Does it move cholesterol or triglycerides?

What this archive is for. Trials of the compound come first, ranked by how many people were actually given it. Studies that only observed people are below them and labelled.

1. 01EnlicitidePeptideStrong. At least two finished studies in people, and at least 1,000 people who took it. 3 completed trials, 2,909 people given it.2 reported

   2,909 people given it1 trial

   • A PCSK9 drug you swallow works, and until now this kind of drug needed a shot. 2,909 people took enlicitide pills or a dummy pill for a year. Their LDL cholesterol fell by about 57 percent, while the dummy group drifted up 3 percent. Other harmful blood fats improved too. This study measured cholesterol, not heart attacks. Whether those falls turn into fewer heart attacks and strokes has not been shown. The maker paid for the study.

     The numbers 2,909 participants randomised 2:1 to enlicitide 20 mg or placebo for 52 weeks. LDL cholesterol fell 57.1 percent at week 24 against a 3.0 percent rise on placebo, an adjusted between-group difference of 55.8 percentage points (p < 0.001). Non-HDL cholesterol, apolipoprotein B and lipoprotein(a) also improved. Funded by the manufacturer.

     New England Journal of Medicine, 2026· 2,909 people

2. 02CJC-1295PeptideLimited. People have taken it in a published study, but fewer than 100 of them. 2 completed trials, none stating how many people.9 reported

   nobody was given it1 watch-only study

   • This looked at proteins in the blood, not at anything a person would notice. 11 healthy young men gave blood before a CJC-1295 injection and again a week later. Five protein spots shifted: two fell and three rose. That is a signal that something changed in the blood. It is not weight, muscle, strength, sleep or any symptom, and none of those was measured.

     The numbers Serum from 11 healthy young adult men before and one week after a CJC-1295 injection. An apolipoprotein A1 isoform and a transthyretin isoform fell; beta-hemoglobin and two albumin-fragment spots rose. A biomarker study with no clinical endpoint.

     Growth Hormone and IGF Research, 2009· 11 peopleobserved only, nobody was given it

Vitamins, minerals, amino acids and botanicals sold over the counter, held to the same standard.

1. 01NiacinSupplementStrong. At least two finished studies in people, and at least 1,000 people who took it. 2 completed trials, 29,087 people given it.7 reported

   29,087 people given it2 trials

   • Niacin failed on top of a statin and it harmed people. 25,673 adults with vascular disease took niacin with laropiprant or a dummy pill for close to four years. Cholesterol numbers moved the right way. Major vascular events did not, at about 13 in every hundred in each group. Treatment caused extra diabetes, extra serious blood sugar upsets, and extra stomach, muscle and skin problems, plus unexpected extra infections and bleeding. A trial this size would have found a benefit if there was one. Funded by Merck among others.

     The numbers HPS2-THRIVE, NCT00461630. 25,673 adults with vascular disease on statin-based therapy randomised to 2 g extended-release niacin with 40 mg laropiprant or placebo for a median of 3.9 years. LDL was 10 mg/dL lower and HDL 6 mg/dL higher on treatment. Major vascular events occurred in 13.2 percent versus 13.7 percent, rate ratio 0.96 (95 percent CI 0.90 to 1.03, P=0.29). Treatment caused absolute excesses in serious disturbances of diabetes control (3.7 percentage points, P<0.001), new diabetes diagnoses (1.3 points, P<0.001), serious gastrointestinal events (1.0 point), musculoskeletal events (0.7 point), skin events (0.3 point), and unexpectedly infection (1.4 points) and bleeding (0.7 points). Funded by Merck and others.

     New England Journal of Medicine, 2014· 25,673 people

   • Niacin improved the blood numbers and did nothing for patients already on a statin. 3,414 people with established artery disease took slow release niacin or a dummy pill on top of their statin. Good cholesterol rose, triglycerides fell and bad cholesterol fell. Heart attacks, strokes and cardiac deaths came out identical, about 16 in every hundred in each group. The trial was stopped after about three years because it was clearly going nowhere. Funded by a government institute and by Abbott.

