By far this is the best known, and most used alternative supplement for cholesterol issues.
Historically red yeast rice has been used for centuries in China for cardiovascular problems.
When the first statin appeared in US...Mevacor by Merck, there was a huge push to remove competitive products like red yeast rice so that Mevacor would have a clear path medically.
This was similar to what happened with l-tryptophan.
The company who made a very high quality product Cholestin, was forced by the courts to change its product and remove red yeast rice. This is the new product:
http://www.pharmanex.com/corp/produc...holestin.shtml
However, interest in red yeast rice did not wane. And today it is back (like l-tryptophan as well).
I've been reading about red yeast rice for years. No one single reference gives all the details about it.
So far I see 3 major things one should be aware of in choosing to try red yeast rice:
1) Where does this red yeast rice come from? Most comes from China but there are companies here in US who make it too. Given the problems lately with China and adulteration, choosing a US produced form may be safer. Two that I know use US product are the NOW company, and Doctor's Best.
They openly state this. I am not going to research all of the suppliers out there, so if you decide to use red yeast rice, I'd strongly suggest you contact the company you intend to use yourself.
2) Not all suppliers have a standarized amount of red yeast rice in them. They all vary.
Consumerlab tested some, and found:
http://www.consumerlab.com/reviews/R...ed_Yeast_Rice/
http://uk.reuters.com/article/health...97022820080709
http://www.liebertonline.com/doi/abs...ournalCode=acm
3) There is a contaminant called citrinin that can be present in some red yeast rice extracts.
Quality manufacturers state clearly that their product does not contain this contaminant: NOW and Doctor's Best are examples.
Quote:
J Altern Complement Med. 2001 Apr;7(2):133-9.Click here to read Links
An analysis of nine proprietary Chinese red yeast rice dietary supplements: implications of variability in chemical profile and contents.
Heber D, Lembertas A, Lu QY, Bowerman S, Go VL.
UCLA Center for Human Nutrition, UCLA School of Medicine, Los Angeles, California 90095-1742, USA. dheber@mednet.ucla.edu
OBJECTIVES: Some strains of Chinese red yeast rice, when prepared by solid fermentation, produce compounds called monacolins that inhibit cholesterol production. When used as a dietary supplement to achieve and maintain healthy cholesterol levels, Chinese red yeast rice has significant potential to reduce health care costs and contribute to public health by reducing heart disease risk in individuals with moderate elevations of circulating cholesterol levels. Whereas one proprietary strain of Chinese red yeast rice has been demonstrated to lower cholesterol levels significantly in clinical trials, other strains being sold as Chinese red yeast rice dietary supplements have not undergone similar evaluation. In order to determine whether the results of a clinical trial conducted with one strain of Chinese red yeast rice could be generalized to other preparations of Chinese red yeast rice, nine different commercially available dietary supplements were purchased tested for chemical constituents. DESIGN: Monacolins were measured by high performance liquid chromatography (HPLC) that separates the various monacolins in Chinese red yeast rice. Citrinin concentration, a toxic fermentation byproduct, was measured by radioimmunoassay. RESULTS: Total monacolin content varied from 0% to 0.58% w/w and only 1 of 9 preparations had the full complement of 10 monacolin compounds. Citrinin was found at measurable concentrations in 7 of the 9 preparations. CONCLUSIONS: The findings from clinical trials demonstrating significant and clinically relevant cholesterol reduction using a defined Chinese red yeast rice preparation containing 10 different monacolins cannot be generalized to preparations that do not contain the same levels and profile of monacolins. Standardized manufacturing practices should be established for Chinese red yeast rice sold as a dietary supplement in order ensure equivalence of content of active ingredients in preparations being sold to the public and to limit the production of unwanted byproducts of fermentation such as citrinin. In common with other botanical dietary supplements, the full potential of this product will not be realized until standards for production and labeling of Chinese red yeast rice are further developed.
PMID: 11327519
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How to use red yeast rice:
Here are two links with good information about this herb:
http://www.umm.edu/altmed/articles/red-yeast-000323.htm
This one goes into a huge drug interaction paragraph which seems rather common to
many that are available on the net..some may not really be applicable to red yeast rice but they are included for safety reasons:
http://www.intelihealth.com/IH/ihtIH...l?d=dmtContent
I have seen one paper of one case of interaction with the antibiotic Biaxin. So the standard warnings for use with Zithromax, erythromycin, antifungals, Biaxin etc (the same warnings for the old Seldane) apply.
I don't think patients should take red yeast rice should do so without a doctor's supervision.
You need to monitor liver functions (it is rare to have this effect on the liver but it should be monitored anyway).
