Pterostilbene

Pterostilbene is a methylated structural cousin of resveratrol found in small amounts in blueberries and Pterocarpus marsupium heartwood. The basic pitch is real: two methoxy groups replace two of resveratrol's hydroxyl groups, which dramatically slows the sulfation and glucuronidation that destroys resveratrol in first-pass metabolism. Animal pharmacokinetics (Kapetanovic 2011 in rats) show pterostilbene reaches roughly 80% oral bioavailability versus resveratrol's ~20% at equimolar doses, with a longer half-life. Mechanistically it hits similar pathways - SIRT1, AMPK, NRF2 - so the lab story is "resveratrol that actually gets into your blood."

The human evidence is much thinner than the marketing implies. The cleanest standalone trial is Riche 2014 at the University of Mississippi: 80 adults with hypercholesterolemia randomized to placebo, 50mg twice daily pterostilbene, 125mg twice daily pterostilbene, or pterostilbene plus grape extract, for 6-8 weeks. Systolic blood pressure dropped 7.8 mmHg and diastolic dropped 7.3 mmHg in the high-dose group. That is a real signal. The same trial also found that pterostilbene monotherapy increased LDL cholesterol by 17.1 mg/dL - a finding the supplement industry tends to leave out of marketing copy. Adding grape extract cancelled the LDL bump. There has been no large replication of either finding.

The 2013 Riche safety analysis from the same 80-patient cohort concluded pterostilbene is generally safe up to 250mg/day with no signal on liver, kidney, or glucose function. The 2025 Otsuka pilot in 30 healthy men (10mg or 100mg daily for 12 weeks) reported no safety issues and some microRNA changes but no clinical endpoints. That is essentially the full standalone human evidence base: one 80-person efficacy trial, a paired safety paper, one 30-person miRNA pilot.

The larger body of evidence is for pterostilbene as a co-ingredient in NRPT (nicotinamide riboside + pterostilbene), sold as Elysium's Basis. Dellinger 2017 in NPJ Aging (n=120 older adults, 8 weeks) showed dose-dependent NAD+ elevation of 40-90% at the standard 250mg NR / 50mg pterostilbene dose, with good safety. Simic 2020 in hospitalized acute kidney injury patients (n=24) showed NRPT restored NAD+ levels that AKI had depleted. The de la Rubia 2019 EH301 trial in ALS (another NR+pterostilbene combo) reported slowed functional decline over 4 months, but it was a small pilot. None of these trials isolate pterostilbene's individual contribution - they test the combination.

Honest bottom line: bioavailability advantage over resveratrol is well-established in animals. The blood pressure signal from one 80-person trial is real but unreplicated. The LDL increase from the same trial is also real and gets ignored. Most positive human data comes from combination products where pterostilbene's individual role is unclear. If you want a polyphenol with the strongest human evidence, the cardiometabolic case is actually slightly better for resveratrol on volume of trials - pterostilbene just absorbs better. Most reasonable use cases for pterostilbene are as the second ingredient in an NAD+ stack, not standalone.