Integrative Medicine: Red yeast rice targets cholesterol

Millions in the United States take medications called statins to lower blood cholesterol. These meds, including Lipitor, Zocor and Mevacor, have made a huge difference for people with high cholesterol levels, especially those with cardiovascular disease or who are at risk of heart attack and stroke.

However, side effects such as muscle aches are common (as high as 10 percent) with these drugs. 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.

One popular alternative medicine product for high cholesterol is red yeast rice, a dietary supplement that has been used in China for centuries. RYR contains a chemical, monacolin-K, that is identical to the active ingredient in the prescription statin Mevacor (lovastatin). And RYR does not seem to cause the side effects .

A new study reported in the Annals of Internal Medicine has shown that RYR may be a safe alternative for people who have been intolerant of statins. 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 a 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 RYR got the equivalent of about 6 mg of lovastatin daily; by the end of the study, they had dropped their total cholesterol by about 15 percent and their LDL cholesterol by about 21 percent, compared with 5 percent to 9 percent in the placebo group. And muscle pain was uncommon in this study.

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 side effects of RYR.

Are there downsides to taking RYR? Yes. RYR can be contaminated with a kidney toxin known as citrinin. 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 rare. Still, we recommend that you be monitored by your physician should you choose to take RYR.

And RYR has not been compared with a statin med in a medical study – this would give us a direct comparison. Until it is, we suggest lifestyle changes: a low-fat, high-fiber diet and exercise to reduce your cholesterol.