     The numbers AIM-HIGH, NCT00120289. 3,414 patients with established atherosclerotic cardiovascular disease and LDL below 70 mg/dL, randomised to extended-release niacin 1500 to 2000 mg daily (n=1718) or placebo (n=1696), all on simvastatin plus ezetimibe as needed. Stopped after a mean of 3 years for lack of efficacy. Niacin raised median HDL from 35 to 42 mg/dL, lowered triglycerides from 164 to 122 mg/dL and lowered LDL from 74 to 62 mg/dL. The primary composite endpoint occurred in 282 niacin patients (16.4 percent) and 274 placebo patients (16.2 percent), hazard ratio 1.02 (95 percent CI 0.87 to 1.21, P=0.79). Funded by the National Heart, Lung, and Blood Institute and Abbott Laboratories.

     New England Journal of Medicine, 2011· 3,414 people

2. 02ResveratrolSupplementModerate. At least one finished study in people, and at least 100 people who took it. 14 completed trials, 403 people given it.7 reported

   192 people given it1 trial1 found nothing

   • found nothingThe longest and largest diabetes trial of resveratrol found nothing that counted. 192 patients took 40 mg, 500 mg or a dummy pill every day for six months. An inflammation marker fell further on resveratrol, but not by enough to call real. Weight, waist, blood pressure, blood sugar, insulin and a string of other markers did not change. Cholesterol and triglycerides rose slightly on the high dose. Patients earlier in their diabetes did show a real fall in inflammation.

     The numbers The largest and longest diabetes trial here: 192 patients, 40 or 500 mg per day for six months. CRP fell 5.6% and 15.9% versus placebo but not significantly, and there was no significant change in weight, BMI, waist, blood pressure, fasting glucose, HbA1c, insulin, C-peptide, free fatty acids, liver enzymes, uric acid, adiponectin or IL-6. Total cholesterol and triglycerides rose slightly on 500 mg. Subgroups with shorter diabetes duration did show a significant CRP reduction.

     Pharmacological Research, 2016· 192 people

   What people using it report

   • Interest leans toward blood test numbers people cannot feel. Posters more often talk about checking cholesterol, blood sugar or CRP than about any change in energy, mood or thinking they noticed day to day.
3. 03BetaineSupplementModerate. At least one finished study in people, and at least 100 people who took it. 3 completed trials, 170 people given it.4 reported

   151 people given it1 trial1 found nothing

   • found nothingBetaine lowers homocysteine and raises bad cholesterol at the same time. Blood fat results were pooled from four studies, three of them betaine trials covering 151 people. At 6 grams a day for six weeks, bad cholesterol rose by 0.36 units and triglycerides by 0.14. Lower doses raised bad cholesterol too, by less. The authors conclude the fat changes may cancel out any heart benefit. About 29 percent of the funding was industry money, disclosed in the paper.

     The numbers Pooled blood lipid data from four placebo-controlled randomised studies, including three of betaine totalling 151 participants. Betaine at 6 g/d for six weeks raised LDL cholesterol by 0.36 mmol/L (95 percent CI 0.25 to 0.46), triacylglycerol by 0.14 mmol/L and the total to HDL ratio by 0.23, with no effect on HDL. Lower doses also raised LDL without significance, and the LDL effect was already evident at two weeks. Folic acid had no effect on lipids. The authors conclude the lipid effects may undo the potential cardiovascular benefit of homocysteine lowering. Funding was 29 percent industrial through a food science consortium, disclosed in the paper.

     PLoS Medicine, 2005· 151 people

4. 04BerberineSupplementModerate. At least one finished study in people, and at least 100 people who took it. 3 completed trials, 186 people given it.4 reported

   116 people given it1 trial

   • A larger diabetes study than the famous 36 person one. 116 adults with type 2 diabetes and high blood fats took 1 gram of berberine a day, or a dummy pill, for three months. Fasting sugar fell from 7.0 to 5.6. HbA1c fell from 7.5 to 6.6 percent. Triglycerides, total cholesterol and LDL fell too. It measured blood tests, not heart attacks or deaths.

