Written by Marcia J. Egles, M.D. A review of 1400 patients found that 1200 mg of over-the-counter red yeast rice supplementation reduced LDL by 21 % and was well tolerated.
Statins, otherwise known as HMG co-enzyme A reductase inhibitors, are a class of medications used to treat high cholesterol. High cholesterol in the blood is an established risk factor for cardiovascular disease. Although statins are generally well tolerated, at least five per cent of millions who take them must discontinue statins because of muscle problems (1). An observational study of patients intolerant to statins, who were later treated with “over-the-counter” red yeast rice dietary supplements, has shown an acceptable lowering of cholesterol as reported recently in the American Journal of Cardiology (2).
The first statins were developed in the 1970’s and isolated from naturally occurring substances made by fungi. Red yeast rice has been used medicinally in China for centuries. It is made from the fermentation of a red yeast over rice. The resulting product contains a mixture of phytosterols, at least 14 different monocolins, and unsaturated fatty acids. All of these substances are capable of lowering cholesterol. One of the monocolins, monocolin K, is biochemically identical to the statin lovastatin (3).
The study consisted of a simple chart review of the records from approximately 1,400 patients referred to the Hartford (Hartford, CT) Cholesterol Management Center. Of these, 25 patients were identified who had been treated with red yeast rice for at least 4 weeks. These patients had been discontinued from statin therapy because of adverse side-effects. Muscle pain had occurred in 89 per cent of them. After stopping statins, they were instructed to consume 1,200 milligrams daily of any “over-the-counter” red yeast rice dietary supplement. The patients chose and purchased their own supplements without limitation to a specific brand. Most of the patients were female (68%), white (96%) and had an average age of 62. No comparison control group of untreated patients was reported.
Ninety-two per cent of these patients tolerated the red yeast rice without complaints of side-effects. One of the twenty-five reported muscle aches and another complained of abdominal “bloating”, but none were found to have significant increases in laboratory measures of muscle damage.
On average, the patients were treated with red yeast rice for 74 days. Low density lipoprotein cholesterol levels before and after treatment, as recorded by the clinic records, decreased by 21 per cent (35 milligrams per deciliter on average). Fifty-six per cent of the patients achieved their LDL cholesterol target goal.
The study’s authors concluded that the red yeast rice was an acceptable alternative treatment in their limited review of past cases. Their clinical experience supports similar results reported in 2009 by a small, randomized controlled trial in which 31 statin-intolerant patients were treated with a specific red yeast rice dosed at 1800 milligrams twice daily for 24 weeks (4).
Source: Venero, Carmelo V., et al. “Lipid-lowering efficacy of red yeast rice in a population intolerant to statins.” The American journal of cardiology 105.5 (2010): 664-666.
© 2010 Elsevier Inc. All rights reserved.
Posted April 22, 2010.
References:
- Joy TR, Hegle RA. Narrative review: statin-related myopathy. Ann Intern Med. 2009; 150 858-68. ( PMID: 19528564).
- Carmeo V. Venero, MD et al. Lipid-Lowering Efficacy of Red Yeast Rice in a Population Intolerant to Statins . Am J Cardiol 2010; 105: 664-666.
- David J. Becker,MD. Red Yeast Rice for Dyslipidemia in Statin-Intolerant Patients, Ann Intern Med. vol. 152 Jan.19,2010. pp. 135-136.
- Becker DJ, Gordon RY, Halbert SC, French B, Morris PB, Rader DJ. Red yeast rice for dyslipidemia in statin-intolerant patients: a randomized trial. Ann Intern Med 2009;150:830–839.
