A rise in cholesterol levels among the Chinese led their researchers to seek less expensive cholesterol-reducing drugs than the statin drugs used here. Their approach was simple: Test the cholesterol- reducing effects of the traditional Chinese remedy, red yeast rice.  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.

Garlic is another herb for cholesterol. The therapeutic effects of Garlic have been scientifically validated in the area of cholesterol and triglyceride lowering, as well as its strong antimicrobial properties. Research in Germany, India, France, China, England and the United States demonstrate consistent results proving the efficacy and safety of Garlic even in high doses. Known as a yang tonic in Chinese medicine, Garlic will stimulate appetite and metabolism, clear toxins, and act as an antimicrobial agent of the mucous membranes. A great deal of recent work has been done on the sulphur bearing amino acids in Garlic.  

Researchers have estimated that for each one percent decrease in low-density lipoprotein (LDL) cholesterol, heart attack risk drops by two percent. By comparison, each one percent increase in HDL levels causes a three to four percent drop in heart attack risk. For these reasons, investigators have tried to find out what effects red yeast rice has on HDL levels. 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.

 

While effective in reducing cholesterol, statins carry risks for liver damage. Patients using statins should have periodic liver enzyme tests to make sure their liver activity is normal. Persistent increases in liver enzymes suggest liver dysfunction and occur in almost two percent of all patients after three to twelve months of lovastatin use. In addition, combining lovastatin with other cholesterol-reducing drugs such as gemfibrozil or with lipid-lowering doses (such as 1 gram or more per day) of nicotinic acid may cause rhabdomyolysis, a condition that involves muscle tissue deterioration. Rhabdomyolysis may also result from lovastatin alone. Because red yeast rice contains statins, it too may trigger these types of adverse effects. 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. See Supplements Program