Many people who cannot tolerate any of the cholesterol-lowering drugs called statins (e.g., Lipitor, Pravachol, Zocor) turn to an herbal supplement called red yeast rice, which lowers the low-density lipoprotein (LDL) cholesterol. Statin intolerance is most often chalked up to muscle pain (myalgia). A rare side effect of all statins is the potentially fatal disease called rhabdomyolysis, which causes destruction of the skeletal muscles.

A new trial, with only 62 statin-intolerant participants, randomly assigned them to take either red yeast rice supplements (1800 mg) or a placebo twice daily for six months. All took part in a 12-week program of education, diet, exercise, and relaxation sponsored by a local cardiology practice.

Both groups lost weight but the people taking the supplements showed greater reductions in LDL than the people on placebos. And the supplement group did not suffer more muscle pain. Yet despite these promising findings, the editorial that accompanied this study, published recently in Annals of Internal Medicine, advised doctors not to recommend the red yeast rice supplement. Reason: it is “an unapproved, unstandardized form of lovastatin labeled as a nutraceutical.”

The basis for this charge is a 2008 test of ten different brands of red yeast rice supplements by ConsumerLab.com. This independent testing group revealed that all ten supplements contained naturally occurring statin compounds in varying doses—some as high as that of prescription statins. This explains why the supplement used in the new study contained lovastatin (sold under the brand name: Mevacor).

There are other reasons why the new trial failed to show that supplements are better than statins. It lasted only six months and thus could not rule out the possibility that red yeast supplements taken longer would cause muscle pain. Unlike statins, the supplements have not been proven to reduce the risk of heart attack and stroke. The new study was primarily funded by the Commonwealth of Pennsylvania.

For information on the risks and small benefits of statin drugs, read this. And if you are taking Zetia or Vytorin, read this. And if you want to know more about statin drugs vs. the Mediterranean diet, read this.

Maryann Napoli, Center for Medical Consumers©

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