Dr. Jay Cohen suggests in his book, that mild to moderately elevated patients may see good lowering of cholesterol. Also he suggests that C-reactive protein may lower as well.
Here is a recent paper from 2008 with results:
Quote:
Chin Med J (Engl). 2008 Aug 20;121(16):1588-94.Click here to read Links
Statin alternatives or just placebo: an objective review of omega-3, red yeast rice and garlic in cardiovascular therapeutics.
Ong HT, Cheah JS.
HT Ong Heart Clinic, Penang, Malaysia. htyl@stremyx.com
OBJECTIVE: The aim of this review is to objectively access the trial evidence on the role of omega-3, red yeast rice and garlic in preventing clinical cardiovascular events. Given the large number of clinical trials favoring statin use in cardiovascular disease, it is important to see if evidence is available for these supplements and whether they could replace statin therapy. DATA SOURCE: A PubMed search was conducted using the keywords 'trial, omega-3, red yeast rice, xuezhikang, garlic, cholesterol, cardiovascular, outcomes'; the resulting trials were reviewed together with the references quoted in the papers obtained. STUDY SELECTION: The studies selected are prospective, randomized, placebo-controlled studies with predefined clinical cardiovascular end-points recruiting at least 2000 patients, with a follow-up over 2 years. RESULTS: Modest dose omega-3 fatty acid has been shown in GISSI-P (11 324 patients, follow-up 3.5 years) to produce a reduction in sudden death of 45%, and in cardiac death of 35%, acting probably via an anti-arrhythmic effect. In JELIS (18 645 patients, follow-up 4.6 years), high dose omega-3 given to Japanese patients on a high fish diet and already on statin treatment produced further benefit with a 19% reduction of nonfatal cardiovascular outcomes; fatal cardiac events are not affected. CCSPS (4870 patients, follow-up 4 years), a secondary prevention trial using xuezhikang, a commercial red yeast rice preparation, produced a 46% reduction in nonfatal myocardial infarction and coronary death. There has been no trial to show that garlic reduces clinical cardiovascular outcomes. A rigorous trial with constant assessment of chemicals in the study material in 192 patients found that over a 6-month follow-up, raw garlic and 2 commercial preparations do not significantly affect lipid levels. CONCLUSIONS: Omega-3 in modest doses reduces cardiac deaths, and in high doses reduces nonfatal cardiovascular events. Red yeast rice reduces adverse cardiac events to a similar degree as the statins. It is unlikely that garlic is useful in preventing cardiovascular disease.
PMID: 18982874
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This is an older study:
http://www.ajcn.org/cgi/content/abstract/69/2/231
And this:
http://www.creators.com/lifestylefea...ol-levels.html
Dosing... To start, I'd go carefully. Start at 600mg twice a day. Do this for 3 months and get retested.
If this works, you don't need to go higher. Many of the medical sites I found suggest 1200mg twice a day. If you use a quality product, going higher is probably not necessary. If you get NO improvements you may have to start a statin at very low doses and titrate up further with that if you choose.
There are not many reports of side effects. I found one at PubMed:
Quote:
Transplantation. 2002 Oct 27;74(8):1200-1.Click here to read Links
Rhabdomyolysis due to red yeast rice (Monascus purpureus) in a renal transplant recipient.
Prasad GV, Wong T, Meliton G, Bhaloo S.
Division of Nephrology, Department of Medicine, St. Michael's Hospital, University of Toronto, 61 Queen Street East, 9th Floor, Toronto, Ontario M5C 2T2 Canada. prasadr@smh.toronto.on.ca
Rhabdomyolysis is a known complication of hepatic 3-methylglutaryl coenzyme A reductase (HMG-CoA) inhibitor (statin) therapy for posttransplant hyperlipidemia, and thus monitoring for this effect is indicated. We report a case of an herbal preparation-induced rhabdomyolysis in a stable renal-transplant recipient, attributed to the presence of red yeast rice (Monascus purpureus) within the mixture. The condition resolved when consumption of the product ceased. Rice fermented with red yeast contains several types of mevinic acids, including monacolin K, which is identical to lovastatin. We postulate that the interaction of cyclosporine and these compounds through the cytochrome P450 system resulted in the adverse effect seen in this patient. Transplant recipients must be cautioned against using herbal preparations to lower their lipid levels to prevent such complications from occurring.
PMID: 12438974
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Compared to statins this is a very low incidence. And this patient was a renal transplant patient getting immune suppressing drugs which act on the liver enzymes and perhaps enhanced the activity of the ingredients in the red yeast rice.
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Weezie looking at petunias 8.25.2017
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