     The numbers 116 adults with type 2 diabetes and dyslipidaemia randomised to berberine 1.0 g/day or placebo for 3 months. Fasting glucose 7.0 to 5.6 mmol/L, post-load 12.0 to 8.9, HbA1c 7.5% to 6.6%, triglycerides 2.51 to 1.61, LDL 3.23 to 2.55, all versus placebo p <= 0.001.

     Journal of Clinical Endocrinology and Metabolism, 2008· 116 people

5. 05CurcuminSupplementModerate. At least one finished study in people, and at least 100 people who took it. 3 completed trials, 195 people given it.5 reported

   100 people given it1 trial

   • A high-absorption mix of curcumin and piperine improved blood fats in people who already had metabolic syndrome. 100 people took 1000 mg a day of the mix, or a dummy pill, for 8 weeks on top of usual care. LDL, triglycerides and total cholesterol fell, and HDL rose. This tested one specific form on blood fats. It is not about turmeric in food, and it did not measure heart attacks.

     The numbers 100 adults with metabolic syndrome randomised to curcuminoids 1000 mg/day plus piperine or placebo for 8 weeks, on standard care. LDL, non-HDL, total cholesterol, triglycerides and lipoprotein(a) fell versus placebo; HDL rose. Small dense LDL did not separate.

     Complementary Therapies in Medicine, 2014· 100 people

6. 06PterostilbeneSupplementLimited. People have taken it in a published study, but fewer than 100 of them. 1 completed trial, 80 people given it.4 reported

   80 people given it1 trial

   • It pushed blood pressure down and bad cholesterol up. 80 adults with raised cholesterol took pterostilbene at 125 mg twice a day, at 50 mg twice a day, at 50 mg with grape extract, or a dummy, for 6 to 8 weeks. On pterostilbene alone, bad cholesterol rose 17.1 units. Adding grape extract removed that rise. On the high dose, the upper blood pressure number fell 7.8 points and the lower one 7.3. Raising bad cholesterol in people who already have too much is a real trade-off.

     The numbers 80 adults with total cholesterol at or above 200 mg/dL and/or LDL at or above 100 mg/dL, in four arms for 6 to 8 weeks: pterostilbene 125 mg twice daily, 50 mg twice daily, 50 mg plus grape extract 100 mg twice daily, or placebo. LDL rose 17.1 mg/dL on pterostilbene monotherapy (p = 0.001), an effect not seen with the grape extract combination (p = 0.47) and attenuated by background cholesterol medication. Systolic blood pressure fell 7.8 mmHg (p < 0.01) and diastolic 7.3 mmHg (p < 0.001) on the high dose. Registered as NCT01267227.

     Evidence-Based Complementary and Alternative Medicine, 2014· 80 people

7. 07PQQSupplementModerate. At least one finished study in people, and at least 100 people who took it. 3 completed trials, 116 people given it.5 reported

   29 people given it1 trial1 found nothing

   • found nothingPQQ did not move triglycerides, which is what it was given for. 29 healthy Japanese adults aged 40 to 57 took 20 mg a day or a dummy for twelve weeks, and nobody involved knew which. Triglycerides came out unchanged. Bad cholesterol dipped slightly in the PQQ group, and dipped more in the few people whose level started high. The study was run by the division of the company that makes the branded PQQ, which makes a small subgroup result worth less.

     The numbers 29 healthy Japanese adults aged 40 to 57 with normal to moderately high triglycerides, 20 mg a day for 12 weeks, randomised and double blind. Mean triglycerides did not change. LDL cholesterol fell marginally in the PQQ group, from 136.1 to 127.0 mg/dL, with a clearer fall in the subgroup whose baseline LDL was 140 mg/dL or above. Run by the division of the company that makes BioPQQ.

