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- Red Yeast Rice - Cholesterol Fighter
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If your cholesterol is a little higher than it should be, you're probably trying to adjust it by following a diet low in saturated fat and cholesterol. Unfortunately for many of us, this approach just doesn't do the trick. Natural treatments, however, may help reduce moderately elevated cholesterol levels. Of these, inositol hexaniacinate (no-flush niacin) and pantethine are vitamins accumulating notable track records, as is the herbal supplement guggulipid. Red yeast rice is a newcomer, and results of studies in both China and the United States indicate that it's a supplement worth considering.
Red yeast rice may more effectively reduce moderately elevated cholesterol levels (200-240 mg/dl) than cholesterol-reducing diets. Its cholesterol reducing actions are thought to be due to mevinolin, a chemical identical to lovastatin. Lovastatin and other statins are chemicals used in conventional medicine to reduce cholesterol. In 1999, lovastatin was also shown to reduce death rates from cardiovascular disease.
Made by fermenting rice with red yeast (Monascus purpureus Went), red yeast rice is not new to China or to neighboring Japan, where it has long been used as a food coloring agent and preservative and to make red rice sake and liqueur. The red edging on boneless Chinese spare ribs is due to red yeast rice. Asians have also used the food product to treat indigestion, diarrhea, and to improve blood circulation. In 1977, a Japanese researcher found that a chemical in red yeast inhibited HMG-CoA reductase, the enzyme that the liver uses to make cholesterol. The chemical, originally called Monacolin-K and mevinolin, is chemically identical to the generic, fat-reducing statin-based drug, lovastatin, which was developed from a strain of fungus (Aspergillus terreus) and introduced in 1987. Lovastatin, mevinolin, and other statins-based drugs reduce by cholesterol which blocking the activity of HMG-CoA reductase deprives the liver of an essential component in cholesterol manufacture. An estimated 80 percent of cholesterol found in the blood is produced by the liver (only 20 percent is contributed by diet), so HMG-CoA reductase inhibitors go a long way toward reducing blood cholesterol levels. But not surprisingly, then, effects demonstrated in the Chinese studies suggest that red yeast rice may be useful in controlling moderately elevated cholesterol. It may also cause some problems, and its effect on high-density lipoprotein (HDL), a factor in overall cholesterol reduction, is still to be determined. |
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In one prominent study in China, the conventional statin-based drug simvastatin (Zocor) was slightly better at reducing total blood cholesterol than the red yeast rice concentrate Xuezhikang. However, simvastatin was significantly better than Xuezhikang at raising HDL levels. Similarly, an American clinical trial showed that Xuezhikang caused predictable reductions in total cholesterol, LDL cholesterol, and triglyceride levels, but had little effect on HDL. However, in a study presented at a March, 1999 American Heart Association conference, red yeast rice increased HDL levels by an average of 15 percent.
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Red yeast rice is recommended in China for the treatment of moderately high cholesterol levels (200-240 mg/dl). Dietary supplements have been developed that are standardized to deliver 0.4 percent lovastatin/mevinolin per dose, or 2.4 mg, at a frequency of one to four times daily, providing a total daily intake of 2.4 to about 10 mg statins. In comparison, the recommended dosing range for lovastatin, as the prescription drug Mevacor, is 20-80 mg per day.
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The basis of the FDA's complaint is that red yeast rice contains substances that are used as drugs, and that, because of the health risks associated with these drugs (liver and muscle tissue damage), red yeast rice should be regulated as a drug. In effect, the agency sees red yeast rice as a statin compound. However, mevinolin occurs naturally in red yeast rice and is not a separate chemical that is isolated and dispensed by itself, as are lovastatin and the other five statins used in the United States to lower cholesterol. Mevinolin is not added to red yeast rice during the manufacturing process, and it is not the only element at work in a red yeast rice product. Other ingredients, such as essential fatty acids, may have therapeutic, balancing, or synergistic effects on the way red yeast rice products work.
More studies are needed to clarify the effects of red yeast rice on HDL and to test its safety. If you decide to give it a go, remember not to use it along with other cholesterol-lowering substances, especially high doses of niacin (1 gram or more per day), because this may increase the risk for developing rhabdomyolysis. Like lovastatin, it may reduce coenzyme Q10 levels, and it may interact adversely with grapefruit juice, which interferes with the metabolism of various drugs that pass through enzyme systems in the liver and/or small intestine for detoxification. In one study, three servings of double-strength grapefruit juice (each dose about 7 fluid ounces) for two days increased the concentration of lovastatin in the blood by 15 times, in patients undergoing lovastatin therapy. Such increases are dangerous.
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