Wednesday, March 12, 2008

Red Yeast Rice for High Cholesterol

What is the safest medicine to lower cholesterol? For a while it seemed it might be red yeast rice.

One of the best-known over-the-counter nutritional supplements for naturally controlling your cholesterol is a product called Cholestin, which nowadays contains a sugar cane derivative called policosanol. Before the makers of Cholestin began making their product with policosanol, however, they used a natural product that contains exactly the same chemical that is in the cholesterol drug Mevachor. That natural product was red yeast rice, once one of the most popular alternatives to statins for lowering cholesterol.

Red yeast rice does not contain a chemical that just works the same way as the statin drug Mevachor (lovastatin). The yeast actually makes Mevachor. When the makers of the older formulation of Cholestin learned that Chinese researchers had confirmed that the fungus can be used to lower both choelsterol and triglycerides, nobody was paying a whole lot of attention to Chinese research.

The natural products maker Pharmanex ran its own clinical trials at the University of California at Los Angeles and confirmed that people with high cholesterol who take red yeast rice can lower their LDL levels by an average of 22 per cent.

These findings meant that the supplement not only was as effective as a prescription statin drug, it worked better than most. And since anybody with the technical expertise can grow red yeast rice without paying royalties on a patent, the product was much, much less expensive than the comparable prescription drugs.

You might have guessed by now that the FDA was not going to allow a natural product that really does lower the "bad" LDL cholesterol to stay on the market.

That's in spite of the fact that the older version of Cholestin was purified, standardized, and clinically tested. That's in spite of the absence of reports of rhabdomylosis (muscle tissue breakdown) as an occasional side-effective of prescription Mevachor. (It's possible other compounds in the yeast prevent side effects.)

The FDA forbade the manufacturer of any clinically tested, standardized, and proven effective red yeast rice supplement.

But it allows red yeast rice that isn't standardized for known purity, effectiveness, and safety. Isn't that just bizarre? Banning the standardized supplement protected a pharmaceutical company's bottom line.

You may read from time to time that red yeast rice supplements are more effective than statin drugs at lowering cholesterol, and, except for the FDA's intervention, that would be true. In other countries where red yeast rice is treated like any other drug, however, new clinical studies come in nearly every year showing that it can in fact lower cholesterol in healthy people and in people at risk for heart disease.

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Citations:

Cicero AF, Brancaleoni M, Laghi L, Donati F, Mino M. Antihyperlipidaemic effect of a Monascus purpureus brand dietary supplement on a large sample of subjects at low risk for cardiovascular disease: a pilot study. Complement Ther Med. 2005 Dec;13(4):273-8. Epub 2005 Sep 9.
Huang CF, Li TC, Lin CC, Liu CS, Shih HC, Lai MM. Efficacy of Monascus purpureus Went rice on lowering lipid ratios in hypercholesterolemic patients. 1: Eur J Cardiovasc Prev Rehabil. 2007 Jun;14(3):438-40.

2 comments:

  1. In researching red yeast rice supplements for my own creeping-upwards LDLs, I have become more confused/dismayed than ever. It appears that FDA is actively going after producers of red yeast rice supplements because they do contain lovastatin (or, as they phrase it, "These red yeast rice products are a threat to health because lovastatin can cause severe muscle problems leading to kidney impairment" as if that were a problem exclusive to red yeast rice) I have read that some supplements ARE being formulated with the lovastatin removed. So now I don't understand if that means that all red yeast rice supplements marketed in this country by default are not allowed to have this active ingredient in them, or what? I read that the specific products mentioned in the warning were removed. Here's the FDA warning:
    http://www.fda.gov/consumer/updates/redyeastrice081007.html

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  2. The siutation is crazy.

    Yes, you do get the active ingredient in red yeast rice products. It does lower cholesterol. And it would make a lot of sense to make sure that the red yeast rice is standardized to make sure you get exactly the same dose all the time, right?

    It certainly does to me. But what the FDA did was to ban standardized red yeast rice products that are, in essence, Mevachor. It allows non-standardized red yeast rice products. Natural products manufacturers can check the lovastatin content before production, just not after.

    This protects the public, they say.

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