     Journal of Nutritional Science and Vitaminology, 2015· 29 people

8. 08NMNSupplementLimited. People have taken it in a published study, but fewer than 100 of them. 4 completed trials, 94 people given it.6 reported

   0 people given it1 trial1 found nothing

   • found nothingA high dose NMN tablet raised NAD in the blood and moved weight and cholesterol, but not muscle. 30 overweight or obese adults took MIB-626, 1000 mg twice a day, or a dummy pill, for 28 days. Weight fell 1.9 kg. The lower blood pressure number and LDL cholesterol fell too. Strength, tiredness, fitness and stair climbing power did not change. Neither did the body's response to insulin. The maker paid for it.

     The numbers 30 overweight or obese adults aged 45 and over randomised 2:1 to MIB-626 (microcrystalline NMN) 1000 mg twice daily or placebo for 28 days. Weight -1.9 kg, diastolic BP -7.01 mmHg, LDL -18.73 mg/dL versus placebo. Muscle strength, fatigability, aerobic capacity and stair-climbing power did not differ. Insulin sensitivity unchanged. Funder: Metro International Biotech.

     Journal of Clinical Endocrinology and Metabolism, 2023· number of people not given

9. 09EpicatechinSupplementLimited. People have taken it in a published study, but fewer than 100 of them. 4 completed trials, 44 people given it.1 reported

   0 people given it1 trial1 found nothing

   • found nothingA food-sized dose of pure epicatechin did nothing. 48 overweight or obese non-smokers with features of metabolic syndrome took 25 mg a day for two weeks, and each took a dummy for two weeks as well, in turn. Nothing moved: not blood pressure, glucose, insulin, triglycerides, or any cholesterol measure. The authors conclude that whatever cocoa does, epicatechin alone does not explain it. Two weeks is short, and the dose was deliberately a dietary one.

     The numbers 48 overweight or obese non-smokers aged 20 to 65 with features of metabolic syndrome, 25 mg (-)-epicatechin a day for 2 weeks in crossover. No significant effect on blood pressure, glucose, insulin, HOMA-IR, triglycerides, total, LDL or HDL cholesterol, or oxidised LDL. The authors conclude the cocoa effect cannot be ascribed to epicatechin alone.

     American Journal of Clinical Nutrition, 2018· number of people not given

10. 10MIB-626SupplementModerate. At least one finished study in people, and at least 100 people who took it. 4 completed trials, 107 people given it.1 reported

    0 people given it1 trial1 found nothing

    • found nothingThe tablet moved some body measurements and left every measure of physical function untouched. 30 overweight or obese adults aged 45 and over took MIB-626 or a dummy tablet for four weeks. Weight fell by about two kilograms. Blood pressure and cholesterol both came down. Strength, stamina, how quickly muscles tired and stair climbing power did not change. Insulin sensitivity, liver fat and belly fat did not change either. The manufacturer helped fund it. This study looked at many things at once, so treat any single result as a hint.

      The numbers Randomised 2:1, 30 overweight or obese adults aged 45 and over, MIB-626 two 500 mg tablets twice daily for 28 days. Body weight fell 1.9 kg (95 percent CI -3.3 to -0.5, P=.008), diastolic blood pressure fell 7.01 mmHg (-13.44 to -0.59, P=.034), total cholesterol fell 26.89 mg/dL (P=.004) and LDL fell 18.73 mg/dL (P=.007). Muscle strength, muscle fatigability, aerobic capacity and stair-climbing power did not change. Insulin sensitivity, hepatic fat and intra-abdominal fat did not change in either group. Metro International Biotech, the manufacturer, is a listed funder. This is a physiologic study with multiple outcomes rather than a trial powered on one of them.

      Journal of Clinical Endocrinology and Metabolism, 2023· number of people not given

Approved drugs, biologics and hormones that have been measured for this. They are here because leaving them out would misrepresent the evidence, and they are below the peptides because that is not what most people come here to read.

1. 01SimvastatinSmall moleculeStrong. At least two finished studies in people, and at least 1,000 people who took it. 2 completed trials, 24,980 people given it.6 reported

   20,536 people given it1 trial

   • The benefit held even in people whose cholesterol already looked normal. 20,536 UK adults aged 40 to 80 with clogged arteries or diabetes were split by chance. One group took 40 mg of simvastatin a day, the other took a dummy pill. 14.7 percent of the dummy group died of any cause, against 12.9 percent on the drug. Heart attacks, strokes and similar events fell from about a quarter of people to a fifth. Muscle damage did happen, in roughly one person in ten thousand each year.

