants, some benzodiazepines)

Risk & Side Effects

  • High: [risks_high]
  • Medium: Increased LDL ("bad") cholesterol
  • Low: Generally mild, non-serious adverse events
  • Speculative: Drug-metabolism interactions; additive blood-pressure lowering; effects in pregnancy and breastfeeding; pro-oxidant or hormetic effects at high doses

Monitoring

Marker Target Why
LDL cholesterol < 100 mg/dL (lower for high CV risk) Detects the main documented risk: pterostilbene monotherapy can raise LDL
Total & HDL cholesterol, triglycerides HDL > 50 mg/dL; triglycerides < 100 mg/dL Provides full lipid context; a downward HDL trend was hinted at in human data
Blood pressure < 120/80 mmHg Tracks the main potential benefit and guards against additive hypotension
Fasting glucose / HbA1c Glucose 70–90 mg/dL; HbA1c < 5.4% Screens for metabolic effects given mixed preclinical glucose findings
ALT & GGT (liver enzymes) ALT < 25 U/L (men) / < 20 U/L (women); GGT low-normal Liver enzymes both signal safety and were the markers improved by the combination product

Cadence: Baseline, then 6–12 weeks after starting, then every 6–12 months with continued use; more frequent lipid checks if a rise is detected or cardiovascular risk is a concern.

Qualitative Assessment

  • Energy levels and exercise tolerance
  • Cognitive clarity and mood
  • General sense of wellbeing
  • Any new symptoms (e.g., lightheadedness suggesting low blood pressure)