Saturday, January 03, 2009

Red yeast rice revisited

I sweat along with one of my fifty-something year old patients at weekly Jazzercise sessions. As a result, I know her elevated cholesterol levels have nothing to do with a lack of exercise. We have tried several statin strategies to lower her numbers. Alas, even using CoQ10 supplements, low alternate day dosing of Crestor, and statins less likely to enter muscle cells, all still result in unacceptable side effects for her. She has chosen to motor on without meds.

She recently told me that she was using red yeast rice supplements as a 'natural' way to lower her cholesterol. I asked her how she was feeling, did she have any muscle pain with the supplement? As a matter of fact, she replied, she did notice that. She was surprised to learn that insofar as taking a supplement made by the fermentation of rice with fungus was natural, a process through which Lovastatin is made, she was going natural. So she was actually taking low-dose Lovastatin in an unregulated sort of way, complete with a risk of toxic contamination by the metabolic byproducts of fungus feasting on rice!

If you are interested in supplements, and I certainly am, I recommend you invest $30 or so in an annual membership to, where you can read reliable information on the science behind those OTC pills we take and the results of their testing various brands for content and contamination.


Eric, AKA The Pragmatic Caregiver said...

Maybe she would consider niacin? It's supplement-y, increases HDL while lowering HDL, has a proven benefit and is dirt-cheap (if you use something like Rugby generic 500mg rather than Slo-Niacin or Niaspan). To avoid the hot flash, titrate really slowly (250 mg qhs at first, increasing to, in my case, 3000 mg qhs, which took months) and take a 220mg naproxen an hour before the niacin.

I didn't want to take a statin (I'm too young, and the inhibition of squalene and CoQ10 synthesis seemed like a poor strategy long-term) and I couldn't afford enough CoQ10 to matter (400mg/day). Other than the one night I forgot to take the naproxen in time, I've had no problems with the niacin, and the numbers look markedly better.

Besides, aren't Women Of A Certain Age already used to hot flashes? What's one more? *ducking*

(seriously, after that one incident of waking up at 0200 practically glowing red, I now know why my mom was so unpleasant all those years).


femail doc said...

I'm always pleased when you stop by Eric; your comments amuse AND inform. She couldn't tolerate niacin, but that's a good lipid lowering strategy to keep in mind. People taking OTC niacin should have their liver enzymes checked although liver toxicity is a bigger risk with the prescription-only timed-release preparations.

Anonymous said...

Eric, you'd better be ducking. All these women of a certain age might just gang up on you. (And we're old, so we don't care).
Yup, it's lovastatin all right. Just with a lot of other stuff (as you mentioned) and will be varying doses batch to batch because it's unregulated, being a "natural food supplement." This stuff really should be regulated by the FDA.

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1smartcanerican said...

I have been successfully taking the red yeast rice recommended by Consumerlab site and it has finally got my cholesterol numbers in the right zones. I take this at night as recommended on the lid.

I am going to add 250 mg of Slo-Niacin in the morning to see if this will improve the numbers even further.

I am a firm advocate of the Consumerlab recommended Red Yeast Rice. It has helped my husband (moved off chemical statins with doctor approval) and all my friends who have tried it, so I'm a believer.