     The numbers 20,536 UK adults aged 40 to 80 with coronary, other occlusive arterial disease or diabetes, randomised to 40 mg simvastatin daily or placebo. All-cause mortality 12.9 percent versus 14.7 percent (p equals 0.0003). Major vascular events fell 24 percent, from 25.2 percent to 19.8 percent. Benefit held even in participants entering with LDL cholesterol below 3.0 mmol/L. The annual excess risk of myopathy was about 0.01 percent.

     Lancet, 2002· 20,536 peoplepoints the wrong way

2. 02NattokinaseBiologicStrong. At least two finished studies in people, and at least 1,000 people who took it. 9 completed trials, 1,795 people given it.6 reported

   225 people given it2 trials1 found nothing

   • In a better built trial, nattokinase alone moved one blood fat and nothing else. 178 patients with stable heart disease, already on their usual medicines, took nattokinase, red yeast rice, both, or a dummy pill for 90 days. Nattokinase alone lowered LDL, the harmful cholesterol, compared with the dummy. Total cholesterol, triglycerides and good cholesterol did not budge. The combination improved every blood fat, and blood pressure as well.

     The numbers Double-blind, placebo-controlled RCT, 178 patients with stable coronary artery disease already taking statins, aspirin or beta-blockers, randomized to nattokinase (3,615 FU/day), red yeast rice, the combination, or placebo for 90 days: nattokinase alone significantly lowered LDL-C versus placebo but not total cholesterol, triglycerides or HDL-C. The combination arm improved every lipid and blood pressure measure and raised antithrombin III more than placebo.

     Frontiers in Nutrition, 2024· 178 people

   • found nothingOn its own, nattokinase did nothing to cholesterol. 47 patients with high cholesterol took nattokinase alone, nattokinase with red yeast rice, or a dummy, for six months. The nattokinase-only group came out no different from the dummy. The combination improved every blood fat from the first month onwards. That positive result cannot be pulled apart, because the red yeast rice was in it too.

     The numbers RCT, 47 patients with hyperlipidemia, nattokinase alone versus nattokinase plus red yeast rice versus placebo for 6 months: the nattokinase-only arm showed no significant lipid change against placebo, while the combination arm improved triglycerides, total cholesterol, LDL-C and HDL-C from month 1. Nattokinase's own lipid contribution cannot be separated from red yeast rice's in the positive result.

     Asia Pacific Journal of Clinical Nutrition, 2009· 47 people

   What people using it report

   • D-dimer is the blood test people mention most, on the idea that a rise means the enzyme is working. That loosely matches the trial finding that one dose raises D-dimer for a few hours. But checking D-dimer yourself months into daily use is a different measure, and nobody has shown it tells you whether nattokinase is working. Lp(a) and standard cholesterol panels also come up in heart-focused talk, with no trial evidence that nattokinase moves Lp(a).
3. 03DanazolHormoneLimited. People have taken it in a published study, but fewer than 100 of them. 3 completed trials, 63 people given it.5 reported

   36 people given it1 trial

   • This is what danazol costs, measured in a different illness. 36 patients with acquired aplastic anaemia took danazol on its own, 10 mg per kilogram a day up to a cap of 600 mg. After six months, good cholesterol had fallen 30 percent and bad cholesterol had risen 11 percent. The size of the heart's main pumping chamber changed, as did how well it pumped and relaxed. The authors conclude the drug causes severe blood fat changes and possible heart damage. Different condition, same drug, similar dose.

     The numbers The cost side, in a different indication. 36 patients with acquired aplastic anaemia on danazol monotherapy at 10 mg per kg per day capped at 600 mg. After 6 months HDL cholesterol fell 30 percent and LDL rose 11 percent, with significant changes in left ventricular mass, ejection fraction and diastolic indices. The authors conclude that danazol causes profound dyslipidaemia and potential cardiac dysfunction.

