Statin-free supplement? Not quite

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Statin-free supplement? Not quite

Red yeast rice mimics statin drugs.

By Woolston

http://www.latimes.com/features/health/la-he-

skeptic14jan14,1,2973474.story?coll=la-headlines-health

The products: Lowly fungi have an amazing ability to create

compounds that have strong effects on humans (alcohol, hallucinogens

and antibiotics, to name a few). As far back as the Tang dynasty in

800, the Chinese harvested a red extract produced by certain types

of fungi growing on rice. The fermented rice itself -- so-

called " red yeast rice " -- was prized as a remedy for stomach

troubles.

Today, red yeast rice enjoys wide acclaim as a cholesterol-lowering

supplement that's a natural alternative to prescription statin drugs

such as Lipitor and Zocor. Prescription statins can cut LDL

cholesterol levels by 50% or more -- a potentially lifesaving

result -- but many consumers worry that the drugs will cause muscle

pain, a complication that occurs in up to 5% of users.

Such concerns have created a market for a variety of red yeast rice

capsules, which are widely available at health food stores and over

the Internet. Among the options: One can buy 90 600-milligram

capsules of Solaray red yeast rice for about $20. (Follow the

instructions -- one capsule twice a day -- and they'll last 45

days.) Expect to pay about $30 for the same capsules from Nature's

Plus, which recommends taking one capsule each day.

The claims: The Solaray website touts red yeast rice as " a powerful

tool in lowering cholesterol and heart disease risks. " The website

of the supplement company Vitabase claims that red yeast rice is

clinically proven to reduce LDL cholesterol by about 20%.

The bottom line: First things first. If you're hoping to avoid

statins, red yeast rice may not be the product for you. The

industrious fungi growing on rice are actually little pharmaceutical

factories creating a natural supply of monacolin K, also known as

lovastatin. As the suffix suggests, lovastatin is a bona fide statin

drug. The first to hit the market, it's sold under the name Mevacor

and is now available as a generic.

Secondly, nature isn't always precise, and different batches of red

yeast rice probably contain different levels of lovastatin. In fact,

by the standards of the Food and Drug Administration some brands of

red yeast rice have enough lovastatin to cross the line between

nutritional supplements and unapproved drugs. Studies of red yeast

rice have shown " impressive " results, says Joe Dixon, an associate

professor with the Center for Lipid Research at Rutgers University

in New Brunswick, N.J. Dixon has evaluated all sorts of alternative

products for cholesterol -- including walnuts and soluble fiber --

and he says red yeast rice stands out.

In one high-profile study published in the American Journal of

Clinical Nutrition in 1999, 83 people with high cholesterol took

either 2,400 milligrams of red yeast rice or a placebo every day for

three months. At the end of the study, the group taking red yeast

rice had, on average, cut about 50 points from their LDL

cholesterol -- a reduction of about 20%.

If patients could somehow re-create that experiment, Dixon says,

they'd definitely be getting their money's worth from red yeast

rice. But because nutritional supplements are not standardized and

largely unregulated, " one never knows what dose is in a particular

product, " he adds. In contrast, prescription lovastatin is highly

consistent and predictable.

Studies generally find that patients taking red yeast rice enjoy

about the same benefits as patients taking a daily low dose (20

milligrams) of lovastatin, says , a cholesterol expert

at the Mayo Clinic in Rochester, Minn. Unfortunately, because users

are still dealing with a statin, they also face the same risks,

including muscle pain. " I've had patients who tried red yeast rice, "

says. " If they had a side effect on statins, they got it

from red yeast rice too. "

Concerned about the high levels of lovastatin in some products, the

FDA in August banned the sale of Cholestrix, a red yeast rice

supplement sold by Sunburst Biorganics, and two other red yeast rice

supplements sold by Swanson Health Products. The FDA reports that

the levels of lovastatin found in the products could be high enough

to cause kidney damage, a rare complication of statins.

According to , there's still one all-natural, side-effect

free way to cut high cholesterol: Go easy on saturated fats while

eating plenty of fruits, vegetables and whole grains. If that isn't

enough, your doctor will probably recommend a statin -- the

prescription variety, that is.

Fungi make some great products, but, according to , it's best

to leave your cholesterol medications to the professionals.