Comments on: Lifestyle change, fish oil, and red yeast rice vs. Simvastatin to reduce cholesterol? http://jmorrow50.wordpress.com/2008/10/13/lifestyle-change-fish-oil-and-red-yeast-rice-vs-simvastatin-to-reduce-cholesterol/ Clinical trial updates on dietary supplements Sat, 24 Oct 2009 16:58:40 +0000 http://wordpress.com/ hourly 1 By: Red Yeast Rice revisited for lowering cholesterol. « Dr. Jarret Morrow’s Dietary Supplement Research Updates http://jmorrow50.wordpress.com/2008/10/13/lifestyle-change-fish-oil-and-red-yeast-rice-vs-simvastatin-to-reduce-cholesterol/#comment-616 Red Yeast Rice revisited for lowering cholesterol. « Dr. Jarret Morrow’s Dietary Supplement Research Updates Wed, 15 Jul 2009 00:27:22 +0000 http://jmorrow50.wordpress.com/?p=401#comment-616 [...] Yeast Rice revisited for lowering cholesterol. Jump to Comments Red yeast rice is an increasingly popular dietary supplement which is used by people who have elevated cholesterol [...] [...] Yeast Rice revisited for lowering cholesterol. Jump to Comments Red yeast rice is an increasingly popular dietary supplement which is used by people who have elevated cholesterol [...]

]]> By: Jarret Morrow http://jmorrow50.wordpress.com/2008/10/13/lifestyle-change-fish-oil-and-red-yeast-rice-vs-simvastatin-to-reduce-cholesterol/#comment-332 Jarret Morrow Sat, 25 Oct 2008 15:45:11 +0000 http://jmorrow50.wordpress.com/?p=401#comment-332 Don, thank you for your insightful comments. I agree that given that the AG group had more than one type of intervention, it makes it difficult to ascertain how much cholesterol lowering was due to the red yeast rice or more specifically the lovastatin. Don, thank you for your insightful comments. I agree that given that the AG group had more than one type of intervention, it makes it difficult to ascertain how much cholesterol lowering was due to the red yeast rice or more specifically the lovastatin.

]]> By: Don Levasseur PharmD http://jmorrow50.wordpress.com/2008/10/13/lifestyle-change-fish-oil-and-red-yeast-rice-vs-simvastatin-to-reduce-cholesterol/#comment-331 Don Levasseur PharmD Sat, 25 Oct 2008 15:20:49 +0000 http://jmorrow50.wordpress.com/?p=401#comment-331 An important point here is the ingredient in red yeast rice (lovastatin) is marketed in the US as a pharmaceutical. It is a statin like the simvastatin used in this study. The FDA prohibits the sale of red yeast rice which have more than trace amounts of lovastatin and has sent warning letters to manufactures who market the product. Two things come to mind here. First, just because the source of lovastatin here is natural does not make it a safer product. Lovastatin as a higher frequency of side effects than simvastatin. Second, how much of the cholesterol lowering seen here was due to the lovastatin? I would like to see this study without the red yeast rice because I believe there are huge benefits to lifestyle modifications and they are too frequently overlooked in t he medical community. An important point here is the ingredient in red yeast rice (lovastatin) is marketed in the US as a pharmaceutical. It is a statin like the simvastatin used in this study. The FDA prohibits the sale of red yeast rice which have more than trace amounts of lovastatin and has sent warning letters to manufactures who market the product. Two things come to mind here. First, just because the source of lovastatin here is natural does not make it a safer product. Lovastatin as a higher frequency of side effects than simvastatin. Second, how much of the cholesterol lowering seen here was due to the lovastatin? I would like to see this study without the red yeast rice because I believe there are huge benefits to lifestyle modifications and they are too frequently overlooked in t he medical community.

]]> By: Jarret Morrow http://jmorrow50.wordpress.com/2008/10/13/lifestyle-change-fish-oil-and-red-yeast-rice-vs-simvastatin-to-reduce-cholesterol/#comment-308 Jarret Morrow Tue, 14 Oct 2008 02:00:36 +0000 http://jmorrow50.wordpress.com/?p=401#comment-308 Oh, there was a recent 'letter to the editor' published in the British Journal of Pharmacology which discussed case reports of rhabdomyolysis from red yeast rice [Monascus purpureus] (Lapi et al, 2008). Key points: ***1. Patients who have had a previous 'statin intolerance' should be cautioned about using red yeast rice! ***2. Do not take red yeast rice if you're currently taking a statin type medication! ***3. If you're taking either a statin medication or red yeast rice and you experience unexplained muscle pain, tenderness, or weakness, seek medical care immediately and have your CK (creatine kinase) levels checked. <strong>Read: If you have had previous a previous statin myopathy or rhabdomyolysis, taking red yeast rice is a very bad idea!</strong> Reference: Lapi F, Gallo E, Bernasconi S, Vietri M, Menniti-Ippolito F, Raschetti R, Gori L, Firenzuoli F, Mugelli A, Vannacci A. Myopathies associated with red yeast rice and liquorice: spontaneous reports from the Italian Surveillance System of Natural Health Products. Br J Clin Pharmacol. 2008 Oct;66(4):572-4. Epub 2008 May 21. Oh, there was a recent ‘letter to the editor’ published in the British Journal of Pharmacology which discussed case reports of rhabdomyolysis from red yeast rice [Monascus purpureus] (Lapi et al, 2008).