     Blood Cells, Molecules and Diseases, 2025· 36 people

4. 04DHEAHormoneModerate. At least one finished study in people, and at least 100 people who took it. 3 completed trials, 267 people given it.5 reported

   24 people given it1 trial

   • In women whose adrenal glands make no DHEA, replacing it helped mood and sexual interest. 24 women took DHEA for four months and a dummy pill for four months. It is a study of people who lack the hormone, not of ageing.

     The numbers 24 women with adrenal insufficiency given 50 mg oral DHEA daily for 4 months and placebo for 4 months in random order, double-blind crossover. DHEA restored serum DHEA, DHEA-S, androstenedione and testosterone to the normal range; SHBG, total and HDL cholesterol fell. Global severity index change -0.18 on DHEA versus +0.03 on placebo (p=0.02); depression and anxiety scores and sexual thoughts, interest and satisfaction improved versus placebo.

     The New England Journal of Medicine, 1999· 24 people

5. 05CardarineSmall moleculePreliminary. Studied in people, but no published study has had people take it. 1 registered with no result.7 reported

   0 people given it1 trial

   • The biggest human trial moved blood fats the right way, and the story still ends badly. 268 people with low good cholesterol took one of three doses or a dummy for 12 weeks. Good cholesterol rose by about a sixth, triglycerides fell by about the same, and another harmful cholesterol marker fell too. Twelve weeks is the longest anyone has taken it in print. Development stopped over cancers in rodents, and that work was never published in full.

     The numbers The largest published human trial, run by GSK: 268 people with low HDL took 2.5, 5 or 10 mg or placebo for 12 weeks. HDL cholesterol rose up to 16.9%, triglycerides fell 16.9% and apoB fell 14.9%. Twelve weeks is the longest published human exposure; the rodent carcinogenicity findings that ended development were never published as a primary paper.

     Arteriosclerosis, Thrombosis, and Vascular Biology, 2012· number of people not given

   What people using it report

   • Bloodwork reports disagree with each other. Sharply raised LDL, the bad cholesterol, and raised liver enzymes after about a month at the higher amounts appear. So do reports of better blood fat results from other people. A raised fasting glucose reading appears and is then questioned by the same poster who raised it.
6. 06SRT2104Small moleculeLimited. People have taken it in a published study, but fewer than 100 of them. 1 completed trial, none stating how many people.

   0 people given it1 trial

   • The thing this trial set out to measure did not change. Twenty four otherwise healthy smokers took a purpose built sirtuin activating drug for four weeks and a dummy for four weeks, without knowing the order. Blood vessel function and platelet behaviour were no different on the drug. Cholesterol and triglycerides did fall. Twenty four people and a blood test result is not evidence of benefit to anyone's health. The drug was tolerated well and never went on to approval.

     The numbers 24 otherwise healthy cigarette smokers, 28 days on SRT2104 and 28 on placebo (NCT01031108). The cardiovascular endpoints the trial was built around did not move: forearm blood flow responses to all three vasodilators, and the fibrinolytic and platelet markers, showed no demonstrable difference from placebo. Total cholesterol, LDL and triglycerides improved. The authors conclude an improved lipid profile without demonstrable differences in vascular or platelet function. Among the few randomised human trials of a sirtuin activator, and the compound did not go on to approval.

     Journal of the American Heart Association, 2013· number of people not given

Supplements

1. 01MCT oilSupplementModerate. At least one finished study in people, and at least 100 people who took it. 1 completed trial, 152 people given it.6 reported

   1 animal or lab study

   Measured in animals or in the lab

   • In mice. Five supplements were mixed into the food from 4 months of age, at three labs: resveratrol, green tea extract, curcumin, oxaloacetic acid and MCT oil. None of them changed how long male or female mice lived.

     The numbers Interventions Testing Program, three test sites, treatment beginning at 4 months of age. None of the five agents, medium-chain triglyceride oil included, had a statistically significant effect on lifespan of male or female mice by log-rank test at the concentrations tested.

     Journals of Gerontology Series A, 2013· animal study