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Every ranking you read, including any number quoted here, is cross-trial inference across different molecules, populations, endpoints, and trial durations

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however, no significant changes were observed in LDL or total cholesterol.28 A 2022 meta-analysis focusing on adults with metabolic syndrome risk factors reached similar conclusions, noting modest reductions in LDL cholesterol and systolic blood pressure but overall marginal changes in total cholesterol.29 A broader 2024 review summarizing human and preclinical data suggests that astaxanthin may enhance insulin sensitivity and glucose uptake while supporting lipid metabolism and antioxidant balance, though these findings are based on limited trials and changes in biomarkers.30 These effects are thought to involve activation of Nrf2, a cellular pathway that turns on the bodys own antioxidant defenses, and improved mitochondrial energy metabolism, which may help regulate oxidative stress