Key points:

***1. Patients who have had a previous ’statin intolerance’ should be cautioned about using red yeast rice!
***2. Do not take red yeast rice if you’re currently taking a statin type medication!
***3. If you’re taking either a statin medication or red yeast rice and you experience unexplained muscle pain, tenderness, or weakness, seek medical care immediately and have your CK (creatine kinase) levels checked.

Read: If you have had previous a previous statin myopathy or rhabdomyolysis, taking red yeast rice is a very bad idea!

Reference:

Lapi F, Gallo E, Bernasconi S, Vietri M, Menniti-Ippolito F, Raschetti R, Gori L, Firenzuoli F, Mugelli A, Vannacci A. Myopathies associated with red yeast rice and liquorice: spontaneous reports from the Italian Surveillance System of Natural Health Products. Br J Clin Pharmacol. 2008 Oct;66(4):572-4. Epub 2008 May 21.

]]> By: Jarret Morrow http://jmorrow50.wordpress.com/2008/10/13/lifestyle-change-fish-oil-and-red-yeast-rice-vs-simvastatin-to-reduce-cholesterol/#comment-307 Jarret Morrow Tue, 14 Oct 2008 01:43:36 +0000 http://jmorrow50.wordpress.com/?p=401#comment-307 Hi Dr. Nicole, thanks again for your comment. With any dietary supplement, the industry is poorly regulated to some extent and consumers should make their best effort to buy top quality supplements. My advice is to at least look for supplements that adhere to some form of 3rd party testing to ensure that the label claims are accurate. With respect to the comment about rhabdomyolysis (rapid break down of skeletal muscle tissue), as you mentioned, statin type medications also carry a risk of this serious adverse side effect. Symptoms often include severe muscle aching, muscle weakness, and dark colored urine. Statin myopathy is less severe, but more common than rhabdomyolysis. I've had numerous patients complain of statin myopathy type symptoms which generally subside when the drug is discontinued. I agree with you that from a therapeutic standpoint, combined treatment including diet, exercise, and fish oil certainly makes sense. However, from a research standpoint, it's impossible to conclude from this particular study what, if any effect, the red yeast rice may actually have on lowering cholesterol. cheers, Jarret Hi Dr. Nicole, thanks again for your comment. With any dietary supplement, the industry is poorly regulated to some extent and consumers should make their best effort to buy top quality supplements. My advice is to at least look for supplements that adhere to some form of 3rd party testing to ensure that the label claims are accurate.

With respect to the comment about rhabdomyolysis (rapid break down of skeletal muscle tissue), as you mentioned, statin type medications also carry a risk of this serious adverse side effect. Symptoms often include severe muscle aching, muscle weakness, and dark colored urine.

Statin myopathy is less severe, but more common than rhabdomyolysis. I’ve had numerous patients complain of statin myopathy type symptoms which generally subside when the drug is discontinued.

I agree with you that from a therapeutic standpoint, combined treatment including diet, exercise, and fish oil certainly makes sense. However, from a research standpoint, it’s impossible to conclude from this particular study what, if any effect, the red yeast rice may actually have on lowering cholesterol.

cheers,

Jarret

]]> By: Dr. Nicole Sundene http://jmorrow50.wordpress.com/2008/10/13/lifestyle-change-fish-oil-and-red-yeast-rice-vs-simvastatin-to-reduce-cholesterol/#comment-306 Dr. Nicole Sundene Tue, 14 Oct 2008 01:18:56 +0000 http://jmorrow50.wordpress.com/?p=401#comment-306 Recently Consumer Labs also found some serious issues with consistency in lovastatin concentrations found in red yeast rice. As much as I prefer to use natural medicines when at all possible, I am not that big of a fan of red yeast rice unless it is a buy a pharmaceutical grade company, as lack of regulation could likely cause rhadomyloysis or similar side effects of statins. People think that just because a statin is "natural" that it is safer. However, although the flaw in this study is that a variety of therapeutics were used, really that is the only way to be successful with cholesterol control using natural means. Diet, exercise, fish oil, therapeutic foods and supplements are all needed to work in synergy to get those numbers down. Recently Consumer Labs also found some serious issues with consistency in lovastatin concentrations found in red yeast rice.

As much as I prefer to use natural medicines when at all possible, I am not that big of a fan of red yeast rice unless it is a buy a pharmaceutical grade company, as lack of regulation could likely cause rhadomyloysis or similar side effects of statins. People think that just because a statin is “natural” that it is safer.

However, although the flaw in this study is that a variety of therapeutics were used, really that is the only way to be successful with cholesterol control using natural means.

Diet, exercise, fish oil, therapeutic foods and supplements are all needed to work in synergy to get those numbers down.

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