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Millions of people in the United States take medications called statins to lower their blood cholesterol.� These meds, including Liptor, Zocor, and Mevacor, have made a huge difference for people with high cholesterol levels, especially those with cardiovascular disease or those at risk for heart attack and stroke.�
However, side effects are common with these drugs, especially muscle aches and pains.� In fact, up to 10% of people on statins may develop muscle pain, often leading them to discontinue their meds.� Some alternative practitioners recommend using co-enzyme Q10 to prevent this type of muscle pain, but a recent review showed no clear benefit from this supplement. Consequently, many people turn to alternative therapies to lower their blood cholesterol.
One popular alternative medicine product for high cholesterol is red yeast rice (RYR).� As we've discussed in this column previously, red yeast rice is a dietary supplement that has been used in China for centuries.� RYR contains among other things a chemical called monacolin-K, which is identical to the active ingredient in the prescription statin Mevacor (lovastatin).�� However, RYR does not seem to cause the side effects that are common to Mevacor and other statins.
A new study in the Annals of Internal Medicine has shown that RYR may be a safe alternative in people who have been intolerant of statins because of muscle pain.� In this study, 62 patients who had stopped taking at least one statin drug because of muscle pain were randomized to receive either red yeast rice or placebo twice daily for 24 weeks.� All patients were encouraged to eat a healthy diet, exercise, and reduce stress, all of which can also lower blood cholesterol. The patients receiving red yeast rice got the equivalent of about 6 mg of lovastatin per day; by the end of the study, they had dropped their total cholesterol by about 15% and their LDL cholesterol by about 21% compared to 5%/9% in the placebo group.�� And - muscle pain was uncommon in this study - 2 patients in the RYR group and 1 in the placebo group developed persistent muscle pain.�
It is not known why RYR may be better tolerated than prescription meds.� RYR contains a number of plant chemicals that may be beneficial in lowering cholesterol without causing side effects.� Also, this study may not have been long enough to detect possible side effects of RYR.�
Are there downsides to taking RYR?� As we have mentioned previously, RYR may be contaminated with a kidney toxin known as citrinin, so we recommend using only RYR products that have been evaluated by independent testing labs.�� RYR has also been reported to cause muscle pain and liver problems just like statin meds, though it seems that side effects from RYR are much more rare than those from prescription cholesterol meds.� Still, we recommend that you get monitored by your physician should you choose to take RYR.� And RYR has not been directly compared with a statin med in a medical study - this would give us a direct comparison of the pros and cons of each.� Until that type of information is available, we suggest lifestyle changes including a low fat, high fiber diet and plenty of exercise to reduce your cholesterol - when we follow that route first, many of us will not require anything more to lower our cholesterol, including red yeast rice.
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